Head-to-head · Cost-Efficiency Index
altRX vs Fitish
Two GLP-1 programs on the bench, scored on the same six factors. Here's how their real cost of ownership compares — and which one we'd start with.
altRX
Cost-first shoppers who want locking in a flat, same-at-every-dose promotional rate before it expires.
Visit altRXFitish
Shoppers who want a genuinely all-in price with no separate consult fee, or a fixed low-dose 'microdose' option.
Visit FitishThe verdict
altRX takes it, leading the Cost-Efficiency Index 70 to 69. altRx is a compounded GLP-1 telehealth platform run through Usable Health, PC and its affiliated medical practices, offering semaglutide and tirzepatide at a flat 'same price at every dose' rate with no membership fee. Fitish still earns a C — Shoppers who want a genuinely all-in price with no separate consult fee, or a fixed low-dose 'microdose' option.
Worth knowing either way: our overall #1 pick is CoreAge Rx (Cost-Efficiency Index 94/100 — the top of the ranking). See how it stacks up: CoreAge Rx vs altRX.
Factor by factor
Both providers scored on our six Cost-Efficiency Index factors. The stronger side on each row is marked in teal.
Normalized Cost/Month
Price Transparency
Nationwide Access
Formulation Options
Clinical Oversight
Contract Flexibility
Pricing, coverage & formulary
The disclosed facts behind the scores. Lower price wins its row (teal).
| Spec | altRX | Fitish |
|---|---|---|
| Cost-Efficiency Index | 70/100 | 69/100 |
| Semaglutide / mo | $89/mo (all doses, promotional rate, plus a separate fee, compounded) | $219/mo (microdose tier, plus a separate fee, compounded) |
| Tirzepatide / mo | $149/mo (all doses, promotional rate, compounded) | $339/mo (microdose tier, compounded) |
| Semaglutide / yr (modeled) | $1,068 | $2,628 |
| Tirzepatide / yr (modeled) | $1,788 | $4,068 |
| Coverage | Coverage not published | All 50 states |
| Oral / sublingual | No | Yes |
| Brand-name access | Yes | Yes |
| Rank here | #85 | #92 |
altRX
70/100Where the value is
- Same price at every dose — titrating up does not raise the monthly cost, unlike per-mg-tiered competitors
- No membership fee, no insurance required; price stated to be all-in (consultation, dosing plan, medication, free delivery, clinician support)
- LegitScript certified
The tradeoffs
- The advertised $89/$149 prices are an explicitly time-limited promotion with a live countdown on the page — the standing price is roughly double, and a naive reading of the headline as a stable price would be wrong within about a week of this research
- No compounding pharmacy is individually named, only '503A compounding pharmacies within the altRx network'
Regulatory note: the FDA issued a warning letter to Trinity HealthCare Supply, LLC dba altRx in June 2026. We still list and link to altRX; you should know the letter is on the public record before you decide.
Fitish
69/100Where the value is
- Price genuinely includes consult, medication, and shipping — confirmed in the product page's own text, not just marketing copy
- A real microdose tier exists at a meaningfully lower fixed price for both drugs
- Injectable and oral tablet formats both offered
The tradeoffs
- No stated minimum commitment or cancellation terms found on the product pages
- No named prescriber, medical director, or specific compounding pharmacy
Regulatory note: the FDA issued a warning letter to FITISH in June 2026. We still list and link to Fitish; you should know the letter is on the public record before you decide.
Assume any provider we list may compensate us — we may earn a commission, at no cost to you. It never changes the Cost-Efficiency Index. Pricing, states and verification reflect each provider's public disclosures at last review; prices change — confirm on the provider's site. Not medical advice. See our disclosure.