Cost Analysis

Side by Side: First-Order Discounts vs. True 12-Month Cost of Ownership

By The Side by Side Meds Editorial Team · August 6, 2026 · 9 min read

The advertised price and the amount that leaves your account over a year are different numbers, and at some providers the gap runs into four figures. This is the arithmetic, done properly.

Key Takeaways

The four things that move the twelve-month number

Intro rate duration. A $49 first month against a $299 ongoing rate saves you $250 once. Over twelve months that is worth about $21 a month, not $250 a month.

Dose escalation timing. At a tiered provider you typically reach a higher-priced tier somewhere in months three to six. Your average monthly cost is therefore weighted toward the higher tiers, not the starting one.

Billing cycle length. Thirteen four-week cycles against twelve calendar months is an 8.3% difference that never appears in a price comparison.

Shipping and fees. Individually small, annually not. Cold-chain shipping charged per order on a monthly plan adds up across twelve orders.

What actually determines your twelve-month total
ProviderYear-one structureWhat drives the annual total
Telos RxIntro month, then flat by plan lengthPlan length chosen — the spread between short and long plans is large
WellorithmFlat published per formatStraightforward — twelve times the published rate
Found Health$189 per 4-week cycleThirteen cycles: roughly $2,457 rather than $2,268
Yucca Health$175 first, then $275/mo, or $206/mo on a 6-month planWhether you take the plan or pay month-to-month
SHEDFrom $199, converting after the initial term; $399 at 7.5 mg+ tirzepatideDose tier reached and when the term converts
MadeMedTiered by dose; quarterly billing availableHow fast you escalate, and whether you take quarterly billing
Embody$69–$99 intro, roughly $299/mo ongoingAlmost entirely the ongoing rate
Strut Health ⚠️Flat published sublingual rateStraightforward — twelve times the published rate
⚠️ FDA Warning Letter disclosure: Providers marked ⚠️ in the table above have received an FDA warning letter — Strut Health (Feb 20, 2026 · Ref. #721448). Review the FDA's published letters before ordering.

Worked example: intro pricing versus flat pricing

Provider A: $49 first month, $299 ongoing. Year one = $49 + (11 × $299) = $3,338.

Provider B: $229 flat, every month. Year one = 12 × $229 = $2,748.

Provider A wins every headline comparison by a factor of nearly five and costs $590 more over the year. This is not a hypothetical distortion — it is the standard structure of the category.

Wellorithm

Lowest published oral price
Oral semaglutide from $147/mo · oral tirzepatide from $249/mo

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

Telos Rx (Tirzepatide)

Flat pricing by plan length
$99 first month · ongoing $129–$449/mo depending on plan length

Telos publishes plan-length pricing rather than dose-tier pricing, so the number you see at signup depends on the commitment you choose, not the milligrams you take.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

Embody

Injectable semaglutide
Intro month $69–$99 · semaglutide refills lock at roughly $299/mo ongoing

Intro-versus-ongoing: Embody's headline price is a first-month promotional rate. Per its published terms, ongoing semaglutide refills are substantially higher. Budget from the refill number. Embody's injectable semaglutide line is what we cover — we do not promote its oral gum product.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

The escalation weighting most people miss

At a tiered provider you do not spend twelve months at the starting price. A typical escalation puts you at a mid tier by month three and near maintenance by month six. If the starting tier is $179 and the maintenance tier is $299, your weighted average is much closer to $299 than the midpoint, because you spend more months at the top than at the bottom.

Anyone comparing tiered providers on their starting price is comparing the two months that matter least.

SHED

Multi-format
Injectable/lozenge from $199/mo · drops $229/mo · tirzepatide $299/mo, rising to $399/mo at the 7.5 mg and higher maintenance tiers

Price-jump disclosure: SHED's tirzepatide pricing increases to $399/mo once you reach the 7.5 mg maintenance tier. Budget for the higher number, not the entry number.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

Found Health

4-week billing cycle
Dissolvable semaglutide tablets from $189 per 4-week supply

A 4-week cycle means your true annual cost is 13 × the quoted price. Worth doing the multiplication before comparing against a monthly-billed competitor.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

Yucca Health

Injectable only
Semaglutide $175 first month → $275/mo · $206/mo on a 6-month plan (new-patient promo $146/mo) · tirzepatide $285 → $385/mo · $325/mo on 6 months (promo $258/mo)

Injectable only. Yucca's headline promo rate is tied to the 6-month new-patient plan — the month-to-month rate is substantially higher.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

The number to write down before you sign up

Take the maintenance rate. Multiply by ten. Add the intro month and the second month at whatever they cost. Add shipping if it is charged separately, multiplied by the number of orders. If the cycle is four-weekly, add one extra cycle.

That total, not the price on the landing page, is what you should compare across providers.

Frequently Asked Questions

Are intro discounts worth chasing?

Only if the ongoing rate is also competitive. A deep intro discount attached to a high ongoing rate costs more over a year than a moderate flat rate.

Is quarterly billing cheaper?

Usually the effective monthly rate is lower, in exchange for paying a larger sum up front and reducing your flexibility to leave.

How much does dose escalation add?

At tiered providers it can be the difference between a $179 starting rate and a $299–$399 maintenance rate. At flat-price providers it adds nothing, which is the entire value of that structure.

Do any providers charge separately for shipping?

Some include it and some do not. Across twelve monthly orders a per-order cold-chain shipping charge is a meaningful annual line item.

Medical disclaimer: This article is for informational purposes only and is not medical advice. Always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Compounding disclosure: Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. Compounded GLP-1 medications are prepared by state-licensed pharmacies and are not the same as FDA-approved brand products.

Affiliate disclosure: Side by Side Meds may earn a commission when you sign up through links on this page, at no additional cost to you. Links marked "Paid link" are sponsored. This never affects our editorial assessments.