Enhance MD Reviews: The $169 NAD+ Catch, and the Verdict

The one-sentence version

Enhance MD advertises NAD+ therapy at "$169/month." That figure exists, but only at the bottom of a twelve-month prepay — the real month-to-month price is $199 for the injection and $99 for sublingual wafers. Everything else about how it prices is unusually clean: the whole ladder is published on the product page, the consult and lab work are inside the figure, and you are refunded in full if you are found ineligible. It grades A, 12 points out of 14, the highest of the three partners we reviewed this week, and the grade is computed from published terms alone and cannot see who pays us.

What it is, and who it's for

Enhance MD is a compounded telehealth practice built around a "metabolic reset" — GLP-1 tiers as the main business, with NAD+ sold beside them in two routes: subcutaneous injection and sublingual wafers. Prescriptions follow an online consultation with a licensed provider, and the program includes periodic monitoring: "your labs will be monitored every six months while enrolled in the Enhance.MD program."

The buyer this suits wants NAD+ at a knowable price without a membership, and either tolerates a lab cadence or actively wants one. The $99 wafer tier is the cheapest published month-to-month NAD+ route on our board — worth knowing before you assume an injection is the only option. On what that monitoring is worth, see longevity biomarker panels.

What it actually costs

All figures verified on enhance.md on 26 July 2026.

The injection ladder. One month $199/mo, billed every 4 weeks. Three months $189/mo (save 5%), billed every 12 weeks. Six months $179/mo (save 10%), billed every 24 weeks. Twelve months $169/mo (save 15%), billed every 48 weeks.

The wafer ladder. $99, $94, $89 and $84 across the same four terms.

The headline is the twelfth rung. The homepage advertises "NAD+ Therapy Starting at $169/month." Nothing you can buy monthly costs $169. That figure is the effective rate of a twelve-month commitment paid in one charge, and the homepage does not say so on its face. The product page does publish the full ladder, plainly, which is why this costs Enhance MD a paragraph here rather than four rubric points.

Two cadence details worth the arithmetic. "Billed every 4 weeks" is thirteen charges a year, not twelve — about $2,587 annually on the injection, not the $2,388 that "per month" implies. And the twelve-month plan is "billed every 48 weeks": a "12-month" plan is 48 weeks of medication, not 52.

What's included. "The costs of our programs include lab work, virtual medical provider visits, medication through partnered pharmacies, and shipping." It also publishes a "same price at every dose" guarantee — a real protection in a category where dose increases routinely reprice the plan.

What happens if you leave. "If at any point during the onboarding process your provider finds you ineligible for medication, Enhance.MD will provide a refund" — 100% of the initial payment. You can pause or cancel at any time, and the subscription "will auto-renew unless canceled before the next billing cycle." One genuine gap: the published terms of service say only that "full subscription and payment terms are provided at checkout," so what happens if you abandon a twelve-month prepay early is not stated anywhere public. Ask before you prepay — see what longevity care costs.

Clinical oversight and the pharmacy

An online consultation with a licensed provider precedes any prescription, that consultation is inside the price, and labs run every six months. Bundling both is above average here.

On pharmacy, Enhance MD states the standard but not the facility: "it is compounded in accordance with federal Section 503A guidelines," on the NAD+ product page, while its FAQ says it "partners with a network of third-party pharmacies." Stating the section earns the top rung of our pharmacy factor, but it should not be read as a quality certification — 503A compounders are specifically not subject to current good manufacturing practice requirements, unlike 503B outsourcing facilities, and FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed¹. To its credit, Enhance MD says this itself: "this compounded formulation is not FDA-approved."

The evidence behind what it sells

The product page describes NAD+ as a "cellular energy reboot" that "raises NAD+ levels to power mitochondria and boost ATP production," delivering "maximum bioavailability… for rapid energy improvement."

The first half is defensible; the second is not. The 2026 PRISMA-guided systematic review of NAD+ for anti-aging and wellness screened 113 studies, 33 of them human intervention trials. Oral precursors reliably engage the target and are well tolerated, but effects on functional, metabolic and vascular outcomes were "heterogeneous and often null or endpoint-specific," with clinical effectiveness "inconclusive"². It also reported that no eligible outcomes trials evaluated intravenous or intramuscular NAD+ itself for these indications² — which bears directly on the injection tier, and on any bioavailability argument for paying twice the wafer price.

A 2025 meta-analysis in adults averaging over 60 found NMN and NR did not improve muscle index, grip strength, gait speed or chair-stand time³. The strongest randomised trial in the field improved six-minute walk distance by about 17.6 metres in peripheral artery disease — a disease endpoint, not an aging one⁴. No completed human trial shows NAD+ repletion improves energy, cognition or the rate of aging. See NAD+ for longevity, do NAD+ peptides actually work and what's proven versus hyped.

Where it's weak, and who should skip it

Skip it if you are buying the "rapid energy improvement" promise; nothing in the trial record delivers it. Skip it if a six-month lab cadence is friction you do not want. And do not prepay twelve months until someone at Enhance MD tells you in writing what an early exit costs — that term is not published.

If the wafers suit you clinically, note that $99 month-to-month is the cheapest published NAD+ route we grade, and it requires no commitment at all.

The verdict, against the rubric

Our rubric scores five things out of fourteen: price transparency (4), a genuine longevity line (4), clinical oversight (2), pharmacy disclosure (2) and human support (2). Enhance MD takes price transparency in full — the entire four-rung ladder is published for both routes, with the billing cadence stated beside each rung, which is more than most of this board manages. It takes four for a real longevity line, two for a consult inside the price, and two for stating its compounding section. It takes zero for human support, because no coaching or bundled clinician time sits in the advertised rate. Twelve of fourteen. An A.

The complaint is narrower than the grade suggests but it is real: the number on the homepage is not a number anyone pays monthly, and the exit terms on the plan that reaches it are not published. Fix the headline and publish the early-cancellation rule, and there would be very little left to criticise. The full graded field is at our provider rankings, the scoring is set out in how we grade, and two neighbours are in our Sprout Health review and Shed review.