Every online ED platform advertises some version of "ED medication starting at $2/dose." What they don't advertise is the consultation fee, the minimum order quantity, the subscription lock-in, the shipping charges, or the fact that $2/dose only applies to the lowest-strength medication that most men won't actually use.
This guide breaks down every hidden cost in online ED treatment so you can calculate what you'll actually pay — not what the ads want you to think you'll pay.
"Starting at $2/Dose" — What They Don't Tell You
When a platform advertises sildenafil "starting at $2/dose," that price almost always refers to the 20mg tablet — a dose originally developed for pulmonary hypertension, not ED. The standard starting dose for ED is 50mg, and many men need 100mg for adequate effect.
Here's how that pricing actually works across platforms:
| Platform | 20mg Price | 50mg Price | 100mg Price | Advertised As |
|---|---|---|---|---|
| Rex MD | $2/pill | $6/pill | $6/pill | "Starting at $2" |
| Lemonaid | $2/pill | $10/pill | — | "Starting at $2" |
| Hims | — | $4/dose | $4/dose | "From $4" |
| BlueChew | — | ~$3–5/chew | — | "From $2/chew" |
The $2/pill price is technically accurate but effectively misleading. A man using sildenafil 50mg twice per week from Rex MD will pay $48/month, not the $16/month the headline suggests. From Lemonaid, the same usage pattern costs $80/month plus a $25 consultation fee the first month.
The Consultation Fee Trap
Most major platforms have moved to "free consultations" — but that doesn't mean the medical evaluation is actually free. The cost is simply baked into the medication pricing. This is why generic sildenafil from Hims costs $4/dose while the same generic from a traditional pharmacy with a GoodRx coupon can cost under $1/pill.
Lemonaid is the notable exception — they charge a separate $25 consultation fee but claim lower medication prices as a result. Whether this is actually cheaper depends on your usage frequency and dose.
Some platforms that advertise "free first consultation" charge for follow-up consultations or dosage adjustments. Read the fine print on what happens when you need to change your medication or dose.
Subscription Commitments & Auto-Renewals
Nearly every telehealth ED platform operates on a subscription model. The lowest per-dose prices are typically locked behind annual or semi-annual billing commitments. Here's how that works:
Monthly billing — Highest per-dose cost, maximum flexibility. You can cancel after any month.
Quarterly billing — Moderate savings, 3-month commitment. You pay for 3 months upfront.
Annual billing — Lowest per-dose cost, 12-month commitment. You pay hundreds of dollars upfront with limited refund options if you want to cancel early.
BlueChew is subscription-only — you cannot make a one-time purchase. Peter MD and some other platforms offer one-time orders without subscription requirements, which is worth considering if you want to try ED medication without a recurring commitment.
The Dose-Dependent Pricing Trap
This is one of the most misunderstood aspects of online ED pricing. Many platforms charge the same price for different dose strengths — meaning a 100mg pill costs the same as a 50mg pill. This creates an interesting arbitrage opportunity: you can order 100mg tablets and split them in half to effectively cut your per-dose cost by 50%.
However, some platforms price by dose strength, charging more for higher strengths. And chewable or compound medications generally can't be split, so you're locked into whatever dose you're prescribed.
Shipping Costs That Add Up
Most major platforms (Hims, Roman, Rex MD) offer free shipping. But not all do. BlueChew charges approximately $5 per shipment. Over 12 months with monthly shipping, that's $60 in shipping costs alone — enough to meaningfully impact total cost.
Expedited shipping (next-day or 2-day) often carries additional fees of $10–$25 per shipment on platforms that don't include it standard. Rex MD stands out by offering free 2-day shipping as a default.
12-Month Total Cost: What You'll Actually Pay
Here's the calculation that matters: what does ED treatment actually cost over 12 months at a typical usage pattern of sildenafil 50mg, 2–3 times per week?
| Platform | Per Dose (50mg) | Monthly (8–12 doses) | 12-Month Total | Hidden Costs |
|---|---|---|---|---|
| MyDrHank | ~$1.67 | ~$13–$20 | ~$160–$240 | None noted |
| Peter MD | ~$90 flat program | Varies | Varies | None — flat rate |
| Rex MD | $6 | $48–$72 | $576–$864 | None (free ship) |
| Hims | $4 | $32–$48 | $384–$576 | None (free ship) |
| Roman | $4 | $32–$48 | $384–$576 | None (free ship) |
| BlueChew | ~$3–5 | $25–$120 | $300–$1,440 | ~$60/yr shipping |
| Lemonaid | $10 (50mg) | $80–$120 | $985–$1,465 | $25 consult fee |
| BraveRX | ~$119–169/mo | $119–$169 | $1,428–$2,028 | None — all inclusive |
The difference between the cheapest and most expensive option is roughly 10x. At the budget end, MyDrHank can cost as little as $160/year. At the premium end, BraveRX's compound formula runs $1,428–$2,028/year — though you're getting a fundamentally different product (multi-ingredient compound + 24/7 medical support vs. a single-ingredient generic).
Platforms with the Most Transparent Pricing
Most Transparent
- Peter MD — $90 flat rate. The clearest pricing in the industry. You know exactly what you'll pay before you start.
- MyDrHank — Simple per-pill pricing, no consultation fees, no subscription tiers to decode.
- BraveRX — Monthly price includes everything: medication, consultation, 24/7 support. No hidden add-ons.
Least Transparent
- Platforms that advertise lowest-dose pricing as their headline rate
- Platforms that require annual billing to achieve advertised per-dose pricing
- Platforms that charge separate consultation + medication + shipping fees
Skip the Hidden Costs
BraveRX includes everything in one monthly price — medication, physician consultation, and 24/7 support. No consultation fees. No shipping charges. No dose-dependent pricing games.
See BraveRX Pricing →Compare Transparent Providers
| Provider | Best For | Starting Price | |
|---|---|---|---|
| BraveRX | All-inclusive compound treatment | ~$119/mo | Visit Site |
| Care Bare Rx | Personalized multi-service | Varies | Visit Site |
| MyDrHank | Lowest cost per pill | ~$1.67/pill | Visit Site |