Head-to-head · Cost-Efficiency Index
Sesame Care vs Silhouette 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.
Sesame Care
People who specifically want FDA-approved brand-name medication (including the Wegovy pill or oral Rybelsus) from an established, verified marketplace and will budget for a two-part cost.
Visit Sesame CareSilhouette MD
People who want hands-on concierge support alongside compounded GLP-1 treatment.
Visit Silhouette MDThe verdict
Sesame Care takes it, leading the Cost-Efficiency Index 86 to 56. The widest real brand-name GLP-1 access on the board — a LegitScript- and BBB-recognized national marketplace running since 2018 that dispenses FDA-approved Wegovy, Zepbound, Ozempic, Mounjaro and Rybelsus, not compounded copies. Silhouette MD still earns a C — People who want hands-on concierge support alongside compounded GLP-1 treatment.
Worth knowing either way: our overall #1 pick is CoreAge Rx (Cost-Efficiency Index 94/100 — the top of the board). See how it stacks up: CoreAge Rx vs Sesame Care.
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 | Sesame Care | Silhouette MD |
|---|---|---|
| Cost-Efficiency Index | 86/100 | 56/100 |
| Semaglutide / mo | $149/mo (brand) | $149/mo (compounded) |
| Tirzepatide / mo | Brand (Zepbound) | $299/mo (compounded) |
| Semaglutide / yr (modeled) | — | $1,788 |
| Tirzepatide / yr (modeled) | — | $3,588 |
| Coverage | Nationwide | Coverage not published |
| Oral / sublingual | Yes | Yes |
| Brand-name access | Yes | Compounded only |
| Rank on the board | #6 | #288 |
Sesame Care
86/100Where the value is
- Widest brand-name formulary we list — Wegovy pen and pill, Zepbound, Ozempic, Mounjaro and oral Rybelsus, all FDA-approved rather than compounded
- Established national marketplace operating since 2018, with LegitScript certification and BBB recognition
- Wegovy pill starts around $149/mo, and oral routes are available for the needle-averse
The tradeoffs
- Two-part cost — the medication price is separate from a platform subscription, so the all-in monthly runs above the $149 headline
- A generalist telehealth marketplace, not a dedicated GLP-1 program
Silhouette MD
56/100Where the value is
- Compounded semaglutide and tirzepatide in both injectable and oral formulations
- Concierge-level support — monitoring, expert guidance, and check-ins included on every plan
- Transparent, published pricing starting at $149/mo for semaglutide injection
The tradeoffs
- Tirzepatide ($299/mo) and oral options ($263–$325/mo) priced above many compounded competitors
- State availability not published
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.