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September 2026

Tirzepatide vs Semaglutide Cost: Compounded Markets and Brand Prices

What tirzepatide and semaglutide cost side by side: the compounded monthly markets computed from every seller that publishes a price, the brand self-pay prices from Lilly and Novo Nordisk, why a cost per milligram cannot compare the two, and what the one head-to-head trial found.

ByDerek MossPricing analystPublished

Compounded tirzepatide runs a typical $249 a month. Compounded semaglutide runs $189. That is $60 a month more for tirzepatide, median to median. Both figures count each seller once, at its lowest published month.

The compounded markets side by side

Compounded injection, per month, September 2026
TirzepatideSemaglutideTirzepatide vs semaglutide
Lowest published month$86$76$10 more
Typical (median) month$249$189$60 more
Sellers counted360380Each seller once, at its lowest month
Compounded injection, per month, September 2026. Computed from every seller that publishes a monthly price for compounded injection, the same rules as the price boards.

A median of lowest months says nothing about the dose behind each one. Each seller’s ladder is on the tirzepatide price board and the semaglutide price board.

Fees sit outside these figures too. The all-in monthly calculator adds consult and membership fees to any quote.

Why a price per milligram misleads here

The usual Wegovy maintenance dose is 2.4 mg a week[2]. Zepbound’s maintenance doses are 5, 10 or 15 mg a week[1]. The two molecules are dosed on different scales.

So a cheaper milligram of tirzepatide is not a cheaper treatment. Compare a month at the dose you will take. The cost-per-mg tool is built for one compound at a time, which is where it works.

The brand prices

The brand versions, maker's self-pay month
StageZepbound (tirzepatide)Wegovy pen (semaglutide)
First month$299$199 (first 2 fills, new patients)
Lowest maintenance dose$399 (5 mg)$349 (up to 2.4 mg)
Top dose$449 (15 mg, on-time refill)$399 (7.2 mg)
The brand versions, maker's self-pay month. LillyDirect (28-day month) and the Wegovy Savings Offer terms (box of 4 pens, 28 days).

Lilly and Novo Nordisk price their weight-loss brands differently. Lilly prices by dose[3]. Novo charges one price from 0.25 to 2.4 mg[4]. The full brand comparison is in Zepbound vs Wegovy cost. The diabetes brands are in Mounjaro vs Ozempic.

What the extra spend buys, in the one direct trial

SURMOUNT-5 randomly assigned 751 adults with obesity and no type 2 diabetes[5]. Each took the highest tolerated dose for 72 weeks[5]. That was tirzepatide 10 or 15 mg, or semaglutide 1.7 or 2.4 mg[5].

Weight fell 20.2% on tirzepatide and 13.7% on semaglutide[5]. Waist size fell 18.4 cm against 13.0 cm[5]. The trial was open-label and funded by Lilly[5].

The rules on compounded versions

Neither drug is on FDA’s shortage list or the outsourcing-facility bulk list[7]. State pharmacies may not regularly compound copies of either[7]. FDA says it will not act on four or fewer such prescriptions a month from one compounder[7].

FDA has also received adverse-event reports that may be related to doses beyond the approved labels, for both[6]. How each is bought legally online is in tirzepatide online and semaglutide online.

FAQ

3 questions

Is tirzepatide more expensive than semaglutide?

Usually, yes. Across every seller that publishes a monthly price, compounded tirzepatide's typical month sits above compounded semaglutide's, and Lilly's Zepbound prices sit above Novo Nordisk's Wegovy pen prices at each stage. The exact gap on this page is computed from current prices.

Is tirzepatide cheaper per milligram than semaglutide?

Comparing per milligram misleads. The usual Wegovy maintenance dose is 2.4 mg a week, while Zepbound's maintenance doses are 5, 10 or 15 mg, so a cheaper milligram of tirzepatide does not mean a cheaper month.

Is tirzepatide worth the extra cost over semaglutide?

In SURMOUNT-5, a 72-week open-label trial funded by Lilly in adults with obesity and no type 2 diabetes, tirzepatide cut weight 20.2% against 13.7% for semaglutide. That trial used the approved brand drugs, not compounded versions.

Sources

7 cited
  1. [1]Eli Lilly and Company (2026). ZEPBOUND (tirzepatide) injection, for subcutaneous use: Prescribing Information DailyMed, U.S. National Library of Medicine. Source
  2. [2]Novo Nordisk (2026). WEGOVY (semaglutide) injection and WEGOVY (semaglutide) tablets: Prescribing Information DailyMed, U.S. National Library of Medicine. Source
  3. [3]Eli Lilly and Company (2026). Zepbound (tirzepatide): KwikPen, single-dose vial and single-dose pen self-pay prices LillyDirect. lilly.com/lillydirect/zepbound
  4. [4]Novo Nordisk (2026). Wegovy Savings Offer: terms and conditions, including the self-pay offer details Novo Nordisk. wegovyterms.com
  5. [5]Aronne LJ, Horn DB, le Roux CW, et al. (2025). Tirzepatide as Compared with Semaglutide for the Treatment of Obesity New England Journal of Medicine. PMID 40353578
  6. [6]U.S. Food and Drug Administration (2026). FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss FDA. Source
  7. [7]U.S. Food and Drug Administration (2026). FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize FDA. Source