Wegovy vs. Mounjaro: The Verdict, the Price, and the FDA Catch

Is Mounjaro stronger than Wegovy for weight loss?

The clearest answer comes from SURMOUNT-5, a trial published in the New England Journal of Medicine in May 2025. It is the only study that has tested the two drugs against each other. It followed 751 adults with obesity and no diabetes for about a year and a half.

Each person took the highest dose they could tolerate. Tirzepatide, the drug in Mounjaro, led to an average weight loss of about 20%. Semaglutide, the drug in Wegovy, led to about 14%. More people on tirzepatide reached each goal the researchers tracked, from 10% up to 25% of body weight. Their waistlines also shrank more. There was no placebo group, and everyone knew which drug they were taking.

One detail dates that result. The trial stopped semaglutide at 2.4 mg, Wegovy's top dose at the time. In March 2026, the FDA approved Wegovy HD, a 7.2 mg dose. In its own trial, called STEP UP, people on 7.2 mg lost about 19% of their weight on average. People on a placebo, a dummy shot, lost about 4%.

That narrows the gap, but it does not settle it. The two numbers come from different trials with different people. No study has yet tested tirzepatide against the 7.2 mg dose. The higher dose is also a next step, not a starting point. It is meant for people who have taken 2.4 mg for at least four weeks and still need to lose more. Stomach side effects were more common at 7.2 mg than at 2.4 mg.

These are trial averages, not a promise. Your own result depends on your dose, how steadily you take it, and your body. Tirzepatide still holds the only direct win. The newer Wegovy dose questions the size of that lead, not whether it exists.

Wegovy vs. Mounjaro cost: which is cheaper, with or without insurance?

Paying cash through the makers, Wegovy costs less than Mounjaro at every dose. Its approval for weight loss also gives it an easier insurance path. Compounded versions can cost less, but not always, and they are not the FDA-approved drugs. The table above lines up the prices. Here is what sits behind each one.

Without insurance: NovoCare for Wegovy, LillyDirect for Mounjaro

Novo Nordisk, the maker of Wegovy, sells it directly through NovoCare. The pen costs about $350 a month at every standard dose. The 7.2 mg dose costs about $400. New patients pay about $200 for each of their first two fills at the lowest doses. That offer ends December 31, 2026. You can get it by mail or pick it up at a local pharmacy.

The Wegovy pill has its own prices. It starts at about $150 a month at the lowest dose. It rises to about $300 a month at the two highest doses.

Eli Lilly, the maker of Mounjaro, now sells it to cash payers through LillyDirect. It costs about $500 a month at every dose, and you need a prescription. That is about $150 more than the Wegovy pen.

Zepbound has the same drug as Mounjaro, and it is approved for weight loss. LillyDirect sells it for about $300 to $450 a month, depending on the dose. From the 7.5 mg dose up, that price needs each refill within 45 days. Late refills cost about $500 to $700, which can top Mounjaro. The offer runs through December 31, 2026. Our Wegovy vs. Zepbound comparison covers that match-up.

With insurance: the two savings cards

This is where the approval gap shows most. Wegovy's savings card needs a commercial plan, meaning insurance through work or bought on your own, that covers Wegovy. Weight management is Wegovy's approved use, so a weight-loss prescription fits. You can pay as little as $25 a month. The card takes off at most $100 a month, so a high copay can leave you paying more.

If your plan does not cover Wegovy, the same offer still gets you the NovoCare self-pay price at the pharmacy. The card is not for Medicare or Medicaid. Wegovy savings walks through how to get it.

Mounjaro's card also starts at $25 a month. But it needs a plan that covers Mounjaro and a prescription that matches its label, which means type 2 diabetes. A chart that says only weight loss does not qualify. The card takes off up to $150 a month. It ends December 31, 2026. If your commercial plan does not cover Mounjaro at all, the card brings it to about $500, the same as LillyDirect.

Compounded tirzepatide vs. compounded semaglutide

Compounded drugs are custom-made by a pharmacy from the same active ingredient. They are not FDA-approved Mounjaro or Wegovy. Curex sells compounded tirzepatide with the visit, the medicine and shipping included, and no membership fee. Its lowest price, about $200 a month, needs a year paid upfront. Month to month, it costs about $250 for a tablet or about $300 for a shot, and more at higher doses.

Fridays sells compounded semaglutide for about $150 a month if you pay for a year upfront. Month to month, it costs about $280. Coaching and a dietitian are included.

Compounded is not always the cheapest choice. Month to month, Fridays costs more than the Wegovy pill at its two lower doses. Since the FDA shortages of both drugs ended, pharmacies may compound them only when a prescriber notes a medical reason for a custom version. Our guide to compounded GLP-1s explains the rules.

List price and GoodRx

The list price is what the maker charges before any discount. For Mounjaro, it is about $1,110 for a four-week box. A GoodRx coupon barely lowers it, to about $1,090. Wegovy's list price is about $1,350, but few people pay it. Novo plans to cut it to $675 on January 1, 2027. NovoCare's self-pay price is far lower either way.

What each option costs over a year

• Fridays compounded semaglutide: about $1,800 for a year paid upfront. Month to month, about $3,350.
• Curex compounded tirzepatide: about $2,390 for a year paid upfront at the lowest dose, about $3,590 at higher doses.
• Wegovy pen through NovoCare, first year: about $4,240, if you start before the offer ends December 31, 2026. That counts two starter fills at about $200, then 11 fills at about $350. A year holds 13 four-week boxes.
• Mounjaro through LillyDirect: about $6,490 a year, for 13 fills at about $500, at any dose.
• Mounjaro at list price: about $14,460 a year, at about $1,110 per four-week box.
• Either drug with insurance and a qualifying savings card: about $325 a year, at $25 a fill. Only Wegovy gets there with a weight-loss prescription alone.
• Mounjaro with a plan that won't cover it: about $6,490 a year with the savings card, the same as LillyDirect.

Wegovy and Mounjaro aren't approved for the same thing: does it matter?

Yes. It is the one fact that changes this comparison most. Wegovy has been FDA-approved for long-term weight management since 2021. In March 2024, it was also approved to lower heart risk in adults with heart disease and overweight or obesity. In August 2025, it was approved for MASH, a serious fatty liver disease, in adults with liver scarring.

In December 2025, the FDA approved a once-daily Wegovy pill. It was the first GLP-1 pill approved for weight management. Our page on Wegovy pills and patches compares the pill and the shot.

Mounjaro is approved only for people with type 2 diabetes. Since May 2022, it has been approved to lower blood sugar. Since August 2026, it is also approved to cut the risk of heart attack, stroke and heart-related death in adults with type 2 diabetes at high risk. It has no approval for weight loss. That belongs to Zepbound, Lilly's other brand of the same drug.

A doctor can still prescribe Mounjaro for weight loss. That is called off-label use, and it is legal and fairly common. But insurers pay by approved use, not by drug. A plan that covers Mounjaro for diabetes often denies it when the chart says only obesity.

Does insurance cover Wegovy or Mounjaro for weight loss?

Wegovy has the clear edge, because coverage follows the label. Many commercial plans with a weight-loss benefit will consider Wegovy. They usually ask first for prior authorization, a form where your prescriber shows you meet the plan's rules. Those rules often cover your BMI, a related health problem, and past diet efforts.

Mounjaro prescribed for weight loss alone is usually denied. Obesity is not one of its approved uses, however well the drug works. With a documented type 2 diabetes diagnosis, coverage is common, often after the same prior authorization step. Mounjaro savings covers the card and coverage rules.

Medicare draws the same line. Part D, Medicare's drug coverage, won't pay for Mounjaro for weight loss alone. Wegovy, as a pen or a pill, is part of the Medicare GLP-1 Bridge, a pilot running from July 1, 2026 to December 31, 2027. Members who meet its weight and health rules pay $50 a month.

The Bridge also covers the Zepbound KwikPen and Foundayo, Lilly's daily weight-loss pill. So on Medicare, the tirzepatide route runs through Zepbound, not Mounjaro.

What's the real difference between semaglutide and tirzepatide?

Semaglutide, the drug in Wegovy, acts on one gut hormone receptor, called GLP-1. It slows digestion and quiets hunger signals in the brain. Tirzepatide, the drug in Mounjaro, does the same GLP-1 work. It also acts on a second receptor, called GIP, which seems to add to the effect on appetite and blood sugar.

That second receptor is the leading explanation for the SURMOUNT-5 gap. Researchers are still sorting out how much comes from the receptor and how much from the doses tested. Our page on semaglutide vs. tirzepatide goes deeper into the science.

Wegovy vs. Mounjaro side effects: is one easier to tolerate?

Both drugs cause the same kind of stomach side effects, for the same reason. Slowing digestion is how they work. Nausea, vomiting, diarrhea and constipation are the most common. They tend to be worst in the weeks after a dose increase, then ease.

In SURMOUNT-5, stomach problems were the most common side effects in both groups, and most were mild to moderate. About 6% of people on tirzepatide stopped because of a side effect. On semaglutide, about 8% did. Many women still tolerate one drug better than the other, for reasons a trial average can't show.

One label point matters for women in their 40s. Mounjaro can make birth control pills work less well. Its label advises switching to a non-pill method, or adding a barrier method, for four weeks after starting and after each dose increase. For the full lists, see tirzepatide side effects and Wegovy side effects.

Which one is right for you? Verdict by profile

• You want insurance to cover weight loss: Wegovy. It is the one approved for weight management, and plans and savings cards are built around that.
• You want the strongest average result: Mounjaro's drug holds the only head-to-head win. Wegovy's 7.2 mg dose has narrowed the gap, so the edge is smaller than the trial headline.
• You pay cash and want a brand name: Wegovy. The pen costs about $350 a month through NovoCare, against about $500 for Mounjaro through LillyDirect.
• You pay cash and want the lowest price: the Wegovy pill starts around $150 a month, and Curex compounded tirzepatide around $250 month to month. Compare the price at the dose you will likely need.
• You have type 2 diabetes: let your coverage decide. If your plan covers Mounjaro, $25 a month is hard to beat.
• You had nausea on a GLP-1 before: in SURMOUNT-5, slightly fewer people quit tirzepatide because of side effects. This varies a lot from person to person.
• Needles are a hard no: the Wegovy pill is the only pill between the two. See Wegovy pills and patches.
• You are on Medicare: Wegovy, through the $50 Medicare GLP-1 Bridge. Mounjaro is not part of it.

Can you switch between Wegovy and Mounjaro?

Yes, and prescribers make this switch often. The usual reasons are a plateau, side effects, or an insurance change that makes one drug cheaper. There is no official dose conversion between semaglutide and tirzepatide. So your prescriber picks your starting dose on the new drug, often a low one. They will also time the change around your weekly shot.

Wegovy vs. Mounjaro for perimenopause and menopause weight gain

Weight often shifts during perimenopause. Falling estrogen can worsen insulin resistance, which means the body handles blood sugar less well. It also moves fat toward the belly. Both drugs help the body handle blood sugar and quiet appetite.

No head-to-head trial has looked at women in this stage, so there is no menopause-specific winner. For most women without type 2 diabetes, the real question is simpler. Does a drug approved for weight loss fit your situation and budget better than a diabetes drug used off-label? That is the gap this whole comparison comes back to. Our guide to GLP-1s in perimenopause covers the bigger picture.