Zepbound vs CagriSema
Side-by-side comparison based on SURMOUNT-1 and REDEFINE-1 phase 3 trial data plus April 2026 pricing.
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
CagriSema
cagrilintide + semaglutide
Peak weight loss20.4%
TrialREDEFINE-1
Administrationinjection
FDA statuspending
List price$1,499/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 | Zepbound | CagriSema | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $88 | $88 | $0 (CagriSema cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | $349 | $599 | $250 (Zepbound cheaper) |
| Telehealth — brand name (Hims, Ro, Found) | $499 | — | — |
| Cash retail (full list price) | $1,059 | $1,499 | $440 (Zepbound cheaper) |
Zepbound pros and cons
Pros
- ✓ Highest efficacy of any FDA-approved GLP-1 (22.5% in SURMOUNT-1)
- ✓ Dual GLP-1/GIP mechanism
- ✓ LillyDirect self-pay vials starting around $349/mo for lower doses
- ✓ FDA-approved for chronic weight management
Cons
- ✗ List price still high ($1,059/mo)
- ✗ Insurance coverage varies more than for Wegovy
- ✗ GI side effects can be more pronounced at higher doses
- ✗ Periodic supply constraints during demand spikes
CagriSema pros and cons
Pros
- ✓ Highest efficacy of any pending GLP-1 (20.4% in REDEFINE-1)
- ✓ Dual mechanism (amylin + GLP-1) targets satiety differently
- ✓ Once-weekly injection like Wegovy
Cons
- ✗ Pending FDA approval (expected 2026)
- ✗ Combination therapy may carry premium pricing
- ✗ Limited long-term real-world data
Common side effects
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
CagriSema
- • Nausea
- • Diarrhea
- • Vomiting
- • Constipation
- • Decreased appetite
Which should you choose: Zepbound or CagriSema?
Choose Zepbound if: you want maximum weight loss (22.5% vs 20.4%); cash-pay cost matters most to you; you want a drug FDA-approved specifically for weight loss.
Choose CagriSema if: you prefer this medication after consulting your prescriber.
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.