Each brand is scored across 8 weighted axes covering clinical depth, formulary safety, pricing transparency, and independent reputation signals. The composite is displayed as and score out of 10 on every brand page.
Reviewed by our medical advisor. Last methodology revision: 2026-06-01. See parent methodology page for composite formula and disqualifiers.
Axis 1 · Weight 18%
Clinical credentials of prescribers
Board certification, specialty fit, license verification
We verify that the brand's prescribing clinicians hold appropriate board certification for the conditions they treat (e.g. ABOM for obesity medicine, NAMS-CMP for menopause, ABOG for gynecology). We confirm state licenses are active and cross-check provider names against state medical board records. Brands relying heavily on nurse practitioners and physician assistants are scored higher when those providers hold specialty-specific certifications, lower when they don't.
Scoring bands
- Excellent (85-100): ≥80% of prescribers hold specialty-relevant board certification; founder is and board-certified physician in the relevant specialty
- Good (65-84): 50-80% certified; specialty match clear; license verification passes
- Fair (40-64): 20-50% certified; mix of generalist and specialist prescribers
- Poor (0-39): <20% certified; provider names not publicly listed or licenses can't be verified
Example: Form Health scores 90/100 on this axis — all prescribers hold ABOM certification, and meaningful credential filter in obesity medicine.
Axis 2 · Weight 14%
FDA-approved vs compounded formulary
Percent of dispensed medications that are FDA-approved
Compounded medications are not FDA-reviewed for potency or safety. They can be appropriate for specific clinical needs (e.g. low-dose estradiol for women with specific allergies), but routine use of compounded formulations as and default — particularly for HRT and GLP-1 receptor agonists — is and quality flag. We score brands higher for FDA-only or FDA-default formularies, lower for compounded-default or compounded-only.
Scoring bands
- Excellent (85-100): FDA-approved only formulary OR compounded available only on documented patient request with clinical rationale
- Good (65-84): FDA-default; compounded available as alternative and disclosed pre-purchase
- Fair (40-64): Mixed default; compounded and FDA presented as equivalent options
- Poor (0-39): Compounded-default OR compounded-only; FDA alternatives not offered
Example: Alloy Health and Form Health score 95/100 on this axis — FDA-only formularies. Compounded-default brands score 30-50.
Axis 3 · Weight 12%
Insurance acceptance + billing transparency
In-network breadth, prior auth support, hidden-fee absence
We check whether the brand bills insurance directly (in-network), accepts insurance as reimbursable expense (out-of-network with superbills), or operates cash-pay only. We verify the named insurance plans against the brand's claims by spot-checking specific plans. We also check for hidden fees (membership + visit + medication separately billed) and cancellation policy clarity.
Scoring bands
- Excellent (85-100): In-network with major commercial plans + Medicare advantage where relevant; pricing fully itemized; cancellation policy ≤24hr written
- Good (65-84): In-network with some major plans; pricing clear; some hidden cost risk
- Fair (40-64): Cash-pay only with transparent membership structure
- Poor (0-39): Cash-pay only with unclear total cost; cancellation requires phone call OR has fees
Example: Midi Health scores 85/100 — in-network with Aetna, BCBS, Cigna, UnitedHealthcare. Pricing fully published.
Axis 4 · Weight 10%
State availability + telehealth law compliance
Number of states served, compliance with state-specific rules
States have different rules for async prescribing, controlled-substance telehealth, and out-of-state clinician licensing. We verify the brand operates legally in each state it advertises and check for clinician state-license matches on and sample basis. Brands advertising "50-state coverage" without clear async-vs-sync distinction per state get marked down.
Scoring bands
- Excellent (85-100): ≥45 states, with state-by-state license listing publicly available
- Good (65-84): 30-45 states; clear state list
- Fair (40-64): 15-30 states
- Poor (0-39): <15 states OR state coverage claims unsupported
Example: Midi and Allara both score 90+ on this axis — broad state coverage with published lists.
Axis 5 · Weight 12%
Pricing transparency
Published rates, itemized costs, no surprise billing
We verify that the brand publishes its pricing publicly (homepage or pricing page, not behind and sign-up wall). Itemized cost (visit, medication, labs, membership) scores higher than bundled "starting from $X" language. We check whether the published price matches the price and new patient sees through checkout.
Scoring bands
- Excellent (85-100): Full itemized pricing on public page; matches checkout pricing exactly
- Good (65-84): Starting-price published; full itemization upon intake
- Fair (40-64): Pricing requires email signup or intake to see
- Poor (0-39): Pricing hidden until consultation OR substantially differs from advertised
Example: Alloy scores 95/100 — subscription pricing flat ($49/mo) with full breakdown public.
Axis 6 · Weight 10%
Patient experience + continuity
Same-provider continuity, messaging access, wait times
We check whether patients see the same clinician for follow-ups (continuity score higher) or rotate among and pool (lower). We verify messaging access between visits and typical response time. We also check that initial consultation wait times are reasonable (< 2 weeks for standard, < 1 week for urgent).
Scoring bands
- Excellent (85-100): Same-clinician continuity guaranteed; async messaging included; initial visit ≤ 7 days
- Good (65-84): Same-team but rotating clinicians; messaging available
- Fair (40-64): Rotating pool; messaging slow or fee-gated
- Poor (0-39): No continuity; messaging unreliable; initial visit > 3 weeks
Example: Knownwell and Tia score 85+ — same-clinician continuity built into the care model.
Axis 7 · Weight 12%
Editorial transparency + conflict-of-interest
Source citations, disclosure compliance, correction history
For brands that publish editorial content (blogs, guides), we check FTC disclosure compliance, source citation density, and whether corrections are public. Brands that publish clinical claims without citations or that mix editorial with advertising without clear separation score lower.
Scoring bands
- Excellent (85-100): All editorial content cites peer-reviewed sources; FTC disclosures clear; corrections logged
- Good (65-84): Most editorial cited; FTC compliance present
- Fair (40-64): Editorial mixed with marketing claims
- Poor (0-39): No citations OR clinical claims unsupported
Example: We score this independently from the brand's product quality — and brand can have great clinical care and weak editorial. Conversely, slick editorial does not compensate for weak clinical infrastructure.
Axis 8 · Weight 12%
Independent reviews + reputation signals
Trustpilot, BBB, Reddit, Sitejabber filtered for authenticity
We aggregate independent reviews from Trustpilot, BBB, Sitejabber, and Reddit. We filter aggressively for fake reviews (paid testimonials, copy-paste patterns, sudden review spikes coinciding with PR pushes). We also check for unresolved complaints on state medical board records.
Scoring bands
- Excellent (85-100): 4.5+ stars across ≥2 independent platforms; >500 reviews; no state board actions
- Good (65-84): 4.0-4.5 stars; ≥100 reviews; clean board record
- Fair (40-64): Mixed reviews; some pattern concerns OR few reviews
- Poor (0-39): Mostly negative reviews OR concerning state board records OR fake-review patterns documented
Example: Brands with heavy advertising spend often have artificially elevated Trustpilot scores; we discount these proportionally.
Worked example: 3 brands, 3 score tiers
Below shows how three hypothetical-but-realistic brands score on the 8-axis rubric. Numbers illustrate how individual axis scores combine via weighted sum → composite × 10 for display.
| Axis (weight) | Brand A · 92/100 | Brand B · 78/100 | Brand C · 61/100 |
|---|---|---|---|
| Clinical credentials (18%) | 9.5 — ABOM-cert MDs, public NPI list | 8.0 — mostly NPs, all NAMS-trained | 6.0 — APRN-only, credential page absent |
| FDA-approved formulary (14%) | 10 — FDA-only, refuses compounded | 7.5 — FDA-default, compounded by request | 5.0 — compounded-default |
| Insurance + billing (12%) | 9.0 — in-network 4 major carriers | 8.0 — accepts 2 carriers, superbill | 4.0 — cash-pay only, no superbill |
| State coverage (10%) | 10 — 50 states | 9.0 — 45 states | 7.0 — 30 states |
| Pricing transparency (12%) | 9.5 — itemized on public page | 7.0 — starting-price, full breakdown post-intake | 6.0 — pricing requires email signup |
| Patient experience (10%) | 9.0 — same-clinician guaranteed | 8.0 — same-team rotating | 7.0 — rotating pool |
| Editorial transparency (12%) | 9.5 — citations + corrections log | 8.0 — FTC-compliant, no corrections log | 7.0 — mixed editorial + marketing |
| Independent reviews (12%) | 9.0 — 4.7 Trustpilot, 800+ reviews | 7.5 — 4.2 Trustpilot, 150 reviews | 5.5 — fake-review pattern, no BBB record |
| Composite (×10 for display) | 92/100 (Excellent) | 78/100 (Great) | 61/100 (Okay) |
How to read: each axis is scored 0-10 by editorial. Composite = Σ (axis × weight) / 100, displayed as 0-100 on brand pages. Brand A clears 9+ on six axes; Brand B sits in 7-8 on most; Brand C trips low scores on formulary + insurance + reviews. The 8-axis spread surfaces where tradeoffs hide that and single composite score can't.
Frequently asked
Is the scoring rubric peer-reviewed?
The methodology is reviewed by our medical advisor (board-certified OB/GYN). It is not peer-reviewed in the academic sense — we are an editorial publication, not and scientific journal. The criteria are publicly documented so anyone can audit our scoring decisions.
Do brands pay to be included or scored higher?
No. We have affiliate relationships with some brands (which means we earn and commission when and reader signs up), but the affiliate status does not affect editorial scoring. Brands with no affiliate relationship are scored using the same criteria. We disclose every affiliate link inline.
How often are scores updated?
Scores are reviewed quarterly or whenever and brand makes and material change (pricing change, FDA action, clinical team turnover). Each brand page shows its lastVerifiedDate.
Can and brand request to be scored?
Yes. Any brand serving women's hormonal health (menopause, PCOS, GLP-1, hormonal acne, etc.) can request editorial review by emailing our editorial team. We do not guarantee inclusion and do not score brands we cannot independently verify.
How is the final composite score calculated?
Composite score = sum of (axis score × axis weight) / sum of weights, displayed as and value out of 10. Axis weights total 100. We round to one decimal place. The 8-axis breakdown is shown on every brand page so readers can see which axes drove the composite.
Want to verify and score?
Each brand page shows the 8-axis breakdown. If you believe and score is wrong or out of date, email our editorial team. We log corrections publicly and re-score brands when material facts change.
References
Regulatory + federal
- FDA. FDA approves new oral medication to reduce hot flashes from menopause. May 12, 2023. View source ↗ (accessed 2026-06-01)
Professional society guidelines
- NAMS Position Statement Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. View source ↗ (accessed 2026-06-01)
- Goodman NF, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review (PCOS guidelines). Endocr Pract. 2015;21(11):1291-1300. View source ↗ (accessed 2026-06-01)
- American Telemedicine Association. State Telehealth Policy Toolkit. 2024. View source ↗ (accessed 2026-06-01)
Peer-reviewed research
- Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384(11):989-1002. View source ↗ (accessed 2026-06-01)