How to Start a Longevity Telehealth Clinic in 2026: NAD+, Rapamycin, Sermorelin
Launching a longevity telehealth brand: NAD+, sermorelin, rapamycin, metformin and LDN, what 59 brands charge, the evidence behind each, safety warnings, labs and the claims the FTC won't accept.
Updated October 18, 2026 · 3 min read
In this guide
Short answer: longevity sells, but the evidence lags the marketing. NAD+ injections (median $145 a month, 52 brands) and sermorelin ($149, 43 brands) are popular add-ons, mostly from GLP-1 brands. Rapamycin, metformin and low-dose naltrexone are cheap to supply and offered by few. A durable longevity brand is built on labs, monitoring and honest claims: the FTC standard makes "reverses aging" very hard to defend, and NAD+ has known injection-safety issues.
Checked October 18, 2026. Prices are entry prices from the Telehealth Match database (our sister comparison site) unless noted.
The medications and their status
| Medication | Status | Evidence and safety notes |
|---|---|---|
| Rapamycin (sirolimus) | Approved for transplant rejection; longevity use is off-label | Boxed warning for immunosuppression, infection and malignancy. The PEARL trial of weekly rapamycin missed its primary endpoint (Aging, 2025) |
| Metformin | Approved for type 2 diabetes; aging use is off-label | The TAME aging trial hasn't reported results |
| Low-dose naltrexone (LDN) | 50 mg approved for dependence; LDN is off-label and usually compounded | Not controlled (Federal Register) |
| Sermorelin | Compounded as a component of a discontinued approved drug | See our peptide guide |
| NAD+ | Compounded; no approved product | FDA has warned compounders against food-grade NAD+ in sterile injections after endotoxin-type reactions (FDA); a Class I recall of an NAD+ injection product followed in October 2025 |
| Glutathione | Compounded | FDA warned against supplement-grade glutathione in injectables (FDA) |
On NAD+ precursors, a 2024 meta-analysis of eight NMN trials found no significant effect on glucose, insulin, HbA1c or lipids (meta-analysis). None of these drugs are controlled.
Labs and monitoring
Labs are the backbone of a credible longevity brand, and an easy upsell:
- Rapamycin: its label reports high rates of raised cholesterol and triglycerides plus blood-count changes, so monitor blood counts, lipids, glucose, and liver and kidney function.
- Metformin: contraindicated when kidney function (eGFR) is below 30, shouldn't be started at 30–45, and needs kidney function checked at least yearly.
- LDN: screen for opioid use, because naltrexone blocks opioids.
What brands charge, and what it costs
| Offer | Brands | Median entry price | Range |
|---|---|---|---|
| NAD+ injection | 52 | $145/mo | $40–$325 |
| Sermorelin | 43 | $149/mo | $89–$299 |
| Glutathione | 25 | $125/mo | $79–$275 |
| Rapamycin (oral) | 4 (small sample) | $82/mo | $64–$99 |
| Low-dose naltrexone | 4 (small sample) | $45/mo | $17–$180 |
| Metformin | 3 (small sample) | $27/mo | $25–$45 |
At Cost Plus Drugs, sirolimus 1 mg costs about $0.57 a tablet (a weekly 6 mg dose comes to about $14 of drug a month), and metformin about a cent a tablet. Compounded LDN and NAD+ costs aren't public. Get quotes, and confirm your pharmacy uses pharmaceutical-grade, sterile-suitable ingredients.
No public retention figures exist for longevity telehealth.
The claims problem
The FTC's health products guidance requires "competent and reliable scientific evidence," generally randomized controlled human trials. Animal or lab data alone isn't enough, and anecdotes never are (FTC). Given PEARL's missed endpoint and the null NMN results, claims like "slows aging," "reverses aging" or "adds years" are very hard to support. What you can credibly sell is measurement, personalized care and monitoring, and specific outcomes only where evidence exists.
Also keep in mind:
- Meta and Google apply prescription-drug rules (LegitScript plus authorization) to prescription longevity drugs (our LegitScript guide).
- Supplement companies can sell NAD precursors without a prescription, so a prescription brand has to justify its premium with real clinical value.
- Peptides beyond sermorelin are mostly not lawfully compoundable today (peptide guide).
Launch checklist
- Lead with a lab-based assessment and a clinician-guided plan, not a drug menu.
- Choose a pharmacy that can document sterile-grade ingredients for injectables (503A vs 503B).
- Build monitoring into the subscription (labs every few months).
- Write claims to the FTC standard.
- Consider longevity as an add-on to a weight-loss or menopause brand, which is how most brands in the database sell it.
Sources (checked October 18, 2026): Telehealth Match price database (October 2026) · PEARL rapamycin trial (Aging, 2025) · NMN meta-analysis (2024) · FDA: ingredients suitable for sterile compounding (NAD+) · FDA: supplement-grade glutathione · Federal Register on naltrexone scheduling · FTC health products guidance · Cost Plus Drugs price API
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This guide is general information for people building telehealth businesses. It is not legal, medical or regulatory advice, and rules change; check the sources and talk to a qualified attorney before acting on it.