Head-to-head · Cost-Efficiency Index
Strut Health vs Direct 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.
Strut Health
Anyone optimising total monthly outlay who will keep an auto-refill running, and anyone whose real objection is the needle.
Visit Strut HealthDirect 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 MedsThe verdict
Strut Health takes it, leading the Cost-Efficiency Index 87 to 71. The lowest true entry cost on this board — $99/month sublingual semaglutide — and the only place selling the same molecule as a lozenge or an injection at one price. 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 board). See how it stacks up: CoreAge Rx vs Strut 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 | Strut Health | Direct Meds |
|---|---|---|
| Cost-Efficiency Index | 87/100 | 71/100 |
| Semaglutide / mo | From $99/mo sublingual, $149/mo injectable | $249/mo (sublingual, 90-day supply billed monthly) |
| Tirzepatide / mo | From $199/mo either route | $299/mo (sublingual, 90-day supply billed monthly) |
| Semaglutide / yr (modeled) | $1,188 | $2,988 |
| Tirzepatide / yr (modeled) | $2,388 | $3,588 |
| Coverage | 49 states (not Arkansas) | Not disclosed |
| Oral / sublingual | Yes | Yes |
| Brand-name access | Compounded only | Compounded only |
| Rank on the board | #4 | #34 |
Strut Health
87/100Where the value is
- Cheapest disclosed monthly cost here at $99/mo for sublingual semaglutide; tirzepatide $199 either route
- Sublingual lozenges for both molecules at the same price as the injection
- Free physician visit, free shipping and free follow-up care included rather than billed separately
The tradeoffs
- The $99 and $149 headline figures require auto-refill — a one-off order costs more, so the true cost depends on staying subscribed
- Asynchronous by design: their FAQ notes some states need no phone consultation, so you may never speak to the prescriber
Direct Meds
71/100Where the value is
- Sublingual AND injection on BOTH molecules — four GLP-1 SKUs, the widest formulation range of any provider on this board
- 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 board'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
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.