Tirzepatide vs Wegovy Cost: A Price-First Comparison

Tirzepatide (Zepbound, Mounjaro) and semaglutide (Wegovy) are the two dominant GLP-1 weight-loss medications, and the cost gap between them varies wildly depending on how you fill the prescription. At list price, Zepbound is $263 per month cheaper. At self-pay through manufacturer programs, the two converge. Through compounding, only tirzepatide has a viable low-cost option. Below is a sourced comparison of every pricing route, followed by the clinical trial data that shows what each dollar buys in weight loss.

Price at a Glance: Tirzepatide vs Wegovy

Sources: Eli Lilly investor relations, LillyDirect, NovoCare, biltrx.com, arc-1.co. All prices verified October 2026.

Self-Pay and Direct Programs

LillyDirect Zepbound Vials ($299-$449)

Eli Lilly sells Zepbound single-dose vials directly to uninsured patients through LillyDirect. October 2026 pricing: $299 per month at 2.5 mg, $399 at 5 mg, and $449 at 7.5 mg through 15 mg with the 45-day refill window. Without the refill window, higher doses jump to $499 or $699. This is FDA-approved tirzepatide at roughly 60% to 70% below list price. For pharmacy-level details, see our Zepbound cost without insurance page.

NovoCare Wegovy Injections ($199-$349)

Novo Nordisk runs the NovoCare savings program for self-pay Wegovy patients. Introductory doses (0.25 mg and 0.5 mg) start at $199 per month. Standard maintenance doses cost $349 per month (NovoCare, October 2026). The introductory price is competitive with Zepbound's starter dose, but the maintenance price is lower than Zepbound's $449 at equivalent treatment stages.

Oral Wegovy Tablets ($149-$299)

Wegovy is now available as an oral tablet, something tirzepatide does not offer. NovoCare pricing for oral Wegovy: $149 per month at 1.5 mg, $199 at 4 mg, and $299 at both 9 mg and 25 mg (NovoCare, October 2026). The oral formulation eliminates the need for injections entirely, which may justify the cost for patients who find self-injection difficult or inconvenient. There is no oral tirzepatide available at this time.

At maintenance doses, Wegovy's NovoCare injection program ($349) undercuts Zepbound's LillyDirect pricing ($449) by $100 per month. The oral Wegovy tablets are cheaper still at $299 for the highest dose. The cost advantage shifts to tirzepatide only when you factor in compounded options or the Zepbound savings card for insured patients.

Insurance Coverage and Copays

Savings Card Comparison

Eli Lilly's Zepbound savings card brings the copay to as low as $25 per month for commercially insured patients, with up to $1,300 in annual savings. The Mounjaro card offers the same $25 copay with a higher annual cap of $1,950 (zepbound.lilly.com/savings and mounjaro.lilly.com/savings-resources, October 2026). Both expire December 31, 2026. Novo Nordisk runs its own savings program for Wegovy, but the terms differ by plan and are less uniformly published. In general, Lilly's savings card structure is more transparent and predictable for patients doing advance budgeting.

Neither Lilly's nor Novo Nordisk's copay cards work with Medicare, Medicaid, TRICARE, VA benefits, or any government-funded insurance. The exclusion applies to both companies equally.

Medicare Coverage Differences

Lilly offers the Medicare GLP-1 Bridge at $50 per month for eligible Medicare Part D patients through LillyDirect. This covers tirzepatide at a flat rate regardless of dose. Novo Nordisk does not currently offer a comparable Medicare-specific program for Wegovy at a publicly listed fixed price. For Medicare patients, tirzepatide has a clear cost advantage through this program. Details on eligibility are in our savings card guide.

Efficacy for the Money: What the Trials Show

Price matters, but so does what you get for that price. Two landmark trials provide the clinical context for this cost comparison.

SURMOUNT-5 Head-to-Head Results

SURMOUNT-5 is the only completed head-to-head trial comparing tirzepatide directly against semaglutide for weight loss (PMID 40353578, NEJM 2025). At 72 weeks, tirzepatide produced 20.2% body weight loss versus 13.7% for semaglutide. The difference of approximately 6.5 percentage points was statistically significant (P<0.001). Both drugs were titrated to their maximum approved doses.

The earlier SURMOUNT-1 trial established tirzepatide's efficacy against placebo (PMID 35658024, NEJM 2022). At 72 weeks: 5 mg produced 15.0% weight loss, 10 mg produced 19.5%, 15 mg produced 20.9%, and placebo produced 3.1%. These numbers provide the dose-response curve that makes tirzepatide's pricing tiers relevant. A patient paying $299 per month for the 2.5 mg starting dose is getting a lower efficacy tier than someone paying $449 for 15 mg.

On a cost-per-percentage-point basis at list price, Zepbound delivers more weight loss per dollar. At $1,086 per month for 20.2% loss, the cost per percentage point is roughly $54. Wegovy at $1,349 per month for 13.7% loss works out to about $98 per percentage point. The gap narrows at self-pay prices, where Wegovy's NovoCare program is cheaper per month, but the per-point calculation still favors tirzepatide. Our generic tirzepatide outlook covers how this comparison might shift as biosimilars eventually enter the market.

The Compounded Option: Tirzepatide Has One, Wegovy Does Not

Compounded tirzepatide is available from licensed 503A pharmacies in the United States. BiltRx offers it at $129 per month regardless of dose (biltrx.com, verified 22 Oct 2026). Arc-1 charges $199.99 to $399.99 depending on dose (arc-1.co, verified 22 Oct 2026). These prices are a fraction of both the tirzepatide and semaglutide brand-name costs.

Compounded semaglutide for weight loss is not currently available in the same way. The regulatory and supply dynamics differ. For patients whose primary concern is cost, compounded tirzepatide is the only sub-$200 injectable GLP-1 option on the market right now. That makes the tirzepatide side of this comparison significantly cheaper at the floor, even though Wegovy's NovoCare injection program and oral tablets are cheaper among brand-name manufacturer programs.

For a deeper look at compounded tirzepatide providers, see our cheapest tirzepatide ranking, which includes verified pricing for BiltRx and Arc-1 alongside all brand-name options.