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GLP1Cost

Wegovy (oral 25mg) vs Zepbound

By Anthony K C Fong, Esq.·Last reviewed:
NY State Bar #5361159 · Hawaii State Bar · Founder, GLP1Cost.org

Side-by-side comparison based on OASIS-4 and SURMOUNT-1 phase 3 trial data plus May 2026 pricing.

Wegovy (oral 25mg)
semaglutide (tablet)
Peak weight loss13.6%
TrialOASIS-4
Administrationoral
FDA statusweight-loss
List price$1,349/mo
Zepbound
tirzepatide (injection)
Higher efficacy
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

ChannelWegovy (oral 25mg)ZepboundDifference
Covered by insurance ($25–150 copay)$63$88$25 (Wegovy (oral 25mg) cheaper)
Manufacturer self-pay (LillyDirect / NovoCare)$149$299$150 (Wegovy (oral 25mg) cheaper)
Telehealth: brand name (Hims, Ro, Found)$449$499$50 (Wegovy (oral 25mg) cheaper)
Cash retail (full list price)$1,349$1,059$290 (Zepbound cheaper)

Wegovy (oral 25mg) pros and cons

Pros
  • No injections - daily oral pill
  • Same molecule as Wegovy injection
  • 13.6% average weight loss in OASIS-4
  • Easier to skip a dose without long-acting tail
Cons
  • Strict fasting requirements before/after dose
  • Slightly lower weight loss than injection (13.6% vs 14.9%)
  • Daily dosing may hurt adherence vs weekly injection
  • Newer drug - fewer real-world data points

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

Wegovy (oral 25mg)
  • Nausea
  • Diarrhea
  • Constipation
  • Vomiting
Zepbound
  • Nausea
  • Diarrhea
  • Constipation
  • Vomiting
  • Decreased appetite

Which should you choose: Wegovy (oral 25mg) or Zepbound?

Choose Wegovy (oral 25mg) if: you prefer a daily pill over a weekly injection.

Choose Zepbound if: you want maximum weight loss (22.5% vs 13.6%); you prefer a weekly injection over a daily pill; cash-pay cost matters most to you.

Final decisions should always be made with a licensed prescriber. This is educational content only.

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Where to actually buy Wegovy (oral 25mg) or Zepbound (and the alternatives)

Manufacturer direct prices (LillyDirect, NovoCare) are usually cheapest. Updated May 2026.

DrugInsuranceMfr directTelehealth (brand)Telehealth (compd)Cash retailGet it
Wegovy
14.9% weight loss
$63$349$329$249
cheapest
$1,349Get →
Ozempic
11.6% weight loss
$63-$399$199
cheapest
$998Get →
Wegovy (oral 25mg)
13.6% weight loss
$63$149
cheapest
$449-$1,349Get →
Zepbound
22.5% weight loss
$88$299
cheapest
$499$299
cheapest
$1,059Get →
Mounjaro
20.9% weight loss
$88-$499$299
cheapest
$1,069Get →
Saxenda
8.4% weight loss
$63-$399
cheapest
-$1,349Get →
Foundayo (orforglipron)
14.7% weight loss
$63$149
cheapest
--$1,099Get →
Some links are affiliate. We earn a commission at no cost to you. We never recommend a product based on commission. Disclaimer.
Run your own projection on the full calculator →
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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