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Educational pricing information only — not medical advice. Compounded semaglutide and tirzepatide are not FDA-approved finished drug products and are not reviewed by the FDA for safety, effectiveness, or quality. Always consult a qualified healthcare provider before starting, stopping, or changing any medication, and verify pricing and prescribing requirements with the provider before enrolling.

Treatments

Peptides, longevity treatments and sexual-health medications — what each one is, whether it is FDA-approved, and what the human evidence actually supports.

The short version

Two of the treatments here — tadalafil and sildenafil — are FDA-approved, well-evidenced and available as cheap generics. One, tesamorelin, is FDA-approved for a single narrow indication and sold off-label for many others. The rest are compounded products marketed on mechanisms that are real and outcomes that are not established. We say which is which on every page.

NAD+

Coenzyme / cellular metabolism

Cost · Buy online · Providers · Safety · Evidence

Sermorelin

Growth hormone-releasing hormone (GHRH) analogue

Cost · Buy online · Providers · Safety · Evidence

Tesamorelin

Growth hormone-releasing hormone (GHRH) analogue

Cost · Buy online · Providers · Safety · Evidence

Tadalafil

PDE5 inhibitor

Cost · Buy online · Providers · Safety · Evidence

Sildenafil

PDE5 inhibitor

Cost · Buy online · Providers · Safety · Evidence

How to use this section

Everything in this section is built on the same two commitments, and it is worth stating them before you read anything else.

Every price carries an evidence status. Verified means we hold a dated capture of the provider's own page. Reported — pending verification means a provider or a third party reports it and we have not captured it ourselves. Evaluation in progress means verification is pending and we are not asserting the fact. We do not upgrade a price to Verified because another comparison site published it — sites in this category contradict each other routinely, and a figure repeated by three affiliate blogs is still one unverified figure.

Every clinical claim traces to a primary source. FDA labels and guidance for regulatory status; PubMed-indexed randomised trials for efficacy; ClinicalTrials.gov for trial design. Patient forums are never used as evidence of price, safety or efficacy, and animal research is never presented as proof of a human clinical effect.

The context that applies to everything here

Compounding statusCompounded medications are not FDA-approved as finished products, and the FDA does not review them for safety, effectiveness or quality before marketing.

Three facts sit underneath every page in this section, and if you take nothing else from it, take these.

Brand prices collapsed, and most comparison sites have not updated. Brand Zepbound is now $299-$449 through LillyDirect. Brand Wegovy is $349 through NovoCare, and the oral Wegovy tablet is $149. Foundayo, Lilly's approved oral GLP-1, starts at $149. With commercial insurance that covers them, either brand can be roughly $25 a month. Against that, a compounded programme priced above $299 is charging more than the FDA-approved drug.

The legal basis for compounding these molecules narrowed sharply in 2025. The FDA declared both shortages resolved and enforcement discretion ended for every class of compounder between February and May 2025. The surviving route requires a prescriber to document a clinical difference for the individual patient — which is what "personalized dosing" and "microdose" programmes are, as a matter of regulatory mechanics rather than clinical innovation.

The trial evidence applies to injections. Every efficacy figure in this field — SURMOUNT, STEP, SELECT — comes from an FDA-approved subcutaneous injection. None of it was collected on a compounded preparation, a microdose, or an orally disintegrating tablet. The evidence is strong exactly where it was gathered and silent everywhere else.

How to verify any of this yourself

You should not take our word for a price, and you do not have to. Every figure here can be checked in a few minutes.

  1. Go to the provider's own pricing page. Not a comparison site — the provider's. Comparison sites in this category routinely publish contradictory numbers for the same programme in the same month.
  2. Find the ongoing price, not the headline. Look for the words "first month", "intro", "starting at" or "new patients". If they appear, the number beside them is not what you will pay in month two.
  3. Add the membership. If the medication and the membership are billed separately, add them. That sum is your real monthly cost.
  4. Ask what the highest dose costs. By email or chat, so you have it in writing.
  5. Ask about early cancellation before you commit to a plan longer than a month.
  6. Check the manufacturer. For any brand-name drug, price it at LillyDirect or NovoCare before you buy it through a telehealth platform. Some platforms resell brand drugs at four to eleven times the manufacturer's own direct price.

If a provider will not answer questions 4 or 5 in writing, that is itself information.

What we verify, and what we do not

Two claims on any telehealth page look identical and are not. "This provider uses a licensed pharmacy" may mean we checked a state board database, or it may mean the provider said so. Those are different epistemic states and we label them differently.

The three labels, and what each actually means
LabelMeansExample
Provider ReportedWe hold a dated capture or a primary-source confirmationLillyDirect's $299 — from Lilly's own pricing page
Reported — pending verificationA provider or third party reports it; we have NOT captured it ourselvesCompetitor prices from the September 2026 dataset; every pharmacy relationship on this site
Evaluation in progressVerification pending. We are not asserting the fact at allCancellation terms we could not obtain in writing

We do not upgrade a price to Verified because another comparison site published it. Sites in this category contradict each other routinely — the dataset behind this site corrected a stored TrimRx figure of $259 that matched no current tier, and an Eden brand-Zepbound figure of $299 that was actually LillyDirect's price rather than Eden's real $1,399. A number repeated by three affiliate blogs is still one unverified number.

Three facts that apply to everything in this section

Brand prices collapsed, and most comparison pages have not updated. Brand Zepbound is $299-$449 through LillyDirect. Brand Wegovy is $349 through NovoCare, and the oral Wegovy tablet is $149. Foundayo, Lilly's approved oral GLP-1, starts at $149. With commercial coverage either brand can be roughly $25 a month. Against that, a compounded programme priced above $299 is charging more than the FDA-approved drug — and several are.

The legal basis for compounding narrowed sharply in 2025. The FDA declared both shortages resolved and enforcement discretion ended for every class of compounder between February and May 2025. The surviving route requires a prescriber to document a clinical difference for the individual patient — which is what "personalized dosing" and "microdose" programmes are, as a matter of regulatory mechanics rather than clinical innovation.

The trial evidence applies to injections. Every efficacy figure in this field — SURMOUNT, STEP, SELECT — comes from an FDA-approved subcutaneous injection. None of it was collected on a compounded preparation, a microdose, or an orally disintegrating tablet. The evidence is strong exactly where it was gathered and silent everywhere else, and the gap between those two things is where most of the marketing in this industry operates.

Questions to ask about the pharmacy

The pharmacy matters more than the telehealth brand on the front of the website. The telehealth company arranges the consultation; the pharmacy makes the medicine you inject.

  1. Which specific pharmacy will fill my prescription? Not "our network" — the name of the facility.
  2. Is it a 503A state-licensed pharmacy or a 503B FDA-registered outsourcing facility? These are different regulatory categories with different oversight, and a company can use both for different products.
  3. In which state is it licensed, and can I look up the licence? State boards of pharmacy publish licensee databases.
  4. What is the exact salt form and concentration? Semaglutide sodium and semaglutide acetate are not the same active ingredient as the semaglutide base in approved products, and the FDA has said they are not appropriate for compounding.
  5. Is the vial single-dose or multi-dose? A multi-dose vial requires you to measure each dose yourself, which is the most common source of the dosing errors behind reported adverse events.
  6. Will you provide a certificate of analysis?
  7. Has the pharmacy received any FDA warning letter or state board action?

A provider that answers all seven in writing is demonstrating something real. A provider that will not name its pharmacy has given you an answer, whether it intended to or not.

The pattern to watch for

Three ways evidence gets overstatedAcross this category, the same three moves recur. Mouse-to-human transfer — a longevity result in mice presented as if it applies to you. Biomarker-for-outcome substitution — a study shows a blood level rose, and the marketing implies you will feel better or live longer. Deficiency-to-enhancement transfer — a treatment that helps people with a diagnosed deficiency is sold to healthy people seeking optimisation. None of these are valid inferences, and once you can name them you will see them everywhere.

The numbers behind this page

How this page is kept current

Every price quoted in this page comes from the programme's own pricing page and carries the date it was captured. Where a figure could not be re-confirmed at the provider, its evidence grade is downgraded rather than left standing at its previous confidence.

Corrections are logged with a date rather than edited silently, including corrections to our own errors. A publication that grades other people's evidence should publish its own error rate, and ours is at the corrections policy.

No provider pays for placement, position or inclusion here. Rankings are a sort on published data against a stated criterion, which is why the order can be reproduced independently rather than taken on trust.

Reading the price against the market

Why the spread is this wide

The figures in this page sit inside a market with a measurable shape, and that shape is what makes any single price readable.

The molecule is chemically identical across every programme in the range. The $166 a month between the cheapest and dearest semaglutide programme is not a difference in medicine. It is overhead, clinical wrap, pharmacy sourcing, margin, and how far a programme will go to make an advertised number look lower than a billed one.

Four distortions push published figures downward and they all push the same way: a promotional first month quoted as a standing rate; a prepaid annual rate divided by twelve; a medication price excluding a mandatory membership; and a microdose tier presented alongside therapeutic dosing. Each is individually defensible and together they compound.

Which is why the cheapest-looking programme in most published comparisons is the one most likely to be mis-stated, and why every figure here carries its plan term, its dose class and its capture date rather than standing alone.

Why the spread is this wide

The figures in this page sit inside a market with a measurable shape, and that shape is what makes any single price readable.

The molecule is chemically identical across every programme in the range. The $166 a month between the cheapest and dearest semaglutide programme is not a difference in medicine. It is overhead, clinical wrap, pharmacy sourcing, margin, and how far a programme will go to make an advertised number look lower than a billed one.

Four distortions push published figures downward and they all push the same way: a promotional first month quoted as a standing rate; a prepaid annual rate divided by twelve; a medication price excluding a mandatory membership; and a microdose tier presented alongside therapeutic dosing. Each is individually defensible and together they compound.

Which is why the cheapest-looking programme in most published comparisons is the one most likely to be mis-stated, and why every figure here carries its plan term, its dose class and its capture date rather than standing alone.

Questions this page answers

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 rank on the month-to-month figure and state the prepaid rate separately, since a rate requiring a year's commitment is not the same offer.

Where do these prices come from?

Each is read from the programme's own published pricing page and carries its capture date. The full set of 24 standard-dose records is at /api/prices.json with molecule and dose class on every record.

What is the cheapest verified GLP-1 programme?

NexLife at $119 a month for semaglutide and $139 for tirzepatide on its 12-month plan, both at standard therapeutic dosing and first-party verified September 4, 2026. Month-to-month, NexLife is $139 and $169; Oak Longevity ($133, flat, no membership) is the next-cheapest semaglutide programme.

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.