Quick answer
Zepbound (tirzepatide) costs less at list price than Wegovy and produces more weight loss. For most patients, Zepbound is the more effective choice. The decision also depends on insurance, access, and individual tolerability.
| Zepbound (tirzepatide) | Wegovy (semaglutide) | |
|---|---|---|
| Mechanism | GLP-1 + GIP agonism | GLP-1 agonism |
| Avg weight loss | 20.9% | 14.9% |
| List price/month | ~$1,060 | ~$1,350 |
| With commercial insurance coupons | ~$25-50 | ~$0-25 |
| CVOT data | Ongoing (SURMOUNT-CVOT) | Published (SELECT - 20% CV risk reduction) |
Efficacy: Zepbound Wins
Tirzepatide at 72 weeks produces 20.9% average weight loss. Semaglutide at 68 weeks produces 14.9%. That is approximately 6 percentage points - roughly 12-15 lbs at a typical starting weight. A direct comparative study (SURPASS-6) confirmed tirzepatide superiority over semaglutide in a head-to-head T2D population.
Cost: Wegovy Has the Higher List Price
At list price, Wegovy (~$1,350/month) costs more than Zepbound (~$1,060/month). Both have savings programs that reduce costs substantially with commercial insurance. Telehealth platforms offer compounded versions of both at significantly lower prices.
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Get My MatchCardiovascular Data: Semaglutide Has the Advantage Now
The SELECT trial showed semaglutide reduced major cardiovascular events by 20% in high-risk patients. Tirzepatide's CVOT is ongoing. If proven cardiovascular outcomes data is the priority, semaglutide currently has that evidence.
Which to Choose
Choose Zepbound if maximum weight loss is the priority. Choose Wegovy if you need proven CV outcomes data or your insurance specifically covers it.
See: tirzepatide vs semaglutide, is tirzepatide worth the cost.
Frequently Asked Questions
Is Zepbound the same as Mounjaro?
Both contain tirzepatide. Mounjaro is for type 2 diabetes; Zepbound is for obesity. The active ingredient and mechanism are identical.
Does insurance cover Wegovy or Zepbound?
Coverage varies. Some commercial plans cover one or both; Medicare does not for obesity alone.
Can I switch from Wegovy to Zepbound?
Yes, with your prescriber's guidance. The transition involves starting tirzepatide at a low dose and escalating.
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