ED telehealth in 2026: what you actually receive, in what form, at what cost per dose

01 / 08The number that reorders the whole category

A pharmacy buys a 100 mg sildenafil tablet for 13.6 cents. A 20 mg tadalafil tablet costs it 19.7 cents. Those are not estimates and they are not our figures: they are the National Average Drug Acquisition Cost, the survey CMS runs on what retail pharmacies actually pay their wholesalers, published as open data and refreshed weekly.

Read the last two rows against the first seven and the category stops being confusing. Brand Viagra costs a pharmacy 616 times what generic sildenafil of the same strength costs it. Brand Cialis costs 323 times its generic equivalent. No pharmacy, no discount card and no telehealth subscription recovers a gap that size; only switching molecule-for-molecule to the generic does, and that is a conversation with a prescriber rather than a shopping decision. We take that comparison apart in detail in our brand-versus-generic price gap analysis.

Then read the vardenafil rows, because they are the ones nobody mentions. Vardenafil is the third oral ED drug and it is generic, yet it costs a pharmacy twenty-one times what generic sildenafil does. Its orally disintegrating version costs $21.39 a tablet, roughly 157 times the sildenafil tablet. That is a real, published, wholesale price difference between two dose forms of the same generic molecule, and it is the single best illustration of what this page is about.

In this category the medicine is not the cost. Almost everything you pay above about twenty cents a dose is buying a prescriber, a delivery, and a dose form, and only one of those three is expensive to produce. RxGrab, on the acquisition figures above

02 / 08Three things you are buying, and only one of them is cheap

Every service on this page bundles three separable things. Pulling them apart is the whole trick to reading the prices.

Once the components are separate, a $79 monthly plan and a $22 monthly plan stop being comparable on price alone. One may be six chewable doses of a compounded four-ingredient preparation; the other may be a month of plain generic tablets. Both can be defensible purchases. They are not the same purchase.

03 / 08Cost per dose, all seven, side by side

Below is every published entry price we could read on 16 September 2026, normalised to what one dose costs and what the service requires you to commit to. Where a provider publishes a minimum order we show it, because a low per-dose price behind an eight-dose monthly minimum is a monthly price wearing a disguise.

Two things fall out of the table immediately. The first is that Lemonaid's $2 a pill is the lowest published per-dose price here, and it is roughly fifteen times wholesale, about as close to the floor as a service with a prescriber attached can get. The second is that Ro's brand Viagra at $90 a dose is barely above the $83.65 a pharmacy pays to acquire that same tablet: Ro is not marking the brand up much, the brand is simply expensive. Those two facts point in opposite directions and both are true, which is why a single ranking of this category would not be honest.

04 / 08The dose form you pay extra for is usually the one that is not FDA-approved

Look at the Status column again. Every product on this page that is a chewable, a gummy, a mint, a sublingual or a multi-ingredient combination is a compounded preparation. Every plain tablet is not. That is not a coincidence and it is not an accusation. It is a consequence of what has actually been approved.

We checked this against the FDA's own approved-products database rather than taking anyone's word for it. Across every approved application, sildenafil exists as a tablet, an oral suspension, a powder for suspension and a solution. Tadalafil exists as a tablet, a capsule, a suspension and a chewable tablet. Routes of administration in the FDA's National Drug Code directory: sildenafil is oral in 232 listings and intravenous in 2; tadalafil is oral in 254 listings and nothing else. There is no FDA-approved sublingual sildenafil, no approved sildenafil gummy, no approved ED mint, and no approved fixed-dose sildenafil-plus-tadalafil combination.

The providers themselves say so, and to their credit most of them say it clearly. Ro's safety page for Sparks states that it “is a compounded drug product” containing sildenafil 55 mg and tadalafil 22 mg, and that compounded drugs “are permitted to be prescribed under federal law, but are not FDA-approved and do not undergo FDA safety, effectiveness, or manufacturing review.” The Daily Rise gummies page carries the same wording. Hims states on its ED page that “the featured products include compounded products which have not been approved by the FDA.” BlueChew's home page and FAQ state that its products are compounded by state-licensed compounding pharmacies, that BlueChew is not itself a compounding pharmacy, and that compounded products “are not the same as, nor are they generic versions of, any FDA-approved medication.”

None of that makes compounded ED medication a bad purchase. Compounding is legal, it is how a chewable version of a tablet-only drug can exist at all, and for someone who genuinely cannot swallow a tablet it is the entire point. What it does mean is that the premium dose forms are the ones carrying the least regulatory assurance, while the plain tablet, the cheapest thing on this page, is the one with a complete approval behind it. That inversion is worth knowing before you choose a plan, and it is not visible from any provider's pricing grid.

One more detail from the table deserves its own sentence. BlueChew's Gold 4-in-1, as listed on its own checkout, contains apomorphine 3 mg and oxytocin 200 IU alongside the two familiar molecules. In Drugs@FDA, apomorphine's approved US products are Apokyn, Kynmobi, Onapgo and a generic: injectables, a solution and a sublingual film, all indicated for Parkinson's disease. Oxytocin's approved products are injectables and solutions used in obstetrics. Neither molecule has an FDA-approved indication for erectile dysfunction in any form. That is a statement about the approval record rather than a judgement about whether the preparation works, and it is the kind of thing worth raising with the prescriber who offers it to you.

The practical test a reader can apply to any of these pages. If a product is sold in a dose form that does not appear in the FDA’s own product directory for that molecule, then whatever the marketing badge says, the thing in the box is a compounded preparation. Sildenafil and tadalafil appear in that directory as oral products only. So a sublingual, a rapid-dissolve, a gummy, a mint or a chewable version of either one is compounded by definition, and a page describing such a product as FDA-approved is describing the molecule rather than the product. Most of the services here state this plainly. One of them, noted in its entry below, does not.

05 / 08The seven, one at a time

Ro: the widest ladder, and the only one that publishes every rung

Ro is the only service here that lets you walk the full range in one place: brand Viagra, brand Cialis, generic sildenafil, generic tadalafil, a compounded sublingual and a compounded daily gummy, each with a published per-dose price and a published minimum. That transparency is genuinely unusual and it is the reason Ro anchors this table. The catch is the minimums: $4 a dose for sildenafil is the headline, but the eight-dose monthly floor makes it $32 a month, and $8 a dose for daily tadalafil across 30 doses is $240 a month, the most expensive generic arrangement on this page. Best for: deciding between forms and strengths without leaving one checkout. Watch: read the minimum before the per-dose figure.

Hims: the cheapest published generic subscription, and the busiest catalogue

Generic sildenafil from $22 a month and generic tadalafil from $24 a month are the lowest monthly subscription prices we found for plain tablets, and Hims states treatments start as low as $2 a dose. Above that sits a wide range of combination products: chews, mints, and multi-ingredient pills bundled with a multivitamin, a hair-loss treatment or a testosterone support product, mostly at $30 to $39 a month. Those combinations are compounded, which Hims discloses on the same page. Best for: the lowest sticker price on an FDA-approved dose form. Watch: the path from a $22 tablet to a $39 multi-ingredient compounded product is short and well designed.

BlueChew: priced per use, and the only four-ingredient preparation here

BlueChew is the one service on this page that prices neither by the month nor by the tablet but by the use: plans are 6, 18 or 24 uses a month. The entry plan is $79 a month for 6 uses, which is $13.17 a use, falling to $8.56 a use on the three-month plan. That is the most expensive per-dose generic on the page by a wide margin, and what you are buying for it is the format and the four-ingredient formulation described above. Pricing is not published anywhere on the marketing site; we could only read it at the checkout. Best for: someone who specifically wants the chewable sublingual format and uses it infrequently. Watch: you cannot compare BlueChew to anything else without going most of the way to a purchase, which is a deliberate design choice.

Lemonaid Health: the lowest published per-dose price, and the cleanest fee structure

From $2 a pill, with a one-time $25 consultation that Lemonaid states covers twelve refills, and free shipping. That is the most legible pricing on the page: a fixed medical fee paid once, and a per-pill price close to what a cash-pay pharmacy charges. The first shipment is listed at $30. Best for: the reader who has decided they want generic tablets and wants the cheapest legitimate route to them. Watch: the $25 consult sits outside the medication price, so the first month is not $2 a pill.

Henry Meds: the only one offering injections, and the least transparent on molecule

Henry publishes $50 a month for oral ED medication, sold as a three-month supply at $150 up front, and $149 a month for injections. The injection option is a real differentiator: injectable ED treatment is a genuinely different clinical route, usually reached when oral medication has not worked. What Henry does not publish on that page is which molecule or which strength you receive for either price, and for a comparison built on molecule and dose form that is the one cell we could not fill from published sources. Best for: someone who has already been told oral treatment is not the right route. Watch: three months billed up front, and confirm what you are being prescribed before you commit.

PlushCare: not a medication service at all, and that is the point

PlushCare sells the consultation and nothing else: $129 for a self-pay visit, and it states the typical out-of-pocket for an insured patient is around $30, being in-network with most major insurers. You take the prescription and fill it wherever you like. On any other comparison page this would look like the worst deal here. On this one it is arguably the best arithmetic available, and section six is entirely about why. Best for: anyone with insurance, and anyone willing to fill at a cash-price pharmacy. Watch: it is a visit fee rather than a subscription, so there is no ongoing convenience and no delivery.

Nu Image Medical: sublingual specialists, with the least published structure

Nu Image sells rapid-dissolve and sublingual tablets from $3 a tablet, including sildenafil-plus-tadalafil combinations at 40/10 mg and 80/20 mg. The combination products are labelled “Compounded Medication / Rx Only” on their own page, which is the correct and expected label for a fixed-dose combination of this kind. The single-molecule sublinguals are labelled differently, and that is worth checking before you buy. On both nuimagemedical.com/sildenafil and nuimagemedical.com/tadalafil, read on 16 September 2026, the product card for “Sildenafil Sublingual” and “Tadalafil Sublingual” carries the badge “FDA Approved / Rx Only”, and the word compounded does not appear anywhere on either page. The FDA’s National Drug Code directory lists no sublingual and no orally disintegrating sildenafil or tadalafil product at all. We ran that query with controls so it could fail honestly: the same search returns two orally disintegrating vardenafil products and one sublingual apomorphine product, so the instrument finds these forms when they exist. We are not in a position to say what is actually dispensed, and we are not suggesting anything improper; we are saying the badge and the federal product record do not line up, and the question belongs to the prescriber before the payment. Best for: a low per-tablet price on a fast-dissolving format. Watch: Nu Image publishes no minimum order and no subscription structure, so the $3 entry price is difficult to translate into a monthly cost without starting an evaluation.

06 / 08Consult-only versus bundled: do the arithmetic once

Every service on this page except PlushCare bundles the prescription with the medicine, and the bundle is convenient. Here is what the unbundled route actually costs, using figures from this site's own pharmacy pricing work rather than anything invented for this page.

A pharmacy acquires generic sildenafil 100 mg at 13.6 cents a tablet. Cash-pay pharmacies price generics at acquisition plus a dispensing fee rather than as a subscription. That is the model we take apart in our Cost Plus Drugs review, our GoodRx versus Cost Plus comparison and our generic pricing guide. Against that, the relevant question is not “which subscription is cheapest” but “what am I paying for the prescriber, and could I pay it once instead of every month.”

Two readers, both wanting generic tadalafil, get different right answers. The reader who uses it twice a month and has insurance is probably better served by a roughly $30 covered visit and a cash-price fill, paid once, than by any monthly plan on this page. The reader who wants it delivered, wants refills handled and does not want to think about it again is buying a service, and $22 to $24 a month for that service is not a bad price for what it is. The mistake is not choosing either one. The mistake is comparing a per-dose price against a subscription price without noticing they answer different questions.

07 / 08Who should skip ED telehealth entirely

• Anyone whose insurance already covers generic sildenafil or tadalafil. A copay on a covered generic will usually beat every price on this page, and none of these services bills insurance for the medication itself.
• Anyone taking nitrates. Every provider here states this and it is the one absolute in the category. It is not a pricing question.
• Anyone who has not had the underlying cause looked at. Erectile dysfunction is frequently a symptom of something else with its own treatment path. A service optimised to write a prescription quickly is not optimised to ask that question, and this page cannot ask it for you.
• Anyone who wants a specific compounded format without knowing why. If the plain tablet suits you, it is the cheapest thing available and the only form with a complete FDA approval behind it.

08 / 08Method, and what we did not do

We read each provider's own published pages on 16 September 2026 and recorded the prices exactly as stated, noting which plan tier each figure belonged to. Where a provider does not publish pricing on its marketing pages we say so rather than substituting an estimate: BlueChew's figures were read from its own checkout, and Nu Image publishes no minimum order that we could find. Where a provider does not publish the molecule or the strength, we say that too, rather than filling the cell.

We did not sign up to any of these services, pay any consult fee, or obtain any prescription. We have not evaluated whether any of these products work, and nothing on this page is medical advice or a recommendation to take anything. This comparison is about access, price, dose form and regulatory status, the things a published record can settle.

The acquisition costs are queryable by anyone. The CMS NADAC 2026 file is open data at data.medicaid.gov, and the figures above are medians across every listed product for each description. The approval records come from Drugs@FDA and the FDA National Drug Code directory. If any figure on this page is wrong, those are the three places it will show.

If the cash price still lands above what you can carry, state prescription assistance programmes are the next place to look, and Health Britannica carries the clinical background on these drugs.