Alternatives to Immortals

A fast, fully async start with a needle-free sublingual tirzepatide option and — a genuine upgrade since our last check — flat pricing stated in writing. The catch is a state list it still won't publish.

Pallas Health removes the two things that usually cost a working parent the most time: it publishes every price before intake, and it runs care asynchronously in 43 of 50 states, so there's no video appointment to wedge into a workday. Compounded semaglutide averages about $199 a month and tirzepatide $299, and unusually the genuine FDA-approved pens sit alongside them — Zepbound $1,069, Ozempic $1,299, Wegovy and Mounjaro $1,349 — all cash-pay from the same clinician. The price is flat at every dose, so a titration never produces a surprise bill, and the plan figure already contains the clinician, dose adjustments, check-ins and messaging with no membership fee. Its cancellation terms are unusually concrete: cancel free through the portal, keep access to the end of the paid period, full refund if a clinician declines you, and a $5 processing fee on a qualifying refund. The trade-offs are that billing lands every 12 weeks in $597 and $897 blocks rather than monthly, the compounding pharmacy is never named, and insurance is never billed.

Async-first compounded GLP-1 with a rarity for this list — free health coaching — at a flat one-price-all-doses rate. Fast and friendly up front; the strict, non-refundable fine print is the trade-off.

The async, needle-optional value play: oral or injectable semaglutide and tirzepatide from a low starting price, no video visit, ~3 days to a script — listed with its February 2026 FDA warning letter in plain view.

RxSpan MD is a genuinely well-disclosed service wrapped in marketing that undercuts it. The disclosure: four compounding pharmacies named with phone numbers, two lead physicians named with NPI numbers that verify as active MDs, flat pricing posted before any intake, both compounded and real FDA-approved brand GLP-1s on one platform, and oral capsules for anyone who won't inject. Compounded semaglutide is $249 a month and tirzepatide $329, with brand Zepbound at $1,069, Ozempic at $1,299 and Wegovy at $1,349. The marketing is the problem. Its testimonials still name a different company — one patient describes what she 'expected from CareGLP' — and the doctors quoted in them are not the clinicians the same page names as its medical team. The homepage is built around a board-certified plastic surgeon who founded the practice but is licensed in California only and isn't the prescriber. Its compounded prices also sit above the roster median, and the oral capsules cost the same or more than the injections.

One flat $195/mo plan covers compounded semaglutide, compounded tirzepatide, or a needle-free sublingual option — plus real brand-name access if you want an FDA-approved pen instead — with a women's-health-first framing and a $99 first month, though it won't name your state until you're inside the signup flow.

Pepti publishes the lowest semaglutide price in this entire roster — $99 a month, flat at every titration dose, with the medication, physician review, shipping, refill management and unlimited messaging with your prescribing doctor all inside it. Tirzepatide is $199 on the same all-in, flat-at-every-dose basis. That number is low enough to deserve skepticism, so it is worth saying exactly where it comes from: Pepti states it on a dedicated cost page, repeats it in its FAQ ('we keep pricing flat and transparent at $99/mo all-in'), and prices the comparison against Hims, Henry Meds and Mochi on the same page. It names two prescribing physicians and says its medication is compounded by FDA-registered 503A or 503B pharmacies, though it never names which. The real limits are reach and format: it ships to 36 states rather than 50, it is cash-pay only and bills no insurance, and its needle-free oral GLP-1/GIP drops cost $349 — well above its own injection.

The widest menu on the board — compounded, oral and four brand pens, all on a chat visit with no camera — sold behind a pricing page that quotes you a monthly figure for a plan you have to pay for a year in advance.

The number on the page is a prepay. Read live on 2026-08-26, GOAL.MD's semaglutide page leads with $99 a month and its tirzepatide page with $159 — and both are 12-month prepaid equivalents, $1,188 and $1,908 handed over up front. Month to month, the same two medications are $179 and $249. The site does say so, in the same sentence, but second. Everything around that pricing is unusually clean for this roster: a named physician with a searchable NPI rather than an anonymous clinical network, "No Auto-Billing. Ever." with a stated check-in before every renewal, a 3-minute online medical visit with no video call mentioned anywhere in the copy, and a published timeline — physician decision in about 24 hours, free shipping in 2–3 days. Two corrections to make if you are comparing: it serves 48 states rather than the whole country, and its brand-name lane is a forwarding service where you pay GOAL.MD $95 a month for supervision and the manufacturer program directly for the drug.