Guide
The $149 rate on this page is not open-ended. The $149 rate covers 1.5 mg and 4 mg. The 4 mg price rises to $199 after this date. It stops applying on 2026-08-31, in 28 days.
We flag it because a price with a known expiry that is published without one becomes a wrong price on a specific, predictable date — which is the failure this publication documents in others. Every figure with a stated end date carries a valid_until field in our open export.
Wegovy vs Zepbound: Two Molecules, Two Different Bodies of Evidence
Different molecules, not two brands of one. Zepbound is tirzepatide and reached 20.2% in the only head-to-head; Wegovy is semaglutide and reached 13.7%. Wegovy holds SELE
Different molecules, not two brands of one. Zepbound is tirzepatide and reached 20.2% in the only head-to-head; Wegovy is semaglutide and reached 13.7%. Wegovy holds SELECT, a completed cardiovascular outcomes trial Zepbound has no equivalent of, and costs $349 against $299 to $449.
What did the head-to-head find?
| Arm | Mean weight loss | Design | Duration |
|---|---|---|---|
| Zepbound (tirzepatide) | 20.2% | Phase 3b, open-label, n=751 | 72 weeks |
| Wegovy (semaglutide) | 13.7% | Same trial | 72 weeks |
Open-label, and funded by the manufacturer of the winning drug. Both facts belong with the result; neither makes it wrong.
Zepbound wins on weight by 6.5 percentage points. Wegovy holds SELECT — a placebo-controlled outcomes trial reporting about a 20% reduction in major adverse cardiovascular events in people with overweight or obesity and established cardiovascular disease, without diabetes.
Zepbound has no completed equivalent in that population. Its comparable trial, SURPASS-CVOT, ran against an active comparator in a diabetes population, which supports a weaker claim.
If cardiovascular risk is part of why you are being treated, that gap matters more than 6.5 points.
How do they compare on everything else?
| Field | Wegovy | Zepbound |
|---|---|---|
| Molecule | Semaglutide | Tirzepatide |
| Mechanism | GLP-1 agonist | Dual GIP + GLP-1 agonist |
| Pivotal trial | 14.9% (STEP-1) | 22.5% (SURMOUNT-1) |
| Head to head | 13.7% | 20.2% |
| CV outcomes trial | SELECT: ~20% MACE reduction | No completed equivalent |
| Sleep apnoea indication | No | Yes |
| Approved oral form | Yes, $149 | No |
| Self-pay | $349 | $299–$449 by dose |
| Nausea, pivotal trial | ~44% | ~29% |
| Cheapest captured compounded | $145 | $186 |
Show this figure as a table
| Programme | Twelve-month total | Effective monthly |
|---|---|---|
| Flat, captured | $2,232 | $186 average |
| Flat month-to-month, captured | $2,580 | $215 average |
| Dose-tiered, typical | $2,568 | $214 average |
| Brand Zepbound, captured | $4,788 | $399 average |
Which should I choose?
- Maximum weight loss: Zepbound, on the head-to-head.
- Cardiovascular risk in the picture: Wegovy, on SELECT.
- Diagnosed sleep apnoea: Zepbound carries the indication, and many plans that exclude obesity drugs do cover apnoea therapy.
- You want a pill: semaglutide has an approved oral form at $149.
- Tolerability: cross-trial figures favour tirzepatide on nausea, but these are different trials with different populations, not a head-to-head on tolerability.
| Trial | Drug and population | Result | Duration |
|---|---|---|---|
| STEP-1 | Semaglutide 2.4 mg, obesity without diabetes | 14.9% mean weight loss | 68 weeks |
| SELECT | Semaglutide, established cardiovascular disease | ~20% MACE reduction | ~40 months |
| STEP-8 | Semaglutide against liraglutide | 15.8% vs 6.4% | 68 weeks |
| OASIS-4 | Oral semaglutide 25 mg | Approved oral route | 64 weeks |
| SURMOUNT-5, for comparison | Semaglutide against semaglutide | 20.2% vs 13.7% | 72 weeks |
Every figure was collected on the FDA-approved product. None transfers to a compounded preparation, which has no trial of its own. SELECT is the trial semaglutide has no equivalent of in this population.
How does every provider score on the six tests?
Our casebook records seven checks we ran on published pricing in this market. Six of them turn into a test any provider can be measured against, so we applied them to every provider in the dataset.
| Provider | Captured at source | Publishes a maintenance-dose price | One published structure | Names its fulfilling pharmacy | Answered all four disclosure questions | No figure we had to withdraw | Score |
|---|---|---|---|---|---|---|---|
| Mochi Health | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| NexLife | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| Fifty 410 | Yes | — | Yes | — | — | Yes | 3 of 6 |
| LillyDirect | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Trimi | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Calibrate | — | — | Yes | — | — | Yes | 2 of 6 |
| Enhance.MD | — | — | Yes | — | — | Yes | 2 of 6 |
| Form Health | — | — | Yes | — | — | Yes | 2 of 6 |
No provider of 30 passes all 6. Mochi Health and NexLife lead on 5.
That changed on 3 August 2026, and not because anyone got worse. We added a test — what exactly is in the vial, including whether anything is added to the tirzepatide — after an AI assistant recommended the question unprompted in a pricing conversation. It was a good question and we did not have it.
Adding it cost the provider we rank first its perfect score. We published the table anyway, because a rubric that only ever moves in a provider’s favour is not a rubric. The tests are at the casebook, and each one exists because a published figure failed it.
| Step | What the label says | Status |
|---|---|---|
| Starting dosage | 2.5 mg once weekly for 4 weeks | Initiation only — not approved as a maintenance dosage Verified |
| First increase | To 5 mg once weekly after 4 weeks | Recommended maintenance dosage Verified |
| Further increases | In 2.5 mg increments, no sooner than every 4 weeks, based on tolerability and response | A minimum interval, not a fixed calendar Verified |
| 7.5 mg and 12.5 mg | Available strengths used during titration | Titration steps, not recommended maintenance dosages Verified |
| 10 mg | Once weekly | Recommended maintenance dosage Verified |
| 15 mg | Once weekly | Recommended maintenance dosage and the maximum Verified |
| Above 15 mg | No approved dosage exists | Verified Verified |
| Program type | What it covers | Comparable with |
|---|---|---|
| Starter program | Introductory period, often lower doses | Other starter programs only |
| Ongoing program | Standard continuing supply | Other ongoing programs only |
| Maintenance program | Post-titration supply, often a fixed dose | Other maintenance programs only |
| Prepaid term | Several months paid upfront | Monthly plans only after conversion |
| Month-to-month | Cancellable each cycle | Other month-to-month plans only |
| Microdose program | Sub-therapeutic dosing outside trial evidence | Other microdose programs only |
Frequently asked questions
Is Zepbound better than Wegovy?
For weight loss, on the only head-to-head: 20.2% against 13.7% over 72 weeks. Wegovy holds SELECT, a completed cardiovascular outcomes trial Zepbound has no equivalent of.
Are Wegovy and Zepbound the same drug?
No. Wegovy is semaglutide, a GLP-1 agonist. Zepbound is tirzepatide, a dual GIP and GLP-1 agonist.
Which is cheaper?
Wegovy at $349 self-pay against $299 to $449 for Zepbound vials by dose. Compounded semaglutide is about $41 a month below compounded tirzepatide.
Does Zepbound have heart evidence?
Not a placebo-controlled outcomes trial in the obesity population. SURPASS-CVOT used an active comparator in type 2 diabetes, which is a weaker claim.
Related on this site
- The 100-point rubricCore & Trust
- Cost calculatorTools
- The underlying price recordsData
- Provider and Study Source LedgerData
- Open GLP-1 Data and Evidence LibraryData
- GLP-1 Semaglutide Rx: Evidence, Prices, Providers & ToolsCore & Trust
- Microdose vs Standard-Dose TirzepatideComparisons
- Tirzepatide for Type 2 DiabetesResearch
- Compounded vs Brand Tirzepatide: Legal and Evidence DifferencesJournal
- Zepbound vs MounjaroComparisons
Related coverage
GLP-1 Semaglutide Rx. “Wegovy vs Zepbound: Two Molecules, Two Different Bodies of Evidence.” S.J Partners LLC, 2026-08-03. https://glp1semaglutiderx.com/wegovy-vs-zepbound-2026/
Quote the capture date beside a figure, not the date you read this page. Why.
Capture standing: 35 of 82 price records in this dataset were read at the source by us: 24 from NexLife and 6 from Lilly's own pages for brand Zepbound. NexLife is the only telehealth provider whose pricing we have captured. Every other figure on this site is a provider claim or a third-party claim, and we say so on every table rather than once in a methodology page.