Ozempic vs Wegovy (oral 25mg)
Side-by-side comparison based on STEP-2 (T2D) and OASIS-4 phase 3 trial data plus April 2026 pricing.
Ozempic
semaglutide (injection)
Peak weight loss11.6%
TrialSTEP-2 (T2D)
Administrationinjection
FDA statustype-2-diabetes
List price$998/mo
Wegovy (oral 25mg)
Higher efficacysemaglutide (tablet)
Peak weight loss13.6%
TrialOASIS-4
Administrationoral
FDA statusweight-loss
List price$1,349/mo
Weight loss comparison (220 lbs starting weight)
% of body weight lost over 18 months, modeled from phase 3 trial data
Monthly cost by payment channel
| Channel | Ozempic | Wegovy (oral 25mg) | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $63 | $63 | $0 (Wegovy (oral 25mg) cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | — | $499 | — |
| Telehealth — brand name (Hims, Ro, Found) | $399 | $449 | $50 (Ozempic cheaper) |
| Cash retail (full list price) | $998 | $1,349 | $351 (Ozempic cheaper) |
Ozempic pros and cons
Pros
- ✓ Often easier to get insurance coverage if you have type 2 diabetes
- ✓ Lower list price than Wegovy
- ✓ Same active ingredient as Wegovy (semaglutide)
- ✓ Strong cardiovascular outcome data (SUSTAIN-6)
Cons
- ✗ Off-label for weight loss — insurance won't cover for that purpose
- ✗ Lower max dose than Wegovy (2.0 mg vs 2.4 mg) means slightly less weight loss
- ✗ Periodic shortages
Wegovy (oral 25mg) pros and cons
Pros
- ✓ No injections — daily oral pill
- ✓ Same molecule as Wegovy injection
- ✓ 13.6% average weight loss in OASIS-4
- ✓ Easier to skip a dose without long-acting tail
Cons
- ✗ Strict fasting requirements before/after dose
- ✗ Slightly lower weight loss than injection (13.6% vs 14.9%)
- ✗ Daily dosing may hurt adherence vs weekly injection
- ✗ Newer drug — fewer real-world data points
Common side effects
Ozempic
- • Nausea
- • Diarrhea
- • Vomiting
- • Constipation
- • Abdominal pain
Wegovy (oral 25mg)
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
Which should you choose: Ozempic or Wegovy (oral 25mg)?
Choose Ozempic if: you prefer a weekly injection over a daily pill; cash-pay cost matters most to you; you have type 2 diabetes (insurance is more likely to cover).
Choose Wegovy (oral 25mg) if: you want maximum weight loss (13.6% vs 11.6%); you prefer a daily pill over a weekly injection; you want a drug FDA-approved specifically for weight loss.
Final decisions should always be made with a licensed prescriber. This is educational content only.
Medical disclaimer: This calculator provides estimates only based on phase 3 clinical trial data and publicly listed prices. It is not medical advice. Real-world weight loss varies significantly. Consult a licensed healthcare provider before starting any medication.