The single most-asked question from readers is the same as the single most-asked question from brands: "how does the score actually work?" This article spells out the methodology in full so both audiences can evaluate it on its merits — and challenge any specific score with the actual data underneath it.
The formula
Composite score = (pricing × 0.20) + (clinical infrastructure × 0.25) + (transparency × 0.20) + (user satisfaction × 0.20) + (value for money × 0.15). Each sub-axis is scored 0–10. The composite is then rounded to one decimal. A 9.2 means the weighted average of the five sub-scores rounds to 9.2.
Pricing (weight 20%)
What we measure: starting price transparency on public marketing pages (5 points), absence of hidden fees discovered at checkout (3 points), pricing predictability across treatment changes (2 points). Brands that don't publish starting prices on public pages lose all 5 transparency points. Brands with surprise consultation fees added at checkout lose hidden-fee points. Brands that dramatically change pricing on treatment escalation (e.g., $49/mo intro then $250/mo after 3 months) lose predictability points.
Clinical infrastructure (weight 25% — highest)
What we measure: clinician credentials (NPI verification, board certification, NAMS/ACOG affiliation — 8 points); clinician-to-patient ratio (1 point); supervisor structure for nurse practitioners and physician assistants (1 point). The highest-weighted axis because clinical infrastructure is what separates a real medical practice from a prescription-mill telehealth.
How we verify: NPI numbers checked on the public NPPES registry; board certification checked on the ABMS or relevant specialty board database; NAMS-certified clinician status checked on the NAMS practitioner directory. Brands that don't name their clinicians publicly cannot earn full credential points.
Transparency (weight 20%)
What we measure: published medical review process (3 points), public methodology for treatment recommendations (3 points), affiliate and commercial disclosure visibility (2 points), regulatory status disclosure for compounded products (2 points). Brands hiding compounded vs FDA-approved status, or burying affiliate disclosure in footer-only legal text, lose points.
User satisfaction (weight 20%)
What we measure: verified reviews on Trustpilot or similar third-party platforms (4 points), BBB rating (2 points), refund/cancellation pattern in complaints (2 points), regulatory complaints (FTC, state attorneys general) on public record (2 points). We weight third-party verified reviews over self-published testimonials because the latter can be cherry-picked.
Value for money (weight 15%)
What we measure: outcome-per-dollar relative to category median (5 points), inclusion of consultations and labs in subscription price (3 points), free-trial or money-back guarantee (2 points). This is the most subjective axis — we calibrate it relative to the brand's category, not absolute terms (an HRT brand and a GLP-1 brand aren't directly comparable on price, so value is scored relative to their respective markets).
Re-verification cycle
Every brand is re-scored on a quarterly cycle. Material changes (pricing, clinician roster, formulary, regulatory status) trigger immediate re-scoring outside the quarterly cycle. Each brand page displays the most recent score date, so readers see how fresh the rating is.
Affiliate independence
Affiliate commission has zero input to the composite score. We track this in two ways: (1) the scoring rubric has no field for commercial relationship; (2) we publish year-over-year score-vs-commission correlation analyses showing no relationship. Brands without affiliate programs routinely outrank brands that pay us — this is the test of an independent ranking, not a marketing claim.
How to challenge a score
If you believe a specific score is wrong: email editorial with the specific axis and the data point you'd challenge (e.g., "Brand X is scored 4/10 on transparency but they do publish their compounding pharmacy partner publicly — link"). Editorial reviews these monthly and re-scores when warranted, with a public note on what changed.
Informational. Our medical advisors review every page; the methodology itself is editor-determined and revised with public versioning.