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Head-to-head · WeighScore

Direct Meds vs Silhouette MD

Direct Meds
Graded #19

Higher grade

vs+13.199999999999989
Silhouette MD
Graded #123

Lower grade

The verdict

Direct Meds takes it — 82.6/100 to 69.4/100.

Direct Meds grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. One of the few programs offering an oral/sublingual route alongside injectable — semaglutide from ~$179 sublingual (~$297 injectable), tirzepatide ~$224/$399, with an intro promo near $147, all-inclusive and no membership.

We may earn a commission if you start care through some of these links, at no extra cost to you. It never moves the WeighScore, which is the weighted average of the six factors shown for every provider, and what we write about a provider is the same either way. See our disclosure.

Factor by factor

The same six graded dimensions, side by side. See the methodology.

Cost valueDirect Meds +11
85
74
Dose & formulationDirect Meds +13
88
75
Clinical oversightDirect Meds +3
80
77
Labs & monitoringDirect Meds +24
78
54
FulfillmentDirect Meds +13
80
67
Contract termsDirect Meds +25
80
55
Direct Meds · left barSilhouette MD · right bar

The numbers

MetricDirect MedsSilhouette MD
WeighScore82.6/10069.4/100
GradeB−C
Scorecard rank#19#123
Semaglutide$179/mo$149/mo (compounded)
Tirzepatide$224/mo$299/mo (compounded)
CoverageNot publicly listedCoverage not published
Brand-name accessCompounded onlyCompounded only
Oral / sublingualYesYes
Direct Meds

Graded #19 · B−

Strengths

  • Rare oral/sublingual option in addition to injectable
  • All-inclusive pricing with no separate membership fee
  • Both molecules — semaglutide and tirzepatide
  • Intro promotional pricing near $147

Where it loses points

  • Compounded only — not FDA-approved
  • Pricing is company-stated, not independently live-verified
  • Newer and somewhat ambiguous (operates across multiple domains)
  • States served are not disclosed
Silhouette MD

Graded #123 · C

Strengths

  • Compounded semaglutide and tirzepatide in both injectable and oral formulations
  • Concierge-level support — monitoring, expert guidance, and check-ins included on every plan
  • Transparent, published pricing starting at $149/mo for semaglutide injection
  • Prescriptions issued and fulfilled by licensed clinical partner OpenLoop Health

Where it loses points

  • Tirzepatide ($299/mo) and oral options ($263–$325/mo) priced above many compounded competitors
  • State availability not published
  • Newer brand with limited independent review history
  • Medications are compounded, not FDA-approved brand-name

Also worth a look

Neither is our top-graded pick — CoreAge Rx leads the scorecard

Across all 499 providers, CoreAge Rx grades highest at 91.8/100 (A−). Top of the scorecard: flat transparent pricing, both molecules, nationwide — no teaser-rate games.

Pricing/verification reflect each provider's public disclosures at last grading; the WeighScore is our editorial judgment per the methodology. Prices change — confirm on each provider's site. Not medical advice; see our disclosure.

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