Zepbound vs Wegovy

Zepbound vs Wegovy — at a glance

Approved indications differ

Both are approved for chronic weight management in adults with BMI ≥30, or BMI ≥27 with a weight-related comorbidity. Zepbound additionally has FDA approval for moderate-to-severe obstructive sleep apnea in adults with obesity (December 2024 — the first injectable pharmacotherapy approved for OSA). Wegovy has FDA approval for cardiovascular risk reduction in adults with obesity who have established cardiovascular disease (March 2024, based on the SELECT trial).

Weight-loss magnitude

In SURMOUNT-1 (72 weeks), Zepbound 15 mg produced mean weight loss of approximately 20.9%. In STEP-1 (68 weeks), Wegovy 2.4 mg produced mean weight loss of approximately 14.9%. These are different trials with different patient populations and durations — no head-to-head data exist as of 2026. Real-world response varies substantially.

Cardiovascular outcomes

Wegovy has positive SELECT trial data: reduced MACE in adults with established CVD and obesity, leading to the 2024 FDA CV indication. Zepbound's CV outcomes trial (SURMOUNT-MMO) is ongoing as of 2026.

OSA: Zepbound's exclusive indication

The SURMOUNT-OSA trial showed clinically meaningful reductions in apnea-hypopnea index in adults with obesity and moderate-to-severe OSA, leading to the FDA approval. This is the first pharmacological therapy approved for OSA and opened Medicare coverage pathways. Wegovy does not have this indication.

Cost

Cash prices are similar at approximately $1,000–$1,200/month before insurance. Lilly's LillyDirect program offers reduced single-dose-vial pricing for Zepbound. Novo's NovoCare offers a cash-pay program for Wegovy. Compounded tirzepatide and compounded semaglutide are both available through telehealth providers at substantially lower cost; neither compounded version is FDA-approved.

Frequently asked

Is Zepbound stronger than Wegovy?
In separate Phase 3 trials, Zepbound 15 mg produced numerically greater weight loss than Wegovy 2.4 mg (approximately 20.9% vs 14.9%). These are not head-to-head data. 'Stronger' depends on the patient's tolerance, comorbidities, and clinical goals.

Can I switch from Wegovy to Zepbound?
Yes, with clinician supervision. Most clinicians restart tirzepatide titration from 2.5 mg weekly after a washout period. Insurance prior authorization is often the rate-limiting step.

Does Medicare cover Zepbound or Wegovy?
Medicare Part D historically excluded coverage of obesity drugs. As of 2025, Medicare Part D began covering Zepbound specifically for the OSA indication in adults with obesity (because OSA is a covered condition). Wegovy received CMS coverage in 2024 for cardiovascular risk reduction in adults with established CVD and obesity. Coverage depends on specific plan and indication.