Pricing a GLP-1 subscription patients actually keep
Acquisition gets the attention, but a GLP-1 program's economics are set by how many patients are still there at month six. Pricing is the biggest lever on that number, and most programs pull it in the wrong direction.
Lithos Staff
Photograph via UnsplashGLP-1 programs are monthly by construction because titration is monthly, so price and retention are the same problem. The structures that retain: a flat monthly price that includes the visit, the medication, and the check-ins (no surprise line items as the dose steps up), a modest first-month offer rather than a deep one (deep discounts recruit patients who leave at the first full charge), transparent dose-step pricing announced in advance, and a maintenance tier for patients at goal. Model contribution per patient over twelve months, not per order, and treat month-three churn as the KPI.
Why retention is decided by month three
GLP-1 therapy starts with a titration ramp: the dose steps up roughly monthly for the first several months. That ramp is where side effects peak, where weight loss is not yet dramatic, and where the second and third full charges land. Programs that lose patients lose most of them here; programs that retain have designed the pricing and the experience around this window.
Four structures, and how they retain
| Structure | How it works | Retention effect |
|---|---|---|
| All-in flat monthly | Visit, check-ins, medication, shipping, supplies in one price | Best. No decision points inside the month; the card just works. |
| Visit + medication separately | A membership fee plus a per-order medication charge | Weaker. Two charges means two chances to reconsider. |
| Deep first-month discount | “First month $49,” then full price | High conversion, high month-two churn; recruits the wrong cohort. |
| Prepaid multi-month | Three or six months up front at a discount | Strong retention for those who buy; lower conversion; refund handling matters clinically. |
Dose steps and price steps
Compounded medication cost typically rises with dose, so it is reasonable for the subscription to step too. What decides whether that step costs you patients is disclosure. Put the full dose-by-dose schedule on the pricing page. Show the next month’s price in the check-in flow before the clinician decides. Send the reminder before the charge. A patient who expected the step continues; a patient who discovers it on a statement calls support and cancels.
The maintenance tier
Patients who reach goal weight do not need to leave. A maintenance tier — a lower or held dose, longer check-in intervals, a lower price — keeps them in the program with a clinician still in the loop, which is also the clinically responsible path. Programs without one hand their best patients to a competitor with a “maintenance” landing page.
The unit economics to actually model
- Contribution per patient-month: price minus medication, pharmacy and shipping, clinician time (initial vs. check-in), payment processing, and support.
- Twelve-month contribution: the sum of the above across your retention curve, not the first-month number times twelve.
- Payback: months of contribution needed to recover acquisition cost. At typical acquisition costs, payback lands inside the titration window — which is why month-three churn is the number that matters.
- Check-in cost: an async check-in with a clinician decision costs far less than the initial visit; a subscription that includes it loses little margin and removes the biggest cancellation trigger.
What to leave out of the price
Outcome claims. “Lose 20 pounds or your money back” creates a refund liability and an ad-review problem at the same time. Price the care and the medication, describe the program honestly, and let retention be the marketing. See LegitScript certification for what reviewers reject.
Frequently asked questions
How much do telehealth GLP-1 programs charge per month?
Published cash-pay prices for compounded GLP-1 programs commonly fall in a range from roughly $150 to $400 per month depending on molecule, dose, and what is bundled; branded-drug programs cost several times that. What matters more than the number is whether it is all-in and whether it steps predictably with dose.
Should the first month be discounted?
A modest introductory price can lift conversion, but deep first-month discounts recruit price-shoppers who churn when the full price hits. Programs generally retain better with a small, honest introductory offer and a clear statement of the ongoing price.
Should price increase as the dose increases?
Compounded medication cost usually rises with dose, so many programs step price with dose. Retention holds when the steps are shown up front on the pricing page and in the check-in flow; it breaks when the increase is a surprise on the card statement.
What should be included in the subscription?
The clinical visit and check-ins, the medication and shipping, supplies, and messaging with the care team. Charging separately for follow-ups or for the check-in that unlocks the refill is a reliable way to lose patients at exactly the moment they are deciding whether to continue.
From first call to first patient, in weeks.
A 15-minute intro call, sandbox credentials the same day, go-live in 3–4 weeks — new launches and existing patient bases alike.