Budget vs premium
Refills vs Start Willow: Which Costs Less Over 12 Months? (2026)
Refills or Start Willow? Side-by-side 2026 pricing, medication and service comparison, extended to six and twelve-month totals.
Published · Pricing as published in our provider dataset, synced · Editorial scores 7.7 and 7.3 out of 10
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The choice between Refills and Start Willow usually comes down to one difference that neither homepage puts in its headline.
Start Willow costs 3.0x more per month than Refills once promotional pricing is out of the picture ($299/mo against $99/mo). Over a year that gap compounds into real money, and the question is what it buys.
Below, the two programs are set against the things that change the bill — the advertised rate, the rate after the promotion expires, the medication class and the inclusions. Anything a provider declines to disclose is marked undisclosed rather than filled in.
The short answer
- Lowest 12-month cost
- Refills — $1,188 against $3,538 at Start Willow, on each provider's own best published pricing.
- Most predictable bill
- Refills — Flat rate at every dose, so titration does not change what you are charged.
- Fastest route to a first shipment
- Refills — 3-minute approval quiz, then free, fast and discreet shipping on every order.
- Easiest to pay for
- Refills — Neither publishes financing; both expect the full amount monthly.
Refills vs Start Willow: the specification
This is the whole comparison in one screen. The sections underneath explain which of these rows should decide it.
| Refills | Start Willow | |
|---|---|---|
| Advertised price | GLP-1 from $99/mo, about $5 a day | From $249 the first month, then $299/mo |
| Rate after promotions | $99/mo | $299/mo |
| Pricing structure | Flat rate at every dose | Promotional first month, then standard rate |
| Medication | Compounded semaglutide and GIP+GLP-1 dual agonist | Compounded semaglutide and compounded tirzepatide |
| Price transparency | Published upfront | Published upfront |
| Tirzepatide | Available | Available |
| Support model | No coaching program stated | No coaching program stated |
| Shipping | Free, fast and discreet shipping on every order | Delivery guaranteed in 3 days or less |
| Patient reviews | 7,400 | 6,385 |
| eRxDoctor score | 7.7/10 | 7.3/10 |
Cost over a full course of treatment
The cheapest first month and the cheapest year are frequently different providers. Here is what each one costs across a realistic course of treatment, on published pricing.
| Refills | Start Willow | |
|---|---|---|
| First month | $99 | $249 |
| Months 2 onward | $99/mo | $299/mo |
| 6-month total | $594 | $1,744 |
| 12-month total | $1,188 | $3,538 |
| Best published plan | No multi-month discount published | No multi-month discount published |
The twelve-month spread is $2,350. That is the number to hold Start Willow against: it has to justify roughly $196 extra every month.
Price escalation to plan for: Start Willow moves from $249 to $299, a 20% increase. Set a calendar reminder for the month it changes.
Is Start Willow worth the premium?
Before treating the cheaper option as the obvious one, it is worth naming what the more expensive one includes — at Start Willow that is direct-pay model that bypasses insurance pre-authorization, plus delivery guaranteed in 3 days or less.
Refills counters with $99 flat at every dosage, from LegitScript-certified pharmacies with third-party USP testing, and the thing it asks you to accept in return: clinicians come from partner networks and availability varies by state.
For a patient who has taken a GLP-1 before, knows how they titrate and needs a reliable monthly refill, the cheaper program is usually the correct one and the premium is a donation. For a first prescription, the calculus changes.
A closer look at Refills
The pitch is $99 flat at every dosage, from LegitScript-certified pharmacies with third-party USP testing. Refills offers personalized compounded GLP-1 from $99/month (~$5/day) with flat pricing, the same price at every dosage, plus free discreet shipping, 24/7 health concierge support, and no membership or app fees.
You start with 3-minute approval quiz; medication arrives via free, fast and discreet shipping on every order. The price behaves as flat rate at every dose.
Free 24/7 health concierge. The formulary covers compounded semaglutide and GIP+GLP-1 dual agonist.
Refills pros
- Flat pricing, the same low price at every dosage, no titration upcharges
- Personalized GLP-1 from $99/mo (~$5/day); GIP+GLP-1 dual agonist available
- 40% off new patient special offers
- No monthly memberships or app fees
Refills cons
- Clinicians come from partner telehealth networks (Beluga, Bask, Wasef Health)
- Compounded medication, not an FDA-approved branded product
- Availability varies by state
The reservation worth holding, particularly next to Start Willow: clinicians come from partner networks and availability varies by state.
Inside the Start Willow program
From $249 per Month
The process is fully online, no in-person visits, then delivery guaranteed in 3 days or less. On money, expect promotional first month, then standard rate — published upfront.
What continues after the first shipment: direct-pay model that bypasses insurance pre-authorization. Formulary: compounded semaglutide and compounded tirzepatide.
Start Willow pros
- Fully online, no in-person visits or insurance forms
- Medications comparable to Ozempic and tirzepatide
- No insurance needed and no membership fees
- Direct-pay model bypasses insurance pre-authorization entirely
Start Willow cons
- Price rises from $249 first month to $299/month ongoing
- Ongoing $299/month is among the higher rates on this list
- Compounded medication only, no branded Ozempic or Wegovy
Read next to Refills, the weak point: at $299 ongoing it is among the most expensive compounded programs here.
Who each program is actually built for
Choose Refills if:
- delivery works the way you want it to: free, fast and discreet shipping on every order
- you want to start on their timeline: 3-minute approval quiz
- the level of clinical contact suits you: free 24/7 health concierge
- the feature you would actually use: $99 flat at every dosage, from LegitScript-certified pharmacies with third-party USP testing
Choose Start Willow if:
- the level of clinical contact suits you: direct-pay model that bypasses insurance pre-authorization
- what it leads on is worth paying for in your case: a delivery guarantee of three days or less and no membership stacked on the medication price
- delivery works the way you want it to: delivery guaranteed in 3 days or less
- you want to start on their timeline: fully online, no in-person visits
The trade-offs, stated plainly
On price. The monthly gap is 3.0x in Refills's favor. Whether that is a saving or a false economy turns on one thing: clinicians come from partner networks and availability varies by state.
On clinical contact. Free 24/7 health concierge at Refills; direct-pay model that bypasses insurance pre-authorization at Start Willow. Neither is a substitute for in-person care if you have complicating conditions, and both bill you directly rather than your insurer.
On medication. Refills covers compounded semaglutide and GIP+GLP-1 dual agonist; Start Willow covers compounded semaglutide and compounded tirzepatide. Neither locks you out of a molecule the other offers, so this is unlikely to be the deciding factor.
On access. Refills advertises 3-minute approval quiz and free, fast and discreet shipping on every order; Start Willow advertises fully online, no in-person visits and delivery guaranteed in 3 days or less. Coverage differs too — availability varies by state against not published — which decides the question before price does if you are in a restricted state.
The clinical evidence, separated from the marketing
It is worth separating the program from the pharmacology. What follows is true of the medication regardless of which of these two writes the prescription.
The NIH position is that weight-management medication works alongside changes in eating and activity, not instead of them, per NIH, NIDDK.
In SURMOUNT-1, tirzepatide reached a mean body-weight reduction of about 21% at the 15 mg dose over 72 weeks, per NEJM, SURMOUNT-1.
Neither platform's marketing changes any of that. It is the same evidence base whichever one takes your card.
Refills vs Start Willow: common questions
Does the price go up as my dose increases?
At Refills, no — $99 flat at every dosage, from LegitScript-certified pharmacies with third-party USP testing. At Start Willow, the published structure is promotional first month, then standard rate, moving from $249 to $299. Since GLP-1 doses escalate over the first months, that difference is worth more than most feature comparisons.
Is Refills cheaper than Start Willow?
Yes, on the ongoing rate. Refills runs $99/mo once promotional pricing ends, against $299/mo at Start Willow — a difference of 3.0x. Compare the first-month offers separately, because both providers discount entry differently from the rate you will actually be paying by month three.
How fast can I start with Refills compared with Start Willow?
Refills advertises 3-minute approval quiz, with free, fast and discreet shipping on every order. Start Willow advertises fully online, no in-person visits, with delivery guaranteed in 3 days or less. Both are subject to clinician review and to whether your state and health history clear, so treat the advertised timeline as a best case rather than a commitment.
Do Refills and Start Willow prescribe the same medication?
Both dispense compounded GLP-1 preparations. Refills lists compounded semaglutide and GIP+GLP-1 dual agonist and Start Willow lists compounded semaglutide and compounded tirzepatide, so the molecules overlap even where the formulary does not match exactly.
Can I switch from Refills to Start Willow later?
Nothing stops you. The friction is administrative rather than clinical: a new intake, a new prescriber, and a delivery gap if you time it badly. Move while you still have two weeks of medication in the fridge.
The verdict
Strictly on cost, Refills takes it — $1,188 to $3,538 over twelve months.
The case for Start Willow is a delivery guarantee of three days or less and no membership stacked on the medication price. That is worth $196 a month to some patients and nothing at all to others — be honest about which you are.
Whichever way you go, the medication is the same class of drug and the clinical questions belong to a clinician. What you are choosing here is a billing model and a support structure.
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Disclaimers and methodology
Medical content is informational only and does not replace professional diagnosis, treatment, or emergency care.
Some links are affiliate links and may generate commission at no extra cost to you.
Pricing reflects what each provider published as of the sync date above and changes frequently; confirm the current rate, and the rate at your maintenance dose, before you pay. Six- and twelve-month totals are calculated from those published rates and exclude anything a provider bills separately.
eRxDoctor is an independent publisher. It is not a medical provider, is not affiliated with or endorsed by Refills or Start Willow, and does not sell treatment. Read our ranking methodology.