In SURMOUNT-5, the only randomized head-to-head trial between the molecules, tirzepatide produced about 20.2% mean body-weight reduction at 72 weeks against 13.7% for semaglutide. Divide each by its cheapest tracked first-year cost and tirzepatide costs about $118 per percentage point against about $87 for semaglutide.
On that metric semaglutide is the better buy and tirzepatide is the better drug. Which matters more depends on whether your constraint is the result or the budget — and on the fact that the cheaper molecule you can sustain for two years beats the better one you abandon in month five.
| Tirzepatide | Semaglutide | |
|---|---|---|
| Mean weight reduction at 72 weeks (SURMOUNT-5) | 20.2% | 13.7% |
| Cheapest tracked all-in monthly price | $199 | $99 |
| Cheapest tracked first-year cost | $2,388 | $1,188 |
| Cost per percentage point | $118 | $87 |
| Oral formulation | None approved | Yes |
| Cardiovascular outcome evidence | Accumulating | Longer and larger |
Why this metric is worth computing
Every comparison of these two molecules quotes the same two percentages and then argues about them. Almost none divides by what each costs. Doing so turns an argument about potency into an arithmetic question you can answer for your own budget: what am I paying per unit of the outcome I actually want?
Where the metric breaks down
Three places, and they matter. It treats a trial mean as if it were your result, when individual response varies widely around both figures. It assumes you reach and hold an adequate maintenance dose of whichever molecule you choose. And it ignores tolerance entirely — a molecule you cannot take at an effective dose has an infinite cost per percentage point regardless of what the table says.
The coverage override
If insurance covers one molecule and not the other, coverage beats every figure above. A covered prescription at a modest copay wins on cost per percentage point by a margin no cash comparison can close. Coverage tracks the indication written on the prescription rather than the molecule itself, so a documented diagnosis of type 2 diabetes or obstructive sleep apnea is worth more than any shopping around.
How to use this if you are deciding
Take the annual difference between the two at your expected maintenance dose, set it against roughly six percentage points of your own starting body weight, and decide whether that trade is worth it to you. That is the decision stated honestly. Anyone telling you one molecule is simply better is answering a different question than the one you are asking.
Tirzepatide vs Semaglutide: Cost Per Percentage Point of Weight Lost: the shortest useful summary
Tirzepatide is a once-weekly injection titrated from 2.5 mg to a 15 mg ceiling in 2.5 mg steps at intervals of at least four weeks, producing roughly 15 to 21% mean weight reduction across the studied maintenance arms at 72 weeks and about 20% against semaglutide's 14% in the only head-to-head trial. It works while it is taken; the withdrawal evidence shows substantial regain after stopping. Compounded preparations cost from $133 a month and are not FDA-approved; brand product is approved and costs considerably more.
Those five facts decide most questions people arrive with. Everything else on this page is detail underneath them — which is worth reading before you spend $2,388 on a first year, but not worth confusing with the outline.
Tirzepatide vs Semaglutide: Cost Per Percentage Point of Weight Lost: where to go next
If you have not chosen a program, price your expected maintenance dose with the projector rather than reading advertisements. If you have, check what it charges at 10 mg against the price-by-dose table. If you are struggling with side effects, the side-effect reference covers each one with reported frequencies and the red flags that need a clinician. And if a program has refused to name its pharmacy, the verification walkthrough explains why that single answer outranks any price difference.
People also ask about tirzepatide vs semaglutide cost
What is tirzepatide vs semaglutide cost?
Tirzepatide vs semaglutide cost is covered in full on this page, with the clinical detail drawn from the tirzepatide prescribing information and the published SURMOUNT and SURPASS trial program, and any price figures drawn from our tracked dataset and dated to their last verification.
Does tirzepatide vs semaglutide cost apply to compounded tirzepatide as well as Zepbound?
The molecule is the same, so the clinical content applies to both. What differs is regulatory status, dose metering and price: compounded preparations are not FDA-approved, arrive as a multi-dose vial you measure yourself, and cost a fraction of the brand routes.
How much does tirzepatide vs semaglutide cost cost per month in 2026?
Compounded tirzepatide runs from $133 per month at the entry dose across the 21 compounded programs we track. At a 10 mg maintenance dose the cheapest tracked route is Oak Longevity at $199 per month, or about $2,388 for a first year on the standard escalation. Brand Zepbound through manufacturer self-pay sits well above that and pharmacy retail well above again. Verified 2026-08-05.
Is tirzepatide vs semaglutide cost FDA-approved?
Brand tirzepatide (Zepbound and Mounjaro) is FDA-approved. Compounded tirzepatide is not: FDA does not approve compounded drugs and does not review them for safety, effectiveness or quality before they are marketed. The active molecule is the same; the regulatory review is not.
Sources
- US prescribing information for tirzepatide (Zepbound and Mounjaro), Eli Lilly and Company.
- SURMOUNT-1 — tirzepatide once weekly for the treatment of obesity, NCT04184622.
- SURMOUNT-5 — tirzepatide versus semaglutide in adults with obesity, NCT05822830.
- US Food and Drug Administration, human drug compounding — compounded drugs are not FDA-approved and are not reviewed by FDA for safety, effectiveness or quality before marketing.
- Program pricing as recorded in our open dataset, with a verification date on every record.