Where the category stands in May 2026 — what's available, who to trust, what costs what. 22-min read, medically reviewed.
Read the guideAn independent overview of the compounded-GLP-1 telehealth market and the providers we cover — market size, what the FDA changed, and an honest read on each.
View the provider overviewAll 14 reviewsPrimers for newcomers and deep dives for the curious. The foundation articles are published; more are in the pipeline.
View all Learn articlesWhat compounded and branded semaglutide and tirzepatide actually cost, from each provider's own published pricing.
Most compounded-GLP-1 platforms will not say which pharmacy fills the prescription. Lavender Sky names fourteen and lets the patient pick, quoting a price for each — the same 1000mg NAD+ vial runs $165 to $280 depending on who makes it. Cross-referencing their own price list against their own state-exclusion table, though, the choice thins out fast: in Alabama none of the six pharmacies quoting that vial can ship it. No physician is named on any of the five public pages where you would expect to find one.
Most direct-to-consumer GLP-1 platforms hide the pharmacy. Lavender Sky Health publishes fourteen of them by name, quotes prices per pharmacy per medication, and lets the patient choose from whichever ones can ship to their state. That transparency is unusual in the category. It's also, as we found when we cross-referenced their own two tables, the thing that most complicates a plain answer to "what does it cost."
The operating entity is Lavender Sky Health, LLC. Its terms page gives an address at 78 Folly Road Blvd, Ste B9-1674, Charleston, SC 29407, names no state of incorporation, and sets governing law as "the laws of the state applicable to the patient's care" rather than a single forum. There is no arbitration clause and no class-action waiver, which is worth noting because in this category there almost always is one.
The about page describes the business as a "physician (and female) owned & operated company" and says "We are proud to serve all 50 states." No physician or medical director is named there, nor on the homepage, /faq/, /contact/ or /book-a-consult/ — we opened each on 6 September 2026 and looked. Patient reviews on Trustpilot do name individual providers ("Dr. Cole" recurs across several), but the company itself doesn't.
The model is cash-pay: the company doesn't bill insurance, though it tells patients to ask their own insurer about coverage of commercial medications before consulting. FSA and HSA cards are accepted. The terms state that "All services provided are voluntary, and you may discontinue services at any time."
Two compounded GLP-1s make up the core menu: semaglutide and tirzepatide. Both are compounded formulations, not the FDA-approved branded products. Lavender Sky's important safety information page states this plainly — "Compounded drugs have not been evaluated or approved by the FDA" — and attributes the boxed warning accurately, to Wegovy and Zepbound rather than to the compounded versions.
A separate NAD+ line sits alongside the GLP-1 menu: 1000 mg and 2000 mg injection vials, plus nasal spray and sublingual tablets, priced per pharmacy. Worth flagging: the NAD+ page carries unhedged efficacy claims — "Enhances DNA repair and activates longevity-related enzymes such as sirtuins" and "Aids in detoxification processes" — with no FDA disclaimer and no citation on that page. The safety page elsewhere on the site does disclose the compounded-not-approved status. The NAD+ page just doesn't repeat it.
Two consult modes. The booking page describes an e-consult "completed asynchronously via secure portal messages with a provider" with "no phone call required (in eligible states)", and a live "phone or video call with a provider (physician or nurse practitioner)."
Pricing is published: $65 per new-patient consult, $40 per follow-up consult, with medication billed separately. Follow-ups are "required every 6 months on active treatment plans, and every 12 months on maintenance dosing", and refills are available in between. A follow-up is also triggered the first time a given medication is prescribed, and switching drugs restarts that clock: "Switching medication types (e.g., Semaglutide to Tirzepatide) requires a follow-up consultation."
That's more clinical touchpoint than the async-only end of the category, and less than a concierge model. There is also a $25 per month plan fee on brand-name GLP-1 plans, separate from the medication and separate from the consult fees.
Fourteen named compounding pharmacies appear on Lavender Sky's pharmacy-and-state-coverage page: Apothecary/New Life Rx, Boudreaux, Empower, OptioRx, Strive, Vios, AbsoluteRx/Nova, Alchemist, Hallandale, Red Rock, ReviveRx, Southend, South Lake, and BPI/The Pharmacy Hub. The page never states the total. Fourteen is our count of it.
The patient picks. Their FAQ confirms it: "Yes, you can choose from our designated list of pharmacy partners, as long as they are available in your state of residence."
Three of the fourteen appear on the FDA's registered outsourcing-facility list — Empower, Nova (registered as White Label Pharmacy dba Nova Pharmacy) and New Life Rx (Maxhealth Group, LLC dba New Life Rx). The other eleven are 503A state-licensed compounders, which is the normal regulatory posture for patient-specific compounding and not by itself a red flag. It does mean most of the menu operates outside the 503B inspection regime.
The same drug costs different amounts depending on which pharmacy fills it. NAD+ 1000 mg, priced across six of the fourteen: AbsoluteRx $165, Red Rock $200, Alchemist $240, Southend $250, South Lake $250, Hallandale $280. That's a 70 percent spread on an identical vial size.
Here is the part that took us longest to piece together. Lavender Sky publishes both the price list and the per-pharmacy state-exclusion table. Neither page combines them.
So a patient in Alabama looking at NAD+ 1000 mg sees six pharmacies quoting a price on one page — and, on another page, discovers that all six exclude Alabama. Zero options at any price. Mississippi patients get exactly one: Southend at $250. California patients get exactly one: Red Rock at $200.
We re-derived this on 6 September 2026 from the two published tables, and it still holds. It is not something the site surfaces. The information is all there. You have to hold two tables open in two browser tabs and match them yourself.
We did not create an account, so the intake flow is not something this review can describe from the inside. Publicly, Lavender Sky describes a standard telehealth intake: medical history, contraindication screening, then either a live consult or an async portal message to a clinician. The mandatory follow-up after a first prescription is more structure than the loosest end of the category offers. What the intake asks for, in what order, and whether labs are ever requested is not published.
Trustpilot: 4.6 out of 5 from 142 reviews, profile claimed May 2025. The distribution is bimodal — 85% five-star, 12% one-star, with 4-, 3- and 2-star each at or below 1%. That shape usually reads as: most people are fine, a small group is furious. The same page states the company has "Replied to 20% of negative reviews", which qualifies the common shorthand that a provider "engages with reviews."
The BBB profile for Lavender Sky Health, LLC shows a D− rating and "Failure to respond to 1 complaint(s) filed against business", against four complaints filed in total. The business is not BBB accredited. The contrast with Trustpilot is real and worth naming: patients who take the time to file with the BBB are the ones who couldn't get resolution through normal support channels. Four is not many. One non-response is one too many.
An exact-name search of the FDA warning letter database returns no match for Lavender Sky Health. No consent decree, no publicly identified enforcement action, and no Eli Lilly litigation naming this entity that we could find.
That said, the entire compounded-GLP-1 category sits inside an active FDA enforcement environment. Tirzepatide came off the shortage list in December 2024 and semaglutide in February 2025; the 503A grace period ended 22 April 2025 and the 503B period 22 May 2025 for semaglutide. In April 2026 the FDA proposed excluding semaglutide, tirzepatide and liraglutide from the 503B Bulks List permanently. It is a proposal, not a rule — but any compounded-GLP-1 provider is exposed to how it lands once the FDA finalises it. Lavender Sky is not uniquely exposed. It's not immune either.
The patient who benefits most from Lavender Sky's model wants pharmacy choice and is willing to do the cross-referencing work: comparing prices across six vendors, checking state coverage, deciding which 503A pharmacy they'd prefer their vial come from. The transparency is genuine — most competitors won't name their pharmacy at all.
The patient this suits least wants a single price, a single decision and a bundled experience. The consult fees, the plan fee, the per-pharmacy pricing and the state exclusions are all real, and they add up to more decision surface than "pay one monthly number." If you're in Alabama looking at the NAD+ line specifically, the answer may be nothing available. Check first.
Lavender Sky Health publishes more about its pharmacy network than almost any DTC competitor we've read. It also charges consult fees on top of medication, applies a plan fee on brand-name plans, and leaves patients to reconcile pricing tables against state-exclusion tables on their own. The D− BBB rating and one unanswered complaint deserve attention; the 4.6 Trustpilot score deserves the qualifier that only a fifth of negative reviewers got a reply.
An honest take: this is a legitimately structured platform with real transparency in one dimension — pharmacy sourcing — a genuine gap in another — no named medical director anywhere on the site — and the standard compounded-GLP-1 category risk that no provider in the space can currently absorb. Patients who want pharmacy optionality and will price it out themselves will get more from Lavender Sky than from a black-box competitor. Patients who want one number and one decision should look elsewhere.
Yes, within limits. The FAQ states: "Yes, you can choose from our designated list of pharmacy partners, as long as they are available in your state of residence." Fourteen pharmacies are named; how many of them can actually ship to you depends on your state.
$65 for a new-patient consult and $40 for a follow-up, with medication billed separately. Brand-name GLP-1 plans carry an extra $25 per month plan fee.
Every six months on an active treatment plan and every twelve on maintenance dosing, with refills available in between. A follow-up is also required the first time a given medication is prescribed, and switching between semaglutide and tirzepatide triggers another one.
Three of the fourteen are, as 503B outsourcing facilities: Empower, Nova and New Life Rx. The other eleven are 503A state-licensed compounders, which is normal for patient-specific compounding but sits outside the 503B inspection regime.
Because the price list and the state-exclusion table are on different pages and neither combines them. Six pharmacies quote NAD+ 1000 mg; all six exclude Alabama, so an Alabama patient has no option at any price. Mississippi has one, Southend at $250. California has one, Red Rock at $200.
No. The about page says the company is "physician (and female) owned & operated" but names nobody, and neither do the homepage, FAQ, contact or booking pages. Patient reviews on Trustpilot do name individual providers; the company itself doesn't.
Editorial note: This page is for informational purposes and doesn't constitute medical advice. Peptide and GLP-1 therapy decisions should be made with a licensed healthcare provider familiar with your medical history.
Prices
This review is about whether the company holds up, so it carries no price list — a figure printed here would be stale within a month and would turn an assessment into a storefront. Our sister site keeps the pricing, read from Lavender Sky Health’s own pages and dated. It is run by the same people as this one.
See Lavender Sky Health’s plans and pricingPeptides To Go · plans, entry price and what the bill excludes