Tirzepatide (Mounjaro, Zepbound) and semaglutide (Ozempic, Wegovy) are two of the most effective medications available today for managing type 2 diabetes and supporting chronic weight loss. Both belong to the class of incretin mimetics, but tirzepatide acts as a dual GIP/GLP-1 receptor agonist while semaglutide targets only GLP-1 receptors. This difference contributes to variations in weight-loss outcomes, side-effect profiles, and—importantly for many patients—monthly and annual cost.
The price difference between the two drugs is one of the most common questions asked by people considering treatment or comparing options after insurance coverage or savings programs are applied. Costs can vary significantly depending on insurance status, pharmacy, location, dose, and whether the medication is obtained as a branded product or through a compounded formulation during shortages.
This article compares current list prices, real-world out-of-pocket costs with and without insurance, manufacturer savings programs, compounded alternatives, and other factors that affect what patients ultimately pay. All figures reflect typical 2025 pricing patterns in the United States.
List Prices for Branded Tirzepatide and Semaglutide
The manufacturer’s list price (wholesale acquisition cost) for both drugs is high, reflecting their status as newer, patent-protected biologics. Without any discounts or insurance, patients pay close to these amounts at the pharmacy counter.
Tirzepatide (Mounjaro or Zepbound) has a list price of approximately $1,060–$1,135 per four-week supply across all available doses (2.5 mg to 15 mg for Mounjaro; 2.5 mg to 15 mg for Zepbound). Semaglutide (Ozempic or Wegovy) carries a similar list price of about $1,000–$1,350 per month, depending on the pen strength and whether it is the diabetes (Ozempic) or weight-loss (Wegovy) formulation.
These are cash-pay prices before insurance, manufacturer coupons, pharmacy discounts, or patient assistance programs. Most insured patients never pay the full list amount, but the high starting point affects coinsurance, deductibles, and out-of-pocket maximums.
List Price Breakdown by Brand and Dose
- Mounjaro/Zepbound (all doses): ~$1,060–$1,135 per 4 weeks
- Ozempic (0.25–2 mg pens): ~$1,000–$1,100 per month
- Wegovy (all doses): ~$1,300–$1,350 per month
Prices are approximate and can vary slightly by pharmacy chain.
Insurance Coverage and Out-of-Pocket Costs
Private commercial insurance coverage varies widely. Some plans cover both drugs with similar copays or coinsurance after prior authorization, while others place one medication on a lower tier or require step therapy (trying metformin or another agent first). High-deductible plans can leave patients responsible for the full list price until the deductible is met.
Medicare Part D covers both drugs for diabetes (Ozempic/Mounjaro) but not for weight loss alone (Wegovy/Zepbound). After the deductible, most Part D plans place these medications in Tier 3 or 4, resulting in copays of $40–$100 per month or 25–50% coinsurance. The Inflation Reduction Act caps annual out-of-pocket spending on Part D drugs at $2,000 starting in 2025, which significantly reduces catastrophic costs for high-cost medications like these.
Medicaid coverage differs by state but generally includes both drugs for diabetes with low or no copays. Weight-loss coverage remains limited. Uninsured patients pay the full cash price unless they qualify for manufacturer patient assistance programs.
Typical Out-of-Pocket Costs After Insurance
- Commercial insurance (good coverage): $25–$100 copay/month
- Commercial high-deductible plan: $1,000–$3,000+ until deductible met
- Medicare Part D (after deductible): $40–$100 copay or 25–50% coinsurance
- Medicare Advantage: varies widely—some plans cap at $0–$50/month
- Uninsured: full list price ($1,000–$1,350/month)
Coverage and copays change frequently—check your plan documents or call member services.
Manufacturer Savings Cards and Patient Assistance Programs
Novo Nordisk (semaglutide) and Eli Lilly (tirzepatide) both offer savings cards for commercially insured patients. These cards reduce copays to as low as $25 per month for up to 12–13 fills per year, with maximum annual savings of $150–$225 per fill depending on the program.
Eligibility is limited to patients with private insurance (not Medicare, Medicaid, or other government plans) and no government-funded coverage for the medication. The cards cannot be combined with other discounts in most cases. Patients must activate the card online or through the pharmacy.
For uninsured or underinsured patients, both manufacturers offer patient assistance programs (PAPs) that provide the medication at no cost or very low cost to those who meet strict income guidelines (usually ≤400% of the federal poverty level). Application processes require proof of income, denial letters from insurance, and a prescription.
Savings Program Comparison
- Novo Nordisk Savings Card (Ozempic/Wegovy): $25 per fill, max 13 fills/year, commercial insurance only
- Eli Lilly Savings Card (Mounjaro/Zepbound): $25 per fill, max 12 fills/year, commercial insurance only
- Patient Assistance Programs: Free or very low cost for uninsured/underinsured, income ≤400% FPL, application required
These programs dramatically reduce costs for eligible patients.
Compounded Semaglutide and Tirzepatide During Shortages
When branded supply is limited, some patients turn to compounded versions of semaglutide or tirzepatide prepared by licensed compounding pharmacies. These are custom-made formulations (usually in vials) and cost significantly less—typically $200–$500 per month compared with $1,000+ for branded pens.
Compounded medications are not FDA-approved finished products. They do not undergo the same pre-market testing, batch-to-batch consistency checks, or post-market surveillance as branded drugs. The FDA has issued warnings about certain compounded semaglutide products containing impurities, incorrect concentrations, or unapproved salt forms (sodium or acetate instead of the base).
Despite these risks, many patients report similar weight-loss results and tolerability with compounded versions when sourced from reputable pharmacies. The lower cost and better availability during shortages make them a practical option for some.
Compounded vs Branded Cost and Considerations
- Branded: $1,000–$1,350/month (list), often $25–$100 with savings card
- Compounded: $200–$500/month, usually not covered by insurance
- Quality control: Branded has FDA oversight; compounded relies on pharmacy standards
- Availability: Compounded often more accessible during shortages
- Safety monitoring: Branded has continuous FDA surveillance; compounded has less
Compounded versions should only be used when prescribed by a licensed provider who has vetted the pharmacy.
Additional Costs Beyond the Medication Itself
Beyond the drug price, patients often face other expenses related to treatment. These include the cost of pen needles or syringes (for compounded versions), alcohol swabs, sharps containers, and follow-up visits with the prescribing clinician.
Telehealth platforms that prescribe semaglutide or tirzepatide may charge monthly membership fees ($50–$150) that cover consultations, messaging support, and prescription renewals. Some include the cost of lab work or body-composition scans, while others bill separately.
Insurance may cover office visits, labs, or nutritional counseling under medical benefits, but copays and deductibles apply. Uninsured patients pay full cash prices for these services unless they qualify for charity care or sliding-scale fees.
Additional Costs to Budget For
- Pen needles/syringes: $20–$50 per month
- Monthly telehealth fees (some platforms): $50–$150
- Follow-up visits or labs: $50–$300 per visit (varies with insurance)
- Sharps disposal container: $5–$20 one-time
- Nutritional counseling or dietitian visits: $100–$250 per session
These costs add up and should be factored into the overall budget.
Practical Tips for Reducing Costs
Use manufacturer savings cards whenever eligible—they can drop copays to $25 per month for up to 12–13 fills per year. Check eligibility on the official program websites and activate the card before filling the prescription.
Compare pharmacy prices even with insurance. Some chains or mail-order pharmacies offer lower cash prices or better copay assistance than others. During shortages, ask your provider about compounded options from reputable pharmacies.
Apply for patient assistance programs if you are uninsured or underinsured. Both Novo Nordisk and Eli Lilly offer free or low-cost medication to qualifying patients based on income. Application processes require documentation but can save thousands of dollars annually.
Cost-Saving Steps
- Activate manufacturer savings card if commercially insured
- Compare cash prices across pharmacies
- Apply for PAPs if uninsured or high out-of-pocket costs
- Ask about 90-day fills to reduce dispensing fees
- Check telehealth platforms for bundled pricing
These actions help lower the overall financial burden.
Conclusion
Tirzepatide and semaglutide carry similar list prices of approximately $1,000–$1,350 per month, but real-world costs vary widely depending on insurance coverage, manufacturer savings cards, pharmacy discounts, and whether compounded versions are used during shortages. With good commercial insurance and savings programs, many patients pay $25–$100 per month for either drug. Uninsured or high-deductible patients often face the full list price unless they qualify for assistance programs or choose compounded alternatives. This article is for informational purposes only and not medical advice. Medication costs and coverage change frequently—always verify current pricing and eligibility with your pharmacy, insurance provider, prescribing clinician, and the manufacturer savings program websites.
FAQ
Which is more expensive—tirzepatide or semaglutide?
List prices are very similar ($1,000–$1,350 per month for both). Real-world out-of-pocket costs depend more on insurance tier, savings cards, and whether compounded versions are used than on the drug itself.
Does insurance cover tirzepatide or semaglutide better?
Coverage varies by plan. Some insurers place one drug on a lower tier or require fewer prior-authorization steps than the other. Medicare Part D covers both for diabetes but not for weight loss alone. Check your specific plan details.
How much do manufacturer savings cards reduce the cost?
Both Novo Nordisk (semaglutide) and Eli Lilly (tirzepatide) savings cards reduce copays to as low as $25 per month for up to 12–13 fills per year for commercially insured patients. Maximum savings per fill are usually $150–$225.
Are compounded versions much cheaper?
Yes. Compounded semaglutide or tirzepatide typically costs $200–$500 per month compared with $1,000+ for branded pens. They are not covered by insurance and carry higher risks of variability and quality issues.
Can I get tirzepatide or semaglutide for free?
Yes, if you qualify for the manufacturer patient assistance programs (usually income ≤400% of federal poverty level and no other coverage). Applications require proof of income and prescription. Both companies offer these programs.
Why do some people pay $25/month while others pay over $1,000?
Patients with good commercial insurance and an activated savings card often pay $25 per month. Uninsured patients or those with high-deductible plans pay closer to list price unless they qualify for assistance programs or use compounded versions.
Does Medicare cover tirzepatide or semaglutide?
Medicare Part D covers both for type 2 diabetes (Ozempic/Mounjaro) but not for weight loss alone (Wegovy/Zepbound). After the deductible, copays are usually $40–$100 or 25–50% coinsurance. The 2025 out-of-pocket cap is $2,000.
Are there other costs besides the medication price?
Yes. Additional costs include pen needles/syringes ($20–$50/month), telehealth platform fees ($50–$150/month on some services), follow-up visits or labs ($50–$300), and sharps disposal. These add up over time.
How can I find the lowest price for tirzepatide or semaglutide?
Use manufacturer savings cards if commercially insured, compare cash prices across pharmacies, apply for patient assistance programs if uninsured, and ask about compounded options during shortages. Check with your provider for samples or bridge supplies.
Should I choose the cheaper option if one is covered better?
Coverage, not just price, should guide the decision. A drug covered at $50/month with insurance is usually better than a non-covered compounded version at $300/month. Discuss coverage and out-of-pocket maximums with your insurance provider.
Dr. Usman is a medical content reviewer with 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic health topics. His work is based on trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Usman is for educational purposes and does not replace professional medical advice.