Drug Comparison
GLP-1 Medication Comparison
Ozempic, Wegovy, Mounjaro, Zepbound, and Rybelsus are the major GLP-1 medications available in the US. Here's how they compare on efficacy, cost, coverage, and use cases.
Wegovy
Semaglutide · Novo Nordisk
Type
GLP-1
Route
Weekly injection
Start dose
0.25 mg/week
Max dose
2.4 mg/week
Avg weight loss
~15%
List price
$1,349/mo (list)
Approved for
Weight loss (BMI ≥30, or ≥27 with weight-related condition)
Coverage
Some commercial plans
The gold standard for GLP-1 weight loss. Highest dose semaglutide available. Titrated over 16 weeks to maintenance dose.
Ozempic
Semaglutide · Novo Nordisk
Type
GLP-1
Route
Weekly injection
Start dose
0.25 mg/week
Max dose
2.0 mg/week
Avg weight loss
~12–14%
List price
$968/mo (list)
Approved for
Type 2 diabetes management; cardiovascular risk reduction
Coverage
Most commercial + Medicare Part D
Widely prescribed off-label for weight loss. Same molecule as Wegovy, slightly lower max dose. Broader insurance coverage due to diabetes indication.
Zepbound
Tirzepatide · Eli Lilly
Type
GLP-1 + GIP (dual agonist)
Route
Weekly injection
Start dose
2.5 mg/week
Max dose
15 mg/week
Avg weight loss
~20–22%
List price
$1,059/mo (list, with savings card)
Approved for
Weight loss (BMI ≥30, or ≥27 with weight-related condition)
Coverage
Growing commercial coverage
Dual GIP/GLP-1 mechanism produces greater weight loss than semaglutide in head-to-head trials. SURMOUNT trial showed up to 22.5% body weight reduction.
Mounjaro
Tirzepatide · Eli Lilly
Type
GLP-1 + GIP (dual agonist)
Route
Weekly injection
Start dose
2.5 mg/week
Max dose
15 mg/week
Avg weight loss
~17–20%
List price
$1,028/mo (list)
Approved for
Type 2 diabetes management
Coverage
Most commercial + Medicare Part D
Same molecule as Zepbound, approved for diabetes. Often prescribed off-label for weight loss. Strong insurance coverage with diabetes diagnosis.
Rybelsus
Semaglutide (oral) · Novo Nordisk
Type
GLP-1 (oral)
Route
Daily oral tablet
Start dose
3 mg/day
Max dose
14 mg/day
Avg weight loss
~5–8%
List price
$850/mo (list)
Approved for
Type 2 diabetes management
Coverage
Many commercial + Medicare Part D
The only oral GLP-1 receptor agonist. Lower weight loss than injections due to reduced bioavailability. Must be taken on empty stomach with small sip of water and wait 30 min before eating.
Semaglutide vs. Tirzepatide: Head to Head
The two dominant mechanisms on the market.
Weight loss
Zepbound/Mounjaro
~20–22% vs ~15% for semaglutide in trials
Nausea/GI side effects
Roughly equal
Both cause similar GI side effects; tirzepatide may have slightly more vomiting
Insurance coverage
Ozempic/Mounjaro
Diabetes indications give broader formulary access
Needle size
Equal
Both use subcutaneous pen injectors with tiny needles
Dosing flexibility
Semaglutide
More granular dose steps; tirzepatide has larger jumps
Cardiovascular benefit
Semaglutide
SELECT trial showed CV risk reduction; tirzepatide CV trial (SURPASS-CVOT) ongoing
Availability
Improves by quarter
Both have had shortage issues; stabilizing through 2025
Which Should You Take?
For maximum weight loss: Zepbound (tirzepatide) consistently outperforms semaglutide in head-to-head studies, with ~20–22% average body weight loss vs ~15% for semaglutide.
For insurance coverage: Ozempic or Mounjaro (diabetes indications) typically have broader formulary access. If you have T2D, these are usually covered. Weight-loss-only indications (Wegovy, Zepbound) face more denials.
For avoiding injections: Rybelsus (oral semaglutide) is the only non-injectable option, though weight loss is lower.
The real answer: Your prescriber's experience, your insurance, and your specific health history determine the best choice more than any comparison chart. This decision belongs between you and your doctor.