Zepbound vs Wegovy

Zepbound, based on the only trial that tested them directly. SURMOUNT-5 randomly assigned 751 adults with obesity but without diabetes to one drug or the other for 72 weeks. Zepbound produced 20.2% average weight loss and Wegovy produced 13.7%. About 32% of people on Zepbound lost at least a quarter of their body weight, against 16% on Wegovy. Averages are not promises, though, and plenty of people do very well on Wegovy.

Three common reasons. First, coverage: your plan may cover one and not the other, and that decides it more often than anything clinical. Second, heart disease: Wegovy is the only one with an FDA-approved claim for reducing heart attack and stroke risk, and it is the reason Medicare covers it for people with obesity and cardiovascular disease. Third, tolerance: some people cannot handle one drug and do fine on the other. There is also now a Wegovy pill, which matters if you will not inject.

Zepbound has the lower list price, about $1,086 a month against about $1,349 for Wegovy. If you are paying cash, both companies sell direct and undercut those numbers badly. LillyDirect sells Zepbound vials at $299 a month at 2.5 mg, $399 at 5 mg and $449 at every other dose, though holding the $449 price means refilling within 45 days. NovoCare sells the Wegovy pens at $349 a month. The cheapest option of all is the Wegovy pill, from $149 a month at the starting dose. With insurance, both land in the same $0 to $25 range when a plan actually covers them.

Yes, and plenty of people do, usually because they stalled or their coverage changed. You do not carry your dose across. Your provider restarts you at the lowest Zepbound dose and steps you up, which means the stomach side effects come back for a few weeks. Do not switch on your own or overlap the two.

They cause the same kinds of problems, mostly stomach related, but Wegovy reported them more often in trials: 44% nausea against 33% for Zepbound, and 24% vomiting against 17%. Both are worst in the first weeks and around dose increases, then settle. That is a population average and tells you nothing certain about how you personally will react.

It varies by plan, and prior authorization is close to universal for both. Medicare does not cover either for weight loss on its own, with two exceptions: Wegovy is covered for people with obesity and cardiovascular disease, and the Medicare GLP-1 Bridge program covers Wegovy and the Zepbound KwikPen at $50 a month through December 2027. Medicaid coverage for obesity is optional and only a minority of states do it. Check our carrier pages for the specifics on your plan.

Same molecules, different labels. Mounjaro is tirzepatide, the same drug as Zepbound, approved for type 2 diabetes instead of weight loss. Ozempic is semaglutide, the same drug as Wegovy, also labeled for diabetes. The weight loss versions use higher maximum doses. Which name you are prescribed usually comes down to your diagnosis and what your plan will pay for.