Comparisons

Verified April 2026: Ozempic and Wegovy are both semaglutide from Novo Nordisk. Ozempic ($1,028/mo list) is approved for type 2 diabetes at max 2mg. Wegovy ($1,349/mo list) is approved for weight loss at max 2.4mg (or 7.2mg HD). Both drop to $349/mo self-pay via NovoCare.

Mounjaro (tirzepatide) and Ozempic (semaglutide) are both FDA-approved only for type 2 diabetes, neither is approved for weight loss (that's their sister brands, Zepbound and Wegovy). In the first head-to-head trial, SURMOUNT-5, tirzepatide beat semaglutide for weight loss (−20.2% vs −13.7% over 72 weeks), and in SURPASS-2 tirzepatide cut A1C more. But Ozempic's semaglutide has the SELECT cardiovascular outcome data Mounjaro doesn't. Here's the data-driven breakdown, plus the cheaper cash-pay paths if your insurance says no.

As of 2026, two FDA-approved oral GLP-1 pills exist for weight loss: Foundayo (orforglipron, 12.4% weight loss, $149/mo self-pay via LillyDirect, no fasting needed, approved April 1) and the Wegovy pill (semaglutide 25mg, 16.6% weight loss, $1,349/mo list price, requires 30-min fast before dosing, approved December 2025). Rybelsus is oral semaglutide but approved for type 2 diabetes only, not weight loss.

Updated June 2026: SURMOUNT-5 head-to-head trial (NEJM): Zepbound 20.2% vs Wegovy 13.7% weight loss at 72 weeks. Wegovy HD (7.2mg, FDA-approved March 2026) closes the gap at 20.7%. Wegovy self-pay: $349/mo (NovoCare). Zepbound self-pay: $299-$449/mo (LillyDirect). Both $25/mo with commercial insurance + savings card.

Updated June 16, 2026: CVS Caremark removed Foundayo's new-to-market block June 1 (~25–30M commercial lives can now be covered); Zepbound becomes co-preferred Oct 1; Medicare GLP-1 Bridge covers Foundayo at $50/mo from July 1. Verified IQVIA launch data runs through Week 3 (1,390 → 3,707 → 5,612 Rx); later weeks are competing analyst estimates (Citi ~16,000 vs Jefferies ~11,700 for late May) that undercount telehealth. Oral Wegovy produces 16.6% weight loss vs Foundayo's 12.4%; Foundayo starts at $149/mo self-pay with no fasting requirement.

IvyRx offers compounded semaglutide from $175/month and tirzepatide from $275/month with a rare flat-rate model, your price never increases as your dose goes up. We reviewed their pricing, clinical oversight, and transparency. Key finding: the flat-rate pricing is genuinely valuable, but IvyRx doesn't publicly disclose a named medical director or their compounding pharmacy partners, which are meaningful gaps for patients who want to verify clinical quality.

Verified April 2026: Zepbound and Mounjaro are the exact same drug (tirzepatide) at the same doses. Mounjaro was FDA-approved May 2022 for Type 2 diabetes. Zepbound was FDA-approved November 2023 for chronic weight management and December 2024 for obstructive sleep apnea. List price is ~$1,087/mo for both; with commercial insurance + savings cards both drop to $25/mo (max $1,950/yr). The real differences: which one your insurance covers, what the FDA label allows, and Zepbound's LillyDirect self-pay vials at $299-$449/mo, a program Mounjaro does not offer.

Verified April 2026: Oral Wegovy (25mg daily pill) produces 16.6% weight loss per the OASIS trial vs 14.9% for injectable Wegovy (2.4mg weekly) per STEP-1. Pill costs $1,349/mo list vs $349/mo self-pay for the injection through NovoCare. Full head-to-head comparison.

Verified April 2026: Tirzepatide produces 20.2% weight loss vs semaglutide's 13.7% in the head-to-head SURMOUNT-5 trial (NEJM). Tirzepatide activates GLP-1 + GIP dual receptors; semaglutide activates GLP-1 only. Tirzepatide costs $449/mo vs $349/mo self-pay. Full comparison.

Two of the biggest telehealth platforms now offer branded Wegovy and GLP-1 programs. We compare Ro and Hims on pricing, medications, insurance, clinical support, and what actually changed after the Novo Nordisk lawsuit.