Head-to-head · Cost-Efficiency Index
Zera Health vs AquaVita NextGen
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.
Zera Health
Shoppers who want a named 503A pharmacy and full 50-state coverage at a moderate compounded price.
Visit Zera HealthAquaVita NextGen
Shoppers in AZ, CA, FL, TX, or NV who want a medspa-backed provider with a real street address.
Visit AquaVita NextGenThe verdict
Zera Health takes it, leading the Cost-Efficiency Index 61 to 60. Zera Health (zerahealth.org) is a cash-pay telehealth platform selling compounded semaglutide, tirzepatide, a lower-cost microdose tier, and an oral GLP-1 tablet option, dispensed through Strive Pharmacy (503A). AquaVita NextGen still earns a C — Shoppers in AZ, CA, FL, TX, or NV who want a medspa-backed provider with a real street address.
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 Zera 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 | Zera Health | AquaVita NextGen |
|---|---|---|
| Cost-Efficiency Index | 61/100 | 60/100 |
| Semaglutide / mo | Not disclosed | $215/mo (compounded) |
| Tirzepatide / mo | Not disclosed | $320/mo (compounded) |
| Semaglutide / yr (modeled) | — | $2,580 |
| Tirzepatide / yr (modeled) | — | $3,840 |
| Coverage | All 50 states | 5 states |
| Oral / sublingual | Yes | Yes |
| Brand-name access | Compounded only | Compounded only |
| Rank here | #240 | #244 |
Zera Health
61/100Where the value is
- Named dispensing pharmacy — Strive Pharmacy, a 503A compounder — disclosed in the footer
- LegitScript Certified badge displayed
- Stated coverage across all 50 states with no exclusions found
The tradeoffs
- The advertised '$149' semaglutide price is explicitly a first-month-only rate; the standing price is $179/mo
- Tirzepatide's '$199/mo' figure has no first-month/standing clarifier on the page, unlike semaglutide, so it's unclear if it will also step up after month one
AquaVita NextGen
60/100Where the value is
- Real, verifiable physical address (23321 El Toro Rd Suite G, Lake Forest, CA) rather than a web-only storefront
- Both semaglutide and tirzepatide offered, with a 3-month discount option on each ($600 and $900 respectively, cheaper per month than paying monthly)
- Explicit, plainly-worded compounding disclaimer present on the site
The tradeoffs
- Only 5 states served: Arizona, California, Florida, Texas, and Nevada — most of the country cannot use this provider
- No dose (mg/week) is disclosed for either the one-month or three-month listings, so it's unclear what strength $215 or $320 actually buys
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.