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 it measures |
|---|---|---|
| Clinical safety and oversight | 25% | Named prescribing clinicians, genuine medical review, dose supervision, contraindication screening |
| Pharmacy transparency | 20% | Is the pharmacy named? 503A or 503B? Licence verifiable? Salt form and concentration disclosed? |
| Total cost, normalised | 20% | Total ongoing monthly cost: medication plus any required membership. Intro rates excluded |
| Pricing transparency | 15% | Are dose-based increases disclosed? Membership fees stated up front? Cancellation terms published? |
| Plan terms and flexibility | 10% | Commitment required, prepayment required, cancellation and refund terms |
| Patient support | 10% | Clinician access between visits, response times, continuity of care |
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'
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, and we may earn a commission when readers use certain links. 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) | $2,232 |
| Mandatory membership fee | $0 |
| Mandatory shipping | $0 — included |
| Dose-based surcharge | $0 — flat at every covered dose |
| Total mandatory payments | $2,232 |
| ÷ months supplied | 12 |
| Effective monthly cost | $186 |
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 are paid to refer.
| Label | Means | Example on this site |
|---|---|---|
| Verified | 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. |