Key Differences at a Glance
| Mounjaro | Wegovy | |
|---|---|---|
| Active ingredient | Tirzepatide | Semaglutide 2.4mg |
| Mechanism | Dual GLP-1 + GIP | GLP-1 only |
| Average weight loss | ~20–22% | ~14–17% |
| TGA: weight management | ✓ (Sep 2024) | ✓ |
| TGA: MASH liver disease | ✗ (pending SYNERGY-NASH) | ✓ Provisional (Apr 2026) |
| PBS listing | No — private only | Narrow eCVD group only |
| Private cost (maintenance) | $285–$690/month | $300–$395/month |
Weight Loss — Mounjaro Leads
Mounjaro consistently produces greater weight loss than Wegovy in head-to-head data. The SURMOUNT-5 trial found tirzepatide achieved approximately 20% body weight reduction versus approximately 14% for semaglutide at 72 weeks.
For patients whose primary goal is maximum weight reduction, Mounjaro's dual mechanism gives it an advantage. Weight loss of 10% or more is associated with significant liver fat reduction in MASLD — so the magnitude difference has downstream hepatic benefits.
Liver Health — Wegovy Has the Evidence Base
For liver disease specifically, Wegovy has the more mature clinical evidence and the only current TGA approval:
Wegovy: ESSENCE trial demonstrated 62.9% MASH resolution at 72 weeks. TGA provisionally approved for non-cirrhotic MASH with F2–F3 fibrosis in April 2026. First GLP-1 with formal liver disease approval in Australia.
Mounjaro: Phase 2 liver data positive — significant liver fat and enzyme improvement. SYNERGY-NASH phase 3 trial results expected 2026. No current TGA liver disease indication.
The nuance: Mounjaro's greater weight loss likely produces greater liver fat reduction on average. But for patients with confirmed MASH requiring treatment under TGA-approved indications, Wegovy is currently the only option.
PBS Status — Neither Is Broadly Subsidised
Neither Mounjaro nor Wegovy is broadly PBS-subsidised for weight management in Australia as of mid-2026.
Wegovy: PBAC recommended PBS listing in December 2025 for adults with established cardiovascular disease (BMI 35+ or 32.5+ for Asian, Aboriginal, or Torres Strait Islander Australians). Price negotiations ongoing. Not broadly available.
Mounjaro: No PBS recommendation yet for weight management. Private prescription only.
For most Australians, both require private payment — $285–$690/month for Mounjaro or $300–$395/month for Wegovy at maintenance doses.
Which to Choose
If you have confirmed MASH with F2–F3 fibrosis: Wegovy is the TGA-approved treatment. This is the clinical decision-maker.
If weight loss is the primary goal and you have comorbid fatty liver: Either is appropriate — Mounjaro may produce greater weight loss and therefore greater liver fat reduction, but both are clinically reasonable.
If you qualify for the narrow PBS Wegovy listing (established CVD, BMI 35+): Wegovy is the cost-effective choice at $31.60 per prescription vs $300–$690/month.
If cost is equal: Discuss with your GP based on your full metabolic profile, GI tolerance, and whether you have confirmed MASH requiring the TGA-approved treatment.
Regardless of which medication you choose, baseline and follow-up liver monitoring is recommended. The MJA September 2025 consensus statement recommends MASLD assessment for all GLP-1 patients with metabolic risk factors.
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Frequently asked questions
Is Mounjaro or Wegovy better for weight loss?
Mounjaro produces greater average weight loss (approximately 20% vs 14–17% for Wegovy) based on head-to-head trial data.
Is Wegovy or Mounjaro better for fatty liver?
Wegovy has more mature MASH-specific evidence and TGA approval for liver disease. Mounjaro's greater weight loss likely produces greater liver fat reduction. SYNERGY-NASH results (2026) will clarify the direct liver comparison.
Which is cheaper in Australia — Mounjaro or Wegovy?
Both are primarily private prescription at similar price points ($285–$690 for Mounjaro, $300–$395 for Wegovy at maintenance). Wegovy has a narrow PBS listing for cardiovascular risk patients that significantly reduces cost for that group.
Can I take both Mounjaro and Wegovy?
No — they are both GLP-1 receptor agonists and should not be taken together. Your GP will advise which is appropriate for your situation.
Related reading
Sources: SURMOUNT-5 NEJM (May 2025); ESSENCE NEJM (May 2025); TGA provisional approval Wegovy MASH (April 2026); PBAC December 2025; Australian pricing data (May 2026).
This article is for educational purposes only. It does not constitute medical advice. Always consult your GP or a specialist about your individual health circumstances.
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