altRX vs Piper
Piper costs $14 less a month, and both sell semaglutide and tirzepatide.
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Piper
Best for: coverage in all 50 states, which most sellers will not confirm
Visit Piper →If you are choosing between altRX and Piper, the first difference is cost: Piper is $14 a month cheaper at the entry price. Both prescribe semaglutide and tirzepatide, so moving from one to the other would not change your drug. Piper leads our six-part score, 7.4 to 6.7. One of the two has an FDA warning letter on record, covered below.
altRX vs Piper price
Piper is the cheaper way in: $135 a month against $149 a month at altRX. That is $14 less each month (9% lower), or about $168 over a year of treatment.
Drug by drug: Semaglutide is cheaper at Piper ($135 a month vs $149 a month); tirzepatide is cheaper at Piper ($199 a month vs $249 a month).
Medications and formats
Both sell semaglutide and tirzepatide.
On format, altRX prices compounded injections and brand-name pens, while Piper prices compounded injections.
If you want the FDA-approved brand rather than a compounded version, altRX is the only one of the two with a brand-name price.
Where each one treats patients
altRX does not publish where it ships, and Piper lists 50 states.
Pricing
altRX
Piper
What each price covers
Both prices cover the clinician visit, the medication itself and shipping.
altRX is silent on lab work and coaching.
Piper is silent on lab work and coaching.
altRX
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
Not stated
Piper
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
Not stated
Where each one scores higher
Overall, Piper scores 7.4 and altRX 6.7 out of 10.
altRX is stronger on value (5.0 vs 3.0).
Piper is stronger on trust & safety (8.5 vs 3.5) and accessibility (10.0 vs 5.0).
Effectiveness, user experience and support are within half a point.
altRX
6.7/10
Piper
7.4/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
FDA warning letters
The FDA sent altRX a warning letter dated June 8, 2026 (letter 728236), and it is still open.
Piper has no FDA warning letter on record with us.
Features & Coverage
| Feature | altRX | Piper |
|---|---|---|
| Starting Price | $149/mo | ✓$135/mo |
| Features | ✓8 features | 3 features |
| States Available | Not disclosed | 50 |
| Compounded | ✓ Yes | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| FDA Warning Letters | 1 letter | ✓None |
About altRX
Compounded plans open at $149 for semaglutide and $249 for tirzepatide. Branded medication runs $1,149-$1,579, a figure that already contains the consult and the shipping. Every one of the four FDA-approved brands is stocked, Mounjaro, Ozempic, Wegovy and Zepbound, which no other entry in our directory matches. altRX works in both modalities, holds LegitScript certification, and prints the FDA compounded-medication disclaimer.
Read our full altRX review →About Piper
Piper is a telehealth weight loss seller offering compounded GLP-1 medications at competitive prices.
Read our full Piper review →Pros & Cons
altRX
What we like
- Tirzepatide costs $1249 a month, close to the $1249 median for brand-name tirzepatide across the sellers we compare
- Shows its price before the medical questionnaire, so you can compare it without handing over health information
- The monthly price includes the medication, clinician visits and shipping
Watch-outs
- Semaglutide costs $1149 a month, 16% above the $990 median for brand-name semaglutide across the sellers we compare
- Confirm it serves your state before you start the intake
- Ask which pharmacy fills the prescription before you pay, so you can check its license
- The FDA has issued altRX a warning letter. Read what it alleges: a letter flags a problem but does not by itself rule a seller out
- Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality
Piper
What we like
- Shows its price before the medical questionnaire, so you can compare it without handing over health information
- The monthly price stays the same as your dose goes up
- The monthly price includes the medication, clinician visits and shipping
- Serves all 50 states
- We found no FDA warning letters issued to Piper
Watch-outs
- Ask which pharmacy fills the prescription before you pay, so you can check its license
- Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality
Our Verdict
Piper wins this one, 7.4 to 6.7, above all for coverage in all 50 states, which most sellers will not confirm. It also costs $14 less each month than altRX. altRX fits better if semaglutide from $1149/month is your priority.
Choose altRX if…
You want semaglutide from $1149/month and an opening price near $149 a month.
Choose Piper if…
You want coverage in all 50 states, which most sellers will not confirm and an opening price near $135 a month.
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Breeze Meds
Knowing which pharmacy fills the vial: it names Belmar Pharmacy
From $199/mo
Get started →HealthRX
Compounded semaglutide at $133/month
From $133/mo
Get started →RNK Health
An oral route if you will not self-inject
From $197/mo
Get started →altRX vs Piper: FAQ
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- Piper vs Somi Health
Or see the full category ranking.
Novo Nordisk A/S owns the Wegovy®, Ozempic® and Rybelsus® marks; Eli Lilly and Company owns Mounjaro® and Zepbound®. Every other product name and mark on this page belongs to whoever owns it. No pharmaceutical manufacturer is affiliated with GLP Watchdog. See trademark disclaimer.