Tirzepatide causes more weight loss than semaglutide
May 20, 2025
Summary: An 18-month study shows that tirzepatide (Zepbound) leads to more weight loss than semaglutide (Wegovy), although both are exceptionally effective at promoting clinically significant weight loss.
Source: Arrone, et al New England J of Medicine May 11, 2025
Researchers randomized about 1,500 people with obesity and without diabetes to be treated with either tirzepatide or semaglutide, both at the highest tolerable recommended doses, and followed them for 72 weeks. This trial was funded by Eli Lilly, the manufacturer of Zepbound (tirzepatide), which participated in the data collection and analysis, although the article was written by the academic researchers.
The second figure shows that a higher portion of people on tirzepatide reached each specific weight loss target compared to those on semaglutide. For context, bariatric surgery can lead to 20% or more long term weight loss.
Source: Arrone, et al New England J of Medicine May 11, 2025
Implications for employers:
Employers looking to cover GLP-1 medications for weight loss should review formulary options to best balance cost and clinical outcomes. Formulary approaches may drive utilization of one or the other drug, both of which offer strong weight loss potential
Employees should continue to monitor this class of medications as there are additional products in the pipeline, including oral semaglutide for obesity, expected to be FDA approved by the end of 2025.
Greater competition in the next several years may lead to lower unit prices
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