Tirzepatide vs semaglutide
A head-to-head trial settled the results question. The price question goes the other way.
Updated 2026-09-18
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Two drugs, two weekly injections, one head-to-head trial and a consistent price gap in the opposite direction.
On results: SURMOUNT-5 compared the two drugs directly. Participants on tirzepatide lost an average of 50.3 lb (22.8 kg); those on semaglutide lost 33.1 lb (15.0 kg). On price: semaglutide is cheaper nearly everywhere on our board, with a floor around $149 a month against $199 for tirzepatide.
What the trials found
Tirzepatide. In SURMOUNT-1, adults with obesity lost an average of 19.5% of body weight on 10 mg and 20.9% on 15 mg over 72 weeks.
Semaglutide. In STEP-1, adults on 2.4 mg lost an average of about 14.9% of body weight over 68 weeks.
Both figures come from controlled trials with structured support behind them. Real-world results are more variable, and people who stop taking either drug generally regain a substantial share of the weight.
How they work
Tirzepatide — A single weekly injection that activates two gut hormone receptors, GIP and GLP-1, rather than one. Sold as Zepbound and Mounjaro by Eli Lilly.
Semaglutide — A weekly injection that activates the GLP-1 receptor, slowing stomach emptying and reducing appetite signalling. Sold as Wegovy and Ozempic by Novo Nordisk.
Side by side
| Tirzepatide | Semaglutide | |
|---|---|---|
| Dose ladder | 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg | 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg |
| Board floor | $199/mo | $149/mo |
| Board ceiling | $449/mo | $297/mo |
| Brand self-pay | $299–$499/mo | $199–$349/mo |
Side effects
Tirzepatide: Nausea, diarrhoea, constipation and reflux, concentrated in the weeks after each dose increase.
Semaglutide: Nausea, vomiting, diarrhoea and constipation, usually worst in the first weeks and after dose increases.
For both, trouble clusters in the fortnight after a dose increase — an argument for a slower ladder even where a programme offers a faster one.
The call
Budget-bound: semaglutide, which still produced about 15% average weight loss in its trials. Chasing the largest average result and able to absorb the difference: tirzepatide. Either way it is a decision for the clinician writing the prescription — both drugs carry contraindications a questionnaire will not always catch.
The boards
| Programme | Advertised | Billed | Gap | Vs board floor |
|---|---|---|---|---|
| Coreage Rx | $149 | $199 | +$50 | +$74/mo |
| Trimi | $125 | $125 | none | — |
| Ozari Health | $125 | $125 | none | — |
| Fifty 410 | $133 | $133 | none | +$8/mo |
| PlexusDx | $129 | $189 | +$60 | +$64/mo |
| Ivím Health | $199 | $199 | none | +$74/mo |
| Programme | Advertised | Billed | Gap | Vs board floor |
|---|---|---|---|---|
| Coreage Rx | $99 | $149 | +$50 | +$63/mo |
| Ozari Health | $86 | $86 | none | — |
| Trimi | $99 | $99 | none | +$13/mo |
| Zealthy | $151 | $151 | none | +$65/mo |
| Mochi Health | $99 | $178 | +$79 | +$92/mo |
| Hims & Hers | $79 | $188 | +$109 | +$102/mo |
More from the desk
- Cheapest right now
Every programme sorted on what it bills, not what it advertises. Floor: $199/mo tirzepatide, $149/mo semaglutide.
- Six fee traps
Every advertised-to-billed gap on our board comes from one of these six structures. Learn them and you can read any of these sites in ninety seconds.
- Best value on the board
Cheapest is one question. Best value — where the money buys something — is another.
- The compounding rules
Cheap GLP-1s exist because of compounding. The FDA moved against it again in April. What that means for the board.
- Where the traps are
The biggest advertised-to-billed gaps on our board, and the programmes charging most for the same category of medication.