Ozempic and Mounjaro are two of the most popular GLP-1 medications. But the landscape has changed significantly in 2026. Two new options — Wegovy HD (7.2 mg) and Foundayo (orforglipron pill) — give patients more choices than ever.
Here is the updated comparison.
Quick Comparison
| Ozempic | Mounjaro | Wegovy HD | Foundayo | |
|---|---|---|---|---|
| Active drug | Semaglutide | Tirzepatide | Semaglutide (high-dose) | Orforglipron |
| Drug class | GLP-1 agonist | Dual GIP/GLP-1 agonist | GLP-1 agonist | GLP-1 agonist |
| FDA approval | Type 2 diabetes | Type 2 diabetes | Weight loss | Weight loss |
| Form | Weekly injection | Weekly injection | Weekly injection | Daily pill |
| Dose range | 0.25 – 2 mg | 2.5 – 15 mg | 7.2 mg | 3 – 17.2 mg |
| Weight loss | ~10-15% | ~15-22% | ~20.7% | ~11% |
| Maker | Novo Nordisk | Eli Lilly | Novo Nordisk | Eli Lilly |
| List price/mo | ~$950-1,000 | ~$1,060 | ~$1,500 | ~$1,050 |
| Medicare Bridge | Not eligible* | Not eligible* | $50/mo (eligible) | $50/mo (eligible) |
*Ozempic and Mounjaro are not eligible for the Medicare GLP-1 Bridge because they are not FDA-approved for weight management.
How They Work
Ozempic / Wegovy HD mimic one hormone (GLP-1) that tells your brain you're full and slows your stomach. Wegovy HD delivers 7.2 mg — triple the standard Wegovy dose — for patients who plateaued on standard doses.
Mounjaro mimics two hormones (GLP-1 and GIP). Two signals instead of one, which is why many people see stronger results.
Foundayo is a daily GLP-1 pill with no food or water restrictions. Unlike Rybelsus (oral semaglutide), you can take it any time of day with or without food.
Weight Loss Results
From clinical trials:
| Medication | Average Weight Loss |
|---|---|
| Mounjaro (15 mg) | ~15-22% |
| Wegovy HD (7.2 mg) | ~20.7% |
| Ozempic (2 mg) | ~10-15% |
| Foundayo (17.2 mg) | ~11% |
Key caveat: These come from different trials with different patient populations. Not a head-to-head comparison.
Mounjaro and Wegovy HD produce the strongest weight loss on average. Wegovy HD is for patients who already stabilized on standard Wegovy (2.4 mg) and need more.
Side Effects
All four cause similar GI side effects (nausea, diarrhea, constipation, vomiting). Two differences worth noting:
- Wegovy HD has a higher rate of altered skin sensation (22% vs 6% on standard doses)
- Foundayo may have fewer GI side effects for some since it's taken as a pill with gradual absorption
Side effects are worst when you start and after dose increases. Most people adjust within a few weeks.
Cost and Insurance (2026 Update)
The pricing picture changed significantly in 2026 with the Medicare GLP-1 Bridge and new options:
| Medication | List Price | With Savings Card | Medicare Bridge |
|---|---|---|---|
| Ozempic | ~$950-1,000 | ~$25/mo (eligible) | Not eligible |
| Mounjaro | ~$1,060 | ~$25/mo (eligible) | Not eligible |
| Wegovy HD | ~$1,500 | $0 first 3 fills, then $299/mo | $50/mo |
| Foundayo | ~$1,050 | ~$25/mo (eligible) | $50/mo |
Medicare GLP-1 Bridge
Starting July 1, 2026, eligible Medicare Part D beneficiaries can get Wegovy, Zepbound (KwikPen), or Foundayo for $50/month with prior authorization. Ozempic and Mounjaro are not included because they are not approved for weight management.
The program runs through December 31, 2027. See our full Medicare GLP-1 Bridge guide for eligibility and how to prepare.
CVS Formulary Update
As of mid-2026, CVS Caremark formularies have been updating to include newer GLP-1 options. Most commercial plans now cover:
- Wegovy HD with prior authorization (requiring documented plateau on 2.4 mg)
- Foundayo with prior authorization
- Standard Wegovy, Ozempic, and Mounjaro with varying tier placement
Always check your specific plan formulary — coverage varies widely by employer and plan type.
Who Should Choose Ozempic?
- You have type 2 diabetes and your insurance covers it
- You prefer a medication with a long track record
- You've used semaglutide before and it works for you
Who Should Choose Mounjaro?
- You want the strongest weight loss option
- You tried semaglutide and didn't get results
- Your insurance covers it and you don't need Medicare weight loss coverage
Who Should Consider Wegovy HD?
- You've been on Wegovy 2.4 mg for at least 4 weeks and plateaued
- You want weight loss results comparable to Zepbound without switching drug classes
- You're eligible for the Medicare Bridge or have commercial coverage
Who Should Consider Foundayo?
- You want a pill, not an injection
- You couldn't handle Rybelsus food/water restrictions
- You're willing to accept lower average weight loss (~11%) for convenience
- You have commercial insurance or Medicare Part D (Bridge eligible)
Other GLP-1 Options to Know
Rybelsus (Oral Semaglutide)
Oral semaglutide currently tops out at 14 mg (FDA-approved for type 2 diabetes). The OASIS trial tested 25 mg and 50 mg doses showing up to 15% weight loss, but these are not yet FDA-approved. See our Rybelsus for weight loss guide for details.
Oral Semaglutide 25 mg
Higher-dose oral semaglutide is not yet on the market. The OASIS trial data is promising — 15% weight loss at 50 mg — but FDA approval and pricing are still pending.
Can You Switch?
Yes. Switching between these medications is possible but requires medical supervision:
- Ozempic to Mounjaro: Common. Start at lowest Mounjaro dose.
- Wegovy to Wegovy HD: If you've been on 2.4 mg for at least 4 weeks and tolerating it well.
- Injection to Foundayo: Possible but requires starting Foundayo at the lowest dose.
- Ozempic to Wegovy: Same drug (semaglutide), different dose ranges.
Always work with your doctor — do not switch on your own.
Bottom Line
Mounjaro and Wegovy HD produce the strongest weight loss (~20-22%), but Wegovy HD is only for patients already on standard Wegovy. Foundayo offers convenience as a daily pill with no restrictions. Ozempic remains a solid option with the longest track record.
The best medication is the one you can afford, tolerate, and stay on. If you're on Medicare, the $50/month Bridge program makes Wegovy HD and Foundayo significantly more accessible starting July 1, 2026.
Work with your healthcare provider to determine which medication is right for you. Individual results and experiences vary.
Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication. Pricing and insurance coverage information is current as of June 2026 and may vary by plan and location.
