What Does 'Available by Consultation' Mean in Telehealth?

If you have browsed our treatment catalog, you may have noticed that some options are listed as "Available by Consultation" rather than appearing on category pages with standard pricing. This is not a marketing decision -- it reflects the regulatory and clinical reality of certain product categories.

Why Some Products Are Consultation-Only

Telehealth platforms -- including Varus -- operate within FDA guidelines, state pharmacy regulations, and clinical standards. Not every product fits comfortably into a standard retail-style listing. Consultation-only designation applies to products where:

The product is not FDA-approved. Compounded medications are prepared by licensed pharmacies but have not been individually reviewed or approved by the FDA. Presenting them alongside FDA-approved products without clear differentiation would be misleading.

Human evidence is limited or preliminary. Some peptide and research-stage compounds have strong preclinical data but limited human clinical trial evidence. Listing them as standard products with pricing implies a level of clinical validation that does not yet exist.

The regulatory landscape is actively changing. FDA's enforcement posture toward certain compounded products has tightened. For example, FDA clarified its position on 503A compounding of GLP-1 products in early 2026, and the agency maintains active watch lists for peptides that may present safety risks in compounded form.

The product requires individualized clinical context. Some treatments have narrow indications, significant contraindications, or evidence limitations that require a clinician to walk a patient through the specific considerations before any prescribing decision.

What This Means Practically

When a treatment is consultation-only on Varus:

1. It does not appear on category pages with a "Start Consultation" button and standard pricing. Instead, it appears on our consultation page with a "Request Consultation" button.

2. Pricing is not foregrounded. Because these products require individualized clinical review, pricing is discussed during or after the consultation rather than presented upfront as a monthly subscription.

3. A clinician reviews your case individually. The provider will discuss the specific product's evidence base, regulatory status, safety profile, and alternatives before making any prescribing decision.

4. Not every request will result in a prescription. The clinician may determine that a consultation-only product is not appropriate for a specific patient based on medical history, contraindications, or clinical judgment.

Categories of Consultation-Only Products on Varus

Compounded GLP-1 Medications

Compounded semaglutide and compounded tirzepatide are available through provider consultation in limited patient-specific circumstances. FDA has tightened 503A compounding rules for GLP-1 products, and these medications should not be presented as routine alternatives to FDA-approved branded products.

Research-Stage Peptides

Peptides like BPC-157, TB-500, and others have attracted significant interest in wellness and recovery communities. However, many are listed on FDA's 503A Category 2 list or have been flagged by FDA as substances that may present significant safety risks in compounded form. Human clinical evidence for most peptides remains limited.

Compounded Anti-Aging Products

Products like GHK-Cu, glutathione injections, and NAD+ injections fall into FDA's 503A Category 1 (under evaluation). While they are available through compounding pharmacies, their regulatory status is still being assessed, and broad wellness claims should not be assumed from their biochemical properties.

Compounded Combination Products

Compounded topical finasteride/minoxidil, for example, combines two active ingredients in a formulation for which no FDA-approved topical finasteride product exists. FDA issued a risk alert on compounded topical finasteride in 2025, which warrants individualized clinical discussion.

How This Differs From "Not Available"

Consultation-only is not the same as unavailable. It is a structured pathway that ensures:

• Patients receive accurate information about evidence and regulatory status
• Clinicians have the opportunity to screen for contraindications and discuss alternatives
• The platform does not present non-FDA-approved products in a way that implies routine retail availability
• Regulatory compliance is maintained as FDA enforcement posture evolves

The Bottom Line

The consultation-only model exists because responsible telehealth requires matching the presentation of a product to its regulatory and evidentiary reality. For products where that reality includes "not FDA-approved," "limited human evidence," or "active FDA scrutiny," a standard product listing with pricing is not appropriate.

If you are interested in a consultation-only option, browse the available treatments and request a consultation. A licensed clinician will review your situation and provide an individualized recommendation.