Semaglutide, tirzepatide, liraglutide — five branded drugs, two compounded alternatives. Side-by-side prices, mechanisms, and the cash-pay path that bypasses insurance gatekeeping.
GLP-1 receptor agonists (and dual GIP/GLP-1 agonists like tirzepatide) mimic incretin hormones that slow gastric emptying, suppress appetite, and improve insulin response. Originally developed for type 2 diabetes, they have reshaped obesity medicine — STEP-1 (semaglutide) and SURMOUNT-1 (tirzepatide) showed 15–22% body weight reduction at one year.
Three molecules dominate the US market:
| Drug | Active | FDA use | Dose range | Retail | Typical cash |
|---|---|---|---|---|---|
| Ozempic | semaglutide | Type 2 diabetes (off-label weight loss) | 0.25–2 mg weekly | $968/mo | $650–900/mo |
| Wegovy | semaglutide | Chronic weight management (FDA-approved) | 0.25–2.4 mg weekly | $1,349/mo | $900–1,200/mo |
| Mounjaro | tirzepatide | Type 2 diabetes (off-label weight loss) | 2.5–15 mg weekly | $1,069/mo | $700–1,000/mo |
| Zepbound | tirzepatide | Chronic weight management (FDA-approved) | 2.5–15 mg weekly | $1,086/mo | $700–1,000/mo |
| Saxenda | liraglutide | Chronic weight management (daily injection) | 0.6–3 mg daily | $1,349/mo | $900–1,200/mo |
| Compounded semaglutide | semaglutide | Off-label (prescriber discretion) | 0.25–2.5 mg weekly | n/a (custom) | $200–400/mo |
| Compounded tirzepatide | tirzepatide | Off-label (prescriber discretion) | 2.5–15 mg weekly | n/a (custom) | $250–500/mo |
Prices indicative, US cash market, May 2026. Manufacturer savings cards may reduce brand prices for commercially-insured patients. Compounded prices vary by pharmacy, dose, and supply chain.
Without insurance, brand-name GLP-1 medications run $400–1,400 per month at the retail counter — Mounjaro at the low end if you can secure a manufacturer savings card, Wegovy at the high end without any discount. That is $4,800–16,800 per year for a single medication that most patients need indefinitely.
Compounded semaglutide and tirzepatide from licensed compounding pharmacies typically run $200–500 per month — a 50–70% reduction. The same molecule, prepared by a state-licensed compounder, dispensed under a valid prescription. For patients paying cash, this is often the only financially-viable long-term option.
FDA acknowledged Ozempic, Wegovy, Mounjaro and Zepbound as in shortage from 2022–2024, which permitted 503A and 503B compounding pharmacies to compound semaglutide and tirzepatide for individual patients. As resolutions ship, compounding under shortage authority is being phased out — but compounded GLP-1 remains legal under 503A patient-specific prescriptions when a prescriber documents a clinical need that the FDA-approved drug cannot meet (e.g., dose customisation, excipient sensitivity).
Head-to-head trials suggest tirzepatide (Mounjaro/Zepbound) produces somewhat greater weight loss than semaglutide (Ozempic/Wegovy), with SURMOUNT-1 reporting ~20–22% body weight reduction on tirzepatide 15 mg vs ~15% on semaglutide 2.4 mg in STEP-1. The "best" drug depends on your tolerability, insurance coverage, prescriber, and cost — many patients respond very well to either class. Script Unlock helps you compare cash prices across all GLP-1 options so cost is not the deciding factor.
Retail cash prices in the US run $968–1,349 per month for brand-name GLP-1 drugs (Ozempic ~$968, Mounjaro ~$1,069, Wegovy ~$1,349, Zepbound ~$1,086). Manufacturer savings cards can bring commercially-insured patients down to $25–500/month. Compounded semaglutide and tirzepatide from licensed compounding pharmacies typically run $200–500/month cash. Script Unlock surfaces real-time pricing across both options.
The active pharmaceutical ingredient (semaglutide) is the same molecule. Compounded versions are prepared by licensed 503A or 503B compounding pharmacies using bulk semaglutide API, and may include additives like B12 or different preservative systems. They are not FDA-approved finished drugs but are legal when compounded under a valid prescription for a specific patient. Quality varies by pharmacy — choose state-licensed compounders with documented sterility testing.
Yes — Wegovy (semaglutide 2.4 mg) and Zepbound (tirzepatide) are FDA-approved for chronic weight management in adults with BMI ≥30, or BMI ≥27 with a weight-related comorbidity. Ozempic and Mounjaro are FDA-approved only for type 2 diabetes but are commonly prescribed off-label for weight loss. Compounded semaglutide/tirzepatide is also prescribed off-label by licensed clinicians. Insurance coverage for weight-loss indications varies widely.
Current evidence supports long-term, indefinite use for chronic weight management. STEP-4 and STEP-1 extension data show that stopping semaglutide leads to substantial weight regain over 12 months. Most obesity-medicine specialists treat obesity as a chronic disease requiring chronic therapy, similar to hypertension or diabetes. Discuss a maintenance plan with your prescriber before starting; this affects long-term cost planning.
Script Unlock shows brand and compounded prices side-by-side from verified pharmacies — find the one that fits your budget and your prescriber.
Start your search