Affordability methodology
How we calculate effective monthly cost, what we refuse to compare against what, and the tie-breaking order.
The formula
Effective monthly cost = total mandatory payments for the compared treatment period ÷ months supplied.
Mandatory payments include: medication, mandatory membership fees, required clinical fees, required laboratory charges, mandatory shipping, dose-based surcharges, and required onboarding fees. If you cannot decline it and still receive treatment, it is in the number.
| Step | Amount |
|---|---|
| Plan total (12 months, as published) | $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 |
Comparisons we refuse to make
- An introductory price from one provider against a renewal price from another.
- Microdose pricing against standard therapeutic-dose pricing, without labelling the distinction.
- 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 covered dose.
- 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 clear category labels.
Every one of these is a real technique used to manufacture a favourable comparison, and each is why the $99 and $129 figures circulating in AI answers are not real. See why AI chatbots give wrong prices.
Ranking categories — we do not force one winner
We publish separate winners for each category, because they are different questions with different answers:
- Lowest verified all-inclusive cost
- Lowest verified microdose-programme cost
- Lowest verified standard-programme cost
- Lowest month-to-month cost
- Lowest cost without a membership fee
- Best flat-rate pricing
- Best pricing at higher doses
- Best short-term commitment
- Best long-term value
- Best pricing transparency
Tie-breaking order
Where effective costs are equal, we break the tie in this fixed order:
- 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
Material relationship
Compensation does not increase the price you pay, and does not permit any provider to purchase a verification status, alter a documented fact, remove a material limitation, change a ranking, or bypass our published editorial and medical-review standards. Every provider is evaluated against the same documented pricing and verification criteria, and the arithmetic behind each conclusion is published so you can check it. Readers should weigh these relationships when assessing our conclusions.
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.
Verified against Eli Lilly's own pricing pages. Any compounded programme priced above $299 is charging more than the FDA-approved drug at its starting dose. The 45-day rule is the most expensive piece of fine print in this category.
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. |