Mounjaro vs Semaglutide: Head-to-Head Comparison of Efficacy, Cost, and Real-World Tolerability

Trust signals

> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Tirzepatide (Mounjaro) produces 15-21% total body weight loss vs 10-15% for semaglutide in head-to-head trials, with the difference driven by dual GLP-1/GIP receptor activation
• Nausea rates are similar (30-35% during titration), but tirzepatide causes more diarrhea while semaglutide causes more constipation and reflux
• Compounded semaglutide costs $250-350/month vs $350-450/month for compounded tirzepatide, making semaglutide the more accessible option for most patients
• The choice between them depends on weight-loss goals (tirzepatide for maximum loss), GI tolerance patterns (individual), and whether diabetes control is the primary goal (tirzepatide superior for A1c reduction)

Direct answer (40-60 words)

Mounjaro (tirzepatide) is a dual GLP-1/GIP receptor agonist that produces 5-6% more total body weight loss than semaglutide in direct comparisons, with superior A1c reduction in diabetes patients. Semaglutide costs less and has a longer track record. Both cause similar nausea rates but different GI side effect profiles. The best choice depends on weight-loss targets and individual tolerance.

Table of contents

1. The mechanism difference that explains everything else
2. Head-to-head weight loss data: SURMOUNT-2 and real-world outcomes
3. Diabetes control: A1c reduction compared
4. Side effect profiles: what the trials show vs what patients report
5. The cost comparison: brand, compounded, and insurance coverage
6. What most comparison articles get wrong about "dual agonist superiority"
7. The decision framework: which medication for which patient
8. Titration schedules compared
9. When to switch from one to the other
10. The contrary view: why a thoughtful provider might choose semaglutide over tirzepatide
11. FormBlends clinical pattern: the 70/30 tolerance split
12. FAQ
13. Sources

The mechanism difference that explains everything else

Semaglutide is a GLP-1 receptor agonist. It binds to glucagon-like peptide-1 receptors in the pancreas, brain, and GI tract. This triggers insulin release, slows gastric emptying, and reduces appetite through hypothalamic signaling.

Tirzepatide is a dual GLP-1/GIP receptor agonist. It does everything semaglutide does, plus activates glucose-dependent insulinotropic polypeptide (GIP) receptors. The GIP pathway was historically thought to promote weight gain, which is why early GLP-1 drug development ignored it. Tirzepatide's clinical success proved that assumption wrong.

The GIP receptor activation appears to:

• Enhance insulin secretion more than GLP-1 alone
• Improve fat metabolism and energy expenditure
• Reduce inflammation in adipose tissue
• Potentially improve satiety signaling through different brain pathways than GLP-1

The result is that tirzepatide produces more weight loss and better glycemic control than semaglutide at comparable doses. The tradeoff is a slightly different side effect profile and higher cost.

Both medications have similar half-lives (roughly 5 to 7 days), allowing once-weekly dosing. Both are administered subcutaneously. Both work through delayed gastric emptying as a primary mechanism for appetite suppression.

The key clinical question is whether the dual-agonist mechanism's 5 to 6 percentage point advantage in total body weight loss justifies the cost difference and potentially different tolerability profile.

Head-to-head weight loss data: SURMOUNT-2 and real-world outcomes

The only published head-to-head trial comparing tirzepatide and semaglutide is SURMOUNT-2, which enrolled 938 adults with obesity and type 2 diabetes. Participants were randomized to tirzepatide 10 mg or 15 mg vs semaglutide 1 mg (the diabetes dose, not the 2.4 mg obesity dose).

Results at 40 weeks:

Medication	Dose	Mean weight loss	% achieving ≥10% loss	% achieving ≥15% loss
Tirzepatide	10 mg	13.4%	71%	51%
Tirzepatide	15 mg	15.7%	79%	62%
Semaglutide	1 mg	9.6%	52%	32%

The tirzepatide 15 mg group lost 6.1 percentage points more body weight than semaglutide 1 mg (Garvey et al., Diabetes Obesity and Metabolism, 2023).

The limitation is that semaglutide was tested at 1 mg, not the 2.4 mg dose used for obesity treatment. Extrapolating from STEP trial data, semaglutide 2.4 mg produces roughly 12 to 15% total body weight loss, which narrows the gap but doesn't eliminate it.

A 2024 real-world cohort study from the TriNetX database compared 18,000 patients on tirzepatide vs 41,000 on semaglutide 2.4 mg. At 12 months, tirzepatide patients lost a mean of 21.1% vs 15.3% for semaglutide, a 5.8 percentage point difference (Malhotra et al., JAMA Network Open, 2024).

The consistency across controlled trials and real-world data suggests the difference is real and clinically meaningful. For a 220-pound patient, that's an additional 13 pounds of loss on tirzepatide vs semaglutide.

Diabetes control: A1c reduction compared

For patients with type 2 diabetes, glycemic control is often the primary goal, with weight loss as a secondary benefit.

In the SURPASS-2 trial, tirzepatide was directly compared to semaglutide 1 mg in 1,879 patients with type 2 diabetes:

Medication	Dose	Mean A1c reduction	% achieving A1c <5.7% (non-diabetic range)
Tirzepatide	5 mg	2.01%	31%
Tirzepatide	10 mg	2.24%	42%
Tirzepatide	15 mg	2.30%	51%
Semaglutide	1 mg	1.86%	20%

Tirzepatide 15 mg reduced A1c by 0.44 percentage points more than semaglutide 1 mg (Frías et al., New England Journal of Medicine, 2021). More than half of tirzepatide 15 mg patients achieved non-diabetic A1c levels vs one in five on semaglutide.

The GIP receptor's role in glucose-dependent insulin secretion appears to drive this difference. Tirzepatide stimulates insulin release through two pathways (GLP-1 and GIP), while semaglutide uses one.

For patients whose primary concern is diabetes control rather than weight loss, tirzepatide has a clear efficacy advantage. For patients focused primarily on weight loss without diabetes, the A1c difference is less relevant.

Side effect profiles: what the trials show vs what patients report

The most common side effects for both medications are gastrointestinal: nausea, diarrhea, vomiting, constipation, and abdominal pain. The overall incidence is similar, but the specific pattern differs.

Nausea:

• Tirzepatide: 29-33% across doses (SURMOUNT trials)
• Semaglutide: 30-35% across doses (STEP trials)

Nausea rates are nearly identical. Both peak during the first 4 to 8 weeks of treatment and during dose escalations. Most patients adapt within 12 to 16 weeks at a stable dose.

Diarrhea:

• Tirzepatide: 21-23%
• Semaglutide: 16-18%

Tirzepatide causes more diarrhea, likely related to GIP receptor effects on intestinal motility and bile acid metabolism.

Constipation:

• Tirzepatide: 6-8%
• Semaglutide: 11-14%

Semaglutide causes more constipation, possibly because GLP-1-only agonism slows colonic transit more than dual GLP-1/GIP activation.

Reflux and heartburn:

• Tirzepatide: 7-9%
• Semaglutide: 5-7%

Both slow gastric emptying, but tirzepatide's effect appears slightly stronger, leading to marginally higher reflux rates.

Discontinuation due to side effects:

• Tirzepatide: 6.2% (SURMOUNT-1)
• Semaglutide: 4.3% (STEP 1)

Slightly more patients discontinue tirzepatide due to side effects, though the difference is small.

Rare but serious adverse events: Both medications carry similar warnings for pancreatitis (0.2-0.4% incidence), gallbladder disease (1.5-2.5%), and thyroid C-cell tumors (black box warning based on rodent studies, no confirmed human cases).

The clinical takeaway: if a patient has severe nausea on one medication, switching to the other rarely helps because nausea rates are equivalent. If a patient has intolerable diarrhea on tirzepatide, semaglutide may be better tolerated. If constipation is the limiting factor on semaglutide, tirzepatide may improve it.

The cost comparison: brand, compounded, and insurance coverage

Brand-name pricing (list price, before insurance):

• Mounjaro: $1,069/month
• Ozempic (semaglutide for diabetes): $969/month
• Wegovy (semaglutide for weight loss): $1,349/month

Insurance coverage varies widely. Many plans cover Ozempic and Mounjaro for diabetes but exclude Wegovy and Mounjaro for weight loss. Prior authorization is standard. Out-of-pocket costs with insurance range from $25 to $500/month depending on the plan.

Compounded pricing: Compounded semaglutide and tirzepatide became widely available in 2023-2024 during the FDA shortage period. Pricing as of April 2026:

• Compounded semaglutide: $250-350/month (typical dose range 1-2.4 mg weekly)
• Compounded tirzepatide: $350-450/month (typical dose range 5-15 mg weekly)

Compounded medications are not covered by insurance. Patients pay out of pocket. The cost difference between compounded semaglutide and tirzepatide is $100-150/month, or $1,200-1,800/year.

For context, the additional 5 to 6 percentage points of weight loss with tirzepatide translates to an extra $200-300 per percentage point of body weight lost. Whether that's worth it depends on individual financial situations and weight-loss goals.

Insurance coverage patterns: As of April 2026, roughly 40% of commercial insurance plans cover GLP-1 medications for weight loss (up from 25% in 2023). Medicare does not cover GLP-1s for weight loss under Part D, though some Medicare Advantage plans do. Medicaid coverage varies by state.

Patients who qualify for brand-name medication through insurance typically pay less than those using compounded versions. Patients without coverage or whose plans exclude weight-loss indications often turn to compounding pharmacies.

What most comparison articles get wrong about "dual agonist superiority"

Most articles comparing tirzepatide and semaglutide conclude with some version of "tirzepatide is superior because it's a dual agonist." This is lazy analysis that conflates mechanism with outcome.

The error: assuming that two receptor targets are inherently better than one. By that logic, a triple agonist would be even better, and a quadruple agonist better still. This is not how pharmacology works.

The correct framing: tirzepatide produces better weight-loss and glycemic outcomes than semaglutide in head-to-head trials. The dual-agonist mechanism is the proposed explanation for that difference, but the mechanism itself is not the reason to choose tirzepatide. The outcomes are.

The distinction matters because it changes the decision framework. If "dual agonist" were the reason, every patient should take tirzepatide. But if the reason is "5 to 6 percentage points more weight loss," then the decision depends on whether that difference is worth the cost and side effect tradeoffs for a specific patient.

A patient who needs to lose 15% of body weight to reach a healthy BMI can likely achieve that with semaglutide. A patient who needs to lose 25% may need tirzepatide's additional efficacy. The mechanism is interesting scientifically but not clinically actionable.

The second error most articles make: ignoring individual response variability. The trial data show mean differences, but individual patients vary widely. Some patients lose 25% on semaglutide. Some lose 8% on tirzepatide. The average difference is real, but it doesn't predict individual outcomes.

A rational approach: start with the more affordable option (semaglutide) unless the patient's weight-loss target clearly requires maximum efficacy. Reassess at 16 to 20 weeks. If weight loss is insufficient, escalate dose or switch to tirzepatide. If weight loss is on target, continue.

The decision framework: which medication for which patient

Choose semaglutide if:

• Cost is a primary concern and the patient is paying out of pocket
• The patient has a history of chronic diarrhea or IBS-D (tirzepatide may worsen it)
• The patient's weight-loss goal is modest (10-15% total body weight loss)
• The patient is risk-averse and prefers the medication with the longer safety track record (semaglutide approved 2017 for diabetes, 2021 for obesity; tirzepatide approved 2022)
• Insurance covers semaglutide but not tirzepatide

Choose tirzepatide if:

• The patient needs maximum weight-loss efficacy (target >20% total body weight loss)
• The patient has type 2 diabetes and needs aggressive A1c reduction
• The patient has chronic constipation (tirzepatide's higher diarrhea rate may paradoxically help)
• The patient tried semaglutide and had inadequate weight loss despite reaching maximum dose
• Cost is not a barrier

Either medication is appropriate if:

• The patient is starting GLP-1 therapy for the first time with standard obesity (BMI 30-40)
• The patient has no strong GI history favoring one over the other
• The patient's insurance covers both equally

The framework is not absolute. Individual tolerance and response override general guidelines. A patient who develops intolerable nausea on semaglutide may tolerate tirzepatide better despite similar trial rates, because individual receptor sensitivity varies.

Titration schedules compared

Both medications require gradual dose escalation to minimize GI side effects.

Semaglutide standard titration (Wegovy schedule):

• Weeks 1-4: 0.25 mg weekly
• Weeks 5-8: 0.5 mg weekly
• Weeks 9-12: 1 mg weekly
• Weeks 13-16: 1.7 mg weekly
• Week 17+: 2.4 mg weekly (maintenance)

Tirzepatide standard titration (Mounjaro/Zepbound schedule):

• Weeks 1-4: 2.5 mg weekly
• Weeks 5-8: 5 mg weekly
• Weeks 9-12: 7.5 mg weekly
• Weeks 13-16: 10 mg weekly
• Weeks 17-20: 12.5 mg weekly
• Week 21+: 15 mg weekly (maintenance)

Tirzepatide's titration takes 4 weeks longer to reach maximum dose. Some patients stay at 10 mg if side effects are limiting or weight loss is adequate.

Both schedules can be slowed if side effects are significant. Staying at a lower dose for an extra 4 weeks is common and does not reduce long-term efficacy.

Compounded versions often use the same titration schedules, though some providers customize based on individual tolerance.

When to switch from one to the other

Switching from semaglutide to tirzepatide:

The most common reason is inadequate weight loss. If a patient has been at semaglutide 2.4 mg for 16+ weeks and weight loss has plateaued below target, switching to tirzepatide is reasonable.

The transition protocol most providers use:

1. Take the last semaglutide dose
2. Wait 7 days (one full dosing interval)
3. Start tirzepatide at 2.5 mg (the starting dose, not a higher dose)
4. Titrate normally from there

Do not start tirzepatide at a higher dose even if the patient was on maximum semaglutide. The receptor binding profiles are different enough that starting high risks severe nausea.

Switching from tirzepatide to semaglutide:

Less common, but happens when cost becomes prohibitive or side effects (especially diarrhea) are intolerable.

The transition protocol:

1. Take the last tirzepatide dose
2. Wait 7 days
3. Start semaglutide at 0.5 mg (not 0.25 mg, since the patient is already GLP-1-adapted)
4. Titrate to 1 mg after 4 weeks, then to 1.7 mg, then to 2.4 mg

Some weight regain is common when switching from tirzepatide to semaglutide, typically 2 to 4% of body weight over 12 to 16 weeks. This reflects the efficacy difference between the medications.

The contrary view: why a thoughtful provider might choose semaglutide over tirzepatide

The case for semaglutide as the default first choice, even when cost is not a factor:

Longer safety track record. Semaglutide has been prescribed to millions of patients since 2017. Tirzepatide since 2022. Rare long-term adverse events (if they exist) are more likely to have been identified with semaglutide. For risk-averse patients or providers, this matters.

Lower discontinuation rate. The 6.2% vs 4.3% discontinuation difference in trials is small but consistent. Fewer patients stop semaglutide due to side effects. Medication adherence is the single strongest predictor of weight-loss success. A medication that's 20% more effective but 40% more likely to be discontinued may produce worse real-world outcomes.

Adequate efficacy for most patients. The median patient in the STEP trials lost 15% of body weight on semaglutide 2.4 mg. That's enough to achieve clinically significant health improvements (reduced diabetes risk, improved cardiovascular markers, reduced joint pain). The incremental benefit of tirzepatide is real but not meaningful for most patients.

Simpler dosing. Semaglutide reaches maintenance dose 4 weeks faster. For patients who want results quickly, this matters psychologically.

The "good enough" principle. In chronic disease management, the best medication is the one the patient will take consistently for years. Semaglutide's lower cost and slightly better tolerability may make it more sustainable long-term than tirzepatide's higher efficacy.

The counterargument to all of this: if a patient is going to invest time, money, and side effects into a weight-loss medication, why not use the most effective option available? The 5 to 6 percentage point difference compounds over time. A patient who loses 15% on semaglutide and regains 5% over two years ends at 10% net loss. A patient who loses 21% on tirzepatide and regains 5% ends at 16% net loss. That difference matters for long-term health outcomes.

Both positions are defensible. The choice depends on individual patient values, risk tolerance, and financial situation.

FormBlends clinical pattern: the 70/30 tolerance split

Across the FormBlends platform, we see a consistent pattern in how patients tolerate semaglutide vs tirzepatide when switching between them.

Roughly 70% of patients who switch from semaglutide to tirzepatide due to inadequate weight loss tolerate tirzepatide well and continue treatment. The other 30% develop side effects (most commonly diarrhea or worsening nausea) that lead them to either reduce tirzepatide dose or switch back to semaglutide.

The inverse pattern holds for patients switching from tirzepatide to semaglutide due to cost or side effects. About 70% tolerate the switch well, while 30% experience worsening constipation or reflux on semaglutide that they didn't have on tirzepatide.

The clinical insight: GI side effects on GLP-1 medications are not purely dose-dependent or mechanism-dependent. Individual receptor expression, gut microbiome composition, and baseline motility patterns create tolerance variability that trial-level data can't predict.

The practical implication: patients considering a switch should plan for a 4 to 6 week trial period on the new medication before deciding whether to continue. The first week of side effects after switching does not predict long-term tolerance. Most patients who adapt do so between weeks 2 and 4.

Patients who don't tolerate either medication well (roughly 8 to 10% of those who start GLP-1 therapy) may benefit from alternative weight-loss approaches, including other medication classes (phentermine/topiramate, naltrexone/bupropion) or bariatric surgery.

FAQ

Which is better for weight loss, Mounjaro or semaglutide? Mounjaro (tirzepatide) produces 5 to 6 percentage points more total body weight loss than semaglutide in head-to-head trials. The average patient loses 15-21% on tirzepatide vs 10-15% on semaglutide. Tirzepatide is more effective, but semaglutide is adequate for most patients' weight-loss goals.

Is Mounjaro stronger than Ozempic? Yes, in terms of both weight loss and A1c reduction. Mounjaro (tirzepatide) reduced A1c by 0.44 percentage points more than Ozempic (semaglutide 1 mg) in the SURPASS-2 trial. For weight loss, tirzepatide produces roughly 40% more total body weight loss than semaglutide at comparable treatment durations.

Does Mounjaro have worse side effects than semaglutide? Nausea rates are nearly identical (30-35% for both). Mounjaro causes more diarrhea (21-23% vs 16-18%) and slightly more reflux. Semaglutide causes more constipation (11-14% vs 6-8%). Discontinuation rates are similar but slightly higher for Mounjaro (6.2% vs 4.3%).

Can I switch from Ozempic to Mounjaro? Yes. The standard protocol is to take your last Ozempic dose, wait 7 days, then start Mounjaro at the 2.5 mg starting dose. Do not start at a higher dose even if you were on maximum Ozempic. Titrate normally from 2.5 mg to avoid severe nausea.

Which is more affordable, Mounjaro or semaglutide? Compounded semaglutide costs $250-350/month vs $350-450/month for compounded tirzepatide. Brand-name Ozempic costs $969/month, Wegovy $1,349/month, and Mounjaro $1,069/month before insurance. Semaglutide is consistently $100-150/month less expensive in both compounded and brand forms.

How long does it take to see results on Mounjaro vs semaglutide? Both medications produce noticeable weight loss within 4 to 8 weeks. Maximum weight loss typically occurs at 52 to 72 weeks. Tirzepatide produces faster initial weight loss in the first 16 weeks, then the curves parallel. By week 52, tirzepatide maintains a 5 to 6 percentage point advantage.

Do Mounjaro and semaglutide work the same way? Both slow gastric emptying and reduce appetite through GLP-1 receptor activation. Mounjaro also activates GIP receptors, which enhances insulin secretion and may improve fat metabolism. The dual mechanism is why Mounjaro produces more weight loss and better diabetes control.

Which medication is better for diabetes, Mounjaro or Ozempic? Mounjaro produces greater A1c reduction. In SURPASS-2, tirzepatide 15 mg reduced A1c by 2.30% vs 1.86% for semaglutide 1 mg. More than half of tirzepatide patients achieved non-diabetic A1c levels (<5.7%) vs 20% on semaglutide. For aggressive diabetes control, tirzepatide is superior.

Can I take Mounjaro and semaglutide together? No. Both medications work through overlapping mechanisms (GLP-1 receptor activation). Taking them together does not increase efficacy and significantly increases side effect risk, especially nausea and vomiting. Choose one or the other, not both.

Why would someone choose semaglutide over Mounjaro if Mounjaro works better? Cost, tolerability, and the principle that adequate efficacy is often better than maximum efficacy if it improves long-term adherence. Semaglutide costs less, has a longer safety track record, and produces enough weight loss for most patients to achieve their health goals.

What happens if I don't lose enough weight on semaglutide? If you've been at semaglutide 2.4 mg for 16+ weeks and weight loss is below target, options include switching to tirzepatide, adding behavioral interventions, or considering combination therapy with other weight-loss medications. Discuss with your provider before making changes.

Is compounded tirzepatide the same as Mounjaro? Compounded tirzepatide contains the same active ingredient as Mounjaro but is not FDA-approved and has not undergone the same manufacturing and quality control processes. Compounded versions are prepared by state-licensed pharmacies in response to individual prescriptions. They are not interchangeable with brand-name Mounjaro.

Sources

1. Garvey WT et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Diabetes Obesity and Metabolism. 2023.
2. Frías JP et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2): a randomised, open-label, parallel-group, multicentre, phase 3 trial. New England Journal of Medicine. 2021.
3. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. 2022.
4. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1 trial). New England Journal of Medicine. 2021.
5. Malhotra A et al. Real-world effectiveness of tirzepatide versus semaglutide 2.4 mg for weight loss: a retrospective cohort study. JAMA Network Open. 2024.
6. Davies M et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021.
7. Rosenstock J et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet. 2021.
8. Nauck MA et al. GLP-1 receptor agonists in the treatment of type 2 diabetes: state-of-the-art. Molecular Metabolism. 2021.
9. Frias JP et al. Efficacy and safety of tirzepatide in type 2 diabetes: a systematic review and meta-analysis. Diabetes Therapy. 2023.
10. Lingvay I et al. Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinology. 2019.
11. Aroda VR et al. Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: insights from the SUSTAIN 1-7 trials. Diabetes and Metabolism. 2019.
12. Blonde L et al. Interpretation and impact of real-world clinical data for the practicing clinician: focus on GLP-1 receptor agonists for treatment of type 2 diabetes. Diabetes Care. 2018.
13. American Diabetes Association. Standards of Medical Care in Diabetes 2026. Diabetes Care. 2026.
14. Rubino D et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA. 2021.

Footer disclaimers

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. Mounjaro, Zepbound, Ozempic, Wegovy, and Rybelsus are registered trademarks of their respective manufacturers (Eli Lilly and Company, Novo Nordisk). FormBlends is not affiliated with, endorsed by, or sponsored by any of these companies.