What are the cost comparisons, including quality metrics and cost per dose, for Mounjaro (tirzepatide) vs Ozempic (semaglutide)?

Cost Comparison: Mounjaro (Tirzepatide) vs Ozempic (Semaglutide)

Tirzepatide provides superior value for money compared to semaglutide, costing approximately $985 per 1% body weight reduction versus $1,845 for semaglutide, while also demonstrating greater clinical efficacy across glycemic control and weight loss outcomes. 1

Direct Cost-Effectiveness Analysis

Cost per Quality-Adjusted Life-Year (QALY):

• Tirzepatide vs. injectable semaglutide: Tirzepatide is less expensive and more effective (95% CI: -$1.5 million to $1.4 million), meaning tirzepatide dominates semaglutide by providing better outcomes at lower cost 2
• Tirzepatide vs. background therapy alone: $59,000 per QALY gained (95% CI: $11,000-$101,000) 2
• Oral semaglutide vs. background therapy: $122,000 per QALY gained 2

Cost Per Dose and Treatment Duration:

• 72 weeks of tirzepatide: $17,527 total cost 1
• 68 weeks of semaglutide 2.4 mg: $22,878 total cost 1
• Cost needed to treat per 1% body weight reduction:
  • Tirzepatide: $985 (95% CI: $908-$1,075) 1
  • Semaglutide: $1,845 (95% CI: $1,707-$1,989) 1

Quality Metrics: Clinical Efficacy Comparison

Glycemic Control (HbA1c Reduction):

• Tirzepatide 15 mg: -2.30 percentage points from baseline 3
• Tirzepatide 10 mg: -2.24 percentage points 3
• Semaglutide 1 mg: -1.86 percentage points 3
• All tirzepatide doses demonstrated statistically significant superiority over semaglutide (P<0.001 for 10 mg and 15 mg doses) 3

Weight Loss Outcomes:

• Tirzepatide 15 mg: 17.8% body weight reduction (95% CI: 16.3%-19.3%) 1
• Tirzepatide 10 mg: Greater weight loss than semaglutide by 3.6 kg 3
• Tirzepatide 15 mg: Greater weight loss than semaglutide by 5.5 kg (P<0.001) 3
• Semaglutide 2.4 mg: 12.4% body weight reduction (95% CI: 11.5%-13.4%) 1

Cardiometabolic Risk Factors:

• Tirzepatide 15 mg showed statistically significant improvements versus semaglutide in: 4
  • Waist circumference reduction
  • Fasting plasma glucose
  • Triglyceride levels
• Both medications demonstrated comparable improvements in HDL, LDL, and blood pressure 4

Cost-Effectiveness Thresholds

At willingness-to-pay threshold of $150,000 per QALY:

• Subcutaneous tirzepatide has 98% probability of being cost-effective compared to other GLP-1 medications 5
• Tirzepatide vs. oral semaglutide: $34,212 per QALY gained, well below the threshold 5

Safety Profile Comparison

Adverse Events:

• Gastrointestinal side effects were comparable between medications: 3
  • Nausea: 17-22% (tirzepatide) vs. 18% (semaglutide)
  • Diarrhea: 13-16% (tirzepatide) vs. 12% (semaglutide)
  • Vomiting: 6-10% (tirzepatide) vs. 8% (semaglutide)
• Hypoglycemia rates were low and similar: 0.2-1.7% (tirzepatide) vs. 0.4% (semaglutide) 3
• Serious adverse events: 5-7% (tirzepatide) vs. 3% (semaglutide) 3

Clinical Decision Algorithm

Choose tirzepatide when:

• Cost-effectiveness is a priority, as it provides better value per unit of clinical benefit 1
• Maximum weight loss is desired (5.5 kg additional reduction with 15 mg dose) 3
• Greater HbA1c reduction is needed (additional 0.45 percentage point reduction with 15 mg) 3
• Patient has type 2 diabetes with obesity or overweight requiring comprehensive cardiometabolic risk reduction 4

Important Caveats:

• Sensitivity analyses indicate results are highly dependent on medication acquisition costs, which vary by insurance coverage and pharmacy benefit design 5
• The cost-effectiveness advantage of tirzepatide assumes current pricing structures; changes in drug pricing or insurance formularies could alter these conclusions 1
• Both medications require similar monitoring for gastrointestinal side effects and treatment discontinuation rates 3