Astra vs Ro: A 2026 Comparison Guide

Key takeaways What are Astra and Ro?  Astra (try-astra.com) is a telehealth platform offering brand-name and compounded GLP-1 medications, peptide therapy, and longevity injectables, with direct-pay pricing and no membership fee. Ro (formerly Roman) is a publicly traded telehealth company that offers FDA-approved brand-name GLP-1 medications through a membership model with built-in insurance support. What’s […]

By Astra Editorial Team

Published:

Updated:

Key takeaways

  • Ro’s weight loss program is built around FDA-approved brand-name GLP-1s only and a hands-on insurance concierge that handles prior authorization for covered patients. Compounded GLP-1s are no longer part of Ro’s lineup.
  • Astra (try-astra.com) still offers compounded semaglutide and tirzepatide through VialsRx, a US-licensed 503A pharmacy, with all-in pricing from $96 per month and no separate membership fee.

What are Astra and Ro? 

Astra (try-astra.com) is a telehealth platform offering brand-name and compounded GLP-1 medications, peptide therapy, and longevity injectables, with direct-pay pricing and no membership fee. Ro (formerly Roman) is a publicly traded telehealth company that offers FDA-approved brand-name GLP-1 medications through a membership model with built-in insurance support.

What’s Ro known for in 2026?

Ro launched its weight loss arm during the 2023 GLP-1 shortage and grew quickly on the back of compounded semaglutide. That product line is gone now. What’s left is a leaner, more medical-feeling program: FDA-approved brand-name GLP-1s and an in-house insurance concierge that submits prior authorizations and appeals on your behalf.

The pitch Ro now leads with is: “We’ll fight your insurance for you.” Astra (try-astra.com) is built differently. It’s a direct-pay platform that prices compounded and brand-name GLP-1s without going through insurance at all.

If you’re trying to decide between them, ask yourself: do you have insurance you want to use, or are you paying cash?

Astra vs Ro: Do they accept insurance?

Quick answer: Ro has a dedicated insurance concierge that handles prior authorizations and appeals, with 70% of covered members reporting a copay under $100 per month. Astra is direct-pay and doesn’t bill insurance, though brand-name medication prescribed through Astra may be covered by your own plan if you coordinate it yourself.

On Ro, the membership fee buys you, among other things, an insurance team that:

Ro reports that 70% of covered members end up with a copay under $100 per month, which is a meaningful number if you have employer-sponsored insurance that covers Wegovy or Zepbound. Ro doesn’t coordinate Medicare or Medicaid coverage, though cash-pay is still available for those patients.

On Astra (try-astra.com), the model is different. Astra doesn’t bill insurance directly. You can use an HSA card for eligible treatments, but Astra doesn’t provide itemized receipts or letters of medical necessity required for some reimbursement. If you want to use insurance for a brand-name GLP-1 prescribed through Astra, you’d coordinate that directly with your pharmacy and insurer.

If you have strong insurance coverage, this is a real Ro advantage. If you’re paying cash, it’s not relevant to the comparison.

Does Ro still offer compounded GLP-1s?

Quick answer: No. Ro’s current GLP-1 menu is FDA-approved only.

In 2026, Ro made the strategic decision to position itself as an FDA-approved-only platform, in part responding to the Novo Nordisk settlements that prompted similar exits at Hims & Hers and LifeMD, in part leaning into a brand identity built around regulatory-approved care.

This is where Astra picks up. Astra still offers compounded semaglutide and compounded tirzepatide through VialsRx, a US-licensed 503A pharmacy. If you’re choosing compounded GLP-1s specifically because they’re more affordable than brand-name versions, Astra is the closer match to what Ro used to offer.

Here’s a background on what 503A compounding is and how to evaluate a compounded provider.

Came here for compounded GLP-1? Ro’s out. Astra’s not.

Astra still offers compounded semaglutide and tirzepatide through VialsRx, a US-licensed 503A pharmacy. From $96/month all-in, reviewed by a licensed clinician.

See if you qualify →

Astra vs Ro: Side-by-side comparison

Astra vs Ro at a glance: Ro wins on insurance support, FSA/HSA convenience, behavioral coaching, and Foundayo availability. Astra wins on compounded GLP-1 access, microdose protocols, no separate membership fee, peptide therapy, and longevity injectables.

AstraRo
Compounded GLP-1sYesNo
Brand-name GLP-1sYesYes
Microdose protocolsYes ($89/mo and up)No
Foundayo (orforglipron)NoYes
Peptide therapy (sermorelin)YesNo
Longevity injectables (NAD+, glutathione)YesYes (NAD+)
Other telehealth servicesNoYes (sexual health, dermatology, fertility, primary care, mental health)
State coverage50 states50 states
Membership feeNone$39 first month, $74-$149/mo after
Compounded semaglutide$96-$145/mo all-inNot offered
Compounded tirzepatide$125-$250/mo all-inNot offered
Wegovy pill (real total)Not currently offered~$223/mo (annual prepay + $149 med)
Wegovy pen (real total)$1,500/mo retail~$273/mo (annual prepay + $199 med)
Zepbound KwikPen (real total)$1,300/mo retail~$373/mo (annual prepay + $299 med)
Insurance billingNot directlyYes (concierge included)
Lab testingNot includedQuest labs included in membership
1:1 health coachingNoYes
HSA/FSA acceptedHSA accepted (no itemized receipts)Yes (at checkout)

How Ro’s pricing actually works

Quick answer: Ro charges separately for membership and medication. Membership is $39 for the first month, then either $149 monthly or as low as $74 monthly on an annual prepay plan. Medication costs $149 to $1,100 depending on the drug and whether you use insurance.

PlanCost
First month (promotional)$39
Annual prepay (12 months upfront)As low as $74/month
Month-to-month after first month$149/month
As of June 2026.

The medication is billed separately. Cash-pay rates as of mid-2026:

MedicationFirst MonthOngoing
Wegovy pill (semaglutide)$149$199-$299
Foundayo (orforglipron)$149$199-$299
Wegovy pen (semaglutide)$199$199-$399
Zepbound KwikPen (tirzepatide)$299$399-$449
Ozempic (semaglutide)Insurance only$900-$1,100 without insurance

Ro reports its cash-pay prices match LillyDirect, NovoCare, and TrumpRx, the manufacturer-direct programs.

A note on the annual prepay: The $74/month rate requires about $888 paid upfront for 12 months of membership. Past membership fees are non-refundable, and refund terms on the unused balance are tighter than the month-to-month plan if you cancel mid-year. 

Worth confirming Ro’s current terms before prepaying, especially if you’re new to GLP-1s and might cycle off within a few months.

Astra’s pricing in comparison

Quick answer: Astra is direct-pay with no separate membership. The monthly price covers your clinical care, medication, and shipping. Compounded plans start at $96 per month; microdose protocols start at $89 per month.

Paying cash?

No insurance concierge needed when the price starts at $96.

If your insurance won’t cover GLP-1s (or you don’t want the paperwork), Astra’s compounded semaglutide is direct-pay, all-in, no separate membership. Same active ingredient as Wegovy.

Start your health profile →

Compounded Semaglutide

Plan lengthPer month
Monthly$145
3-month plan$125
6-month plan$120
3-month starter pack$96

Compounded Tirzepatide

Plan lengthPer month
Monthly$250
3-month plan$215
6-month plan$166*
12-month plan$125
3-month starter pack$166*

Microdose protocols

Plan lengthMicrodose semaglutideMicrodose tirzepatide
Monthly$99$119
3-month plan$95$115
6-month plan$89$109

Brand-name GLP-1 through Astra

MedicationStarting price
OzempicFrom $1,200/mo
ZepboundFrom $1,300/mo
WegovyFrom $1,500/mo

Brand-name pricing reflects medication cost through Astra’s retail pharmacy partner. If brand-name access matters most to you and you have insurance, Ro’s concierge is likely to land you a lower out-of-pocket cost than Astra’s retail pricing. 

If you’re paying cash for compounded, Astra’s all-in monthly price runs about $1,500 to $4,000 less per year than Ro’s brand-name path, depending on the medication. The narrower end of that range compares Astra’s compounded semaglutide ($1,740/year) to Ro’s Wegovy pill on annual prepay ($3,276/year). The wider end compares Astra’s microdose semaglutide ($1,068/year) to Ro’s Zepbound KwikPen on annual prepay ($5,364/year).

The bottom line on Astra vs Ro cost: For brand-name GLP-1s, Ro is meaningfully cheaper if you have insurance (potentially under $100/month copay) or even if paying cash with the annual prepay ($223/month for Wegovy pill). For compounded GLP-1s, Astra is the only option of the two, and runs about $1,500 to $4,000 less per year than Ro’s cheapest brand-name path, depending on the medication.

For a complete breakdown across the market, see our GLP-1 cost guide.

What does Astra offer that Ro doesn’t?

Quick answer: Ro doesn’t offer microdose GLP-1 protocols, peptide therapy, longevity injectables, or compounded GLP-1 medications. All four are part of Astra’s standard menu. 

Three Astra-only categories worth knowing about:

Microdose GLP-1. Lower-dose protocols designed for gradual introduction or for patients who want the metabolic and appetite effects without the full standard dose. Compounded microdose semaglutide starts at $89/month on the 6-month plan; microdose tirzepatide starts at $109/month on the 6-month plan.

Standard doses too much? Microdose isn’t on Ro’s menu.

Astra offers structured microdose GLP-1 protocols from $89/month. Smaller starting dose, gentler ramp, lower cost. Reviewed by a licensed clinician, filled by a US-licensed 503A pharmacy.

See if microdose fits →

Peptide therapy. Sermorelin ($120/month) for recovery, sleep quality, and energy. This is a growth hormone-releasing peptide prescribed for adults whose goals overlap with weight management but aren’t strictly weight-loss focused.

Longevity injectables. NAD+ ($135/month), glutathione ($75/month), Lipo C and Lipo MIC+B12 ($99.50/month each). These sit in the “metabolic optimization” category rather than weight loss specifically.

If your interest in telehealth extends beyond GLP-1 into peptide therapy or longevity-style injectables, Astra has these built into the same patient relationship. Ro covers other verticals (dermatology, mental health, sexual health, fertility, primary care) but doesn’t currently offer peptides or longevity injectables other than NAD+.

Astra vs Ro: Which platform should you actually pick?

Pick Ro if any of these apply to you:

Pick Astra if any of these apply to you:

Where to go from here

If your decision is being driven by insurance, Ro is built for that and Astra isn’t. 

If you want compounded GLP-1s, Astra offers that. If you want microdose protocols, peptide therapy, or longevity injectables, Ro doesn’t offer them. If you want a single all-in monthly price with no separate membership, Astra is structured for that and Ro isn’t.

To start with Astra (try-astra.com), the next step is a health profile reviewed by a licensed clinician at Wasef Health, PC. Compounded prescriptions are filled by VialsRx, a US-licensed 503A pharmacy. Compounded semaglutide starts at $96/month, compounded tirzepatide starts at $125/month on the 12-month plan, and microdose protocols start at $89/month.

Two platforms. Two different bets. Pick the one that fits you.

If you want compounded GLP-1s, microdose protocols, or direct-pay pricing with no separate membership, Astra is built for you. Compounded semaglutide from $96/month.

Start your health profile Takes about 5 minutes.

Frequently Asked Questions

Can I get compounded semaglutide on Ro?

No. Ro transitioned to FDA-approved-only GLP-1 medications in 2026. If compounded is what you’re after, Astra (try-astra.com) and a handful of other 503A-based platforms are the active options.

What does Ro’s insurance concierge actually do?

The concierge contacts your insurer, verifies coverage for the prescribed GLP-1, submits prior authorization paperwork, and files appeals if your initial request is denied. This service is included in the Ro Body membership. Ro reports 70% of covered members have a copay under $100/month after the concierge’s work. Medicare and Medicaid coordination isn’t currently supported.

Is the $39 first month all I’ll pay on Ro?

No. The $39 first-month fee applies only to your first month of membership. After that, membership renews at $149/month, or as low as $74/month if you prepay annually. Medication is billed separately on top. Multiple reviews mention surprise around this structure, so it’s worth knowing before signing up.

Does Ro offer microdose GLP-1?

No. Ro’s GLP-1 menu uses standard FDA-approved dosing schedules. Microdose protocols are a feature of compounded GLP-1 platforms, including Astra (try-astra.com).

Can I use my HSA card on Astra?

Astra (try-astra.com) accepts HSA cards at checkout, but doesn’t provide itemized receipts or letters of medical necessity that some HSA/FSA administrators require for reimbursement audits. Ro accepts FSA/HSA cards directly at checkout and provides standard receipts.

References

  1. Ro Body. (2026). Weight Loss Treatment and GLP-1 Medications. https://ro.co/weight-loss 
  2. US Food and Drug Administration. (2026, April 1). FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize 
  3. Eli Lilly. (2026, April 1). FDA approves Foundayo (orforglipron) for chronic weight management. https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-foundayotm-orforglipron-only-glp-1-pill

This article is for educational purposes only and does not constitute medical advice. Consult a licensed physician regarding any medical condition or treatment.