In Trulicity vs Ozempic, Ozempic lowered A1C and body weight more in the head-to-head SUSTAIN 7 trial. Trulicity is FDA-approved for children 10 and older and for heart protection in a wider group of adults, and it comes in a single-dose pen. Both are once-weekly type 2 diabetes injections, and neither is approved for weight loss.
Below, we compare what each label covers, what the trials showed, side effects, the pens, and what each drug costs in 2026 with insurance, with Medicare or Medicaid, and when you pay cash.
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Decision Verdict
For most adults with type 2 diabetes who need more A1C lowering or more weight loss, Ozempic has the stronger head-to-head evidence. Trulicity is a sound choice when your plan covers it better, a child or teen needs treatment, or a single-dose pen suits you better.
- Best for Trulicity: Children 10 and older with type 2 diabetes, adults with several heart risk factors but no diagnosed heart disease, and people who prefer a new single-dose pen each week.
- Best for Ozempic: Adults who want the larger A1C and weight drop seen in SUSTAIN 7, and adults with type 2 diabetes and chronic kidney disease, since Ozempic is the one with a kidney indication.
- Not ideal for either: Anyone with a personal or family history of medullary thyroid cancer or MEN 2, people with severe gastroparesis, and anyone whose main goal is weight loss without type 2 diabetes.
- The factor that matters most: Your plan's formulary. Both drugs list above $1,000 a month, so which one your insurer prefers usually decides your cost.
Trulicity vs Ozempic at a glance
| Trulicity (dulaglutide) | Ozempic (semaglutide) | |
|---|---|---|
| Maker | Eli Lilly | Novo Nordisk |
| How often | Once a week | Once a week |
| Approved ages | Adults and children 10 and older | Adults |
| Blood sugar (type 2 diabetes) | Yes | Yes |
| Lowers risk of heart attack, stroke or heart-related death | Adults with type 2 diabetes and heart disease or multiple heart risk factors | Adults with type 2 diabetes and established heart disease |
| Kidney indication | No | Yes: adults with type 2 diabetes and chronic kidney disease |
| FDA-approved for weight loss | No | No (the weight-loss version of semaglutide is Wegovy) |
| Strengths | 0.75, 1.5, 3 and 4.5 mg | 0.25, 0.5, 1 and 2 mg |
| Device | Single-dose pen, 4 pens per box | Multi-dose pen, about one pen a month, new needle each time |
| List price | $1,006.93 a month | $1,027.51 per pen |
Sources: the Trulicity and Ozempic prescribing information, Lilly's Trulicity pricing page and NovoCare's Ozempic list price page.
Which lowers A1C more, Trulicity or Ozempic?
Ozempic did, in SUSTAIN 7, the head-to-head trial that compared them directly. SUSTAIN 7 randomly assigned 1,201 adults with type 2 diabetes who were on metformin to one of the two drugs for 40 weeks.
| SUSTAIN 7 group | Average A1C drop | Average weight loss |
|---|---|---|
| Ozempic 0.5 mg | 1.5 points | 4.6 kg (about 10 lb) |
| Trulicity 0.75 mg | 1.1 points | 2.3 kg (about 5 lb) |
| Ozempic 1 mg | 1.8 points | 6.5 kg (about 14 lb) |
| Trulicity 1.5 mg | 1.4 points | 3.0 kg (about 7 lb) |
At both dose pairs, Ozempic lowered A1C by about 0.4 points more and weight by about 2.3 to 3.6 kg more. The trial was open-label and funded by Novo Nordisk, the maker of Ozempic.
It's also an older trial. It didn't test Ozempic 2 mg or Trulicity's higher 3 mg and 4.5 mg doses, so it gives no head-to-head answer at the top doses. In Lilly's separate AWARD-11 trial, Trulicity 4.5 mg lowered A1C by 1.77 points and weight by 4.6 kg over 36 weeks, compared with 1.54 points and 3.0 kg on 1.5 mg. Results from different trials can't be lined up against each other fairly, because the people and the trial designs differ.
Which is better for weight loss?
Ozempic produced roughly twice the weight loss of Trulicity in SUSTAIN 7. But neither drug is FDA-approved for weight loss. Both are approved to treat type 2 diabetes.
If weight is your main goal and you don't have type 2 diabetes, the FDA-approved semaglutide option is Wegovy. See our Ozempic vs Wegovy comparison. If you want a telehealth team to check what your insurance covers for weight-management GLP-1s, Ro is one option. Ro says Ozempic "may be prescribed off-label if a provider deems it appropriate," and its team checks your insurance coverage for GLP-1s. Ro charges a separate membership fee: $39 to start, then as low as $74 a month on an annual prepaid plan, or $149 a month on a monthly plan. Ro says it can't coordinate GLP-1 coverage for government plans such as Medicare or Medicaid.
Check your GLP-1 coverage with Ro (sponsored affiliate link, opens in a new tab)
How do the side effects compare?
The side effects are similar, and they're mostly in the stomach and gut. Each label lists these as the most common:
| Trulicity | Ozempic | |
|---|---|---|
| Most common side effects (5% or more) | Nausea, diarrhea, vomiting, belly pain, decreased appetite | Nausea, vomiting, diarrhea, belly pain, constipation |
| Boxed warning | Thyroid C-cell tumors | Thyroid C-cell tumors |
| Do not use if | Personal or family history of medullary thyroid cancer, or MEN 2 | Personal or family history of medullary thyroid cancer, or MEN 2 |
| Severe gastroparesis | Not recommended | Not recommended |
In SUSTAIN 7, stomach and gut side effects were reported by 43% to 44% of people on Ozempic, 33% on Trulicity 0.75 mg and 48% on Trulicity 1.5 mg. They were the most common reason people stopped either drug. Both labels also warn about pancreatitis, low blood sugar when used with insulin or sulfonylureas, gallbladder problems, kidney injury from dehydration, and diabetic eye complications.
How are the pens different?
- Trulicity comes as a single-dose pen. You use one pen per weekly dose, and each box has 4 pens. The pens are kept in the fridge, and each one can stay at room temperature (up to 86°F) for a total of 14 days.
- Ozempic comes as a multi-dose pen that usually lasts a month. You attach a new needle for each injection. Once you start a pen, it can be used for 56 days. Novo Nordisk also now sells an Ozempic pill, sold in bottles of 30 tablets.
If you'd rather not attach needles, Trulicity's single-dose pen may suit you. If you'd rather handle fewer pens, one Ozempic pen covers a month.
How much do Trulicity and Ozempic cost in 2026?
Both list for just over $1,000 a month, but very few people pay list price. Here's what each maker posts as of October 29, 2026:
| Trulicity | Ozempic | |
|---|---|---|
| List price | $1,006.93 a month | $1,027.51 per pen (about a month) |
| Commercial insurance with coverage, maker's savings card | As little as $25 for up to a 3-month fill. Saves up to $150 a month and $1,950 a year. Card ends December 31, 2026 | As little as $25 for up to a 3-month fill. Saves up to $100 a month, for up to 48 months |
| Cash price from the maker | Starting at $389 a month through LillyDirect | New patients: $199 a month for the first 2 fills of 0.25 or 0.5 mg. Then $349 a month (0.25, 0.5 or 1 mg) or $499 a month (2 mg) |
| Medicare or Medicaid | Savings card not allowed. Lilly says about 70% of its Medicare patients and about 90% of its Medicaid patients paid $0 per fill in 2024 | Savings offer not allowed. Novo says most Part D plans cover Ozempic. Cash price still available |
| Free-medicine program | Lilly Cares Foundation, for people who qualify | NovoCare Patient Assistance Program, for people who qualify |
What a year of cash pay comes to (our math from the posted prices): Trulicity at $389 a month is $4,668. Ozempic for a new patient who stays at 1 mg or less is $3,888 (2 months at $199, then 10 at $349). Ozempic at 2 mg all year is $5,988. Cash purchases don't count toward your insurance deductible.
Lilly's figures on how many patients pay $0 come from its own analysis of 2024 pharmacy data. Only your insurer or pharmacy can tell you your real price. For Ozempic in detail, see Ozempic cost with insurance.
Can you switch from Trulicity to Ozempic?
Yes, a prescriber can move you from one GLP-1 to another. Common reasons include A1C or weight goals not being met, side effects, or a plan changing its formulary. How and when to switch, and which starting dose to use, is your prescriber's call. SUSTAIN 7 compared people who started on each drug. It didn't study switching. Before you ask about a switch, check which drug your plan prefers and whether it needs prior authorization.
Which one fits you
| Your situation | Likely better fit | Why |
|---|---|---|
| A1C still high on metformin, adult | Ozempic | Larger A1C drop in SUSTAIN 7 |
| Weight loss matters alongside blood sugar | Ozempic | About twice the weight loss in SUSTAIN 7 |
| Type 2 diabetes with chronic kidney disease | Ozempic | Only one with a kidney indication |
| Child or teen 10 or older with type 2 diabetes | Trulicity | Ozempic is approved for adults only |
| Several heart risk factors, no diagnosed heart disease | Trulicity | Its heart indication covers multiple risk factors |
| Prefer a single-dose pen each week | Trulicity | One pen per dose, no reusing |
| Your plan covers only one of them | The covered one | Both list above $1,000 a month |
Either way, both drugs are FDA-approved. Neither is a compounded medicine, and neither appears on the FDA's drug shortage list as of October 29, 2026.
Compare your GLP-1 options in 2 minutes
What we actually verified
- Read the current FDA prescribing information for Trulicity (revised March 2026) and Ozempic (revised May 2026) for approved uses, ages, strengths, pens, storage, warnings and common side effects.
- Read the published abstracts of SUSTAIN 7 and AWARD-11 on PubMed and took every trial number from them.
- Opened Lilly's Trulicity pricing page, LillyDirect's Trulicity page and Lilly's Trulicity savings card terms.
- Opened NovoCare's Ozempic list price page and Ozempic's savings page.
- Opened Ro's Ozempic page and Ro's pricing page.
- Checked the FDA drug shortage database for dulaglutide and semaglutide.
- Did the yearly cash-pay math ourselves from the posted prices.
What we did not do: get a quote from any insurer, pharmacy or provider, confirm any plan's formulary, or check whether Ro prescribes Trulicity. Prices and savings offers change, so confirm them before you fill.
Frequently asked questions
Is Ozempic stronger than Trulicity?
In SUSTAIN 7, Ozempic lowered A1C by about 0.4 points more than Trulicity at both dose pairs tested, and it lowered weight about 2.3 to 3.6 kg more. The trial didn't test the highest doses of either drug.
Can Trulicity be used for weight loss?
Trulicity is approved only for type 2 diabetes, not for weight loss. People in its trials did lose some weight: 3.0 kg on 1.5 mg and 4.6 kg on 4.5 mg in AWARD-11.
Is Trulicity cheaper than Ozempic?
At list price they're close: $1,006.93 a month for Trulicity and $1,027.51 per Ozempic pen. Paying cash, Trulicity starts at $389 a month. Ozempic is $199 for a new patient's first 2 months, then $349 for doses up to 1 mg. With commercial coverage, both savings cards can bring the cost as low as $25.
Which has fewer side effects, Trulicity or Ozempic?
Neither clearly wins. In SUSTAIN 7, stomach and gut side effects ranged from 33% on low-dose Trulicity to 48% on Trulicity 1.5 mg, with Ozempic in between at 43% to 44%.
Does Medicare cover Trulicity and Ozempic?
Novo Nordisk says most Medicare Part D plans cover Ozempic. Lilly says about 70% of its Medicare patients paid $0 per Trulicity fill in 2024. Your cost depends on your plan, and people with Medicare can't use either maker's $25 savings card. Check your plan's formulary.
Is Trulicity being discontinued?
We found no sign of that. LillyDirect still lists all four Trulicity strengths for sale, and dulaglutide doesn't appear in the FDA's drug shortage database as of October 29, 2026.
Can kids take Ozempic or Trulicity?
Trulicity is approved for children 10 and older with type 2 diabetes. Ozempic is approved for adults only.
Still not sure which GLP-1 path fits you? Take The RX Index's free Find My GLP-1 Path quiz — about 2 minutes, no signup.
Sources
- Trulicity prescribing information (Eli Lilly, revised March 2026; checked October 29, 2026)
- Ozempic prescribing information (Novo Nordisk, revised May 2026; checked October 29, 2026)
- Pratley RE et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7). Lancet Diabetes Endocrinol. 2018;6(4):275-286
- Frias JP et al. Efficacy and safety of dulaglutide 3.0 mg and 4.5 mg versus dulaglutide 1.5 mg (AWARD-11). Diabetes Care. 2021;44(3):765-773
- Lilly: Trulicity pricing information (checked October 29, 2026)
- LillyDirect: Trulicity self-pay (checked October 29, 2026)
- Trulicity savings card and resources (checked October 29, 2026)
- NovoCare: Ozempic list price explained (checked October 29, 2026)
- Ozempic: savings and cost (checked October 29, 2026)
- FDA drug shortage database (checked October 29, 2026)
- Ro: Ozempic, pricing (checked October 29, 2026)