Zepbound vs Ozempic 2026: Different Drugs, Different Labels — Which One Wins for Weight Loss, Diabetes, and Cost?

Zepbound (tirzepatide, Eli Lilly) and Ozempic (semaglutide, Novo Nordisk) are different molecules from different makers, approved for different things — Zepbound for chronic weight management, Ozempic for Type 2 diabetes. In the SURMOUNT-5 head-to-head, tirzepatide produced 20.2% body weight loss vs 13.7% for semaglutide. But Ozempic has 8+ years of cardiovascular and kidney outcome data and broader diabetes coverage. Both savings cards drop you to $25/month with commercial insurance. Cash-pay: Zepbound vials $349-$499/mo, Ozempic retail $998/mo. Compounded tirzepatide runs $99-$349/mo; compounded semaglutide $99-$258/mo. Here's the head-to-head by clinical fit, cost, and the cheapest legitimate path for each.