Semaglutide vs Tirzepatide: Cost Without Insurance and Results Compared (2026)
What semaglutide and tirzepatide cost without insurance in 2026, brand and compounded, by dose, and what the head-to-head trial showed for weight loss.
Educational content · Not medical advice · Provider evaluation required for any treatment
Disclosure: Anabolic Insights publishes this page and sells compounded semaglutide and tirzepatide, so we have a financial interest. Brand prices were checked on the manufacturers' sites and TrumpRx.gov on October 11, 2026.
Without insurance, brand tirzepatide (Zepbound) costs $299 to $449 a month depending on dose, and brand semaglutide (Wegovy) costs $349 a month for most pen doses or $149 to $299 a month for the pill. In the only head-to-head trial, tirzepatide produced more weight loss: an average of 20.2% of body weight at 72 weeks, versus 13.7% with semaglutide (Aronne et al., N Engl J Med 2025).
Compounded versions through Anabolic Insights start at $159 per vial for semaglutide and $199 per vial for tirzepatide. Compounded drugs are not FDA-approved.
The short answer
- Brand prices depend on dose. Zepbound rises from $299 to $449 as the dose goes up, and late refills cost up to $699. Wegovy pens are a flat $349 except the 7.2 mg dose ($399).
- Compounded is a different product. It isn't FDA-approved, it wasn't the drug tested in the trials below, and how long a vial lasts depends on your prescribed dose.
- Tirzepatide won the head-to-head. Side effects were mostly stomach-related and similar between the two.
Semaglutide vs tirzepatide at a glance
| Semaglutide, brand (Wegovy) | Tirzepatide, brand (Zepbound) | Compounded semaglutide at Anabolic Insights | Compounded tirzepatide at Anabolic Insights | |
|---|---|---|---|---|
| Price without insurance | Pen: $349/month ($199 for first 2 months for new patients; $399 for 7.2 mg). Pill: $149 to $299/month | Vial or KwikPen: $299 to $449/month with on-time refills; up to $699 if a refill is late | $159 (0.5 mL), $199 (1 mL), $249 (2 mL) per 5 mg/mL vial | $199 (1 mL), $299 (2 mL), $399 (3 mL), $499 (4 mL) per 10 mg/mL vial |
| Does price change with dose? | Pen: only the 7.2 mg dose costs more. Pill: yes | Yes | Higher doses use a vial faster | Higher doses use a vial faster |
| What's included | 1 box of 4 pens (or 30 tablets) per month; prescription and provider visit not included | 4 vials or 1 KwikPen per 28 days; needles or syringes bought separately; provider visit not included | Provider review (no fee), medication if prescribed, free shipping; no membership | Provider review (no fee), medication if prescribed, free shipping; no membership. Formulated with glycine and B12 |
| Dose schedule | Pen once weekly or pill once daily; dose raised in steps per the label | Once weekly; dose raised in steps per the label | Once weekly, as prescribed | Once weekly, as prescribed |
| Time to full dose | Several months of step-ups | Up to 20 weeks of step-ups in SURMOUNT-1 | Set by your provider | Set by your provider |
| Average weight loss in trials | 14.9% at 68 weeks (STEP-1); 13.7% in SURMOUNT-5 | 20.9% at 72 weeks on 15 mg (SURMOUNT-1); 20.2% in SURMOUNT-5 | Not studied in these trials | Not studied in these trials |
| Provider review | Your own clinician or a telehealth service writes the prescription | Your own clinician or a telehealth service; LillyDirect links to independent telehealth partners | A licensed provider reviews every request; prescribed only if appropriate | A licensed provider reviews every request; prescribed only if appropriate |
| FDA status | FDA-approved | FDA-approved | Not FDA-approved; prepared by a state-licensed compounding pharmacy | Not FDA-approved; prepared by a state-licensed compounding pharmacy |
| Labs to consider | A1c, glucose, lipids, kidney and liver markers, B12 | Same | Same | Same |
For which labs and why, see GLP-1 blood work monitoring and B12 labs to check on a GLP-1.
Brand self-pay prices by dose
These are the manufacturers' own cash prices, for people paying without insurance. You still need a prescription.
Zepbound (tirzepatide), single-dose vial or KwikPen, through LillyDirect. One month is 28 days: four vials or one KwikPen.
| Dose | Self-pay price, on-time refills | If a refill is more than 45 days late |
|---|---|---|
| 2.5 mg | $299 | $299 |
| 5 mg | $399 | $399 |
| 7.5 mg | $449 | $499 |
| 10 mg | $449 | $699 |
| 12.5 mg | $449 | $699 |
| 15 mg | $449 | $699 |
Lilly says the $299 self-pay price applies to the KwikPen or vial, not the Zepbound single-dose pen. The single-dose pen is the version most insurance plans cover, and Lilly lists a $25 copay card for people whose commercial plan covers it.
Wegovy (semaglutide) through NovoCare Pharmacy.
| Form | Self-pay price |
|---|---|
| Pen, 0.25 mg or 0.5 mg, new patients | $199/month for the first 2 fills, through December 31, 2026 |
| Pen, 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg | $349/month |
| Pen, Wegovy HD 7.2 mg | $399/month |
| Pill, 1.5 mg | $149/month |
| Pill, 4 mg | $199/month |
| Pill, 9 mg or 25 mg | $299/month |
NovoCare lists Wegovy's list price at $1,349.02 per package. TrumpRx.gov shows Zepbound's wholesale acquisition cost as $1,087.
Ozempic and Mounjaro are approved for type 2 diabetes, not for weight management. For reference, TrumpRx.gov lists Ozempic at $199 for the first two monthly fills of 0.25 mg or 0.5 mg, then $349 a month for 0.25 mg to 1 mg and $499 for 2 mg. It lists Mounjaro at $499 a month through LillyDirect.
What is TrumpRx.gov?
TrumpRx.gov is a federal website that lists drug makers' self-pay prices, which it calls Presidential deals. For these four drugs, the prices it shows match the manufacturers' own programs. Zepbound and Mounjaro orders are routed to LillyDirect, while Wegovy and Ozempic use a coupon at a retail pharmacy. It's a way to find the price, not a separate, cheaper source.
Compounded semaglutide and tirzepatide at Anabolic Insights
| Medication | Vial size and price |
|---|---|
| Compounded semaglutide, 5 mg/mL | 0.5 mL $159, 1 mL $199, 2 mL $249 |
| Compounded tirzepatide with glycine and B12, 10 mg/mL | 1 mL $199, 2 mL $299, 3 mL $399, 4 mL $499 |
Our product pages label these vials as 30-, 60-, 90- and 120-day supplies, but how long a vial lasts depends on the dose your provider prescribes. At higher doses, a vial runs out sooner. These are one-time purchases with no membership. A licensed provider reviews every request, and medication is prescribed only if the provider decides it's appropriate.
Compounded medications are not FDA-approved. They're prepared by a state-licensed compounding pharmacy pursuant to a valid prescription for an individual patient. They aren't the same products as Wegovy, Ozempic, Zepbound or Mounjaro.
What the FDA has said, in its own words:
- Shortages are over. The FDA determined the tirzepatide injection shortage was resolved (most recently on December 19, 2024) and the semaglutide injection shortage was resolved on February 21, 2025 (FDA, April 2026).
- Not reviewed before sale. "Compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed" (FDA).
- Approved drugs first. The same FDA page says compounded drugs "should only be used in patients whose medical needs cannot be met by an FDA-approved drug." Your provider weighs this for your situation.
Which produced more weight loss?
Head-to-head: SURMOUNT-5. 751 adults with obesity but without type 2 diabetes got the highest dose they could tolerate of tirzepatide (10 or 15 mg) or semaglutide (1.7 or 2.4 mg), once weekly for 72 weeks. Average weight loss was 20.2% with tirzepatide and 13.7% with semaglutide. Waist size fell by 18.4 cm versus 13.0 cm. The trial was open-label and funded by Eli Lilly, which makes Zepbound (Aronne et al., N Engl J Med 2025).
Semaglutide vs placebo: STEP-1. Semaglutide 2.4 mg weekly produced an average 14.9% weight loss at 68 weeks, versus 2.4% with placebo (Wilding et al., N Engl J Med 2021).
Tirzepatide vs placebo: SURMOUNT-1. At 72 weeks, average weight loss was 15.0% on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg, versus 3.1% with placebo (Jastreboff et al., N Engl J Med 2022).
The Wegovy pill: OASIS 4. Oral semaglutide 25 mg daily produced an average 13.6% weight loss at 64 weeks, versus 2.2% with placebo (Wharton et al., N Engl J Med 2025).
Separate trials enrolled different people, so their numbers aren't directly comparable. SURMOUNT-5 is the cleanest comparison because both drugs were tested in one trial. These are averages, and results vary.
Side effects and stopping treatment
Stomach side effects were the most common with both drugs and were mostly mild to moderate, mainly while the dose was being raised. In SURMOUNT-5's posted results, nausea affected 44% on tirzepatide and 44% on semaglutide, diarrhea 24% and 23%, constipation 27% and 28%, and vomiting 15% and 21% (ClinicalTrials.gov NCT05822830).
In STEP-1, 4.5% stopped semaglutide because of stomach side effects, versus 0.8% on placebo. In SURMOUNT-1, side effects led 4.3% to 7.1% to stop tirzepatide, depending on dose, versus 2.6% on placebo.
Both brand labels warn that the drugs caused thyroid tumors in rodents. Neither should be used by anyone with a personal or family history of medullary thyroid carcinoma or MEN 2.
Lean mass: not all the weight is fat
In a body-composition substudy of SURMOUNT-1, about 75% of the weight lost on tirzepatide was fat and about 25% was lean mass, the same split seen with placebo (Look et al., Diabetes Obes Metab 2025). Across GLP-1 trials, the lean share has varied widely, and lean mass includes organs and water as well as muscle (Neeland et al., Diabetes Obes Metab 2024). Resistance training and enough protein matter. More in GLP-1 muscle preservation.
Where brand-name is the better choice
- It's the drug that was studied. Every trial number on this page comes from the manufacturers' products, not compounded versions.
- It's FDA-approved, with FDA review of safety, effectiveness and manufacturing quality.
- Extra approved uses. Wegovy is approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight. Zepbound is approved for moderate-to-severe obstructive sleep apnea with obesity.
- A pill option. If you don't want injections, the Wegovy pill starts at $149 a month.
- A lower start for new Wegovy patients, at $199 a month for the first two fills.
- Insurance. If your plan covers it, a copay card can bring the cost down to as little as $25 a month.
Where compounded may fit
- A lower price to start, from $159 a vial for semaglutide and $199 for tirzepatide.
- Provider review included at no fee, with free shipping and no membership. With brand self-pay, the visit with a prescriber is usually a separate cost.
- The trade-offs: it isn't FDA-approved, it wasn't the product tested in trials, and your cost rises as your dose goes up. A licensed provider decides whether it's appropriate for you. For how our tirzepatide process works, see tirzepatide online, physician-reviewed. For how we compare to another telehealth service, see Anabolic Insights vs Ro.
Labs to consider before and during treatment
A baseline lets you see what actually changed besides the scale. Common markers include A1c, fasting glucose and insulin, a lipid panel, a CMP for kidney and liver function, and B12. At Quest through Anabolic Insights, a CMP is $7, a lipid panel is $10, and the Monitoring Panel (A1c, insulin, lipids, ApoB, GGT, cystatin C and more) is $140, with no lab or draw fee. Draws are at a Quest, LabCorp or BioReference patient service center, and results typically take 7 to 14 days. Results are educational and don't replace your provider's evaluation.
FAQs
How much does semaglutide cost without insurance in 2026?
Brand Wegovy from NovoCare Pharmacy is $349 a month for pen doses from 0.25 mg to 2.4 mg, $399 for the 7.2 mg dose, and $199 for the first two months for new patients. The Wegovy pill is $149 to $299 a month depending on dose. Compounded semaglutide through Anabolic Insights starts at $159 a vial and is not FDA-approved.
How much does tirzepatide cost without insurance in 2026?
Zepbound vials or KwikPen from LillyDirect are $299 at 2.5 mg, $399 at 5 mg and $449 at 7.5 mg to 15 mg if you refill within 45 days. Late refills cost $499 to $699 at the higher doses. Compounded tirzepatide through Anabolic Insights starts at $199 a vial and is not FDA-approved.
Is tirzepatide more effective than semaglutide?
In the SURMOUNT-5 head-to-head trial, people on tirzepatide lost an average of 20.2% of their body weight at 72 weeks, versus 13.7% on semaglutide. Individual results vary.
Is TrumpRx cheaper than buying from the manufacturer?
For Wegovy, Ozempic, Zepbound and Mounjaro, the prices on TrumpRx.gov match the manufacturers' self-pay programs. Zepbound and Mounjaro orders still go through LillyDirect, and you still need a prescription.
Can I switch from semaglutide to tirzepatide?
People do switch, but the starting dose and timing are your prescriber's call. Don't change medications or doses on your own.
Is compounded semaglutide or tirzepatide the same as Wegovy or Zepbound?
No. Compounded versions are not FDA-approved and weren't tested in the trials behind the brand drugs. They're prepared by a state-licensed compounding pharmacy for an individual patient with a valid prescription.
How we compared
We checked brand prices on October 11, 2026, on NovoCare's Wegovy pricing page, Lilly's Zepbound savings and self-pay terms pages, and TrumpRx.gov. FDA statements come from fda.gov, and our prices from our live product pages on the same date. Trial results come from the papers below and, for side-effect rates, from ClinicalTrials.gov. Prices and programs change, so check before you buy.
References
- Aronne LJ, Horn DB, le Roux CW, et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025;393(1):26–36.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002.
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205–216.
- Wharton S, Lingvay I, Bogdanski P, et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity. N Engl J Med. 2025;393(11):1077–1087.
- Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720–2729.
- Neeland IJ, Linge J, Birkenfeld AL. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes Obes Metab. 2024;26 Suppl 4:16–27.
- ClinicalTrials.gov. SURMOUNT-5, NCT05822830: posted results.
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize.
- U.S. Food and Drug Administration. FDA's concerns with unapproved GLP-1 drugs used for weight loss.
- NovoCare. Wegovy pricing.
- Eli Lilly. Zepbound savings and coverage and Zepbound self-pay terms.
- TrumpRx.gov. Zepbound, Wegovy, Wegovy pill, Ozempic, Mounjaro.