The headline ranking table
| Rank | Drug | Best for | Cost/month |
|---|---|---|---|
| #1 cheapest | Ozempic on PBS | T2D patients meeting Authority criteria | $31.60 |
| #1 efficacy | Mounjaro | Maximum weight loss, cost not primary concern | $450-$580 |
| #1 on-label WL | Wegovy | Weight loss without T2D, on-label option | $420-$530 |
| #1 cheapest WL | Ozempic off-label | Cost-conscious private weight loss | $380-$450 |
| Niche | Saxenda | Daily injection preference, weekly intolerance | $340-$420 |
| Niche | Rybelsus | Needle-phobic T2D patients | PBS varies |
#1 Mounjaro (tirzepatide), best for maximum weight loss
Eli Lilly's dual GIP/GLP-1 agonist. The newest entrant and the TGA-approved in trials. SURMOUNT-1 showed roughly 20% body weight loss at the 15mg dose over 72 weeks. Approved for type 2 diabetes; widely used off-label for weight management.
Cost: $450-$580/month at retail pharmacy. $400-$550 via telehealth bundle.
PBS: Not listed. Eli Lilly submissions are with the PBAC; outcomes pending.
Dose: Escalates 2.5mg → 5 → 7.5 → 10 → 12.5 → 15mg over 5-6 months.
Best for: Patients who have responded inadequately to maximum Ozempic dose, or those prioritising efficacy with cost as secondary. Detailed Ozempic vs Mounjaro comparison.
#2 Wegovy (semaglutide 2.4mg), best on-label weight loss option
Novo Nordisk's high-dose semaglutide product, TGA-approved specifically for chronic weight management. Same molecule as Ozempic but dosed higher. STEP trials show roughly 15% body weight loss at 2.4mg over 68 weeks.
Cost: $420-$530/month retail. $290-$450 via telehealth bundle.
PBS: Not listed.
Dose: 0.25mg → 0.5 → 1.0 → 1.7 → 2.4mg over 16-20 weeks.
Best for: Patients without T2D pursuing weight loss who want the on-label, evidence-supported option. Wegovy PBS coverage guide.
#3 Ozempic (semaglutide 0.25-1.0mg), best for T2D + cheapest off-label option
The original. Novo Nordisk's lower-dose semaglutide product, TGA-approved for type 2 diabetes. PBS-subsidised under Authority Streamlined for eligible T2D patients. Widely used off-label for weight loss.
Cost: $31.60 PBS (general T2D), $7.70 PBS (concession), $380-$450 private retail, $290-$420 via telehealth bundle.
PBS: Yes, Authority Streamlined for T2D meeting HbA1c criteria.
Dose: 0.25mg → 0.5 → 1.0mg over 8-12 weeks.
Best for: T2D patients (via PBS). Also viable off-label for weight loss patients prioritising cost. Ozempic PBS coverage guide.
#4 Saxenda (liraglutide 3mg), niche, daily injection
Novo Nordisk's daily liraglutide product, TGA-approved for chronic weight management. Now largely superseded by weekly options but still has a small role.
Cost: $340-$420/month private. No PBS for weight loss.
Dose: Daily injection (vs weekly for others). Escalates daily over 5 weeks.
Best for: Patients with severe injection anxiety who prefer smaller daily injections to larger weekly ones, or patients with specific gastroparesis where liraglutide's shorter half-life is preferred. Saxenda cost guide.
#5 Rybelsus (oral semaglutide), needle-free for T2D
Daily oral tablet form of semaglutide. TGA-approved for type 2 diabetes. PBS access varies by criteria. Rarely used for weight loss because available oral doses are lower-equivalent than injectable Ozempic.
Cost: PBS varies; private around $300-$400/month.
Dose: 3mg → 7mg → 14mg daily tablets.
Best for: Severely needle-phobic T2D patients who can comply with strict pre-dose fasting requirements (must be taken on empty stomach, no food/drink for 30 minutes after).
#6 Trulicity (dulaglutide), alternative weekly GLP-1 for T2D
Eli Lilly's once-weekly GLP-1 agonist, TGA-approved and PBS-subsidised for type 2 diabetes under specific Authority criteria. Less commonly discussed than Ozempic but a legitimate alternative for T2D patients.
Cost: $31.60 PBS (general T2D); private equivalent to Ozempic.
Best for: T2D patients where Ozempic supply is short or who prefer Lilly's auto-injector device.
Decision tree: which should you take?
- Have T2D + HbA1c above threshold: PBS Ozempic. Period.
- Weight loss only, cost-sensitive: Off-label Ozempic via telehealth bundle.
- Weight loss only, want on-label option: Wegovy via telehealth bundle.
- Weight loss only, maximum efficacy: Mounjaro via telehealth bundle.
- Needle phobia + T2D: Rybelsus (oral semaglutide).
- Daily injection preference: Saxenda.
- Ozempic shortage: Trulicity (T2D) or Wegovy/Mounjaro (weight loss).
Compare your real out-of-pocket cost across options in our GLP-1 switch cost calculator.