Ozempic vs Zepbound: different drugs, different approvals

People searching "Ozempic vs Zepbound" are usually comparing two things that aren't quite comparable. They are different medicines from different companies, approved for different conditions. Ozempic is semaglutide, made by Novo Nordisk, approved for type 2 diabetes. Zepbound is tirzepatide, made by Eli Lilly, approved for weight management and for obstructive sleep apnea in people with obesity.

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," with additional approvals to lower heart and kidney risk in adults with type 2 diabetes and certain heart or kidney conditions. Weight loss is not one of its approved uses.
• Zepbound, in Eli Lilly's words, is used with a reduced-calorie diet and more physical activity to help adults with "obesity, or some adults with overweight who also have weight-related medical problems, to lose excess body weight and keep the weight off," and adults with "moderate-to-severe obstructive sleep apnea (OSA) and obesity to improve their OSA."

So for weight loss, Zepbound is approved and Ozempic is not. The semaglutide approved for weight management is Wegovy, and that is the drug Zepbound has actually been tested against.

What the trials show

There is no trial of Zepbound against Ozempic. There are two that matter for this comparison.

Tirzepatide against placebo. In SURMOUNT-1, adults with obesity were assigned "to receive once-weekly, subcutaneous tirzepatide (5 mg, 10 mg, or 15 mg) or placebo for 72 weeks." SURMOUNT-1 reported that "the mean percentage change in weight at week 72 was -15.0%" with 5 mg, "-19.5%" with 10 mg, and "-20.9%" with 15 mg, against "-3.1%" with placebo.

Tirzepatide against semaglutide at Wegovy's doses. In SURMOUNT-5, adults with obesity but without type 2 diabetes were assigned "to receive the maximum tolerated dose of tirzepatide (10 mg or 15 mg) or the maximum tolerated dose of semaglutide (1.7 mg or 2.4 mg) subcutaneously once weekly for 72 weeks." SURMOUNT-5 reported that "the least-squares mean percent change in weight at week 72 was -20.2%" with tirzepatide and "-13.7%" with semaglutide.

Those semaglutide doses are Wegovy's. Ozempic's pen stops at 2 mg, and neither trial tested Ozempic, so neither result tells you what Ozempic does for weight.

What each costs self-pay

Read from each manufacturer's own pharmacy page:

Dose	Ozempic (Novo Nordisk, NovoCare Pharmacy)	Zepbound (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	2.5 mg: starting at $299 a month
Next dose	1 mg: $349	5 mg: starting at $399 a month
Higher doses	2 mg: $499	7.5 mg to 15 mg: starting at $449 a month "when you refill within 45 days"

Lilly's $449 depends on refilling on time. Its own terms: "Regular prices will apply if prescription is not refilled within 45 days ($499 for 7.5mg, $699 for 10mg, $699 for 12.5mg, and $699 for 15mg)." Lilly defines a month as 28 days. Zepbound comes as single-dose vials, a single-dose pen and a multi-dose KwikPen; the self-pay prices above are Lilly's for the vial and the KwikPen.

For weight loss specifically, the like-for-like price comparison is Zepbound against Wegovy, which Novo sells self-pay at $349 a month for its standard pen doses.

Insurance and Medicare

What each manufacturer says:

• Ozempic. Novo's copay offer requires a prescription "for an FDA-approved indication within Ozempic's labeling," which a weight-loss prescription is not.
• Zepbound with commercial insurance. Lilly's card lets eligible patients "Pay as low as $25" "per month for up to a 3-month prescription." Lilly excludes government beneficiaries, which it says include "any state, federal, or government funded healthcare program, like Medicaid, Medicare."
• Zepbound with Medicare. Lilly's Medicare page describes the Medicare GLP-1 Bridge: "the Medicare GLP-1 Bridge program allows you to access select weight loss medicines for just $50 per month," with a "$50 cost to you after prior authorization (PA) approval." It covers "Zepbound (tirzepatide) Single-Patient-Use KwikPen for weight management," and "Zepbound Single-Dose Pen and Single-Dose Vial are not covered."

Our guide on getting Ozempic covers how to get a prescription and what online clinics charge for brand drugs.