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Head-to-head · WeighScore

PauseRX vs Silhouette MD

PauseRX
Graded #150

Lower grade

vs+0.9000000000000057
Silhouette MD
Graded #131

Higher grade

The verdict

Silhouette MD takes it — 69.4/100 to 68.5/100, but only just.

Silhouette MD grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Concierge-style GLP-1 telehealth offering compounded semaglutide and tirzepatide in both injectable and oral forms, with provider oversight and full-service support included on every plan. PauseRX is close behind and may still be the better fit — see the factor split below.

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 valueSilhouette MD +8
66
74
Dose & formulationPauseRX +10
85
75
Clinical oversightPauseRX +6
83
77
Labs & monitoringSilhouette MD +2
52
54
FulfillmentSilhouette MD +6
61
67
Contract termsSilhouette MD +14
41
55
PauseRX · left barSilhouette MD · right bar

The numbers

MetricPauseRXSilhouette MD
WeighScore68.5/10069.4/100
GradeCC
Scorecard rank#150#131
Semaglutide$199/mo$149/mo (compounded)
Tirzepatide$249/mo (starting dose, compounded)$299/mo (compounded)
CoverageCoverage not publishedCoverage not published
Brand-name accessYesCompounded only
Oral / sublingualInjection onlyYes
PauseRX

Graded #150 · C

Strengths

  • Names its 503A pharmacy partner (Strive Pharmacy, Gilbert AZ) — buyers can independently verify its licensure
  • Names its physician network (Beluga Health) — you can research the clinical platform handling your prescriptions
  • Publishes the FDA compounded-medication disclaimer
  • Corporate legal entity disclosed (PauseRX, Inc.) — uncommon for direct-to-consumer GLP-1 platforms
  • Flat $199 'all doses' compounded semaglutide pricing — no per-tier escalation

Where it loses points

  • States served not listed — site claims nationwide, but you must contact support to confirm availability
  • Restrictive cancellation policy — orders can't be changed or canceled once submitted, and medications can't be returned
  • No named medical director (Beluga Health is the network, not a named MD)
  • LegitScript certification number not shown — badge only, so no direct lookup
  • Insurance not accepted — cash-pay only; HSA/FSA eligibility not confirmed
Silhouette MD

Graded #131 · 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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