Semaglutide vs Tirzepatide: how they compare

Side-by-side

Semaglutide

Semaglutide is a GLP-1 receptor agonist that lowers blood sugar and reduces appetite by mimicking the incretin hormone GLP-1. It is FDA-approved as Ozempic and Rybelsus for type 2 diabetes and as Wegovy for chronic weight management. In trials, weight-management dosing produced roughly 15% average body-weight reduction over 68 weeks.

Tirzepatide

Tirzepatide is a dual GIP and GLP-1 receptor agonist — it activates two incretin receptors rather than one. It is FDA-approved as Mounjaro for type 2 diabetes and as Zepbound for chronic weight management. In the pivotal SURMOUNT-1 trial, the highest dose produced about 20.9% average body-weight reduction over 72 weeks.

Six different meanings of "cheapest" — and why we refuse to merge them

Almost every comparison page in this category gives you a single "cheapest" number. There are at least six honest answers to that question, and they point to different providers. A page that merges them has chosen which answer flatters its preferred provider.

• Lowest advertised starting price. Frequently an introductory rate. TrimRx and MEDVi both advertise $179; both charge $299 ongoing.
• Lowest introductory price. Noom Med at $79 for a first month, then $199. Useful only if you plan to leave.
• Lowest month-to-month price. No commitment, no prepayment — the honest comparison for anyone who is not certain they will stay a year.
• Lowest committed-plan monthly equivalent. The plan total divided by the plan months. Lower, but you are locked in.
• Lowest full-dose cost. Excludes microdose programmes, which sit below every dose studied in the trials and are therefore not the same product.
• Lowest FDA-approved option. Brand Foundayo (oral) at $149/month and oral Wegovy at $149 now undercut most of the compounded market — while actually being approved.

These are six different questions. We publish all six and let you take the one that matches your situation.

The cost of switching later

Most comparisons treat the choice as permanent. It rarely is, and the ability to switch has real value that a price table does not capture.

Three switching scenarios are common. Insurance approves a brand product — a provider with a brand pathway keeps you on one account; a cash-only compounded provider means starting over elsewhere. You cannot tolerate the dose — a provider with a microdose programme can step you down; one without cannot. The regulatory position changes — compounding of these molecules rests on a narrowed legal basis, and a provider forced to stop leaves you without continuity of supply, potentially mid-titration.

Ask any provider what its contingency plan is if its pharmacy receives an FDA or manufacturer notice. The answer tells you how seriously it has thought about the risk it is asking you to carry.

Dose escalation and the real annual gap

Before you choose either: check your insurance

How to verify any of this yourself

You should not take our word for a price, and you do not have to. Every figure here can be checked in a few minutes.

1. Go to the provider's own pricing page. Not a comparison site — the provider's. Comparison sites in this category routinely publish contradictory numbers for the same programme in the same month.
2. Find the ongoing price, not the headline. Look for the words "first month", "intro", "starting at" or "new patients". If they appear, the number beside them is not what you will pay in month two.
3. Add the membership. If the medication and the membership are billed separately, add them. That sum is your real monthly cost.
4. Ask what the highest dose costs. By email or chat, so you have it in writing.
5. Ask about early cancellation before you commit to a plan longer than a month.
6. Check the manufacturer. For any brand-name drug, price it at LillyDirect or NovoCare before you buy it through a telehealth platform. Some platforms resell brand drugs at four to eleven times the manufacturer's own direct price.

If a provider will not answer questions 4 or 5 in writing, that is itself information.

How to read our labels

A decision framework, rather than a winner

A comparison that declares one provider the winner for everybody is not a comparison — it is an advertisement with a table attached. Different patients are optimising for genuinely different things, and the honest structure is to name those things and say which provider serves each.

The things a price table cannot show you

Four factors routinely matter more than the fifteen-dollar difference people agonise over, and none of them appear in a pricing column.

Continuity of supply. Compounding of these molecules rests on a legal basis the FDA narrowed sharply in 2025. A provider whose pharmacy is forced to stop leaves you without medication, potentially mid-titration. Ask what the contingency is.

Who you actually see. Some programmes give you a named clinician; others route you to whoever is available, which makes continuity of clinical judgement difficult across dose escalations.

What happens at the top of the ladder. A programme that is cheapest at 2.5mg and most expensive at 15mg is not cheap. Model your cost at the dose you expect to maintain.

Whether they will put it in writing. A provider that answers questions about its pharmacy, its salt form and its cancellation terms by email is telling you something. So is one that will not.

The same question, asked of both

Rather than trusting either provider's marketing, ask both the identical set of questions and compare the answers rather than the advertising. We would ask these seven, in writing:

1. What will I pay per month at the highest dose you cover?
2. Is there any fee — membership, consultation, laboratory, shipping — that is not in the price you quoted me?
3. Which specific pharmacy fills my prescription, and is it a 503A or a 503B facility?
4. What is the exact salt form and concentration, and is the vial single-dose or multi-dose?
5. If I cancel in month three of a twelve-month plan, what exactly happens to my money?
6. If your pharmacy is forced to stop compounding, what happens to my supply?
7. Will I see the same clinician at each follow-up?

The provider that answers all seven plainly is demonstrating something that no price table can. In our experience the answers, rather than the prices, are what actually separate these companies.

Limitations of this analysis

Every page on this site should tell you where it stops being reliable. This one stops here.

Prices decay quickly. This is the fastest-moving data we publish. Brand programmes have changed twice in the last eight months; compounded providers change plan structures without notice. Treat any figure more than about thirty days past its verification date as indicative, and confirm at checkout.

Competitor pricing is reported, not captured by us. We hold dated captures for brand pricing and for NexLife. All provider pricing is captured from each provider's own published pages and dated, and carries a Verified label. Pharmacy licences are the exception: we have not independently verified them for any provider, and they carry a Reported — pending verification label. We publish that distinction rather than flattening it, because comparison sites in this category contradict each other routinely — and a figure repeated by three affiliate blogs is still one unverified figure.

We have not audited pharmacy licences. Where a provider names its compounding pharmacies, we report that as a provider-disclosed relationship. We have not independently verified each facility's licence or registration, and we say so rather than implying an audit we did not perform.

Advertised availability is not your availability. Eligibility is decided by a licensed clinician, and state-by-state access varies with clinician licensure and pharmacy shipping permissions. No page can promise you a price you will actually be offered.

We are commercially funded. The publisher and certain principals have financial relationships with some of the providers listed here, and we may earn a commission from provider links. That is disclosed in the footer of every page. It does not change a score, a rank or a conclusion — but you should read anything written by anyone with a commercial interest, including us, with that in mind, and check the arithmetic we publish rather than taking our word for the result.