Ozempic vs Zepbound
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Side-by-side comparison based on STEP-2 (T2D) and SURMOUNT-1 phase 3 trial data plus May 2026 pricing.
Ozempic
semaglutide (injection)
Peak weight loss11.6%
TrialSTEP-2 (T2D)
Administrationinjection
FDA statustype-2-diabetes
List price$998/mo
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
Weight loss comparison (220 lbs starting weight)
% of body weight lost over 18 months, modeled from phase 3 trial data
Monthly cost by payment channel
| Channel | Ozempic | Zepbound | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $63 | $88 | $25 (Ozempic cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | - | $299 | - |
| Telehealth: brand name (Hims, Ro, Found) | $399 | $499 | $100 (Ozempic cheaper) |
| Cash retail (full list price) | $998 | $1,059 | $61 (Ozempic cheaper) |
Ozempic pros and cons
Pros
- ✓ Often easier to get insurance coverage if you have type 2 diabetes
- ✓ Lower list price than Wegovy
- ✓ Same active ingredient as Wegovy (semaglutide)
- ✓ Strong cardiovascular outcome data (SUSTAIN-6)
Cons
- ✗ Off-label for weight loss - insurance won't cover for that purpose
- ✗ Lower max dose than Wegovy (2.0 mg vs 2.4 mg) means slightly less weight loss
- ✗ Periodic shortages
Zepbound pros and cons
Pros
- ✓ Highest efficacy of any FDA-approved GLP-1 (22.5% in SURMOUNT-1)
- ✓ Dual GLP-1/GIP mechanism
- ✓ LillyDirect self-pay vials starting around $349/mo for lower doses
- ✓ FDA-approved for chronic weight management
Cons
- ✗ List price still high ($1,059/mo)
- ✗ Insurance coverage varies more than for Wegovy
- ✗ GI side effects can be more pronounced at higher doses
- ✗ Periodic supply constraints during demand spikes
Common side effects
Ozempic
- • Nausea
- • Diarrhea
- • Vomiting
- • Constipation
- • Abdominal pain
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
Which should you choose: Ozempic or Zepbound?
Choose Ozempic if: cash-pay cost matters most to you; you have type 2 diabetes (insurance is more likely to cover).
Choose Zepbound if: you want maximum weight loss (22.5% vs 11.6%); you want a drug FDA-approved specifically for weight loss.
Final decisions should always be made with a licensed prescriber. This is educational content only.
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Where to actually buy Ozempic or Zepbound (and the alternatives)
Manufacturer direct prices (LillyDirect, NovoCare) are usually cheapest. Updated May 2026.
| Drug | Insurance | Mfr direct | Telehealth (brand) | Telehealth (compd) | Cash retail | Get it |
|---|---|---|---|---|---|---|
| Wegovy 14.9% weight loss | $63 | $349 | $329 | $249 cheapest | $1,349 | Get → |
| Ozempic 11.6% weight loss | $63 | - | $399 | $199 cheapest | $998 | Get → |
| Wegovy (oral 25mg) 13.6% weight loss | $63 | $149 cheapest | $449 | - | $1,349 | Get → |
| Zepbound 22.5% weight loss | $88 | $299 cheapest | $499 | $299 cheapest | $1,059 | Get → |
| Mounjaro 20.9% weight loss | $88 | - | $499 | $299 cheapest | $1,069 | Get → |
| Saxenda 8.4% weight loss | $63 | - | $399 cheapest | - | $1,349 | Get → |
| Foundayo (orforglipron) 14.7% weight loss | $63 | $149 cheapest | - | - | $1,099 | Get → |
Some links are affiliate. We earn a commission at no cost to you. We never recommend a product based on commission. Disclaimer.
Medical disclaimer: This calculator provides estimates only based on phase 3 clinical trial data and publicly listed prices. It is not medical advice. Real-world weight loss varies significantly. Consult a licensed healthcare provider before starting any medication.
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