Ozempic vs Mounjaro: two type 2 diabetes drugs compared

Ozempic and Mounjaro are both weekly injections approved for type 2 diabetes, and they are the two drugs most often compared for it. They are different medicines: Ozempic is semaglutide, made by Novo Nordisk; Mounjaro is tirzepatide, made by Eli Lilly. Neither is approved for weight loss. The versions of each approved for weight management are sold under other names: Wegovy (semaglutide) and Zepbound (tirzepatide).

What each is approved for

• Ozempic, in Novo Nordisk's words, is used "along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes." The injection is also approved to lower the risk of heart attack, stroke and worsening kidney disease in adults with type 2 diabetes and certain heart or kidney conditions.
• Mounjaro, in Eli Lilly's words, is used along with diet and exercise "to improve blood sugar (glucose) in adults and children 10 years of age and older with type 2 diabetes," and to reduce the risk of heart attack, stroke or death in adults with type 2 diabetes who are at high risk for these events.

One difference stands out: Mounjaro's approval for type 2 diabetes extends to children 10 and older. Ozempic's covers adults.

What the head-to-head trial found

The two were compared directly in SURPASS-2, a trial funded by Eli Lilly. In SURPASS-2, researchers "randomly assigned 1879 patients, in a 1:1:1:1 ratio, to receive tirzepatide at a dose of 5 mg, 10 mg, or 15 mg or semaglutide at a dose of 1 mg" in an open-label, 40-week, phase 3 trial.

On blood sugar, the trial's main measure, SURPASS-2 reported that the mean change in the glycated hemoglobin level (HbA1c) "was -2.01 percentage points, -2.24 percentage points, and -2.30 percentage points with 5 mg, 10 mg, and 15 mg of tirzepatide, respectively, and -1.86 percentage points with semaglutide."

On weight, SURPASS-2 reported that "reductions in body weight were greater with tirzepatide than with semaglutide," with an estimated treatment difference of -1.9 kg, -3.6 kg and -5.5 kg at the three tirzepatide doses.

Two limits on reading this. The semaglutide arm was 1 mg, not Ozempic's highest dose of 2 mg. And the trial was in people with type 2 diabetes, so it says nothing about either drug in people without it.

What each costs self-pay

Read from each manufacturer's own pharmacy page:

	Ozempic (Novo Nordisk, NovoCare Pharmacy)	Mounjaro (Eli Lilly, LillyDirect)
Starting doses	$199 for the first 2 fills of 0.25 mg or 0.5 mg (new patients, through December 31, 2026), then $349	Starting at $499 a month
Higher doses	$349 (1 mg), $499 (2 mg)	Starting at $499 a month at every dose from 2.5 mg to 15 mg

Lilly says "Mounjaro is available for self-pay through LillyDirect" and lists "Starting at $499/month" for each dose. On Novo's prices, Ozempic costs less self-pay at every dose up to 1 mg and the same at 2 mg.

Insurance

What each manufacturer says:

• Ozempic. Novo's copay offer lets commercially insured patients with Ozempic coverage pay as little as $25, but only if prescribed "for an FDA-approved indication within Ozempic's labeling."
• Mounjaro. Lilly's savings card says "You may pay as little as $25 for up to a 3-month prescription of Mounjaro" if you are commercially insured with coverage for it, "Governmental beneficiaries excluded," and with "a prescription for an approved use consistent with FDA-approved product labeling." Lilly's pharmacy page says Mounjaro is "Covered by many insurance plans nationwide, including Medicare and select Medicaid plans depending on the provider."

Both copay programs require an approved use, so for either drug, type 2 diabetes is the prescription they are built for.

If your question is really about weight loss, the comparable approved pair is Wegovy and Zepbound, and our guide on getting Ozempic explains where a prescription comes from and what online clinics charge.