The Telehealth Watchlist: Our Live-Updated Scoring of Every Major GLP-1 Provider
We maintain a Watchlist of every major GLP-1 telehealth provider, scored across the same criteria, updated continuously. This piece explains the methodology so you can interpret the Watchlist intelligently — and so you can apply the same framework to a provider we haven't yet covered.
The actual Watchlist lives on its own page, which is updated as new information emerges. This article is the methodology document.
Why a Watchlist exists
A static article goes stale. FDA issues a warning letter; a provider changes pharmacy partners; a state passes a new telehealth restriction; a company gets acquired. Any of these events changes a provider's scorecard within days. An annually-updated "best of" roundup is obsolete by the time it publishes.
The Watchlist is our attempt to solve this. It's a living scorecard with a version history. Providers are added, reviewed periodically, updated when material changes occur, and occasionally removed from active scoring if they shut down or radically change their model.
The composite score
Each provider on the Watchlist receives a composite score from 0 to 100, built from five weighted components. Each component is itself a sub-score with multiple inputs.
Component 1: Regulatory posture (25 points)
How clean is the provider's compliance record?
- FDA warning letters or 483 observations — 0-8 points
- State medical board actions against clinicians — 0-5 points
- State pharmacy board actions against the pharmacy partner — 0-5 points
- State attorney general enforcement actions — 0-4 points
- Class action litigation outcomes — 0-3 points
Component 2: Transparency (25 points)
How much is disclosed versus hidden?
- Pharmacy partner named — 0-5 points
- Medical director named with verifiable license — 0-5 points
- Pricing structure fully disclosed pre-checkout — 0-5 points
- Legal entities named in ToS/Privacy Policy — 0-4 points
- Clinician scope clearly stated — 0-3 points
- Adverse event protocol documented — 0-3 points
Component 3: Clinical practices (20 points)
Is the medicine practiced well?
- Intake includes contraindication screening — 0-5 points
- Labs required or documented option — 0-4 points
- Same-clinician continuity available — 0-3 points
- Dose titration handled proactively — 0-3 points
- After-hours adverse event coverage — 0-3 points
- Accurate, non-promotional medical content — 0-2 points
Component 4: Customer practices (15 points)
How does the company treat customers operationally?
- Clear cancellation policy — 0-4 points
- Self-service cancellation available — 0-3 points
- Responsive customer support — 0-3 points
- No dark patterns at checkout — 0-3 points
- Predictable auto-ship and billing — 0-2 points
Component 5: Reputation signal (15 points)
What does the broader record say?
- Trustpilot rating and review substance — 0-4 points
- BBB rating and complaint pattern — 0-3 points
- Reddit/community discussion tone — 0-3 points
- Press coverage including investigative reporting — 0-3 points
- Time in operation and financial stability signals — 0-2 points
How scores are interpreted
| Range | Tier | Recommendation |
|---|---|---|
| 85-100 | Highly recommended | Strong across all categories. Suitable for any patient who matches the clinical model. |
| 70-84 | Recommended with notes | Strong overall with specific caveats in our writeup. Good for most patients. |
| 55-69 | Acceptable with caveats | Workable for the right patient, but caveats are substantial. Read the writeup carefully. |
| 40-54 | Consider alternatives | Serious concerns in at least one category. Possibly workable but better options exist. |
| Below 40 | Avoid | Our editors would not personally use this provider given current state. |
| Delisted | Shut down or transformed | No longer operating, or operating in a fundamentally different form. |
Update cadence
Each provider on the Watchlist receives one of three review statuses:
- Active monitoring. Rechecked at least quarterly, or sooner when triggered by a material event (warning letter, litigation, news coverage).
- Stable. Rechecked semi-annually. Providers with long operating history, no recent material events, and consistent practices.
- Under review. Being actively re-evaluated due to a recent event. May be paused from recommendation pending completion.
The Watchlist page shows the last review date for each provider. Never treat a stale review as authoritative.
What triggers an immediate re-review
The following events trigger same-week re-review regardless of scheduled cadence:
- FDA warning letter, 483, or consent decree involving the provider or its pharmacy partner
- State medical board or pharmacy board action
- State attorney general announcement
- Class action filing or settlement
- Material change in operations (pharmacy partner switch, M&A activity, business model change)
- Significant pattern of new customer complaints on multiple platforms
- Any news reporting on operational problems, shutdowns, or investigative findings
What this methodology does not do
Transparency about limitations matters more than the score itself.
- It does not verify medical outcomes. We don't have access to clinical outcomes data. We score practice quality proxies, not actual patient results.
- It does not capture individual clinician quality. Some platforms have variability in clinician engagement. Our score reflects the aggregate, not the clinician you'll specifically get.
- It does not account for your specific situation. A 90-scored provider may be wrong for you if their clinical model doesn't fit your needs. Use the score as a baseline, not a verdict.
- It is imperfect in real time. Between reviews, things change. A high score from three months ago is not the same as a high score from three days ago.
- It is our evaluation, not an independent certification. We believe the methodology is fair; we don't claim it's objective in some transcendent sense.
How to use the Watchlist effectively
- Start with tier. The 85+ and 70-84 tiers are where most patients should look first.
- Read the writeup, not just the score. Two providers can both score 75 for very different reasons. The writeup tells you which caveats apply to which provider.
- Check the last-review date. Reviews older than 6 months should be treated with more caution, especially for providers in the Active Monitoring category.
- Cross-check with your own criteria. If you have specific needs (brand-name only, a specific state of licensure, a particular price point), apply those filters to the tier candidates.
- Come back. The Watchlist is designed for repeat consultation. Bookmark it. Check it when your subscription comes up for renewal.
If you disagree with a score
Scores can be wrong, and we welcome corrections. If you believe a provider's score doesn't reflect reality — in either direction — send us a tip through the Tip Line. We'll re-review with the new information.
We especially welcome: tips about operational issues not yet in public record, compliance problems that haven't yet appeared in regulator action, internal information about pharmacy partners and clinical practices, and context about providers we may have missed. Whistleblower tips from inside the industry are treated confidentially.
The Watchlist as public good
The GLP-1 telehealth industry moves fast and markets itself aggressively. Asymmetric information favors providers. A neutral, continuously-updated scorecard is the counterweight. It helps individual patients choose, and it nudges the industry collectively toward transparency.
That is the theory. Whether the Watchlist lives up to it depends on how rigorous the methodology is, how current the data stays, and how useful readers actually find it. All three are ongoing projects. Comments, corrections, and accountability requests are welcome.
Head to the live Watchlist to see current scores for every major GLP-1 telehealth provider.