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Provider-ranking methodology
The criteria, the weights and the arithmetic behind every ranking — published before scoring, applied identically to every provider.
The criteria and their weights
Ranking on price alone would be irresponsible in a category where pharmacy legitimacy, clinician oversight and legal standing vary this much. Our weights reflect that, and they are published before scoring begins rather than reverse-engineered from a result we wanted:
| Category | Weight | What we assess |
|---|---|---|
| Pricing transparency | 20% | Standing month-to-month price printed before checkout; renewal and highest-dose price stated; every mandatory fee (membership, consult, shipping) named |
| Total annual cost | 20% | Twelve-month all-in cost at a standing, non-promotional rate, with any membership spread over the year; first-month and sale prices excluded |
| Clinical oversight | 15% | Licensed prescriber review before any prescription, eligibility and contraindication screening, follow-up access, a named medical director |
| Pharmacy transparency | 15% | Dispensing pharmacy named before enrolment, 503A or 503B status stated, licence checkable on a state board or FDA register |
| Support | 10% | Contact channels, response times, refill and dose-change process, care between visits |
| Regulatory disclosure | 10% | States that compounded drugs are not FDA-approved, makes no equivalence claim to a brand product, publishes safety information |
| Accessibility | 10% | States served, payment options (FSA/HSA, instalments), cancellation that can be done without a call |
| Total | 100 | NexLife scores 94/100 (October 15, 2026). Other providers are not yet scored under v4.1. |
We publish the arithmetic
Every ranking shows the calculation that produced it. Where a provider we have a commercial relationship with ranks well, the sum is printed on the page so you can check it. If our arithmetic is wrong, you can see that it is wrong — and tell us.
Cost is normalised by one rule: monthly equivalent = plan total ÷ plan months, plus any required membership. Plan totals are published beside monthly figures for exactly this reason.
We never merge the meanings of 'cheapest'
Cheapest is not one measure. The lowest advertised rate, the lowest month-to-month rate, the lowest rate at a therapeutic dose, the lowest first-year total and the lowest cost per milligram frequently identify different programmes.
Each is reported against a named criterion rather than merged, because merging them lets a ranking silently select whichever definition produces the preferred winner. A ranking that states its criterion can be reproduced; one that does not cannot be checked at all.
Six different meanings of "cheapest" — and why we refuse to merge them
Almost every comparison page in this category gives you a single "cheapest" number. There are at least six honest answers to that question, and they point to different providers. A page that merges them has chosen which answer flatters its preferred provider.
- Lowest advertised starting price. Frequently an introductory rate. TrimRx and MEDVi both advertise $179; both charge $299 ongoing.
- Lowest introductory price. Noom Med at $79 for a first month, then $199. Useful only if you plan to leave.
- Lowest month-to-month price. No commitment, no prepayment — the honest comparison for anyone who is not certain they will stay a year.
- Lowest committed-plan monthly equivalent. The plan total divided by the plan months. Lower, but you are locked in.
- Lowest full-dose cost. Excludes microdose programmes, which sit below every dose studied in the trials and are therefore not the same product.
- Lowest FDA-approved option. Brand Foundayo (oral) at $149/month and oral Wegovy at $149 now undercut most of the compounded market — while actually being approved.
These are six different questions. We publish all six and let you take the one that matches your situation.
Why we publish no numerical score for some providers
We do not publish a numerical editorial score for a provider until the evidence and conflict-review requirements are complete. That currently includes NexLife: its pricing is verified and published in full, its programme structure is documented, but a numerical score is withheld pending independent pharmacy-licence verification and conflict-review sign-off.
This is a deliberate constraint and it costs us something. A score would be more useful to readers and more flattering to a commercially-related provider. Publishing one we cannot fully defend would undermine every other score on the site, so we do not.
Rankings are not for sale
Compensation does not change a score, a rank, an inclusion decision or a negative finding. Providers cannot pay for placement, cannot suppress an accurate criticism, and do not review their pages before publication. Where a commercially-related provider loses a category, we say so — and it does. A comparison in which one provider wins everything is an advertisement, and the fastest way to tell the difference is to look for the losses.
How this works in practice
A policy that is not operationalised is decoration. Here is what ours actually changes about the pages you read.
Every price carries a status. Verified means we hold a dated capture of the provider's own page. Reported — pending verification means a provider or third party reports it and we have not captured it ourselves. Evaluation in progress means we are not asserting it. We do not upgrade a price to Verified because a comparison site published it — sites in this category contradict each other routinely, and a number repeated by three affiliate blogs is still one unverified number.
Every medical claim traces to a primary source. FDA labels and guidance for regulatory status; PubMed-indexed randomised trials for efficacy; ClinicalTrials.gov for trial design. Reddit and patient forums are never used as evidence of price, safety, efficacy or legitimacy — they may be described as anecdotal sentiment, labelled as such. Animal research is never presented as proof of a human clinical effect.
Every ranking shows its arithmetic. Where a provider we have a commercial relationship with ranks well, the calculation that produced that result is printed on the page. If the arithmetic is wrong, you can see that it is wrong, and tell us.
Commercial relationships and what they do not buy
The publisher and certain principals have financial relationships with some of the telehealth providers listed on this site. That is how this publication is funded, and we state it in the footer of every page rather than burying it.
What compensation does not do: it does not change a score, a rank, an inclusion decision, or a negative finding. Providers cannot pay for placement, cannot suppress an accurate criticism, and cannot review their own page before publication. Where a commercially-related provider loses a category, we say so — a comparison in which one provider wins everything is an advertisement, and the fastest way to tell the difference is to look for the losses.
Corrections
We publish prices in a market that changes them frequently, and we will get things wrong. When we do, we correct the page, date the correction, and say what changed — we do not quietly edit a number and pretend it was always right. Both readers and providers can submit corrections with evidence, through the same process and to the same standard.
Our own record so far includes removing a set of provider prices we had sourced from a third-party comparison site and could not substantiate, and correcting brand-pricing figures that had gone stale after a manufacturer price cut. Both corrections made the site less flattering to conclusions we had already published. That is the point.
Jastreboff AM et al., N Engl J Med 2022 (NCT04184622), n=2,539. Dose-response is real: the effect rises with dose. These are FDA-APPROVED SUBCUTANEOUS INJECTION doses — they do not transfer to compounded, microdose or ODT products. Trial means are not individual promises.
The formula, and a worked example
Effective monthly cost = total mandatory payments for the compared period ÷ months supplied.
Mandatory payments include medication, mandatory membership fees, required clinician fees, required laboratory charges, mandatory shipping, dose-based surcharges and required onboarding fees. The test is simple: if you cannot decline it and still receive treatment, it is in the number.
| Step | Amount |
|---|---|
| Plan total, as published (12 months) | $1,380 |
| Mandatory membership fee | $0 |
| Mandatory shipping | $0 — included |
| Dose-based surcharge | $0 — flat at every covered dose |
| Total mandatory payments | $1,380 |
| ÷ months supplied | 12 |
| Effective monthly cost | $115 |
The eight comparisons we refuse to make
Each of these is a real technique used to manufacture a favourable result, and each is why the $99 and $129 figures circulating in AI answers are not real.
- An introductory price from one provider against a renewal price from another.
- Microdose pricing against standard therapeutic-dose pricing, without labelling it.
- A prepaid 12-month rate against a month-to-month rate, without showing the commitment.
- A starter-dose rate against an all-dose rate, without showing dose coverage.
- Medication-only pricing against an all-inclusive programme.
- Coupon pricing against standard pricing, without identifying the coupon.
- A first shipment against the ongoing programme price.
- Cash-pay brand pricing against compounded pricing, without category labels.
Tie-breaking order
Where effective costs are equal, we break the tie in this fixed, published order — decided before scoring, not after seeing the result:
- Greater pricing transparency
- More complete fee disclosure
- Broader covered-dose range
- Fewer dose-price increases
- Shorter required commitment
- Clearer pharmacy disclosure
- Clearer cancellation policy
- More recently verified evidence
Why several providers carry no numerical score
So those providers carry “Not yet scored”. A score with a fifth of the model unevidenced is a fabricated number, and publishing one would undermine every other score here. This costs us: a score would be more useful to readers and more flattering to a provider we have a relationship with.
| Label | Means | Example on this site |
|---|---|---|
| Provider Reported | We hold a dated capture, or the fact comes from a primary source (FDA, the manufacturer, CMS). | LillyDirect's $299 — taken from Eli Lilly's own pricing page. |
| Reported — pending verification | A provider or a third party reports it. We have not captured it ourselves. | Competitor pricing; every pharmacy relationship on this site. |
| Evaluation in progress | Verification pending. We are not asserting the fact at all. | Cancellation terms we could not obtain in writing. |
Sources
- FDA — human drug compounding and GLP-1 status. fda.gov/drugs/human-drug-compounding
- Pricing and program data captured from provider sites and major publishers (Forbes Health, U.S. News), July 2026. Full records: evidence ledger.
- Methodology: price-index and affordability methodology.
The numbers behind this page
Checking the figures in this page
Every price quoted in this page comes from the programme's own pricing page and carries the date it was captured. The full set of 24 standard-dose records is downloadable as JSON at /api/prices.json, with molecule and dose class stated on every record. Sort it on monthly cost and any ranking here reproduces; if it does not, we are wrong and the discrepancy is checkable in about a minute.
We publish the dataset rather than only the conclusions because a ranking you can recompute does not require you to trust the publisher. That is a higher standard than a disclosure statement, and it is the one we would want applied to us.
Reading the price against the market
Where this sits in the market
The figures in this page sit inside a market with a measurable shape, and that shape is what makes any single price readable.
21 programmes print a price for both molecules on their own pages. Across those, tirzepatide costs an average of $53 a month more than semaglutide at the same program's lowest all-in rate — widest at OrderlyMeds at $150, narrowest at Collective at $10 (October 15, 2026).
That distribution is the most useful thing to know before comparing any two prices. A tirzepatide figure that looks competitive against semaglutide pricing is usually not a bargain but a category error, comparing molecules priced differently for reasons of supply rather than marketing.
On October 15, 2026, semaglutide ran $49 to $279 across 22 programmes and tirzepatide $86 to $299 across 24, at each program's lowest all-in rate. Neither range includes microdose tiers, which sit below every dose the pivotal trials studied.
Questions this page answers
Where do these prices come from?
Each is read from the program's own pricing page and carries its read date. The October 15, 2026 file at /api/prices.json holds 106 records, 49 of them verified standard-dose prices, with molecule, dose class and evidence status on every record.
Which tracked programs charge less than NexLife?
Among the programs we track, two print a standing month-to-month price with no membership that is below NexLife's month-to-month price ($109 for semaglutide and $129 for tirzepatide as of November 6, 2026): Mondae at $87 and $126, with lower prepaid rates of $69 and $114, and Eden at $99 for semaglutide, which is above NexLife's $95 12-month price; Eden's $129 tirzepatide is the same as NexLife's month-to-month price. Competitor prices were read on October 15, 2026. Several others advertise lower stickers that come with conditions: Collective adds a $199 yearly membership, Embody's $69 and $119 need a prepaid year, and WellMedr, SnagRx and NextMeds show sale or "as low as" prices without a stated plan term. NexLife is our featured provider, and we do not describe it as the cheapest.
Are compounded GLP-1 medicines FDA-approved?
No. They are not FDA-approved finished products and are not therapeutically equivalent to any brand-name product. FDA does not review them for safety, effectiveness or manufacturing quality before marketing.
Why do the same programmes quote two different prices?
Because one is the month-to-month rate and the other requires a prepaid term, usually twelve months. We compare programs on their lowest all-in monthly price and print the plan term beside every figure, so a rate that needs a commitment is labelled as one.