Hims, Ro, and the Telehealth GLP-1 Price War: Market Analysis

Introduction

In May 2024, Hims & Hers Health launched compounded semaglutide at $199 per month. Eighteen months earlier, Wegovy® was selling at retail for around $1,349 per month with limited insurance coverage. The collapse in cash prices for GLP-1 therapy is the single biggest story in consumer healthcare since the launch of direct-to-consumer telemedicine itself.

The price war was driven by three things at once. The FDA-declared shortage of semaglutide and tirzepatide opened a window for personalized compounding under section 503A of the Federal Food, Drug, and Cosmetic Act. Telehealth companies built distribution and prescribing infrastructure fast enough to capitalize. And Eli Lilly and Novo Nordisk responded with their own direct-to-consumer cash programs once they realized how much volume was flowing through compounding.

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How Did Hims & Hers Enter the GLP-1 Market?

Hims & Hers Health, the publicly traded telehealth company founded by Andrew Dudum in 2017, launched compounded semaglutide on May 20, 2024. The product was priced at $199 per month for the full 12-month plan, undercutting the Wegovy list price by more than 85%.

Quick Answer: Hims & Hers launched compounded semaglutide at $199/month in May 2024, then raised it to $299 by mid-2025

The launch was timed to the FDA’s official shortage designation for semaglutide. Under section 503A of the Federal Food, Drug, and Cosmetic Act, licensed compounding pharmacies could produce personalized doses of semaglutide while the drug was on the shortage list. Hims partnered with multiple compounding pharmacies to manufacture and distribute the product through its existing telehealth platform.

The market response was immediate. Hims stock jumped roughly 32% the week of the announcement. By Q2 2024 earnings, Hims reported weight loss subscribers had reached over 100,000 in the first months. Full-year 2024 weight loss contribution was approximately $250 million out of total revenue of $1.2 billion.

In mid-2025, after the FDA removed semaglutide from the shortage list in February 2025, Hims raised its compounded semaglutide pricing to $299 per month and added tirzepatide options. The company has continued to operate within the section 503A personalized compounding framework.

What About Ro?

Ro, the company formerly known as Roman that started as a men’s health telehealth platform, launched Ro Body in March 2024. The platform offered compounded semaglutide initially with pricing in a similar range to Hims, then pivoted toward branded products as the legal environment tightened.

In November 2024, Ro became one of the launch partners for LillyDirect, the manufacturer’s direct-to-consumer program for Zepbound® vials. Ro patients can access Zepbound at $349 to $499 per month depending on dose, paid in cash without insurance.

Ro’s strategy positions it differently from Hims. Where Hims continues to lean on compounded products, Ro has shifted more toward branded Lilly products through the LillyDirect partnership. The bet is that branded products with FDA approval and full safety oversight will outlast compounded alternatives as the regulatory environment tightens.

Ro has not disclosed standalone GLP-1 revenue figures publicly. Industry estimates put Ro Body subscribers in the low hundreds of thousands by late 2025.

How Did Eli Lilly Respond?

Eli Lilly’s response evolved over 12 months. The company first sued multiple compounders and telehealth platforms in 2023 and 2024 for trademark infringement and false marketing of compounded tirzepatide. By mid-2025 Lilly had filed more than 30 such lawsuits.

In parallel, Lilly launched LillyDirect in January 2024 and added single-dose Zepbound vials in August 2024. The vials priced at $399 to $549 per month initially, then dropped to $349 for the lowest dose in early 2025. Patients order through LillyDirect and pick up at a local pharmacy or have it shipped.

Lilly publicly disclosed during a Q3 2024 earnings call that LillyDirect had reached “hundreds of thousands of patients” without specifying a number. CFO Anat Ashkenazi said the program “is meaningfully eating into compounded volume” and represented a long-term answer to cash-pay competition.

The FDA removed tirzepatide from the shortage list in October 2024, which under section 503B largely ended bulk compounding of tirzepatide. Personalized 503A compounding continues for patients with documented clinical need.

How Did Novo Nordisk Respond?

Novo Nordisk took longer to roll out a direct-to-consumer program. The company finally launched NovoCare Pharmacy in March 2025, offering Wegovy at $499 per month for all doses to cash-pay patients.

Novo also pursued legal action against compounders, filing roughly 50 lawsuits against pharmacies, telehealth platforms, and medspas through 2024 and 2025. The lawsuits targeted what Novo described as “salt forms” of semaglutide that aren’t equivalent to the approved product, and unauthorized use of the Wegovy and Ozempic® trademarks.

The FDA’s February 2025 removal of semaglutide injection from the shortage list created the same dynamic for semaglutide compounding that played out earlier with tirzepatide. Bulk 503B compounding largely ended. Personalized 503A compounding for documented clinical need continues with stricter scrutiny.

Novo’s stock underperformed Lilly’s significantly during this period in part because the company moved more slowly to launch direct-to-consumer pricing and continues to face questions about CagriSema and pipeline momentum.

What Does Pricing Actually Look Like in 2026?

Cash and compounded GLP-1 pricing in early 2026 sits in three tiers:

Branded products through insurance. Patients with covered indications pay $25 to $200 per month after insurance, depending on the plan. The 2025 Inflation Reduction Act $2,000 out-of-pocket cap for Medicare Part D substantially lowered costs for covered Medicare beneficiaries.

Manufacturer direct programs. LillyDirect Zepbound vials at $349 (2.5mg) to $499 (higher doses). NovoCare Wegovy at $499 all doses. Both require cash payment without insurance billing.

Compounded telehealth. Hims compounded semaglutide at $299 per month. Other licensed providers including TrimRx range from $150 to $400 per month depending on dose, provider, and program duration. Personalized compounding under section 503A.

The price compression is dramatic. Wegovy’s launch list price was $1,349 monthly in 2021. The same molecule from the same manufacturer is now $499 through NovoCare. Compounded alternatives run lower still. List prices remain near $1,000+ but that figure increasingly matters only for patients without alternatives.

How Big Is the Telehealth GLP-1 Market?

Industry estimates put telehealth-distributed GLP-1 patient counts at roughly 2 to 3 million in the US by late 2025. That’s perhaps 10 to 15% of the total US GLP-1 patient population.

Hims & Hers reported weight loss subscribers of more than 100,000 by Q3 2024, climbing to several hundred thousand by year-end. Ro has not disclosed specific numbers but is generally believed to operate at similar scale.

LillyDirect and NovoCare patient counts combined likely exceed both Hims and Ro by mid-2025, since the manufacturer programs grew faster after shortage resolution restricted compounding.

Smaller telehealth providers including TrimRx, Henry Meds, Eden, Calibrate, Mochi, and dozens of others collectively represent another major chunk of the market. The total market structure has become fragmented enough that no single telehealth provider has more than perhaps 15 to 20% share of telehealth-distributed volume.

Key Takeaway: Novo’s Wegovy direct program prices all doses at $499/month launched in early 2025

What Does the Regulatory Environment Look Like?

The legal landscape for telehealth GLP-1 distribution shifted substantially in 2024 and 2025. Key developments:

FDA shortage list changes. Tirzepatide removed October 2024. Semaglutide injection removed February 2025. These triggered restrictions on bulk 503B compounding.

Section 503A personalized compounding. Remains legal for individual patients with documented clinical needs. This is the framework most established telehealth providers including TrimRx now operate within. Personalization typically means custom dosing, combination with other agents like B12 or glycine, or other documented clinical considerations.

Litigation. Eli Lilly and Novo Nordisk have collectively filed roughly 80 lawsuits against compounders, telehealth platforms, and medspas. A March 2025 federal court ruling in the Northern District of Texas (Outsourcing Facilities Association v. FDA) largely upheld FDA’s authority to restrict compounded tirzepatide once shortage ended.

State telehealth rules. Each state regulates telehealth prescribing separately. Most states require an evaluation by a licensed clinician with prescribing authority in that state. Asynchronous evaluation (questionnaire-based) is permitted in most states but not all.

The net effect is a tighter operating environment for telehealth providers. Established platforms with physician oversight, proper compounding partnerships, and personalization frameworks continue to operate. Mass-marketed unbranded compounded products from offshore or unlicensed sources face heightened legal risk.

How Does Hims Compare to Ro on Financials?

Hims & Hers is publicly traded (NYSE: HIMS) and discloses detailed financials. Ro is privately held and discloses limited information.

Hims reported 2024 full-year revenue of $1.48 billion (up 69% year-over-year), with weight loss being the largest contributor to incremental growth. Q4 2024 revenue was $481 million. The company projected 2025 revenue of $2.3 to $2.4 billion.

Hims weight loss subscribers reached approximately 200,000 by year-end 2024 and continued growing through 2025. Mean revenue per weight loss subscriber was roughly $1,200 to $1,500 annually.

Ro was last valued at $7 billion in a 2022 funding round, then reportedly raised additional funding at a lower valuation in 2024. The company has not publicly disclosed 2024 revenue but is generally estimated to be in the $600 million to $900 million range. Weight loss is a meaningful but smaller contributor to revenue than at Hims.

What About Other Major Telehealth Competitors?

The telehealth GLP-1 landscape includes dozens of providers beyond Hims and Ro. Notable players:

WeightWatchers (WW International) acquired Sequence in 2023 for $132 million and integrated GLP-1 prescribing into its membership platform. The company filed for bankruptcy in early 2025 and emerged restructured with a continued focus on GLP-1 plus behavioral support.

Calibrate, a venture-backed telehealth company, pivoted to enterprise sales and partners with employers and health plans rather than competing on consumer cash prices.

Noom Med launched in 2023 as Noom’s GLP-1 prescribing arm, focused on Wegovy and Zepbound through insurance billing.

Henry Meds, Eden, Mochi, Sesame, and dozens of others occupy the cash-pay compounded segment with various pricing models.

TrimRx operates in the cash-pay compounded segment with a model focused on physician-prescribed compounded semaglutide and tirzepatide under the personalized 503A framework. Patients start with a free assessment quiz to determine eligibility for a personalized treatment plan.

What Does the Future Look Like?

Three forces will reshape the telehealth GLP-1 market through 2026 and 2027:

Continued price compression on cash pay. As more competitors enter and shortage-driven margins normalize, expect cash prices to drift lower. Branded direct programs may cut prices further to defend share. Compounded options will continue to operate at significantly lower price points.

Insurance expansion. As more GLP-1 indications get FDA approval and as state-level coverage expands, more patients will gain insurance coverage and exit cash-pay channels. This is a long tailwind but uneven by geography and plan type.

Generic and biosimilar entry. Semaglutide composition-of-matter patent expires December 5, 2031 in the US. International markets including Canada, India, and Brazil will see generic entry sooner. Eventual biosimilar entry will compress branded pricing further.

Telehealth providers that survive will likely combine multiple offerings (branded, compounded, behavioral support), maintain strong clinical oversight, and operate within evolving regulatory frameworks. The hands-off pure-compounding model that worked during the 2023-2024 shortage period will not work in the more regulated environment of 2026 onward.

Bottom line: Hims & Hers 2024 revenue topped $1.2 billion with weight loss contributing roughly $250 million

FAQ

How Much Does Hims Charge for Compounded GLP-1?

Hims launched compounded semaglutide at $199 per month in May 2024 and raised the price to $299 per month by mid-2025. The company has added compounded tirzepatide options at higher price points. Pricing varies by plan duration and dose.

Is Ro Body Cheaper Than Hims?

Pricing depends on the specific product and plan. Ro shifted toward branded Zepbound through LillyDirect partnership at $349 to $499 per month, which is more expensive than Hims compounded semaglutide but offers branded product. For compounded options Ro pricing is generally similar to Hims.

Did the FDA Shut Down Compounded GLP-1?

No. The FDA removed semaglutide and tirzepatide from the shortage list in February 2025 and October 2024 respectively, which restricted bulk compounding under section 503B. Personalized compounding under section 503A continues for individual patients with documented clinical needs.

Is Wegovy Cheaper Through Manufacturer DiRECT?

Yes. Novo Nordisk’s NovoCare Pharmacy launched in March 2025 sells Wegovy at $499 per month for all doses to cash-pay patients, well below the $1,349 list price. Lilly’s LillyDirect program sells Zepbound vials at $349 to $499 per month.

How Many People Use Telehealth GLP-1 Services?

Industry estimates put telehealth-distributed GLP-1 patient counts at roughly 2 to 3 million in the US by late 2025, or about 10 to 15% of total US GLP-1 patients. The number includes both compounded products through telehealth platforms and branded products through manufacturer direct programs distributed through partners.

Are Compounded GLP-1s Safe?

Compounded GLP-1s produced by licensed 503A pharmacies with proper personalization and prescribed by appropriately licensed clinicians have a safety profile broadly similar to branded products when the active ingredient is true semaglutide or tirzepatide. Safety concerns are higher for unbranded products from offshore or unlicensed sources, and for products containing salt forms or unapproved variants. Telehealth providers including TrimRx that work with licensed US compounding pharmacies and physician oversight follow the personalized compounding framework.

What’s the Cheapest Legit Way to Get a GLP-1?

For patients with type 2 diabetes, cardiovascular disease, or obstructive sleep apnea, insurance coverage typically provides the lowest out-of-pocket cost. For patients without coverage, cash-pay options run from $150 to $499 per month depending on whether you choose branded products through manufacturer direct programs or compounded products through licensed telehealth providers like TrimRx.

Disclaimer: This content is for informational purposes only and does not constitute medical advice. It is not intended to diagnose, treat, cure, or prevent any disease or condition. Individual results may vary. Always consult a qualified healthcare professional before starting any weight loss program or medication.