Both tirzepatide and semaglutide are highly effective, but expensive, injectable medications for type 2 diabetes and/or weight management. The question of which is more affordable is complicated, with no single answer applying to everyone. While list prices offer a starting point, they rarely reflect the actual out-of-pocket cost for patients. The final price depends heavily on a patient's specific insurance plan, their eligibility for manufacturer savings cards or patient assistance programs, and how the medication is prescribed.
Brand-Name Breakdown: Tirzepatide vs. Semaglutide
To properly compare costs, it's essential to understand the different brand-name products. Tirzepatide is sold under the names Mounjaro® (for type 2 diabetes) and Zepbound® (for weight loss). Semaglutide is available as Ozempic® (for type 2 diabetes) and Wegovy® (for weight loss), both weekly injections, and Rybelsus® (an oral tablet for type 2 diabetes). The list prices of these brand-name medications are set by their respective manufacturers, Eli Lilly and Novo Nordisk, but their real cost can vary significantly.
List Price Comparison (Without Insurance)
On average, the list prices for a one-month supply of these medications are generally high and differ between brands. However, these figures are the prices before any insurance coverage or discounts are applied and are not what most patients will pay.
- Ozempic® (Semaglutide): Varies by dosage but can range from approximately $850 to $1,000 per month. A one-month supply of Wegovy® can be upwards of $1,350.
- Mounjaro® and Zepbound® (Tirzepatide): These are often similarly priced to their semaglutide counterparts, with retail prices ranging from $1,000 to $1,200 per month.
The Impact of Insurance and Savings Programs
For many patients, the actual monthly cost is dramatically reduced by a combination of insurance coverage and manufacturer assistance programs. These programs have specific eligibility requirements, often excluding patients with government-funded insurance like Medicare or Medicaid.
Eli Lilly (Zepbound®, Mounjaro®):
- LillyDirect: Eli Lilly offers lower self-pay prices through its direct-to-consumer pharmacy, LillyDirect. For patients paying out-of-pocket, Zepbound is available for $349 per month for the starter dose (2.5 mg) and $499 per month for higher doses (up to 10 mg) via a vial-and-syringe format. This cash-pay price for higher doses is comparable to Novo Nordisk's program for semaglutide.
- Savings Card: For commercially insured patients, Eli Lilly provides a savings card that can reduce the out-of-pocket cost for Mounjaro or Zepbound, potentially to as low as $25 per fill for a limited duration.
Novo Nordisk (Wegovy®, Ozempic®):
- NovoCare Pharmacy: Novo Nordisk offers a direct-to-patient pharmacy service. As of 2025, cash-paying patients can get Wegovy for $499 per month. This price cut makes it significantly more competitive with LillyDirect's offerings for Zepbound. Ozempic, however, has often been available for a lower cash price through this program as well, around $499 per month.
- Savings Card: Commercially insured patients can often utilize manufacturer savings cards to lower their copay.
Cost-Effectiveness vs. Upfront Cost
Beyond the monthly price, another critical consideration is the medication's overall value, which factors in its effectiveness. Several studies have compared the cost-effectiveness of tirzepatide and semaglutide based on weight loss and health outcomes.
One study found that the estimated cost per 1% body weight reduction was significantly lower for tirzepatide ($985) compared to semaglutide ($1,845). This suggests that tirzepatide may provide greater weight loss per dollar spent, making it a more 'cost-effective' option in the long run, even if the monthly price is similar. A separate economic analysis also found that tirzepatide was likely to be more cost-effective for weight management over a 68-week period.
Comparison Table: Tirzepatide vs. Semaglutide Cost Factors
| Factor | Tirzepatide (Zepbound®, Mounjaro®) | Semaglutide (Wegovy®, Ozempic®) |
|---|---|---|
| Manufacturer | Eli Lilly | Novo Nordisk |
| Approximate List Price (Monthly) | ~$1,000 - $1,200 | ~$1,030 - $1,350 |
| Direct-to-Consumer Cash Price | Zepbound: $349 (starter dose), $499 (higher doses) via vial-and-syringe | Wegovy: $499 via NovoCare Pharmacy Ozempic: ~$499 via NovoCare Pharmacy |
| Patient Savings Card | Eligible commercially insured patients may pay as little as $25. | Eligible commercially insured patients may pay as little as $0 for a limited time. |
| Cost-Effectiveness (per 1% weight loss) | ~$985 | ~$1,845 |
| Impact on Weight Loss | Generally shown to result in greater weight loss in head-to-head trials. | Very effective, but slightly less so than tirzepatide in some comparative studies. |
| Government Insurance | Ineligible for savings card/cash-pay programs; coverage depends on plan. | Ineligible for savings card/cash-pay programs; coverage depends on plan. |
Conclusion: Which is the Cheaper Option?
Ultimately, determining which medication is cheaper for an individual is a complex calculation. The initial retail price comparison might suggest they are in a similar, high-cost range. However, manufacturer self-pay programs have made access more affordable for uninsured patients, with both companies offering competitive pricing via their direct pharmacy channels. For those with commercial insurance, the out-of-pocket cost is dependent on plan coverage and the generosity of manufacturer savings programs.
Several studies have concluded that tirzepatide may offer a better value per unit of body weight reduced, implying that it could be more cost-effective in the long run. However, this is a measure of overall value, not the monthly bill. Semaglutide can also be a highly effective and potentially affordable option, especially with the latest pricing adjustments. The most important step for any patient is to discuss treatment and financial options with a healthcare provider and pharmacist to understand their specific situation and find the most affordable path forward.
For more information on patient assistance options, the Pharmaceutical Research and Manufacturers of America (PhRMA) website offers resources.
