Zepbound vs Wegovy

Zepbound did better than Wegovy 2.4 mg in the only trial that tested them directly. That trial did not include the higher 7.2 mg Wegovy HD dose, which has never been tested against Zepbound. 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 at the top of its range, $1,086.37 per fill against $1,349.02 a package for Wegovy, and that range starts at $499 depending on the product and dose. If you are paying cash, both companies sell direct and undercut those numbers badly. LillyDirect sells the Zepbound KwikPen or a 4-count vial for a 28-day supply at $299 at 2.5 mg, $399 at 5 mg, $499 at 7.5 mg and $699 at 10 to 15 mg, with a $449 first-fill offer on the 7.5 mg and higher KwikPen that holds only while each refill purchase is completed within 45 days of your previous delivery, through December 31, 2026. 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, the cost depends on your plan; when a commercial plan covers them, the savings cards from both makers can bring either to as little as $25 a month for eligible patients, with savings capped at $100 a month.

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.