Budget vs premium
Start Willow vs Maximus: Which Costs Less Over 12 Months? (2026)
Start Willow $299/mo vs Maximus $133/mo. 2026 comparison of pricing, medication and support, with 12-month totals rather than first-month offers.
Published · Pricing as published in our provider dataset, synced · Editorial scores 7.3 and 7.0 out of 10
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On paper, Start Willow and Maximus sell the same thing: a prescription, a vial and a delivery date. In practice they are priced and staffed on different assumptions.
Start Willow costs 2.2x more per month than Maximus once promotional pricing is out of the picture ($299/mo against $133/mo). Over a year that gap compounds into real money, and the question is what it buys.
Everything here is drawn from each provider's own published pricing and program detail, then extended into six- and twelve-month totals so the two become comparable. Where a provider quotes only after intake, that is recorded as the answer rather than replaced with a guess.
The short answer
- Lowest 12-month cost
- Maximus — $1,596 against $3,538 at Start Willow, on each provider's own best published pricing.
- Most predictable bill
- Maximus — Flat rate at every dose, so titration does not change what you are charged.
- Tirzepatide access
- Start Willow — The only one of the two that publishes a dual GIP/GLP-1 option.
- Longest public track record
- Start Willow — 6,385 patient reviews against 2,896.
Side-by-side comparison
Read the second row before the first: the advertised price and the price you actually run at are frequently different numbers.
| Start Willow | Maximus | |
|---|---|---|
| Advertised price | From $249 the first month, then $299/mo | $132.99/mo |
| Rate after promotions | $299/mo | $133/mo |
| Pricing structure | Promotional first month, then standard rate | Flat rate at every dose |
| Medication | Compounded semaglutide and compounded tirzepatide | Compounded semaglutide |
| Tirzepatide | Available | Not published |
| Price transparency | Published upfront | Published upfront |
| Shipping | Delivery guaranteed in 3 days or less | Home delivery |
| Support model | No coaching program stated | No coaching program stated |
| Patient reviews | 6,385 | 2,896 |
| eRxDoctor score | 7.3/10 | 7.0/10 |
What you will have spent by month twelve
Almost every complaint about telehealth GLP-1 pricing traces back to comparing month one instead of month twelve. The totals below are the honest version, built from the rates each provider publishes.
| Start Willow | Maximus | |
|---|---|---|
| First month | $249 | $133 |
| Months 2 onward | $299/mo | $133/mo |
| 6-month total | $1,744 | $798 |
| 12-month total | $3,538 | $1,596 |
| Best published plan | No multi-month discount published | No multi-month discount published |
Over a year that is a $1,942 difference, in Maximus's favor. Whether it is the right call depends on whether Start Willow gives you $162 a month of something you will use.
Price escalation to plan for: Start Willow moves from $249 to $299, a 20% increase. Set a calendar reminder for the month it changes.
Maximus is cheaper. Does that make it better?
The gap runs to 2.2x a month. What Start Willow offers for it: direct-pay model that bypasses insurance pre-authorization, plus delivery guaranteed in 3 days or less.
Maximus counters with a low flat rate with a simple direct-pay structure and nothing bolted on, and the thing it asks you to accept in return: the smallest patient base here, with limited published detail on tirzepatide.
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 Start Willow
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
- Direct-pay model bypasses insurance pre-authorization entirely
- Delivery guaranteed in 3 days or less
- Medications comparable to Ozempic and tirzepatide
Start Willow cons
- Compounded medication only, no branded Ozempic or Wegovy
- Price rises from $249 first month to $299/month ongoing
- Ongoing $299/month is among the higher rates on this list
Set beside Maximus, the thing to weigh: at $299 ongoing it is among the most expensive compounded programs here.
How Maximus works
The pitch is a low flat rate with a simple direct-pay structure and nothing bolted on. $132.99 per Month
You start with telemedicine intake, no clinic visits; medication arrives via home delivery. The price behaves as flat rate at every dose.
On the clinical side, prescriptions approved by licensed doctors, filled through U.S. pharmacies, prescribing compounded semaglutide.
Maximus pros
- Simple, straightforward direct-pay model
- Prescriptions approved by licensed doctors
- Medication filled through trusted U.S. pharmacies
- Low flat rate at $132.99/month
Maximus cons
- No published outcome or weight loss guarantee
- Limited published detail on tirzepatide availability and program features
- Compounded medication only, no branded Ozempic, Wegovy, or Zepbound
Against Start Willow specifically, the trade you are making: the smallest patient base here, with limited published detail on tirzepatide.
Who should choose Start Willow, and who should choose Maximus
Choose Start Willow if:
- the level of clinical contact suits you: direct-pay model that bypasses insurance pre-authorization
- you want to start on their timeline: fully online, no in-person visits
- you want tirzepatide available without changing provider later
- 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
Choose Maximus if:
- you want to start on their timeline: telemedicine intake, no clinic visits
- the level of clinical contact suits you: prescriptions approved by licensed doctors, filled through U.S. pharmacies
- delivery works the way you want it to: home delivery
- you want the price you sign up at to survive titration
The trade-offs, stated plainly
On price. $133/mo against $299/mo. Start Willow is asking you to pay for a delivery guarantee of three days or less and no membership stacked on the medication price; decide whether that is a line item you will use.
On medication. Start Willow covers compounded semaglutide and compounded tirzepatide; Maximus covers compounded semaglutide. Only Start Willow publishes a tirzepatide route, which matters if semaglutide underdelivers.
On clinical contact. Start Willow provides direct-pay model that bypasses insurance pre-authorization. Maximus provides prescriptions approved by licensed doctors, filled through U.S. pharmacies. Both are asynchronous-first services and neither replaces a physician who can examine you.
On predictability. The pricing structures differ (promotional first month, then standard rate versus flat rate at every dose), and structure, not headline rate, determines the twelve-month bill.
The clinical evidence, separated from the marketing
Weight loss percentages quoted in telehealth marketing come from trials neither Start Willow nor Maximus ran. Here is the source material, and what regulators say alongside it.
The FDA has published specific concerns about unapproved GLP-1 drugs sold for weight loss, including dosing errors made when patients measure their own doses, per FDA.
The FDA maintains a standing page on medications containing semaglutide, including what separates an approved product from a copy, per FDA.
None of that settles which of these two to use. It does mean the drug is doing the work, and you are choosing who supplies it and on what terms.
Start Willow vs Maximus: common questions
Which costs less over a year, Start Willow or Maximus?
Maximus, at roughly $1,596 for twelve months against $3,538 at Start Willow, using each provider's own best published pricing. Those totals cover medication and program fees as published; they exclude anything a provider bills separately, and they assume you stay on the same plan for the full year.
Is Maximus cheaper than Start Willow?
Yes, on the ongoing rate. Maximus runs $133/mo once promotional pricing ends, against $299/mo at Start Willow — a difference of 2.2x. Compare the first-month offers separately, because both providers discount entry differently from the rate you will actually be paying by month three.
Does Start Willow or Maximus offer tirzepatide?
Start Willow does. Maximus publishes compounded semaglutide only, so moving to tirzepatide would mean moving provider — a new intake, a new price, and the loss of any rate you had locked in.
Do Start Willow and Maximus prescribe the same medication?
Both dispense compounded GLP-1 preparations. Start Willow lists compounded semaglutide and compounded tirzepatide and Maximus lists compounded semaglutide, so the molecules overlap even where the formulary does not match exactly.
Are Start Willow and Maximus legitimate?
Both are licensed telehealth platforms that route a prescription through a clinician review before anything is dispensed; neither sells medication without one. Start Willow operates on promotional first month, then standard rate with pricing published upfront, Maximus on flat rate at every dose, published upfront. The meaningful due diligence is on the medication category and the terms, not on whether the platforms are real.
What happens if I stop taking the medication?
Both programs are month to month, which makes stopping easy and makes the consequence of stopping the thing to plan for: published extension data shows most of the lost weight returns within about a year. That is an argument for choosing on annual cost rather than entry price.
The verdict
Maximus is the cheaper year by $1,942, and for a straightforward course of treatment that settles it.
Start Willow earns the difference in one situation: when a delivery guarantee of three days or less and no membership stacked on the medication price is something you will genuinely use. If you cannot say that out loud, take the cheaper program.
Both platforms are legitimate routes to a GLP-1 prescription. The decision is commercial, and it should be made with the twelve-month figure in front of you rather than the first-month one.
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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 Start Willow or Maximus, and does not sell treatment. Read our ranking methodology.