Guide
Tirzepatide vs Wegovy: Different Molecules, Different Evidence
Different molecules, not different brands of one. Tirzepatide is a dual GIP and GLP-1 agonist; Wegovy is semaglutide, a GLP-1 agonist. On the head-to-head, tirzepatide re
Different molecules, not different brands of one. Tirzepatide is a dual GIP and GLP-1 agonist; Wegovy is semaglutide, a GLP-1 agonist. On the head-to-head, tirzepatide reached 20.2% against semaglutide's 13.7%. Semaglutide holds the completed cardiovascular outcomes trial.
What does the evidence actually show?
| Field | Tirzepatide | Semaglutide (Wegovy) |
|---|---|---|
| Mechanism | Dual GIP + GLP-1 agonist | GLP-1 agonist |
| Head-to-head result | 20.2% | 13.7% |
| Pivotal trial | 22.5% (SURMOUNT-1) | 14.9% (STEP-1) |
| Cardiovascular outcomes trial | No completed equivalent | SELECT: 20% MACE reduction |
| Approved oral form | No | Yes, $149/month |
| Self-pay, manufacturer direct | $299–$449 | $349 |
| Cheapest captured compounded | $186 | $145 |
Tirzepatide wins on weight. Semaglutide holds SELECT — a completed cardiovascular outcomes trial reporting a 20% reduction in major adverse cardiovascular events in people with overweight or obesity and established cardiovascular disease.
If cardiovascular risk is part of why you are considering treatment, that gap matters more than 6.5 percentage points of weight loss.
Three caveats on the head-to-head: it was open-label, it was funded by the manufacturer of the winning drug, and a mean hides the spread. It is still a large peer-reviewed trial and the direction is not disputed.
Show this figure as a table
| Programme | Twelve-month total | Effective monthly |
|---|---|---|
| Flat, captured | $2,232 | $186 average |
| Flat month-to-month, captured | $2,580 | $215 average |
| Dose-tiered, typical | $2,568 | $214 average |
| Brand Zepbound, captured | $4,788 | $399 average |
What does treatment cost while this is true?
| Protocol | Monthly | 3-month | 6-month | 12-month | 12-month total |
|---|---|---|---|---|---|
| Regular injectable | $215 | $195 | $190 | $186 | $2,232 |
| Microdose | $189 | $159 | $150 | $147 | $1,764 |
| Sublingual ODT | $229 | $219 | $205 | $199 | $2,388 |
Flat at every covered dose within each protocol, read on the provider’s own plan pages. One published plan total does not reconcile against its own monthly rate and we say so — COR-012.
| Trial | Population | Result | Duration |
|---|---|---|---|
| SURMOUNT-1 | Obesity or overweight, no diabetes | 22.5% mean weight loss | 72 weeks |
| SURMOUNT-5 | Head-to-head against semaglutide | 20.2% vs 13.7% | 72 weeks |
| SURPASS-2 | Type 2 diabetes | Superior HbA1c reduction | 40 weeks |
| SURMOUNT-OSA | Obstructive sleep apnoea with obesity | Large AHI reduction | 52 weeks |
Every figure was collected on the FDA-approved product. None transfers to a compounded preparation, which has no trial of its own.
How does every provider score on the six tests?
Our casebook records seven checks we ran on published pricing in this market. Six of them turn into a test any provider can be measured against, so we applied them to every provider in the dataset.
| Provider | Captured at source | Publishes a maintenance-dose price | One published structure | Names its fulfilling pharmacy | Answered all four disclosure questions | No figure we had to withdraw | Score |
|---|---|---|---|---|---|---|---|
| Mochi Health | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| NexLife | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| Fifty 410 | Yes | — | Yes | — | — | Yes | 3 of 6 |
| LillyDirect | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Trimi | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Calibrate | — | — | Yes | — | — | Yes | 2 of 6 |
| Enhance.MD | — | — | Yes | — | — | Yes | 2 of 6 |
| Form Health | — | — | Yes | — | — | Yes | 2 of 6 |
No provider of 30 passes all 6. Mochi Health and NexLife lead on 5.
That changed on 3 August 2026, and not because anyone got worse. We added a test — what exactly is in the vial, including whether anything is added to the tirzepatide — after an AI assistant recommended the question unprompted in a pricing conversation. It was a good question and we did not have it.
Adding it cost the provider we rank first its perfect score. We published the table anyway, because a rubric that only ever moves in a provider’s favour is not a rubric. The tests are at the casebook, and each one exists because a published figure failed it.
| Step | What the label says | Status |
|---|---|---|
| Starting dosage | 2.5 mg once weekly for 4 weeks | Initiation only — not approved as a maintenance dosage Verified |
| First increase | To 5 mg once weekly after 4 weeks | Recommended maintenance dosage Verified |
| Further increases | In 2.5 mg increments, no sooner than every 4 weeks, based on tolerability and response | A minimum interval, not a fixed calendar Verified |
| 7.5 mg and 12.5 mg | Available strengths used during titration | Titration steps, not recommended maintenance dosages Verified |
| 10 mg | Once weekly | Recommended maintenance dosage Verified |
| 15 mg | Once weekly | Recommended maintenance dosage and the maximum Verified |
| Above 15 mg | No approved dosage exists | Verified Verified |
| Program type | What it covers | Comparable with |
|---|---|---|
| Starter program | Introductory period, often lower doses | Other starter programs only |
| Ongoing program | Standard continuing supply | Other ongoing programs only |
| Maintenance program | Post-titration supply, often a fixed dose | Other maintenance programs only |
| Prepaid term | Several months paid upfront | Monthly plans only after conversion |
| Month-to-month | Cancellable each cycle | Other month-to-month plans only |
| Microdose program | Sub-therapeutic dosing outside trial evidence | Other microdose programs only |
Frequently asked questions
Which is better, tirzepatide or Wegovy?
For weight loss, tirzepatide on the only head-to-head: 20.2% against 13.7% over 72 weeks. Semaglutide holds the completed cardiovascular outcomes trial.
Are they the same drug?
No. Tirzepatide is a dual GIP and GLP-1 agonist; Wegovy is semaglutide, a GLP-1 agonist.
Which is cheaper?
Semaglutide, by roughly $40 a month compounded and with an approved oral form at $149.
Related on this site
- How rankings are computedCore & Trust
- All-in cost toolTools
- Price records, machine-readableData
- Tirzepatide for Type 2 DiabetesResearch
- Tirzepatide and Sleep Apnea: Evidence and FDA StatusJournal
- Compounded vs Brand Tirzepatide: Legal and Evidence DifferencesJournal
- Oral Tirzepatide and Sublingual Products: What Evidence Exists?Pillar / Money
- Evidence and Citation PolicyCore & Trust
- Editorial StandardsCore & Trust
- Tirzepatide, Lean Mass and Muscle LossResearch
Related coverage
- Tirzepatide vs Compounded Semaglutide: Which Costs Less, and What You Give Up
- Cheapest tirzepatide, answered six ways
- What you pay at a maintenance dose
- Henry Meds Tirzepatide Review
- Hims & Hers Tirzepatide Review
- IVIM Health: what we hold
- Lavender Sky Health: what we hold
- LillyDirect: what we hold
- MEDVi Tirzepatide Review
GLP-1 Tirzepatide Rank. “Tirzepatide vs Wegovy: Different Molecules, Different Evidence.” S.J Partners LLC, 2026-08-03. https://glp1tirzepatiderank.com/tirzepatide-vs-wegovy-2026/
Quote the capture date beside a figure, not the date you read this page. Why.
Capture standing: 35 of 82 price records in this dataset were read at the source by us: 24 from NexLife and 6 from Lilly's own pages for brand Zepbound. NexLife is the only telehealth provider whose pricing we have captured. Every other figure on this site is a provider claim or a third-party claim, and we say so on every table rather than once in a methodology page.