Methodology

How the audit works

The test of this page: hand our CSV to a stranger, have them apply the rules below, and they should reproduce every ranking on this site. If they can't, something here is broken and we want to hear about it.

The field comes first

Every US telehealth program offering compounded tirzepatide or semaglutide that we can locate gets a file — affiliate or not, responsive to our emails or not. A ranking over a partial field is a rigged ranking, however honest the math. The field currently holds 16 programs plus a brand shelf (LillyDirect, NovoCare) used for calibration and never ranked.

The four figures

Each file normalizes to sticker (the advertised monthly), street (recurring reality with membership, consultation and shipping folded in), step-up (the monthly at a typical maintenance dose), and year-one (the twelve-month all-in). Year-one is the ranking figure. All four publish in prose with conditions attached and in open CSV.

Audits, and how they age

An audit means a human re-walked the program's live checkout or plan pages this cycle and confirmed each figure. Audits stamp with a date and age out at 45 days, downgrading to on-record until renewed. The iron rule of the whole site: an audited figure outranks an on-record figure regardless of magnitude. A ~$133 sticker waits behind an audited $139 until its own audit closes. Current cycle: 1 of 16 files audited; the queue is public and boring, as it should be.

The Bench Score

Cards display a score out of 10, assembled from parts, never vibes: 5.0 base; +2.5 for a current audit; up to +1.0 for year-one position against the field; +0.5 for a contractually dose-proof rate; +0.5 for bundling (clinician, supplies, shipping inside one number, no membership); +0.5 for file completeness (pharmacy identity and type, state list, prescriber roster). NexLife's 9.5 is that formula with the completeness half-point withheld — its pharmacy fields are open. Unaudited programs cap out provisional. No component is purchasable at any price.

Belts

One title per question, each labeled by evidence class (audited or on record), recomputed every cycle. Several belts sit with programs that pay us nothing; where a commercial relationship exists with a belt-holder, the ownership page says so in words.

The money firewall

Outbound partner links carry rel="sponsored" plus UTM tags, and commissions fund the audits. Sequence is the firewall: rankings compute from the CSV first, links get placed second, and a plain-language disclosure sits within sight of every link cluster. Catch the sequence running backwards anywhere and the error desk treats it as a five-alarm correction.