Pillar 1: Clinical protocol and named medical director
Look for a provider that names its medical director by full name and credentials, with a verifiable state license. The clinical model should describe individualized prescribing (your dose ladder based on your response and tolerance), not a fixed standing-order protocol applied uniformly to all patients.
Red flag: a website that names no clinician, or where the 'medical team' is depicted only with stock photography. Green flag: a named MD or DO with a state license verifiable through the relevant state medical board's online portal.
Pillar 2: Pharmacy traceability
Get this in writing: which compounding pharmacy will dispense your medication, is it 503A or 503B, and is a certificate of analysis (CoA) available on request? Reputable providers disclose this upfront. Marketing copy alone — e.g., 'FDA-registered facility' — is not adequate disclosure. You want a pharmacy name and a pathway.
The single best disclosure pattern is dual 503A/503B disclosure, where the provider explains which pathway will route your specific prescription and why.
Pillar 3: Outcomes transparency
Has the provider published cohort outcomes — mean weight loss, discontinuation rates, common adverse events — for its patient population? Almost no telehealth provider publishes this, which is itself a signal about industry maturity. The few that do tend to be in the higher-transparency tier of our rubric.
In the absence of published outcomes, ask your provider what their typical discontinuation rate is and how they support patients through GI side effects in weeks 4–12 of titration. The clarity of the answer is informative.
Pillar 4: Flat pricing across the dose ladder
GLP-1 dose ladders go from 2.5 mg to 15 mg over 4–6 months. If your $189/month tirzepatide quote applies only to the starting dose, your real cost at maintenance will be substantially higher.
Look for flat-rate pricing that explicitly applies across the entire titration ladder. If pricing is not flat, ask for a written quote at the dose you expect to maintain (typically 7.5–15 mg for tirzepatide, 1.0–2.4 mg for semaglutide).
Pillar 5: Lab integration and longitudinal follow-up
Initial labs (CBC, comprehensive metabolic panel, lipid panel, HbA1c, TSH) should be required before starting and typically included in the program cost. Beyond initial labs, ask about scheduled clinician check-ins at 4, 12, 26, and 52 weeks — not just an intake visit and a refill flow.
A program that describes itself as 'medication-only' is making a transactional pitch. A program that emphasizes a 12-month relationship with documented check-ins is making a clinical pitch. The latter is what produces durable outcomes in the published trials.
Pillar 6: Regulatory clarity
Does the provider clearly explain that compounded GLP-1 medications are not FDA-approved drug products and are not the same as the brand-name versions? Or does it describe its product as 'the same as' or 'equivalent to' Mounjaro, Zepbound, Ozempic, or Wegovy?
Misleading equivalence claims have been the subject of FDA warning letters to multiple telehealth companies. A provider that's clear about what compounded medications are — and what they are not — is operating with the regulatory clarity our rubric requires.