Alternatives to Nova

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.

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.

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 price-first partner: some of the lowest flat, all-inclusive compounded pricing we track, nationwide and async — strong if the monthly number is your deciding factor and you read the annual-prepay fine print.

Dose-scaling pricing from $189/mo (starting dose) up to $389/mo (top tirzepatide dose), confirmed by pulling the site's own production pricing and states data directly — genuinely specific 48-state coverage (all but AL and MS) and no hidden cancellation fee found in its own Refund Policy.

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.

Coby publishes its whole dose-scaling ladder up front, which is rarer than it should be: read live on 2026-08-26, compounded semaglutide runs $159, $199, $229, then $249 and holds there, and tirzepatide runs $239, $299, $329, $379, then $439. Every rung is unchanged since early August. It also answers the two questions most sellers dodge. On video, its FAQ says outright that unless your state requires one, no video visit is needed and your provider reviews everything online. On coverage, it names the four states it does not reach — Arkansas, Louisiana, Mississippi and New Mexico — instead of staying vague. Two things go the other way. Coby's month is four weeks by its own arithmetic, since it sells a three-month bundle as twelve weeks and a six-month bundle as twenty-four, so a year is thirteen bills rather than twelve. And changing your mind costs money: canceling before the prescription reaches the pharmacy deducts a $50 non-refundable visit and clinical fee from the refund, and once it has been sent, the order cannot be changed at all.

This record changed completely between checks, and mostly for the better. The founding-member framing that dominated it a week ago is gone: read live on 2026-08-26 KERNX simply says "Semaglutide starts at $129/month and Tirzepatide starts at $229/month. Pricing varies by prescribed dose. No membership fee. No required 3 month plan." What has not gone is the cost outside those figures, and KERNX is unusually straight about it — a provider consultation fee applies when treatment is approved, at $25 for a message-based review, $35 for a standard live visit or $60 for a complex live visit. Two more things this record previously had wrong. It does say where it operates: licensed providers in all 50 states, repeated in its banner and its FAQ. And it publishes a real timeline: a free five-minute assessment, provider review typically within 24 hours, pharmacy processing 1–2 business days and transit 2–3, so most first orders arrive within three to five business days of approval. It also says nothing is charged until a provider approves you.

The Edit is one of the very few providers on this page that names both the medical practice writing your prescription and the pharmacy compounding it — Arora Health & Aesthetics, LLC and The Pharmacy Hub — rather than gesturing at 'licensed US providers'. Compounded semaglutide is $209 a month and tirzepatide $309, the same price at every dose, with the prescription, all injection supplies, the clinician visit and temperature-controlled two-day shipping inside that one number and no membership fee on top. First orders are $100 off, and three- and six-month plans bring the per-month equivalent down to $192 and $178 for semaglutide. It covers all 50 states and, unusually for this market, runs a complete Spanish-language version of the site rather than a machine-translated shim. The limits are real but narrow: it is compounded-only, so there is no FDA-approved Wegovy or Zepbound here, and there is no postpartum, breastfeeding or PCOS guidance anywhere on the site.