How we rank providers
Our scoring criteria, weights, and data sources, and exactly how FDA warning letters and manufacturer lawsuits affect a provider's score.
Last updated
Every provider gets a score from 0 to 10, a weighted average of five criteria. We use public, citable information only. We haven't personally tested any medication or enrolled as patients, and our scores don't measure clinical outcomes. Rank order follows the score and nothing else.
We list providers whether or not they pay us. Our rankings currently include 40 compounded GLP-1 providers. 8 of them have no affiliate program with us; their cards say "No affiliate link" and link to their site with a plain link. For the others, until an affiliate program approves us, the button simply goes to the provider's own site. Every provider is scored with the same formula, whatever the link type.
The five criteria
| Criterion | Weight | How it's scored |
|---|---|---|
| Safety & regulatory record | 30% | Rule-based (see below): FDA warning letters, manufacturer lawsuits, marketing concerns, LegitScript, pharmacy regulatory history |
| Transparency | 25% | Editorial, anchored: about 9 if the pharmacy is named, recurring prices are published, and products are clearly labeled "not FDA-approved"; about 7 with two of the three; about 5 with one; about 3 with none |
| Price & value | 20% | Rule-based: lowest advertised recurring monthly price. Under $125 = 9; $125–174 = 8.5; $175–199 = 8; $200–249 = 7.5; $250–299 = 6.5; $300+ or not published = 6 |
| Reputation | 15% | Editorial, anchored: about 8 with a strong Trustpilot score and good BBB handling; about 6.5–7 with a strong Trustpilot score but a poor BBB rating; 5.5 when we couldn't verify; 3–4.5 when both are weak or there's a review-integrity flag |
| Access & care | 10% | Editorial, anchored: about 9 for 49–50 states plus extras (labs, brand-name options); about 8 for most states; about 7 for 40–44 states; 6.5 for fewer states or an unpublished state list |
How the regulatory record affects scores
The safety and regulatory record is the most heavily weighted criterion (30%). It's calculated from a fixed set of rules, so we can't adjust it by hand for any provider. Every provider starts at 9.5 (no provider gets a perfect 10, because we can't inspect operations ourselves). Then these adjustments apply:
| Item on the record | Adjustment |
|---|---|
| FDA warning letter to the company (2025 or later) | −3.5 |
| Each additional FDA warning letter | −1 |
| Pending lawsuit by a brand-name manufacturer (e.g., Eli Lilly or Novo Nordisk) | −3 |
| Manufacturer lawsuit dismissed but under appeal | −1 |
| Website marketing that implies sameness with FDA-approved drugs | −2.5 |
| Other marketing claims we couldn't verify (e.g., outcome claims) | −1 |
| LegitScript certification not confirmed | −0.5 |
| No LegitScript certification found | −1.5 |
| A named partner pharmacy has documented regulatory actions | −1 |
In practice, an FDA warning letter or a pending manufacturer lawsuit reduces the overall score by roughly 0.9–1.1 points on its own, because the safety criterion carries 30% of the weight. A provider with either one can't be labeled Featured, whatever its price or reviews. Its card also shows a dated, neutral note with a link to the letter or case.
What a warning letter means: it's FDA's formal notice that the agency believes a company violated federal law, for example through false or misleading claims about compounded drugs. It isn't a court ruling, and companies can respond and correct the problem. We link every letter we cite so you can read it yourself.
What a lawsuit means: manufacturer lawsuits contain allegations, not findings. We describe their status (pending, dismissed, on appeal) as reported in court records or reputable legal coverage.
Labels you'll see
Labels are calculated, not assigned. They never change rank order.
- Featured: no FDA warning letter, no manufacturer lawsuit, no marketing that implies sameness with FDA-approved drugs, a reputation score of at least 7, a transparency score of at least 7, and an overall score of at least 8.0.
- Caution: doesn't meet the Featured rules, with an overall score of 6.0 or higher. The card lists what's on the record, with sources.
- High caution: overall score below 6.0. The card lists what's on the record, with sources.
- No affiliate link: we don't earn anything from this provider. It's scored and ranked the same way.
Data sources
- FDA warning-letter database, searched by brand and legal entity
- Provider websites and terms (prices, states, pharmacy disclosures), with the check date recorded
- LegitScript, Trustpilot, and BBB profiles (when we can't check directly, we cite dated third-party reports)
- Court records and reputable legal coverage for manufacturer lawsuits
Update cadence
We aim to re-check prices and FDA records at least monthly, and right away when FDA announces new telehealth warning letters. Each page shows its last-updated date.
Affiliate relationships
Affiliate relationships never change scores, rank order, labels, or the notes on a provider's card. A provider can't pay to be featured, to be listed, or to remove a label. See our affiliate disclosure and editorial policy.
Score change log
Every change to the formula, the labels, or the provider list is logged here. Routine price updates that move a value score are reflected on the cards and in the price tracker.
- : 13 providers added
- Added 13 compounded GLP-1 providers, scored with the same published formula as everyone else: MEDGm (7.9), Aspen (7.8), MadeMed (7.4), FeelGood (7.2), HealthRX (6.9), CoreAge Rx (6.6), WellMedr (6.6), altRx (6.5), Wellorithm (6.5), Elevate Health (6.4), HumeCare+ (6.3), IVY RX (5.8), and Real Care (5.5).
- altRx's card shows its June 2026 FDA warning letter. HealthRX and Real Care carry a marketing note for comparing compounded drugs to brand-name products.
- No existing provider's score changed. Some existing providers moved down in rank because new providers scored above them.
- : Labels made rule-based; providers without affiliate programs added
- Labels (Featured, Caution, High caution) are now calculated from each provider's record and score instead of being assigned by our editors. Rules are listed on this page.
- Label changes from that switch: PeterMD and TrimRx moved from High caution to Caution (scores 7.1 and 6.5); Henry Meds, SkinnyRx, and Remedy Meds moved from Caution to High caution (scores 5.8, 5.5, and 5.2). No scores changed.
- Fixed score rounding so .x5 results always round up (floating-point noise had rounded some down). Displayed scores that changed: Fridays 8.4 to 8.5 (raw 8.45) and bmiMD 7.6 to 7.7 (raw 7.65). Rank order didn't change.
- Added six compounded GLP-1 providers that we don't have affiliate links for, scored with the same formula: Trimi (8.1), NexLife (6.6), Maximus (5.9), Eden (5.8), Strut Health (5.1), and Zealthy (4.5).
- Rank order is now strictly by score across all providers. Trimi ranks #5 on score and is labeled Caution because of its reputation score (Trustpilot review-integrity flag).
- State availability now comes only from each provider's own website. Where we couldn't find a state list there, the card says "Not verified." Access & care scores were not changed in this update.
- : Methodology v2: rule-based safety and value scores
- Safety & regulatory record and Price & value became fully rule-based (tables above).
- Score changes from that switch: Fridays 8.5 to 8.4, Found 8.4 to 8.3, bmiMD 7.4 to 7.6, Henry Meds 6.0 to 5.8.
- Added 14 compounded providers that have FDA warning letters or other items on their record, ranked below the Featured group by the same formula.
- : Initial rankings
- First published scores for Enhance MD, Fridays, Found, Gala, bmiMD, Oak Longevity, and Henry Meds.