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Wegovy Alternatives & Comparison

Wegovy (semaglutide) set beside Zepbound, Saxenda, Foundayo: how each works, what its trials measured, what it costs, and who sells it.

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Wegovy Alternatives Compared

ZepboundTirzepatide · Eli Lilly and Company

Adds GIP to the GLP-1 action, and head-to-head data puts average weight loss higher

Zepbound works through tirzepatide's dual GIP/GLP-1 mechanism to reduce appetite through both central brain signals and peripheral metabolic effects.

One head-to-head settles the weight question and does not settle the whole question. SURMOUNT-5 put Zepbound at −20.2% against Wegovy's −13.7% at 72 weeks, a 6.5-point gap under one protocol. Wegovy answers a different question: SELECT cut major cardiovascular events 20%, and Zepbound's SURPASS-CVOT does not read out until 2027. Cash pricing is a wash at $349–$499. So the honest split is magnitude of weight loss against proven event reduction — and that is a prescriber's call, not a table's.

Full Zepbound vs Wegovy comparison →
SaxendaLiraglutide · Novo Nordisk A/S

The daily GLP-1 injection that came first, with a long approval history behind it

Liraglutide is an acylated, 97%-homologous analog of native human GLP-1, modified with a fatty-acid side chain that lets it bind albumin and resist DPP-4 degradation — extending its half-life from minutes to about 13 hours.

Both from Novo Nordisk, both for weight management, and Saxenda is the older drug in every sense. Liraglutide's ~13-hour half-life forces daily injection where semaglutide's ~7 days allows weekly. Wegovy has SELECT and its MACE −20%; Saxenda has no dedicated obesity outcomes trial, only LEADER's −13% at a diabetes dose. The commercial gap is stark — $349–$499 through NovoCare against roughly $1,400 retail with no comparable cash program. There are few arguments left for Saxenda.

Full Saxenda vs Wegovy comparison →
FoundayoOrforglipron · Eli Lilly and Company

Daily oral GLP-1, nothing to inject

Orforglipron is a non-peptide small molecule that binds and activates the GLP-1 receptor directly.

STEP-1 reported −14.9% at 68 weeks for Wegovy; ATTAIN-1 reported −11.1% at 72 weeks for Foundayo. Close enough that delivery and cost may decide it — but Wegovy carries the completed cardiovascular outcome, MACE −20% in SELECT, and Foundayo has no MACE data yet. That is a real asymmetry rather than a footnote: one has been shown to prevent events, the other has been shown to reduce weight. Wegovy runs $349–$499 through NovoCare; Foundayo's pricing is still landing.

Full Foundayo vs Wegovy comparison →
ContraveNaltrexone hydrochloride / Bupropion hydrochloride · Currax Pharmaceuticals LLC

An oral option outside the GLP-1 class, usually picked on cost or GI tolerance

Bupropion stimulates hypothalamic pro-opiomelanocortin (POMC) neurons, which release alpha-MSH to reduce appetite, but POMC neurons also release beta-endorphin, which feeds back onto mu-opioid receptors on the POMC neurons themselves and shuts them off — limiting the appetite-suppressing effect.

The widest cost-to-effect spread in this market. STEP-1 reported −14.9% at 68 weeks for Wegovy; COR-I reported −6.1% at 56 weeks for Contrave. Contrave runs about $99 a month through the Currax direct program against Wegovy's $499 maintenance. Different mechanisms entirely — GLP-1 satiety against an opioid antagonist plus bupropion working on reward and craving. Contrave is also what many insurers make you fail first, which makes this comparison less hypothetical than it sounds.

Full Contrave vs Wegovy comparison →
QsymiaPhentermine and topiramate extended-release · VIVUS LLC

Established oral combination outside the class, for anyone avoiding injectables

Qsymia combines two mechanisms in a single capsule.

STEP-1 reported −14.9% at 68 weeks for Wegovy; EQUIP reported −10.9% at 56 weeks for Qsymia at its top 15/92 mg dose — closer than most people expect. Qsymia runs about $100–$200 a month, and generic phentermine plus topiramate can be around $50, against Wegovy's $499. ⚠ Topiramate carries real teratogenic risk, which is why the pregnancy questions on a Qsymia intake are not a formality.

Full Qsymia vs Wegovy comparison →

Compare compounded Semaglutide providers

Compounded semaglutide sits at a middle figure of $190/month across 481 price points in the register, spanning $65 to $1,585. The partners below are ordered by our partner economics.

Strut Health
compounded
Telos Rx
compounded
CoreAge Rx
compounded
Live Vital
compounded

Compare compounded Tirzepatide providers

Compounded tirzepatide sits at a middle figure of $258/month across 435 price points in the register, spanning $83 to $1,400. The partners below are ordered by our partner economics.

Found
compounded
$169/mo
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Telos Rx
compounded
$139/mo
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Gala
compounded
$149/mo
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CoreAge Rx
compounded
$149/mo
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Compare every Wegovy provider

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