Research methodology
How we find, grade and represent the scientific literature behind these treatments.
How we find studies
PubMed and ClinicalTrials.gov first, manufacturer press releases last. We prefer registrational and head-to-head randomised trials, and we read the limitations section before the abstract.
How we grade them
Every study page states the design, population, sample size, intervention, comparator, duration, primary endpoint, funder and — the section usually missing — what the study does not prove. Extrapolation past the tested population, dose, duration or dosage form is the most common misuse of this literature, and it is the one we guard against hardest.
How we represent results
We give absolute figures alongside relative ones. A '20% reduction in cardiovascular events' is an absolute reduction from 8.0% to 6.5% over roughly three years. Both are honest; only one tells you what to expect.
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. |