Mounjaro vs Zepbound: Same Medication, Different Prices — Your 2026 Guide

If you're confused about Mounjaro and Zepbound, you're not alone. They're the exact same medication — tirzepatide — made by Eli Lilly. The only differences are the label, the marketing, and critically, how much you'll pay.

Head-to-Head Comparison

Why Two Brand Names?

Eli Lilly's strategy mirrors Novo Nordisk's Ozempic/Wegovy approach. By creating separate brands:

• They can market to diabetes and weight loss markets separately
• Different pricing structures for different payer environments
• Separate supply chains help manage shortages
• Physicians can prescribe the "appropriate" indication for insurance

The practical result: if you have diabetes, Mounjaro is your ticket. If you don't, you'll need to pursue Zepbound — or find a creative insurance strategy.

Cost Breakdown: What You'll Actually Pay

With Insurance (Diabetes)

Mounjaro coverage for type 2 diabetes is relatively good. Most commercial plans cover it with copays of $25-150/month after prior authorization. Some plans prefer it over Ozempic due to superior A1C reduction.

With Insurance (Weight Loss)

Zepbound faces the same challenges as Wegovy — only about 40% of plans cover weight loss medications. You'll need documented BMI ≥30 (or ≥27 with comorbidities), failed diet attempts, and often a letter of medical necessity.

Self-Pay: The LillyDirect Game-Changer

Eli Lilly's direct-to-patient program offers tirzepatide vials at $399/month — regardless of whether you're prescribed Mounjaro or Zepbound. You draw your own doses from a vial instead of using pre-filled pens.

This self-fill option saves approximately $600-700/month compared to retail pen pricing. The tradeoff: you need to be comfortable with syringes.

Compounded Tirzepatide

Telehealth providers offer compounded tirzepatide starting at $199-299/month. These are prepared by licensed compounding pharmacies but are not FDA-approved products.

Effectiveness: They're Identical

Since Mounjaro and Zepbound contain the same medication at the same doses, their effectiveness is identical:

• Weight loss: Average 20-25% of body weight at highest doses
• A1C reduction: 2.0-2.3% decrease (for diabetes patients)
• Cardiovascular benefits: Ongoing studies show promise

Tirzepatide is a "dual agonist" targeting both GLP-1 and GIP receptors, which may explain its superior weight loss compared to semaglutide (Ozempic/Wegovy).

Which Should You Choose?

Choose Mounjaro If:

• You have type 2 diabetes or pre-diabetes
• Your insurance covers diabetes medications better than weight loss drugs
• Your A1C is elevated (5.7%+ for pre-diabetes, 6.5%+ for diabetes)

Choose Zepbound If:

• Weight loss is your primary indication
• Your insurance specifically covers weight loss medications
• You're paying self-pay anyway (same vial pricing through LillyDirect)

Choose Compounded Tirzepatide If:

• You have no insurance coverage for either brand
• $399/month for LillyDirect vials is still too expensive
• You're comfortable with compounded (non-FDA-approved) medications

The Pre-Diabetes Strategy

If your A1C falls in the pre-diabetic range (5.7-6.4%), some physicians will prescribe Mounjaro for diabetes prevention. This can unlock insurance coverage that would otherwise deny weight loss indications.

This approach is medically valid — tirzepatide does help prevent progression to type 2 diabetes — and may be worth discussing with your healthcare provider.

Mounjaro vs Zepbound vs Compounded: Price Summary

The Bottom Line

Mounjaro and Zepbound are marketing distinctions, not medical ones. Your decision should be purely financial:

1. Check if your insurance covers either brand
2. If you have diabetes indicators, pursue Mounjaro for easier approval
3. If paying self-pay, LillyDirect vials are $399 regardless of brand
4. For the lowest cost, compounded tirzepatide starts at $199/month

Don't let the branding confuse you. Get tirzepatide at the best price you can, from a source you trust, and stick with it long enough to see results.