Head-to-head · Cost-Efficiency Index
Direct Meds vs Trillium Meds
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 MedsTrillium Meds
Cost-first shoppers who want all-50-state compounded GLP-1 with a real month-to-month option and a cheaper 3-month prepay path.
Visit Trillium MedsThe verdict
Trillium Meds takes it, leading the Cost-Efficiency Index 73 to 71. Trillium Meds is a small, Portland-OR-based telehealth platform connecting patients to independent licensed providers and compounding pharmacies for GLP-1 therapy, serving all 50 states plus Puerto Rico. Direct Meds still earns a C — 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.
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 Trillium 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 | Trillium Meds |
|---|---|---|
| Cost-Efficiency Index | 71/100 | 73/100 |
| Semaglutide / mo | $249/mo (sublingual, 90-day supply billed monthly) | $159/mo (all doses, compounded) |
| Tirzepatide / mo | $299/mo (sublingual, 90-day supply billed monthly) | $249/mo (all doses, compounded) |
| Semaglutide / yr (modeled) | $2,988 | $1,908 |
| Tirzepatide / yr (modeled) | $3,588 | $2,988 |
| Coverage | Not disclosed | All 50 states |
| Oral / sublingual | Yes | No |
| Brand-name access | Compounded only | Compounded only |
| Rank here | #64 | #71 |
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.
Trillium Meds
73/100Where the value is
- Discloses both a real month-to-month rate ($159/$249) and the 3-month prepay rate, rather than only advertising the lower prepay number
- LegitScript certified, all 50 states plus Puerto Rico, with a real street address published
- Syringes and alcohol wipes included; Klarna and Affirm financing available
The tradeoffs
- The lowest advertised rate ($119/mo semaglutide, ~$200/mo tirzepatide) requires a $357 or $599 upfront 3-month payment, not a standing monthly charge
- Partner pharmacy names are referenced in the FAQ structure but were not visible in the page text pulled this session — re-verify before citing a specific pharmacy
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.