Quick answer: in the tirzepatide vs semaglutide cost comparison, tirzepatide is usually pricier per month: Zepbound costs $299 to $449 a month self-pay versus $349 for most Wegovy doses in October 2026.[2][4] But tirzepatide produced more weight loss head to head (20.2% vs 13.7%), so the cost per percentage point of weight lost is similar or slightly lower.[1]
Prices and program terms checked October 2026. They change often; confirm with the manufacturer or your plan.
Tirzepatide is sold as Zepbound (weight loss, sleep apnea) and Mounjaro (type 2 diabetes). Semaglutide is sold as Wegovy (weight loss, heart risk, MASH) and Ozempic (type 2 diabetes). For the clinical comparison, see semaglutide vs tirzepatide. Drug details are on our tirzepatide and semaglutide pages.
Side-by-side price table
| Zepbound | Wegovy injection | Mounjaro | Ozempic pen | |
|---|---|---|---|---|
| List price per month | About $1,086[6] | $1,349.02[2] | $1,112.16[7] | About $1,000[6] |
| Self-pay, starting dose | $299 (2.5 mg)[4] | $199 intro, first 2 fills[2] | Not confirmed | $199 intro, first 2 fills[3] |
| Self-pay, next step | $399 (5 mg)[4] | $349[2] | Not confirmed | $349[3] |
| Self-pay, top doses | $449 (7.5-15 mg)[4] | $349 (2.4 mg); $399 (7.2 mg)[2] | Not confirmed | $499 (2 mg)[3] |
| List price from Jan 1, 2027 | No change announced | $675[8] | No change announced | $675[8] |
Zepbound’s $449 price for higher doses applies only if you refill within 45 days of your last delivery.[4] Vials and the multi-dose KwikPen have the same self-pay prices.[5] Lilly said in November 2025 that Mounjaro would be added to LillyDirect at 50-60% off list price.[13] We could not confirm the current figure, so check LillyDirect.
Cost per % of weight lost (SURMOUNT-5)
SURMOUNT-5 is the only head-to-head obesity trial. It randomized 751 adults without diabetes to the highest tolerated dose of tirzepatide (10 or 15 mg) or semaglutide (1.7 or 2.4 mg) for 72 weeks. Average weight loss was 20.2% with tirzepatide versus 13.7% with semaglutide.[1]
Seventy-two weeks is 18 four-week fills. At today’s maintenance self-pay prices:
| Tirzepatide (Zepbound) | Semaglutide (Wegovy 2.4 mg) | |
|---|---|---|
| Price per fill | $449 | $349 |
| 18 fills | $8,082 | $6,282 |
| Weight lost in SURMOUNT-5 | 20.2% | 13.7% |
| Cost per 1% of body weight lost | About $400 | About $459 |
For a 220-pound (100 kg) person, 1% is about 2.2 pounds. So tirzepatide works out to roughly $180 per pound lost and semaglutide about $210.
What the first year costs on each
Both drugs start low and step up every four weeks or more, and the price changes with the dose. Here is a rough first year (13 four-week fills) at October 2026 self-pay prices, for someone who reaches a top maintenance dose:
- Wegovy injection: 2 intro fills at $199, then 11 fills at $349. Total: about $4,240.[2]
- Zepbound: 1 fill at $299 (2.5 mg), 1 at $399 (5 mg), then 11 at $449. Total: about $5,640.[4]
So in year one, Zepbound costs about $1,400 more out of pocket. Whether that is worth it depends on how much more weight you lose and how well you tolerate each drug. Some people do well on a lower tirzepatide dose, which costs less: someone who stays at 5 mg pays $399 a month.
Your prescriber decides the dose. Neither label requires you to reach the top dose; the aim is the dose that works and that you can tolerate.[11][12]
Insurance differences
Coverage depends on the brand and what it is approved for, not just the ingredient.
| Use | Semaglutide | Tirzepatide |
|---|---|---|
| Type 2 diabetes | Ozempic | Mounjaro |
| Weight management | Wegovy[11] | Zepbound[12] |
| Heart attack and stroke risk | Wegovy[11] | Not for Zepbound |
| Obstructive sleep apnea | Not approved | Zepbound[12] |
| MASH (fatty liver) | Wegovy[11] | Not approved |
Diabetes brands are covered by most plans, often with prior authorization. Weight-loss coverage varies a lot: many employer plans exclude it. A plan that excludes weight loss may still cover Wegovy for heart risk or Zepbound for sleep apnea, if you have that condition.
Savings cards. With commercial coverage, Novo’s card lets you pay as little as $25 a month for Wegovy, with savings capped at $100 a month.[2] Lilly offers its own Zepbound savings card; check its current terms on the Zepbound site. Neither card works with Medicare or Medicaid.
Medicare differences
- Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027): eligible Part D enrollees pay $50 a month for Wegovy (injection or pill) or Zepbound KwikPen only. Zepbound vials are not covered.[10]
- Regular Part D: plans can cover Wegovy for heart risk or MASH and Zepbound for sleep apnea. People with those conditions or type 2 diabetes go through their plan, not the Bridge.[10]
- Negotiated prices: Medicare’s negotiated price for semaglutide (Ozempic, Rybelsus, Wegovy) is $274 per 30 days from January 1, 2027.[9] Tirzepatide is not on a negotiated list.
The November 2025 federal agreements set a $245 Medicare price for Ozempic, Wegovy, Mounjaro and Zepbound.[6]
Diabetes brands: Mounjaro vs Ozempic
For type 2 diabetes, insurance covers both drugs far more often than for weight loss, so your copay usually depends on which one your plan prefers. Ask your plan which brand is “preferred” on its formulary; the preferred one often has the lower copay.
Without insurance, Ozempic has a published self-pay price: $349 for most doses and $499 for 2 mg.[3] Mounjaro starts at $499 a month for every dose through LillyDirect,[14] so Ozempic is usually the cheaper self-pay option. On list price the two are close: Mounjaro is $1,112.16 for four pens and Ozempic is about $1,000.[7][6]
Which costs less for you?
- Paying cash at a low dose: Wegovy’s $199 intro offer is cheapest for the first two months; after that, Zepbound 2.5 mg ($299) is cheaper than Wegovy ($349).
- Paying cash at a high dose: Wegovy 2.4 mg ($349) is $100 a month cheaper than Zepbound 7.5-15 mg ($449).
- Commercial insurance: whichever brand your plan prefers on its formulary.
- Medicare: both cost $50 a month through the Bridge if you qualify.
Switching between the two drugs is not a dose-for-dose swap; your prescriber sets the new dose. Our GLP-1 dose conversion chart explains why. For every brand’s price, see GLP-1 cost without insurance, and for more on this drug class, our GLP-1 basics hub.
