Ozempic alternatives: 4 options to consider
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Ozempic is a once-weekly injection used to improve blood sugar levels in patients with Type 2 diabetes. It comes in doses of 0.25, 0.5, 1 and 2 milligrams (mg). The active ingredient, semaglutide, helps the pancreas create more insulin, decreasing blood sugar.
Ozempic has become a popular choice for individuals without a Type 2 diabetes diagnosis, which has created a shortage. According to data from the Health Care Cost Institute, a nonprofit research institute that researches healthcare spending in the U.S., the share of Ozempic users without a diabetes diagnosis increased from 4% in 2018 to 13% in 2021. Rising demand has helped create a limited supply of the drug, which also drives up retail prices.
With that in mind, we’ll take a closer look at four Ozempic alternatives to consider and compare their pros, cons and costs.
Why consider alternatives to Ozempic?
Here are the most common reasons to consider alternatives to Ozempic:
- Cost is a critical factor to consider when researching weight loss medication alternatives to Ozempic. Ozempic can cost $1,000 or more for just a one-month supply if health insurance doesn’t cover most of it.
Keep in mind that health insurance won’t cover Ozempic for off-label use (in this case, for weight loss if you don’t have diabetes). Even with health insurance coverage, a one-month supply of the drug can get pricey, with approximate copay costs ranging between $45 and $200.
- Side effects are another reason to evaluate the alternatives. In clinical trial results published on the Ozempic website, the most common adverse effects reported were nausea, diarrhea, vomiting, abdominal pain and constipation.
Patients using Ozempic along with insulin or insulin secretagogues — medicines that lead to the pancreas secreting more insulin — may have an increased risk of hypoglycemia, a condition in which glucose levels fall below the standard range.
There are other more serious conditions to consider before taking a GLP-1 receptor agonist class drug like Ozempic. The safety profile published on the Ozempic website outlines specific warnings about worsening diabetes-related retinopathy, pancreatitis, medullary thyroid cancer and acute (sudden) kidney injury. There have been case reports of gastroparesis (a condition which prevents adequate stomach emptying).
Top Ozempic alternative medications
Several other weight loss medications available on the market today may compare to Ozempic in terms of effectiveness and safety. Rybelsus (the pill form of semaglutide) and Mounjaro are FDA-approved drugs to help blood sugar levels in patients with Type 2 diabetes. Wegovy and Zepbound are approved for weight loss.
- Rybelsus uses semaglutide as the active ingredient but is taken as a once-daily pill as opposed to a once-weekly injection like Ozempic. It comes in 7-mg or 14-mg doses.
While Ozempic can be administered at any time of day, Rybelus must be taken at least 30 minutes before the first meal or beverage of the day.
In terms of effectiveness, a six-month study showed that Rybelsus helped adults lower their A1c by an average of 1% (on 7 mg) and 1.3% (on 14 mg). In addition, participants lost an average of 4.8 pounds on the 7-mg dose and 6.8 pounds on the 14-mg dose.
The possible side effects of Rybelsus are similar to those of Ozempic, with nausea being the most reported adverse reaction in clinical trials. The drug insert also includes the same warnings for pancreatitis, hypoglycemia, acute kidney injury and diabetic retinopathy complications.
- Mounjaro is a once-weekly injection but uses the active ingredient tirzepatide. Injectable pens come in 2.5-, 7.5-, 10-, 12.5- or 15-mg doses that can be administered at any time of day. Mounjaro clinical trial results showed that adults with Type 2 diabetes were able to lower their A1c by 1.8% when on the 5-mg dose (1.7% on the 10- and 15-mg doses). Depending on the dose, participants also lost an average of 13.9 to 17.2 pounds.
Side effects of Mounjaro are also comparable to those of Ozempic, with nausea occurring in 18% of study participants on the 15-mg dose. In addition to similar warnings of pancreatitis, hypoglycemia, etc, there is also the possibility of developing acute gallbladder disease, which was reported in 0.6% of participants.
- Wegovy is also a semaglutide injection but is approved for weight loss purposes. It’s also the only weight loss medication approved to lower the risk of major cardiovascular events in individuals with known heart disease and are considered either overweight or obese. In a 68-week medical study published on the Wegovy website, participants lost an average of 35 pounds compared to 6 pounds from those on placebo.
Comparing Ozempic to Wegovy, the possible side effects are similar due to using the same active ingredient. However, it’s important to note that a higher percentage of patients using Wegovy in a clinical trial experienced nausea than those in the Ozempic clinical trial (44% on Wegovy 2.4mg compared to 14% on Ozempic 2mg). Increases in resting heart rate were also reported in clinical trials.
- Zepbound and Mounjaro use tirzepatide as the active ingredient and have the same available doses. However, Zepbound is FDA-approved for weight loss and management in adults considered obese or overweight. Results from a 72-week study of adults without diabetes show that participants lost between 34 and 48 pounds while using various doses of Zepbound, along with diet and exercise, compared to 3 pounds on the placebo.
Similar to other medications, nausea was the most common adverse effect in clinical trials, occurring in 29% of participants on the 10-mg dose. Other potential side effects include acute kidney injury, acute gallbladder disease, acute pancreatitis and hypoglycemia. Some severe gastrointestinal adverse reactions were also reported in about 2.5% of participants on the 10-mg dose.
Cost comparison of Ozempic and its alternatives
Medication costs can depend on your health insurance coverage. If you have Type 2 diabetes and your doctor prescribes Rybelsus or Mounjaro to help manage your blood sugar, the majority of costs may be covered by your plan. Zepbound and Wegovy may also be covered if you meet certain criteria. We break down the costs of each medication without insurance coverage below:
- Rybelsus: $1,100 to $1,240 a month
- Mounjaro: $1,000 to $1,200 a month
Brand-name drugs with no generic alternatives, like Rybelsus and Mounjaro, may be considered Tier 3 drugs in health insurance plans, with copayments ranging from $45 to $248.
- Wegovy: $1,350 and $1,600 a month
- Zepbound: $1,250 to $1,330 a month
Many health insurance companies, like Blue Cross Blue Shield, Aetna, United Healthcare and Cigna, offer plans that cover Wegovy, according to a prescription savings company, SingleCare. You will have to meet certain eligibility requirements to qualify.
Some of those requirements include an initial Body Mass Index (BMI) of 27 or greater and at least one weight-related health condition like high cholesterol or sleep apnea. If you have to pay out of pocket, retail prices for Wegovy typically range between for a one-month supply of the 0.25-mg dose.
Zepbound may or may not be covered by health insurance, so you’ll need to contact your provider for details on coverage. A new program through LillyDirect online pharmacy enables consumers to get 2.5-mg or 5-mg doses for $399 and $549 per month direct from Eli Lilly.
| Medication | Retail price* |
|---|---|
| Ozempic | $1,000 to $1,200 |
| Rybelsus | $1,100 to $1,240 |
| Mounjaro | $1,000 to $1,200 |
| Wegovy | $1,350 to $1,600 |
| Zepbound | $1,250 to $1,330 ($399 and $549 through LillyDirect) |
Natural and non-insulin alternatives
Certain lifestyle changes can make a big impact in managing diabetes and losing weight.
- Healthy lifestyle: According to the Centers for Disease Control and Prevention (CDC), eating healthy, being active, getting adequate sleep and managing stress can help you live a healthier life, regardless of a diabetes diagnosis. Incorporating exercise (150 minutes of moderate-intensity exercise per week is recommended by the American Diabetes Association) may be a low-cost first step.
- Herbs and supplements, like cinnamon and berberine, may also help reduce blood sugar levels. Note that berberine is not an FDA-approved weight loss medication.
Fiber, in particular, which can be found in fruits, vegetables, legumes and whole grains or in supplements like psyllium husk, has been shown to aid in blood sugar regulation. It can also make you feel full and satisfied.
According to the Mayo Clinic, current recommendations for daily fiber intake are 38 grams for men 50 years old and younger (25 grams for women) and 30 grams for men 51 and older (21 grams for women). However, consult with your doctor before adding any supplements to your daily regime because it can change the effectiveness of your current medications.
FAQ
How do Ozempic alternatives compare in terms of effectiveness?
Study results show that participants on Mounjaro reduced their A1c by 1.7% when on the 10-mg or 15-mg dose. In a separate study, participants on Ozempic lowered their A1c by 2.1% on a 2-mg dose. Based on these results, Ozempic may be more effective in lowering A1c than Mounjaro.
How much do Ozempic alternatives cost?
Mounjaro, the other once-weekly injectable available on the market today, ranges from $1,000 to $1,200 per month. Weight-loss injections, Wegovy and Zepbound, typically have higher retail prices than Ozempic, ranging from $1,250 to $1,600. However, a new program from LillyDirect allows consumers to get 2.5- mg or 5-mg doses for $399 and $549 per month direct from Eli Lilly.
Which weight loss medications are similar to Ozempic?
The best weight loss alternatives to Ozempic available today are Wegovy and Zepbound. The best alternatives for managing blood sugar levels in patients with Type 2 diabetes are Rybelsus and Mounjaro.
Bottom line
There are several Ozempic alternatives available today, like Rybelsus, Mounjaro, Wegovy and Zepbound. Other medications may also be approved by the FDA in the near future.
It’s important to consult with your healthcare provider when considering alternatives to Ozempic. They can discuss your treatment goals — whether that’s lowering blood sugar and/or losing weight — and help you make the right choice based on your situation.