Ozempic vs. Mounjaro: Understanding the Price Difference
When comparing what is more expensive, Ozempic or Mounjaro, the answer is not as simple as looking at a single price tag. While Mounjaro's manufacturer list price is typically higher than Ozempic's, your ultimate cost depends heavily on your individual insurance situation and access to savings programs.
Ozempic (semaglutide) and Mounjaro (tirzepatide) are both injectable medications, though they belong to slightly different drug classes. Both were initially developed and approved for the treatment of Type 2 diabetes. However, due to their appetite-suppressing effects, they are frequently prescribed off-label for weight loss. This distinction—and whether it is an FDA-approved use for your specific condition—is crucial for insurance coverage and cost.
Manufacturer List Price vs. Retail Cost
For uninsured or cash-paying patients, the most straightforward comparison is the manufacturer's list price. Historically, Mounjaro's list price has been slightly higher than Ozempic's. According to recent reports, the list price for a one-month supply is approximately $1,079.77 for Mounjaro and $997.58 for Ozempic. At retail pharmacies, without any discounts, the average price for a month's supply of Mounjaro can be around $1,493, while Ozempic is around $1,384, again showing a slight edge in Mounjaro's price.
- Ozempic (Semaglutide): List price around $995; Retail price can vary, sometimes higher.
- Mounjaro (Tirzepatide): List price around $1,080; Retail price can vary, sometimes higher.
The Critical Role of Insurance Coverage
Insurance is the single most important variable in determining your final cost. Both medications are more likely to be covered when prescribed for their FDA-approved indication: Type 2 diabetes. Most insurance plans require prior authorization for these medications, meaning your doctor must provide justification for its necessity. Coverage for off-label weight loss is much less common and often denied.
- Private/Commercial Insurance: For patients with coverage, out-of-pocket costs typically take the form of copayments. The medication's tier on your plan's formulary (list of covered drugs) determines your copay, which can range from as little as $25 to over $150 per month, depending on your plan and deductible status. Some dietitians and experts note that Ozempic may have had better overall insurance coverage in the past, but coverage criteria are constantly changing.
- Medicare and Medicaid: Coverage for these government-funded programs is complex. For Medicare, Part D plans often cover Ozempic and Mounjaro for Type 2 diabetes but not for weight loss. Medicaid coverage varies by state.
Manufacturer and Pharmacy Savings Programs
To help reduce costs, both manufacturers offer savings programs. However, these programs have specific eligibility requirements, often excluding those with government-funded insurance like Medicare or Medicaid.
- Ozempic Savings Card: For commercially insured patients with coverage, this can reduce the cost to as little as $25 per prescription fill for up to 48 months. There are also options for uninsured patients, like a reduced cash price of $499 per month through Novo Nordisk's online pharmacy.
- Mounjaro Savings Card: For eligible commercially insured patients with coverage, this program can also lower the cost to $25 for a one- or three-month supply. For commercially insured patients without Mounjaro coverage, a different savings program can offer significant discounts, up to $463 off a one-month prescription.
Third-party pharmacy discount cards from companies like SingleCare and GoodRx can also provide substantial savings for both insured and uninsured patients. For instance, recent SingleCare data showed Ozempic prices starting at $825 and Mounjaro at $872, reinforcing Mounjaro's slightly higher cost even with discounts.
Ozempic vs. Mounjaro: A Cost Breakdown
| Cost Factor | Ozempic (Semaglutide) | Mounjaro (Tirzepatide) |
|---|---|---|
| Manufacturer List Price (per month) | ~$998 | ~$1,080 |
| Average Retail Price (per month, uninsured) | ~$1,384 | ~$1,493 |
| Cost with Commercial Insurance & Savings Card | As little as $25 | As little as $25 |
| Uninsured Cost with Discount Card (e.g., SingleCare) | ~$825 | ~$872 |
| Primary FDA-Approved Use | Type 2 Diabetes | Type 2 Diabetes |
| Other FDA-Approved Drugs (Same Active Ingredient) | Wegovy (weight loss), Rybelsus (oral diabetes) | Zepbound (weight loss) |
Key Considerations Beyond Price
- Effectiveness and Side Effects: Clinical trials suggest tirzepatide (Mounjaro) may be more effective for blood sugar control and weight loss due to its dual-action mechanism, but may also have a slightly higher rate of side effects. A higher price may be justified by better results for some individuals.
- Dosage: The weekly dosage of both medications varies, but this does not typically affect the fixed cost per month for the branded pens.
- Off-Label Use: If prescribed for weight loss without a Type 2 diabetes diagnosis, obtaining insurance coverage is significantly more difficult for both drugs, forcing patients to rely on savings programs or cash prices.
Conclusion
When addressing the question of what is more expensive, Ozempic or Mounjaro, the retail and list price suggests that Mounjaro is slightly more expensive. However, this is rarely the final cost for patients, especially those with commercial insurance. Your out-of-pocket expense is primarily determined by your insurance plan, eligibility for manufacturer savings programs, and use of third-party discount cards.
Since coverage rules are constantly changing, the best approach is to consult with your healthcare provider and pharmacist. They can help you navigate your specific insurance plan's formulary, check for necessary prior authorizations, and determine your eligibility for manufacturer assistance, which often leads to the lowest possible cost for either medication.
For more information on the distinctions between these medications, including their mechanisms of action and approved indications, you can refer to authoritative sources like Drugs.com, which provides detailed comparisons.
