Industry news · event 2025-05-11 · 3 min read
SURMOUNT-5 Publishes: Tirzepatide Beats Semaglutide Head-to-Head, 20.2% vs 13.7% (2025)
The trial everyone wanted finally reported in 2025 — 751 adults randomized to maximum-tolerated tirzepatide vs semaglutide 2.4 mg, with tirzepatide winning every weight threshold. It reset both prescribing and pricing.
GRGLP1ProviderCompare Research Team
Pricing & policy research
Quick answerThe trial everyone wanted finally reported in 2025 — 751 adults randomized to maximum-tolerated tirzepatide vs semaglutide 2.4 mg, with tirzepatide winning every weight threshold. It reset both prescribing and pricing.
The comparison the entire market had been inferring from separate trials became a direct answer in 2025: SURMOUNT-5, published in the New England Journal of Medicine, randomized 751 adults with obesity (without diabetes) to maximum-tolerated doses of tirzepatide or semaglutide 2.4 mg for 72 weeks. Tirzepatide averaged a 20.2% body-weight reduction against semaglutide's 13.7% — roughly 50 pounds versus 33 — with more tirzepatide patients clearing the 15%, 20%, and 25% thresholds.
The result did two things to the market we price. Clinically, it made "switch to tirzepatide" the standard plateau conversation, formalizing the upgrade path our switching guide documents. Commercially, it justified the tirzepatide premium in cash pricing — the $70–$100/month gap between the molecules' compounded floors ($215 vs $133 verified today) is, in effect, the market's price on those 6.5 percentage points.
What it did not do: dethrone semaglutide's outcomes evidence (SELECT's cardiovascular indication remains unmatched) or its oral option. The full breakdown of what each molecule still wins lives in tirzepatide vs. semaglutide.