Intake Forms and Screening

What you are actually buying

A telehealth subscription bundles four things that are frequently priced as one: a clinical review, a prescription, fulfilment through a pharmacy, and ongoing access to somebody who will answer a question. Programmes differ enormously in how much of each they provide, and the difference is invisible in a monthly price.

The question that separates care from a vending machine

Can this programme decline to prescribe? A service that guarantees approval before a clinician has seen your history is not running a clinical process, whatever else it discloses. The most reassuring thing a telehealth service can do is turn someone away.

What the care model changes about your bill

Video visits, included laboratory work and real clinician access cost money to provide, and programmes that provide them are rarely the cheapest. That is not a scandal — it is what you are paying for. The failure is paying a premium for an asynchronous questionnaire that a cheaper programme provides identically.

What we could not verify

Response times, whether the same clinician sees you twice, and how a programme behaves when something goes wrong. We hold no measurements of those we would defend, so they are absent from every table rather than estimated.

What a subscription actually buys

Four things, usually priced as one: a clinical review, a prescription, fulfilment through a pharmacy, and ongoing access to somebody who will answer a question. Programmes differ enormously in how much of each they provide, and the difference is invisible in a monthly price.

The most expensive programmes are not reliably the ones providing the most. Some are simply carrying more marketing cost, and a cheaper programme that names its pharmacy and answers messages within a day is providing more of what matters.

The test that separates care from a vending machine

Can this programme decline to prescribe? A service that guarantees approval before a clinician has seen your history is not running a clinical process, whatever else it discloses. The most reassuring thing a telehealth service can do is turn somebody away.

Ask what histories would stop a prescription being written. A programme that can answer has clinical governance; one that treats the question as an obstacle does not.

Where asynchronous care is genuinely adequate

For an uncomplicated patient with a clear history, a well-designed questionnaire reviewed by a licensed clinician is a reasonable standard of care and is how a large share of prescriptions in this category are written. It is faster, cheaper and no less careful when the intake is designed to surface contraindications.

It is weaker where the history is complicated, where the answers need follow-up questions, or where somebody is likely to under-report. A video visit is not automatically better care, but it is harder to complete on autopilot.

How this connects to what you will actually pay

Everything in this section resolves to one number: the all-in monthly cost at the dose you end up holding. Across the 16 programmes we price, that runs from $215 at the cheapest tracked route to several times that at the most expensive, for the identical molecule from the same category of licensed pharmacy.

5 of those programmes charge a recurring platform fee on top of medication and 12 hold one price at every strength. Those two facts explain most of the spread between advertised prices and real ones.

What we could verify and what we could not

11 of 32 tracked programmes have a price we read at the provider or manufacturer. The rest carry third-party figures we have not confirmed, or publish nothing we can interpret. Every table on this site marks which is which, and the comparison matrix lets you filter to verified prices only.

Where we have checked a third-party figure against a provider's own page, it has almost always moved — and it has moved upward. Promotional first months, prepaid bundle rates and medication-only figures that exclude memberships are all published as ongoing all-in prices. Assume an unverified figure is optimistic.

The regulatory distinction that sits under all of this

Compounded tirzepatide is not FDA-approved. FDA does not review compounded preparations for safety, effectiveness or quality before they are marketed. The active molecule is the same as the branded product; the pre-market review is not, and the assurance comes instead from the pharmacy, the state board that licenses it and, at good operations, batch sterility and potency testing.

That is a legitimate framework rather than a loophole, and it is also why the price is lower. It puts more of the verification burden on the patient, which is the honest trade being made.

Compounded is not a generic, and the difference is technical

A generic medicine has demonstrated bioequivalence to a reference product and been approved on that basis. A compounded preparation has done neither. It contains the same active molecule, but the formulation, concentration, excipients, container and beyond-use dating are decisions made by the compounding pharmacy rather than specifications reviewed by a regulator.

Practically, that means two vials of compounded tirzepatide from different pharmacies are not necessarily interchangeable. Concentration varies between operations, which is why dosing instructions are given in units or millilitres rather than by the pen click a Zepbound user would recognise, and why switching programmes mid-course requires confirming the new concentration rather than assuming it.

None of that makes compounding illegitimate. It does move a layer of quality assurance from a federal review process onto a pharmacy you can, and should, check.

Where the evidence stops

The trial evidence for tirzepatide concerns the approved product at studied doses. It does not extend to compounded preparations, to microdosing schedules marketed as a cheaper entry point, or to combination vials with added vitamins. Those may be reasonable in practice, but the evidence base does not follow them.

Anyone citing trial outcomes to sell a compounded preparation is borrowing credibility from a product they are not dispensing. The honest framing is that the molecule has strong evidence behind it and the specific preparation in the vial has the pharmacy's assurance behind it.

What the dose ladder means for your bill

The approved ladder runs 2.5, 5, 7.5, 10, 12.5 and 15 mg weekly. Clinical trials studied 5, 10 and 15 mg as maintenance arms; the intermediate steps exist for titration rather than as targets. Where a person settles is a clinical decision driven by response and tolerability, not a preference.

That matters commercially because a dose-scaled programme is quoting you a price for a decision your prescriber has not made yet. If you settle at 15 mg on a programme that reprices at every step, you will pay materially more than the figure that attracted you. If you settle at 5 mg, you may pay less than a flat programme would charge.

Flat pricing is therefore worst value at the bottom of the ladder and best at the top. It is less a lower price than insurance against an outcome nobody can predict at signup. The cheapest flat option we verify is NexLife at $215 a month all-in.