CagriSema vs Wegovy: What the Amylin Combination Adds
CagriSema (cagrilintide + semaglutide, Novo Nordisk) vs Wegovy (semaglutide, Novo Nordisk)
Last verified July 2026
The verdict
REDEFINE-1 reported about 20.4% at 68 weeks for CagriSema (PMID 40544433) against STEP-1's 14.9% at 68 weeks for Wegovy (PMID 33567185) — same duration, which makes this cross-trial comparison unusually readable. The added component is cagrilintide, an amylin analog working through a different satiety pathway. CagriSema is not commercially available; Wegovy is, at about $499 with savings programs. The result also undershot Novo's own 25% guidance, which is why coverage of it varies.
Side-by-side comparison
| Field | CagriSema | Wegovy |
|---|---|---|
| Peak weight loss (vs placebo) | ~20.4% at 68 wk — REDEFINE-1 (PMID 40544433) | ~14.9% at 68 wk — STEP-1 (PMID 33567185) |
| Head-to-head vs semaglutide | -18.4% in direct phase 3a RCT vs semaglutide (PMID 42009015) | -11.9% semaglutide arm in same direct RCT |
| Mechanism of action | Dual amylin receptor + GLP-1 receptor agonist (cagrilintide + semaglutide 2.4 mg) | GLP-1 receptor agonist (semaglutide 2.4 mg) |
| Cardiovascular outcomes | No completed CV outcomes trial; data pending | 20% MACE reduction in SELECT trial, 2023 (PMID 37952131) |
| FDA approval status | Investigational — not FDA-approved (as of mid-2026) | FDA-approved for chronic weight management since June 2021 |
| Administration | Once-weekly subcutaneous injection (investigational) | Once-weekly subcutaneous injection (0.25–2.4 mg, dose escalation) |
| Commercial availability & price | Not commercially available — clinical trials only | Available by prescription; ~$499/mo with savings programs |
What each one costs in the compounded market
Standing monthly cash prices from the 556 sellers on this register. These are compounded preparations, not the approved products compared above.
CagriSema — cagrilintide + semaglutide
No seller on this register publishes a compounded price for it. For a drug still in trials that is expected — and anyone selling it anyway is doing so outside the system this register covers.
Wegovy — semaglutide
from $79 /mo
283 sellers publish a standing price; the median is $174 a month.
⚠ A compounded preparation is not the approved product. No agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed when the shortages closed. The price gap is real, and so is the difference in oversight. Every seller, with its price record.
Frequently asked questions
Which works better for weight loss, CagriSema or Wegovy?
On the trial evidence, neither clearly. CagriSema recorded ~20.4% at 68 wk — REDEFINE-1 (PMID 40544433) and Wegovy ~14.9% at 68 wk — STEP-1 (PMID 33567185), and the head-to-head comparison put CagriSema at -18.4% in direct phase 3a RCT vs semaglutide (PMID 42009015) against Wegovy at -11.9% semaglutide arm in same direct RCT. A head-to-head is the strongest form of this evidence because both arms run under one protocol — separate trials are not directly comparable however alike they look.
Are CagriSema and Wegovy the same drug?
Chemically, yes — both are cagrilintide + semaglutide. They are sold under different names for different approved uses, and usually at different doses and different prices. That is a labeling and commercial distinction, not a pharmacological one, which is why a prescription for one is not automatically interchangeable with the other at the pharmacy counter.
Is CagriSema or Wegovy cheaper?
On the manufacturers' own cash pricing: CagriSema at Not commercially available — clinical trials only, Wegovy at Available by prescription; ~$499/mo with savings programs. ⚠ That is the list-price comparison, and it is not what most people pay. What you actually pay depends on whether your plan covers it, which formulary tier it sits in, and whether you have met your deductible — and for many people the honest comparison is between an insured copay and a cash-pay compounded alternative rather than between these two figures.
Does either one have better cardiovascular evidence?
Neither has a clear edge does. CagriSema: No completed CV outcomes trial; data pending. Wegovy: 20% MACE reduction in SELECT trial, 2023 (PMID 37952131). This matters more than it first appears — a drug with a completed outcomes trial has evidence about events that matter, not only about weight, and that is often what decides coverage.
How is each one taken?
CagriSema: Once-weekly subcutaneous injection (investigational). Wegovy: Once-weekly subcutaneous injection (0.25–2.4 mg, dose escalation). Worth weighing honestly against your own habits — the best drug for you is partly the one you will still be taking in eight months, and a dosing routine that does not fit a life gets abandoned.
What does a compounded version of each actually cost?
Across the 556 sellers in this register, the cheapest standing monthly cash prices we hold are semaglutide from $79 a month. ⛔ A compounded preparation is not the approved product: no agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed once the shortages closed. The price gap is real and so is the difference in oversight.
Can I switch from CagriSema to Wegovy?
People move between them regularly, since it is the same molecule — but the dose ladders differ, so a prescriber has to map where you land rather than matching the number. Do not assume your current dose transfers.
Which one should I ask for?
That is a prescriber's call, and anyone answering it from a table is guessing. What a page like this can do is tell you what the trials measured, what the manufacturers charge, and where the evidence is still missing, so the conversation starts from the record rather than from an advertisement.
References
- 1.Garvey WT, Blüher M, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1) N Engl J Med. 2025;393(7):635-647. 2025. PMID: 40544433.
- 2.Yamauchi T, Becker NP, Hagemann CA, et al. Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity Lancet Diabetes Endocrinol. 2026;14(6):450-462. 2026. PMID: 42009015.
- 3.Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1) N Engl J Med. 2021;384(11):989-1002. 2021. PMID: 33567185.
- 4.Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT) N Engl J Med. 2023;389(24):2221-2232. 2023. PMID: 37952131.
- 5.Verma S, Böttcher M, Brown P, et al. CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1 Hypertension. 2026. 2026. PMID: 41328546.
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