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Weight Loss

Maia Anderson

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Ozempic vs. Wegovy, Mounjaro vs. Zepbound, semaglutide vs. tirzepatide—there are a lot of names and terms to keep straight in the GLP-1 world.

 the obesity treatment market will hit $95 billion by 2030, now may be the time to learn the difference.

So if you’re confused about what’s what and who’s who, never fear: Healthcare Brew has put together a handy guide giving a rundown of the key players.

Semaglutide is the active ingredient in brand-name drugs Ozempic, Wegovy, and Rybelsus. It’s a single-hormone agent that mimics glucagon-like peptide-1, or GLP-1, according to Chika Anekwe, obesity medicine clinical director at Massachusetts General Hospital’s weight center.

GLP-1 is a hormone naturally released by the gut after meals, Anekwe told Healthcare Brew. While the organic version lasts just a few minutes, the medication version is altered to be more stable and last for several days.

The hormone “helps with regulating glucose, and it delays how quickly food empties out of your stomach so you feel fuller for longer,” Anekwe said. “Overall, it’s really beneficial for appetite suppression and blood sugar control and, ultimately, weight loss.”

Semaglutide was developed by Novo Nordisk and received FDA approval in December 2017 under the name Ozempic as a Type 2 diabetes treatment. An alternate version called Rybelsus was approved in September 2019, also as a Type 2 diabetes treatment, and semaglutide received approval for weight loss in June 2021 under the brand name Wegovy.

While semaglutide works on a single hormone, tirzepatide—the active ingredient in brand-name drugs Mounjaro and Zepbound—is a dual-hormone medication, according to Anekwe.

That means, in addition to GLP-1, it targets a hormone called glucose-dependent insulinotropic polypeptide, or GIP, which “increases insulin secretion and stimulation, improves fat metabolism and energy expenditure, and helps suppress appetite,” Anekwe said.

Tirzepatide was developed by Eli Lilly and received FDA approval in May 2022 under the name Mounjaro as a Type 2 diabetes treatment. It was 

 in November 2023 as Zepbound for obesity treatment.

You may be wondering why semaglutide and tirzepatide have multiple brand names.

Ozempic, Wegovy, and Rybelsus are all semaglutide. Rybelsus is the standout among the three because it comes in pill form while the other two are injectables—plus, it’s not prescribed as often for weight loss, as it’s currently only approved as a diabetes treatment and isn’t available in doses as strong as Ozempic’s.

But Ozempic and Wegovy are the exact same drug, according to Brian Wojeck, assistant professor of endocrinology at the Yale School of Medicine.

The only difference between the two is what they’re approved to treat (diabetes vs. obesity) and the dosages they come in, Wojeck said. For instance, the max dosage of Ozempic is 2mg while Wegovy’s is 2.4mg.

Mounjaro and Zepbound are also the same but approved to treat different things—even though they come in the same dosages, according to Wojeck.

The difference between semaglutide and tirzepatide, besides the fact that one is a single-hormone and the other is a dual-hormone agonist, is how effective they are, Anekwe said. Studies have shown that tirzepatide is more effective when it comes to weight loss compared to semaglutide.

 last year, patients taking the highest dose of semaglutide lost an average of 15% of their body weight compared to 21% on the highest dose of tirzepatide.

Semaglutide and tirzepatide also have treatment indications for conditions aside from obesity and diabetes, Wojeck said. Wegovy is approved to reduce the risk of 

, and Zepbound is approved to treat obstructive sleep apnea.

In their most recent earnings reported in early August, Eli Lilly said Mounjaro and Zepbound brought in a combined $8.6 billion in Q2, and Novo Nordisk reported Ozempic and Wegovy brought in a combined $8 billion for the quarter.

While semaglutide and tirzepatide are generally the most talked about, they’re not the only GLP-1s on the market. There’s also liraglutide and dulaglutide.

Liraglutide was approved by the FDA under the name Victoza as a Type 2 diabetes treatment in January 2010 and then rebranded as Saxenda for obesity treatment in December 2014. They are both made by Novo Nordisk. Eli Lilly’s dulaglutide was approved in September 2014 under the name Trulicity as a Type 2 diabetes treatment.

The difference between these older GLP-1s versus semaglutide and tirzepatide is that they’re not as effective in terms of weight loss and diabetes, according to Wojeck. They’re also mostly prescribed to treat diabetes instead of obesity, Anekwe added.

There are “a lot of advancements” coming in the world of GLP-1s and obesity treatments in general, Wojeck said.

One is retatrutide, an injectable drug Eli Lilly is developing that’s a triple agonist, meaning that in addition to GLP-1 and GIP, it also targets glucagon. Experts think this means it’ll be even more effective in terms of weight loss, Wojeck said. Eli Lilly is expected to release Phase 3 results on the drug in late 2025 or early 2026.

 more effective oral GLP-1s to the market, which Wojeck said he believes will “make things easier for a good deal of patients.”

Eli Lilly reported in Q2 2025 earnings on Aug. 7 that its revenue increased 38% compared to the same quarter last year, thanks to growth in Mounjaro and Zepbound sales. Novo Nordisk reported in its Q2 earnings on Aug. 6 that diabetes and obesity treatment drug sales increased 16% YoY.

A hand with a medical glove holding up pharma pills next to a measuring tape and GLP-1 injectionables

What’s the difference between the GLP-1s on the market?

From semaglutide vs. tirzepatide to Ozempic vs. Wegovy.

Novo Nordisk and Eli Lilly, makers of leading GLP-1s Ozempic and Zepbound, respectively, both reported earnings in early May, with each drugmaker leading in different areas. Eli Lilly, for example, saw strong sales growth in Q1 2025, while Novo had the competitive advantage in bringing the first oral GLP-1 to market.

 Novo’s GLP-1 sales results were somewhat mixed.

Wegovy, its obesity GLP-1, brought in $2.6 billion in Q1, up roughly 85% from $1.4 billion in Q1 2024 but down about 13% from $3 billion in Q4 2024. Ozempic, its Type 2 diabetes GLP-1, made nearly $5 billion, up 19% from $4.2 billion in Q1 2024 but down almost 3% from $5.1 billion in Q4 2024.

Lilly’s obesity GLP-1, Zepbound, on the other hand, brought in $2.3 billion in Q1, up almost 345% from $517 million YoY. And its Type 2 diabetes GLP-1, Mounjaro, brought in $3.8 billion, up 111% from $1.8 billion last year.

Overall, Novo brought in $11.8 billion in revenue for the first quarter, up 19% YoY compared to $9.9 billion. Lilly brought in $12.7 billion in revenue for the first quarter, up 44% from $8.8 billion Q1 2024.

Part of Novo’s GLP-1 sales decrease was due to more compounders selling copycat versions of semaglutide, according to EVP and CFO Karsten Munk Knudsen.

“It became clear over the first quarter that the amount of business that had gone to the compounders was just significantly bigger than what we had anticipated,” he reportedly told 

However, Novo expects GLP-1 sales to improve in the second half of the year, President and CEO Lars Fruergaard Jørgensen said during a May 7 earnings call, as compounders will 

 May 1 it would make Novo’s Wegovy—instead of Lilly’s Zepbound—the preferred GLP-1 on its formulary.

Eli Lilly chair and CEO David Ricks responded to the retail pharmacy chain’s move during the company’s May 1 earnings call by saying “it seems like the wrong idea to reduce choice,” but added he wasn’t surprised and Lilly would “work through it.”

Jørgensen said Novo didn’t pursue the placement, but he believes “the formulary decision by CVS speaks to the benefits of Wegovy.”

 that allows Hims & Hers to sell Wegovy on the telehealth company’s website.

 Both Novo and Lilly are working to bring oral versions of their GLP-1s to the market.

Jørgensen said Novo submitted an application to the FDA for “Wegovy in a pill” in February. Ricks said Lilly plans to submit an application for its oral GLP-1, called orforglipron, for obesity treatment later this year and then for Type 2 diabetes in the first half of 2026, as long as the Phase 3 trial results, which Lilly expects in Q3, come back successful.

Both Ricks and Jørgensen said the tariffs currently in place likely won’t affect their respective companies much, but warned 

President Donald Trump said on May 5 he would announce pharma tariffs within two weeks, 

Ricks said during Lilly’s earnings call that while the company supports “the US government’s goals to increase domestic investment,” he doesn’t think tariffs “are the right mechanism.”

“Enhanced tax incentives and/or the extension of the Tax Cuts and Jobs Act are better tools to achieve their goals,” he said.

Jørgensen highlighted Denmark-based Novo’s US manufacturing efforts, saying the company has invested $24 billion in its US-based manufacturing sites over the past 10 years. He also said the company’s oral GLP-1 would be made and packaged entirely in the US.

Eli Lilly, Novo Nordisk report strong earnings as GLP-1 race heats up 

Both drugmakers saw strong YoY sales, though Novo’s GLP-1 sales were down slightly from Q4 2024. 

Aetna is waving goodbye to the ACA marketplace.

Executives announced during CVS Health’s Q1 2025 earnings call on May 1 that the insurance giant is withdrawing from the individual marketplace created under the 

, as the company expects to lose as much as $400 million from that part of the business in 2025.

“We are disappointed by the continued underperformance from our individual exchange products and have recently determined there is not a near- or long-term pathway for Aetna to materially improve its position in this product,” David Joyner, president and CEO of CVS Health, said during the earnings call.

Aetna, one of the largest health insurers in the US, currently sells ACA plans in 17 states and has around 1 million beneficiaries, according to 

The decision to exit the marketplace comes as executives are trying to 

 Aetna’s financial performance. The insurance business faced higher-than-expected medical costs in 2024, and in response, CVS Health saw its net income fall 45% over the year (from $8.4 billion to $4.6 billion). Since then, executives have announced several 

And the tide may be starting to turn. Aetna brought in nearly $2 billion in adjusted operating income in Q1 2025, up 173% from $732 million in the same quarter last year.

CVS reported total revenues of $94.6 billion for the first quarter, up 7% from the same period in 2024.

The company also saw a net income of roughly $1.8 billion, up nearly 60% YoY from $1.1 billion.

Total revenues for Aetna increased 8%, thanks largely to the Medicare business and improved Medicare Advantage (MA) star ratings, according to the company’s earnings release.

 UnitedHealth Group hard in its most recent earnings, and the insurer lowered its annual earnings guidance to $26.00–$26.50 per share, down from $29.50–$30.00 per share. Elevance, on the other hand, came out relatively unscathed, and Humana also 

 strong earnings despite lower MA star ratings.

CVS Health raised its 2025 earnings guidance to $6.00–$6.20 per share, up from $5.75–$6.00 per share.

​​CVS also announced during the call a new deal between Wegovy maker Novo Nordisk and CVS’s PBM business, Caremark. The deal will give the GLP-1 preferred status on Caremark’s formulary as well as in CVS’s 9,000 pharmacies dispensing the drug. That comes just days after Novo 

 a deal with telehealth company Hims & Hers to sell Wegovy.

“Because of the high cost of these medications, about one-third of our clients have elected not to cover GLP-1s as part of their benefits due to affordability concerns, and so today we’re pleased to announce this partnership with Novo Nordisk to significantly increase the access to Wegovy for our members at a more affordable price,” Prem Shah, EVP and group president of CVS Health, said during the call.

Shah added that the lower price will be available for “tens of millions” of beneficiaries.

The partnership may be bad news for Eli Lilly, whose GLP-1 competitor Zepbound was previously given preferred status on Caremark’s formulary.

However, David Ricks, Eli Lilly’s chair and CEO, downplayed concerns during the company’s earnings call, also on May 1, saying he wasn’t surprised “this kind of thing was announced” and that Lilly will “work through it.”

 their business these days, and Joyner was no exception.

CVS isn’t currently being affected much by existing 

, he said, as the “vast majority” of front-of-store items are sourced from US-based companies.

, he said the company is “obviously watching closely the announcements that will be made over the course of the next week or so,” and that it’s hard to project any potential impacts since there are “many variables in play.” 

Aetna to leave ACA marketplace while CVS partners with Novo Nordisk on Wegovy  

It was a busy Q1 for the retail pharmacy giant. 

Drugmakers that have raked in billions from GLP-1s, such as Ozempic maker Novo Nordisk, are racing to figure out how to innovate as sales of the blockbuster drug 

The next big thing in the GLP-1 space will likely be more user-friendly versions of the drugs: oral pills, rather than the injectable formats popular weight loss drugs typically come in, Jayne Hornung, chief clinical officer at pharma consultancy MMIT, told Healthcare Brew.

“Patients always prefer an oral tablet over having to self-inject something, so I see this becoming the market leader in GLP-1s,” Hornung said.

Oral GLP-1s could also save patients money, as pills are generally cheaper to make than injectable drugs, according to 

. However, “it’s all about supply and demand,” Hornung said. “I would hope that the pill would be cheaper, but [drugmakers are] going to price it according to market demands.”

 Eli Lilly announced on April 17 positive results from a Phase 3 clinical trial of an oral GLP-1 called orforglipron, which the drugmaker is testing to treat both Type 2 diabetes and obesity.

Trial participants taking orforglipron lost on average 8% of their total body weight over 40 weeks, according to Eli Lilly. Comparatively, Lilly’s injectable obesity GLP-1, Zepbound, led to an average total body weight loss of 20.2% over 72 weeks in a separate Phase 3 trial, and its Type 2 diabetes GLP-1, Mounjaro, led to a mean total body weight loss of 26.6% over 84 weeks.

And Eli Lilly has already prepared to bring the oral GLP-1 drug to market, reporting in a 2024 SEC filing that it had stockpiled up to $548 million’s worth of orforglipron.

However, Novo breezed by Lilly when executives confirmed the company had submitted an application to the FDA “earlier this year” for approval of its own oral GLP-1, 

Novo executives announced in 2023 that a Phase 3 clinical trial of its oral semaglutide pill had shown strong results, with participants losing 15.1% of their body weight after 68 weeks. (Comparatively, a Phase 3 clinical trial of injectable semaglutide 

 an average 14.9% body weight reduction after 68 weeks.)

Though Novo executives previously said they would file for FDA approval in 2023, spokesperson Jamie Bennett told Healthcare Brew the company decided to wait because it was “awaiting the results from the entire OASIS [Oral Semaglutide Treatment Effect in People with Obesity] program to include a full package for submission.” (OASIS is the name of Novo’s oral semaglutide clinical trials.)

Eli Lilly said in a statement the company plans to ask the FDA to approve its oral GLP-1 for weight loss treatment by the end of 2025 and as a Type 2 diabetes treatment in 2026.

On the flip side, Pfizer announced on April 14 it would 

 developing its oral GLP-1 candidate, a once-a-day pill called danuglipron, because a clinical trial participant developed a potentially drug-induced liver injury. Pfizer previously tested a twice-daily version of danuglipron but discontinued that development as well, as gastrointestinal side effects were reported at high rates in Phase 2 trials.

With Novo and Lilly pulling a strong lead in the oral GLP-1 race, Hornung said she could see other manufacturers abandoning similar pursuits.

“A lot of the manufacturers see the writing on the wall that they won’t be the first to market and there’ll be a lot of competition, so they’ve opted to pull back on developing an oral GLP-1,” she said.

A measuring tape wrapping around a large-scaled pill.

The next big thing in the weight loss market may be oral GLP-1s 

Because who doesn’t prefer swallowing a pill over getting a shot?

What’s next for GLP-1s?

Pharma giant Novo Nordisk and telehealth company Hims & Hers announced April 29 a partnership to sell Wegovy, Novo’s GLP-1 approved to treat obesity, directly to consumers.

It’s a bit of an unlikely alliance given that Hims & Hers 

 a compounded version of semaglutide (the active ingredient in Wegovy and Novo’s Ozempic, its GLP-1 approved for Type 2 diabetes) since May 2024, and Novo 

 more than 100 lawsuits against companies doing just that.

 Starting this week, customers can access NovoCare Pharmacy, a direct-to-consumer platform the pharma company 

 at the beginning of March, on the Hims & Hers website, according to a company press release.

There, patients can purchase any dose of Wegovy, which is bundled with a Hims & Hers membership plan that gives them access to “24/7 care, ongoing clinical support, and nutrition guidance” starting at $599 per month, the release stated.

Hims & Hers execs said in the release the company plans to continue offering its other weight loss products, including oral weight loss pills and nutrition kits.

 about its opposition to companies selling compounded versions of its GLP-1.

The FDA allows pharmacies to make compounded versions of brand-name drugs, which are composed of the same ingredients, when the branded drug is in shortage. But the FDA doesn’t currently approve the compounded version, which Novo argues poses risks to patient safety.

 says it’s “deeply concerned about companies promoting and selling compounded, non-FDA-approved, or knock-off ‘semaglutide’ and sources spreading misinformation about GLP-1s to the public.”

 (which has since been taken down) said telehealth providers may be conducting insufficient clinical evaluations before prescribing patients semaglutide, and emphasized the company “is not directly supplying semaglutide to any telehealth providers.”

 from health experts and lawmakers in February for a Super Bowl ad that promoted its compounded semaglutide without disclosing the side effects of the drug.

Despite the friction, the partnership could be mutually beneficial.

With prescriptions for Wegovy on the decline, sales have also slowed, increasing around 15% between Q3 and Q4 2024 compared to 48% between Q2 and Q3 2024. And the company is facing increasing competition from rival Eli Lilly as the two 

Hims & Hers will no longer be able to sell compounded semaglutide as of May 22 after the FDA 

 the drug is no longer in shortage. The company’s revenue has skyrocketed since it began selling compounded GLP-1s, from $271.9 million in 2021 to $1.5 billion in 2024.

And the two companies hinted that Wegovy is just the start of their partnership.

David Moore, Novo’s EVP of US operations, said in the press release the companies are “developing a roadmap” to combine Novo’s medications with Hims & Hers’s ability to deliver care at scale to improve chronic disease outcomes more affordably.

Novo Nordisk, Hims & Hers partner to sell Wegovy 

The telehealth provider has sold compounded versions of Novo’s GLP-1 since 2022. 

The Centers for Medicare and Medicaid Services (CMS) won’t go forward with a 

 that would’ve required the government payers to cover GLP-1 drugs for obesity.

 on April 7, CMS listed Part D coverage of anti-obesity medications as one of several Biden administration proposals for the 2026 contract year to be scrapped. The agency didn’t give details on why it decided against GLP-1 coverage, but said it might revisit the issue later on.

While Medicare currently covers GLP-1s for certain diagnoses like diabetes and cardiovascular disease, the Biden administration proposed in November requiring GLP-1 coverage for obesity, which goes against federal statute. States are allowed to cover anti-obesity drugs through Medicaid, but only 13 states currently do so, according to KFF.

Insurers have been largely against the proposal, arguing that covering GLP-1s would be costly.

America’s Health Insurance Plans (AHIP), the health insurance industry’s largest trade group, submitted comments to CMS in February saying the costs of covering the drugs could “place upward pressure on premiums and government costs.”

The Congressional Budget Office estimated in October 2024 that requiring Medicare to cover GLP-1s for obesity would add nearly $35 billion to federal spending by 2034. CMS estimated it would increase Medicaid spending by $15 billion over 10 years.

AHIP said in its comments that the actual costs “may far exceed CMS estimates.”

Mary Beth Donahue, CEO of the Better Medicare Alliance, a nonprofit advocacy group for Medicare Advantage, said in a statement that the group was “encouraged that the administration took a measured approach and declined to make major changes at this time.”

Some argue the up-front costs would be worth it.

Manuel Jurado, associate partner at consulting firm the Dedham Group, told Healthcare Brew in December that Medicare and Medicaid coverage of obesity medications could save costs down the road, as GLP-1s may also 

University of Southern California researchers estimated in a 2023 

 that GLP-1 coverage would save Medicare up to $245 billion in 10 years if private insurers also covered the drugs.

Millicent Gorham, CEO of the Alliance for Women’s Health and Prevention, said in a statement that the coverage would have been “transformative” for people with obesity who rely on Medicare and Medicaid.

The American Medical Association also supports GLP-1 coverage, but in a January letter to CMS, CEO and EVP James Madara cautioned against increasing premiums.

Courtney Breen, a US biopharma senior research analyst at brokerage firm Bernstein, reportedly told 

 CMS’s decision not to cover GLP-1s was “not surprising,” as the Trump administration is also considering imposing pharmaceutical tariffs.

After CMS finalized the rule on April 4, Eli Lilly and Novo Nordisk—the makers of Zepbound and Ozempic—saw their stocks drop 6.5% and 6.8%, respectively, by market close, according to Zacks Investment Research.

“Today, over 55 million Americans have insurance coverage for FDA-approved obesity medications—it is essential that seniors are in the same position,” Novo Nordisk spokesperson Jamie Bennett said in a statement sent to Healthcare Brew. “We cannot support a system where a patient loses insurance coverage for a chronic disease simply because they entered into Medicare.”

Eli Lilly spokesperson Jared Shapiro said in an emailed statement that the company is “disappointed” in the Part D rule “because it is not the best reading of the statute and impacts patient access to obesity treatments.”

“We will continue to work with the Trump administration and congressional leaders to ensure people living with obesity are covered by Medicare and Medicaid and are no longer left behind,” he said.

Catherine Howden told Healthcare Brew Medicare Part D and Medicaid coverage is "not appropriate at this time," but CMS may consider options in the future for anti-obesity medications.

Update 04/10/25: This story has been updated to include a comment from CMS.

Semaglutide injection pen or cartridge pen for diabetics and weight loss in female hand. Medical equipment for diabetes patients

Medicare, Medicaid won’t be required to cover GLP-1s for obesity, CMS says 

Insurers have warned the proposed requirement would be costly. 

Cassie McGrath

 in the pharmaceutical industry. Now, AbbVie wants a piece of the pie.

The North Chicago-based drug company announced a $350 million deal on March 3 to purchase Denmark-based biotech company Gubra and its weight loss medication, GUB014295, also known as Gubamy. The deal also left room for up to $1.9 billion in performance-based milestone payments.

Gubamy, a once-weekly injection, is currently in a Phase 1 clinical trial. It mimics the hormone amylin, which regulates blood sugar and appetite, and can send signals to the brain that suppress eating and slow digestion, according to a release.

This is different from competitors that create drugs to mimic the GLP-1 hormone, which has, so far, been the more popular approach for approved weight loss drugs like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound. Novo’s new drug CagriSema, which combines Wegovy’s active ingredient with an amylin analog, is in a Phase 3 trial, and 

 is working on an amylin-based drug that’s in Phase 2 trials.

 that amylin differs from GLP-1s, as it may help patients lose more fat than lean mass (like muscle) and may cause less side effects.

“Our partnership with Gubra marks our entry into the obesity field, offering a compelling opportunity based on the potential to address patient needs while also fostering long-term growth for our company,” AbbVie CEO Robert Michael said in the release.

The weight loss market is highly competitive, and has been for most of the 2020s. In addition to Novo and Lilly, which are currently the two highest-performing drugmakers in the sector, companies like Hims and Hers have also tried to enter the competition through 

, which is the process of making similar medications using the same ingredients.

 could come to market in the next five years, Healthcare Brew previously reported. Biotech consulting firm 

 that in 2023, the global weight loss drug market reached $24 billion, and predicted that number could reach $131 billion by 2028.

Angela Fitch, chief medical officer of weight loss primary care company 

, told Healthcare Brew in a statement that “the more innovation we have in the metabolic health and weight management disease space, the better off we will be.”

“It’s good news that so many companies are getting into this underserved space,” she added.

A general view of AbbVie, a biopharmaceutical company.