Tirzepatide vs. semaglutide: how they compare for weight loss
How tirzepatide and semaglutide work, what head-to-head research shows, side effects, cost and how to choose with your clinician.
If you're paying for GLP-1 weight loss without insurance, the price you see first is rarely the price you pay every month. Starter doses are cheaper, higher doses cost more, and some offers only last a couple of months. This guide to GLP-1 cost without insurance puts the real 2026 cash prices side by side, so you can budget for a full year, not just the first box.
All prices below were checked on October 17, 2026, on each company's own website. They can change, so confirm before you buy.
The short answer
Paying cash, GLP-1 medicine in the U.S. usually costs $129 to $449 a month for most people, depending on the medicine, the dose and how long you commit. Brand-name injections from the manufacturers start around $199–$299 and rise to $349–$449 at maintenance doses. Clinician-prescribed compounded versions through telehealth often cost less, and many plans keep the same price as your dose goes up.
Brand-name prices, paid directly
Both manufacturers now sell to self-paying patients through their own pharmacies.
| Medicine | How it's sold | Cash price per month |
|---|---|---|
| Zepbound® (tirzepatide) vials | LillyDirect | $299 (2.5 mg), $399 (5 mg), $449 (7.5–15 mg) |
| Wegovy® (semaglutide) pen | NovoCare Pharmacy | $199 for the first 2 fills at 0.25–0.5 mg, then $349 |
| Wegovy® HD pen (7.2 mg) | NovoCare Pharmacy | $399 |
| Wegovy® pill (oral semaglutide) | NovoCare Pharmacy | $149 (1.5 mg), $199 (4 mg), $299 (9 mg and 25 mg) |
A few things in the fine print matter:
- Zepbound's $449 price needs on-time refills. For the 7.5 mg dose and up, Lilly lists $449 only if you refill within 45 days. Otherwise it lists $499 (7.5 mg) and $699 (10–15 mg). Vials also need syringes, bought separately.
- Wegovy's $199 is an intro offer. It covers the first two monthly fills for new patients and runs through December 31, 2026. After that, injectable doses are $349.
- The doctor visit isn't included. Buying direct still needs a prescription, so add the cost of a visit, plus any follow-ups when your dose changes.
Compounded GLP-1 prices through telehealth
Many telehealth programs offer compounded tirzepatide or semaglutide. A licensed clinician prescribes it after reviewing your health, and a state-licensed pharmacy prepares it for you individually. Compounded medicines are not FDA-approved and aren't generic versions of Zepbound or Wegovy. The FDA does not review them for safety, effectiveness or quality before they're sold, so who prescribes and who dispenses matters a lot. Our guide to compounded GLP-1s explains the difference in plain language.
Here is what Rovymi charges, as an example of how these plans are usually priced:
| Rovymi plan | 1 month | 3 months | 6 months |
|---|---|---|---|
| Semaglutide + B12 | $279 | $166/mo ($497 total) | $129/mo ($774 total) |
| Tirzepatide + B12 | $259 | $209/mo ($627 total) | $179/mo ($1,074 total) |
Clinician review, dose changes, messaging with your care team and shipping are included, and the price doesn't rise when your dose goes up. Longer plans are paid up front, which is why the monthly price is lower. See every option on our pricing page.
What a year actually costs
Monthly prices hide the real number, so here is a rough first-year total for one person who moves up to a maintenance dose. These are estimates for budgeting, not quotes.
- Zepbound vials (LillyDirect): about $299 + $399 for the first two months, then $449 a month if every refill is on time. That's roughly $5,190 a year, plus syringes and doctor visits.
- Wegovy pen (NovoCare): two intro months at $199, then $349 a month. That's roughly $3,890 a year, plus doctor visits.
- Compounded tirzepatide + B12 (Rovymi, two 6-month plans): $2,148 a year, with clinician care and shipping included.
- Compounded semaglutide + B12 (Rovymi, two 6-month plans): $1,548 a year, with clinician care and shipping included.
Hidden costs to ask about
Before you sign up anywhere, ask these five questions:
- Is the clinician visit included, and are follow-ups extra?
- Does the price change when my dose goes up? Many brand and telehealth prices do.
- Are needles, syringes and alcohol pads included?
- Is shipping free, and is the medicine shipped cold when it needs to be?
- What happens if I need to pause or cancel?
Does insurance cover GLP-1s for weight loss?
Sometimes. Some employer plans cover Zepbound or Wegovy for weight management, often with prior authorization and a BMI requirement. Medicare's rules for weight-loss coverage have been changing, so check your own plan. If you do have coverage, a manufacturer savings card can bring the brand price down a lot, and that may beat any cash price.
Which option is right for you?
The best choice depends on your health, your budget and how you feel about FDA-approved brands versus compounded medicine. Brand-name medicine has the clinical trial evidence behind it. Compounded medicine can make treatment affordable, but it isn't FDA-approved, so it should only come from a licensed clinician and a state-licensed pharmacy.
If you'd like a clinician to look at your options, the online visit takes about five minutes. You'll only be prescribed if treatment is safe and appropriate for you.
Sources
This article is for general information and isn’t medical advice. See our Important Safety Information.
