Head-to-head · Cost-Efficiency Index
Rivo Health vs altRX
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.
Rivo Health
Patients willing to commit to a 12-month prepay plan to reach the advertised $149-199/mo rate, who also want dietitian and coaching support bundled in.
Visit Rivo HealthaltRX
Cost-first shoppers who want locking in a flat, same-at-every-dose promotional rate before it expires.
Visit altRXThe verdict
Rivo Health takes it, leading the Cost-Efficiency Index 71 to 70. Rivo Health is a large nationwide GLP-1 telehealth program (115,000+ members claimed, Trustpilot 4.7) whose advertised $149/mo semaglutide and $199/mo tirzepatide are the 12-month annual-plan rate, not month-to-month. altRX still earns a C — Cost-first shoppers who want locking in a flat, same-at-every-dose promotional rate before it expires.
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 Rivo Health.
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 | Rivo Health | altRX |
|---|---|---|
| Cost-Efficiency Index | 71/100 | 70/100 |
| Semaglutide / mo | $149/mo (starting dose, annual plan, compounded oral) | $89/mo (all doses, promotional rate, plus a separate fee, compounded) |
| Tirzepatide / mo | $199/mo (starting dose, annual plan, compounded oral) | $149/mo (all doses, promotional rate, compounded) |
| Semaglutide / yr (modeled) | $1,788 | $1,068 |
| Tirzepatide / yr (modeled) | $2,388 | $1,788 |
| Coverage | All 50 states | Coverage not published |
| Oral / sublingual | Yes | No |
| Brand-name access | Compounded only | Yes |
| Rank here | #83 | #85 |
Rivo Health
71/100Where the value is
- Bundles a membership (unlimited provider visits, dietitian, coaching) into the plan at no separately-billed cost
- Large, established program with a stated 115,000+ member base and 4.7 Trustpilot rating
- Both injectable and oral compounded options for semaglutide and tirzepatide
The tradeoffs
- The headline $149/$199 prices require a 12-month annual-plan commitment — the genuine month-to-month rate, shown crossed out on the same page, is $279/mo and $389/mo, 87-95% higher
- Compounding pharmacy partner is not named anywhere reachable
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.
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.