For people who are purely cost-driven (like me), here's the real math:

Cheapest legitimate path to semaglutide in the US (March 2026):

1. Push Health consult: $69 one-time
2. Prescription sent to compounding pharmacy of YOUR choice: You pick the pharmacy, you control the quality
3. Good compounding pharmacy (e.g., CompoundPharm): $249 for 10mg vial = ~$125/month at 1.0mg/week dose
4. Janoshik test on first order: $80 one-time

Total first month: $398. Subsequent months: ~$125.

Compare that to Found at $149/month or Henry Meds at $199-349/month for the convenience of an integrated platform. You're paying $25-200/month extra for the convenience of not having to manage the process yourself.

If you're comfortable reconstituting and injecting on your own, the DIY route with Push Health + independent pharmacy is the best value.

Great discussion everyone. My final recommendations based on different user profiles:

• If you want maximum convenience and don't mind paying more: Calibrate (if you have insurance) or Found (without insurance). They handle everything.
• If you want the cheapest option and are comfortable self-managing: Push Health + independent compounding pharmacy. Requires more effort but saves significantly.
• If you want good quality with reasonable oversight: Ro is the sweet spot — reasonable pricing, lab requirements, and decent medical oversight.
• If you want brand-name only: Calibrate or Push Health (with a brand-name Rx filled at a retail pharmacy with a GoodRx coupon).

No matter which route you choose: get baseline labs, monitor your health, and don't treat telehealth as a way to avoid medical oversight. These are powerful medications.

One final note: HSA/FSA eligibility. GLP-1 medications prescribed for a medical diagnosis (obesity or T2D) are eligible for HSA/FSA reimbursement. This includes telehealth consult fees and the medication itself.

That effectively gives you a 25-35% discount (depending on your tax bracket) on the total cost. On a $150/month compounded semaglutide spend, that's $450-630 in tax savings over a year.

Make sure your telehealth provider gives you a proper receipt with diagnosis codes (E66.01 for obesity, E11 for T2D) for your HSA/FSA claim.