Head-to-head · Cost-Efficiency Index
Direct Meds vs He & She MD
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.
Direct Meds
Needle-averse shoppers who want a sublingual route on either molecule and will pay above the going rate for it, having accepted a three-month supply as the smallest unit sold.
Visit Direct MedsHe & She MD
Shoppers comparing injectable semaglutide specifically, where the advertised $199 genuinely is the standing price — not oral semaglutide or tirzepatide, which roll higher after 6 months.
Visit He & She MDThe verdict
Direct Meds and He & She MD tie on the Cost-Efficiency Index at 71/100, so neither wins outright on the numbers. For most shoppers we'd start with Direct Meds (ranked #64, a hair above #65) — Needle-averse shoppers who want a sublingual route on either molecule and will pay above the going rate for it, having accepted a three-month supply as the smallest unit sold. But He & She MD is a genuine coin-flip alternative here.
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 Direct Meds.
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 | Direct Meds | He & She MD |
|---|---|---|
| Cost-Efficiency Index | 71/100 | 71/100 |
| Semaglutide / mo | $249/mo (sublingual, 90-day supply billed monthly) | $199/mo (month to month, compounded; every lower rate is a prepaid term) |
| Tirzepatide / mo | $299/mo (sublingual, 90-day supply billed monthly) | $299/mo (month to month, compounded; every lower rate is a prepaid term) |
| Semaglutide / yr (modeled) | $2,988 | $2,388 |
| Tirzepatide / yr (modeled) | $3,588 | $2,388 |
| Coverage | Not disclosed | All states except Louisiana (GLP-1) |
| Oral / sublingual | Yes | Yes |
| Brand-name access | Compounded only | Yes |
| Rank here | #64 | #65 |
Direct Meds
71/100Where the value is
- Sublingual AND injection on BOTH molecules — four GLP-1 SKUs, the widest formulation range of any provider in this ranking
- Every price is published per SKU in a public shop, with no quiz, intake or email capture in front of it
- Each product page prints a per-day equivalent beside the monthly rate ($8.03/day at $249), which is unusually concrete for this category
The tradeoffs
- $249/mo sublingual is well above this ranking's ~$144 median, and the injection route is $297 — the cheapest thing here is dearer than most rows' headline price
- The only purchasable option on every product page is a 90-DAY SUPPLY billed monthly, so three months is the smallest unit sold — there is no month-to-month rate to compare against the rows beside it
Regulatory note: the FDA issued a warning letter to directmeds.com, Inc. dba DirectMeds in September 2025. We still list and link to Direct Meds; you should know the letter is on the public record before you decide.
He & She MD
71/100Where the value is
- Compounded semaglutide and tirzepatide (injectable or oral), with brand-name access to Ozempic, Wegovy, and Zepbound also offered
- Named pharmacy (F&F Pharmacies Inc DBA Jungle Jim's Pharmacy, Fairfield OH) and named CMO (Dr. Ozita Cooper, MD)
- Free expedited shipping and unlimited board-certified clinician access
The tradeoffs
- Its own FAQ says the pharmacy it names holds a license in 44 US states, none in California, Nevada, New Jersey, North Carolina, Texas, Massachusetts, Mississippi, New Hampshire, West Virginia or Delaware, and “cannot dispense sterile compounds” — while the same FAQ says GLP-1s ship everywhere except Louisiana. Injectable GLP-1s are sterile compounds, and the site never says which of its two pharmacies covers the gap
- The uniform '$199 to start' banner across all three tracks obscures that only injectable semaglutide holds at $199 ongoing — oral semaglutide rolls to $239/mo and injectable tirzepatide rolls to $289/mo after the first 6-month cycle
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.