NAD+ therapy cost: what to expect, and how to evaluate any quote

How NAD+ therapy differs from the alternatives

NAD+ is not a peptide, and it is not like the others on this site. Sermorelin and tesamorelin are GHRH analogues that act on the pituitary. NAD+ is a coenzyme — a small molecule present in every living cell, central to mitochondrial energy production and to sirtuin and PARP enzyme activity.

That difference matters for how you should read the evidence. With the GHRH peptides, the mechanism is demonstrable and the outcome evidence is weak. With NAD+, the underlying cell biology is genuinely solid — NAD+ levels really do decline with age, and that decline really is implicated in mitochondrial dysfunction. What has not been established is that raising NAD+ in a human reverses any of it.

Human trials of NAD+ precursors have been small and short, have generally shown that blood NAD+ can be raised, and have largely failed to demonstrate the downstream clinical benefits the marketing promises. This is the purest example on the site of biomarker-for-outcome substitution: a real biological change being sold as a health outcome it has not been shown to produce.

Cost

How to evaluate any quote you are given

Since we will not hand you a number we cannot stand behind, the useful thing we can give you is the method. Every quote in this category should be normalised the same way we normalise GLP-1 pricing.

Why we publish no number here, when every competitor does

Search this treatment and you will find a dozen pages confidently quoting a monthly price. We could do the same in five minutes. We have not, and the reason is worth stating because it is the whole difference between this site and those.

A price is a claim about the world. To publish one responsibly you need to have captured it — from the provider's own page, on a stated date, with the fee structure, the commitment, the dose ceiling and the cancellation terms attached. Anything less is repetition, and repetition is how the contradictory figures in this industry propagate: one site guesses, three copy it, and by the fourth it reads as consensus.

We have captured that evidence for GLP-1 pricing, which is why our GLP-1 pages carry dated figures and evidence labels. We have not captured it for this treatment. So we publish the method for evaluating a quote instead of a number we cannot defend — and when we do capture it, it will appear here with a source and a date.

What a commitment actually costs you

Questions to ask before you pay

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.

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.

The context that applies to this whole category

Three patterns recur across peptide and longevity marketing, and once you can name them you will see them everywhere.

Mouse-to-human transfer. A striking longevity or fat-loss result in mice is presented as though it applies to you. Mouse longevity findings have a long and well-documented history of not translating to humans.

Biomarker-for-outcome substitution. A study shows a blood level rose — NAD+, IGF-1, growth hormone — and the marketing implies you will therefore feel better, look better or live longer. Raising a biomarker is not the same as improving an outcome, and for most of these treatments the outcome studies simply have not been done.

Deficiency-to-enhancement transfer. A treatment that genuinely helps people with a diagnosed deficiency is sold to healthy people seeking optimisation. Tesamorelin works for HIV-associated lipodystrophy; that is not evidence that it works for a healthy 45-year-old who wants a flatter stomach.

None of these are valid inferences. All three are standard in this industry's marketing.