Pallas Health Review: The $189 Is a 12-Week Prepay

The one-sentence version

Pallas Health does the disclosure work almost nobody in this category does — it names six dispensing pharmacies, explains the 503A/503B distinction, publishes two physicians with NPI numbers it invites you to check, and carries a LegitScript certification that resolves. Then it sells that programme in a shape this board penalises hard: there is no month-to-month option for NAD+, and the advertised "$189/mo average" is a 12-week prepay divided by three. It grades B, 8 points out of 14, and both of the factors it zeroes are structural rather than a suggestion of bad faith. The grade is computed from published terms alone and cannot see who pays us — Pallas Health is a paid partner here.

What it is, and who it's for

The operator is Brentmoor, Inc., at 131 Continental Dr, Suite 305, Newark, DE 19713. Clinical care is delivered by Lion MD, described as a nationwide team of US-licensed clinicians, running on the CareValidate clinical-operations platform. Pallas states the arrangement plainly: it is a technology platform and does not employ medical providers. That is a more honest framing than most of this board manages, and it is worth knowing before you decide who you are actually buying from.

The line this board ranks is narrow and real: NAD+ as a daily nasal spray or as a weekly subcutaneous injection. Those are the only two forms offered — there is no oral route on sale, whatever else you may find written about the brand. Pallas also runs a separate compounded GLP-1 line on its own lander with its own catalogue and its own prices; this review does not quote those figures, because a reader arriving here lands on the NAD+ lander and none of them appear on it.

Coverage is all 50 states plus DC, fully asynchronous in 43 of them. Eight jurisdictions require one video visit — Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, West Virginia and Washington DC. It is cash-pay only, no insurance ever, FSA/HSA eligible per its own site banner, with free shipping when a clinician prescribes.

It is also new. Pallas launched on the affiliate network on 1 July 2026, so there is no track record to weigh here — only published terms, which is what this rubric grades anyway.

What it actually costs, and what "$189" is doing

All figures below were read on Pallas's own funnel, its published page bundle and its marketing fineprint on 7 August 2026. All three agree, which is itself worth crediting: the marketing price is the commerce price, and there is no bait-and-switch at the card screen. That is not the norm here.

NAD+ nasal spray — $79 for the first month, then $567 billed every 12 weeks. Advertised as "$189/mo average".

NAD+ injection — $89 for the first month, then $597 billed every 12 weeks. Advertised as "$199/mo average".

Here is the finding. There is no month-to-month rung for either product. The funnel renders no cadence selector at all — those are the only options that exist. So the "/mo average" beside each price is not a plan you can buy; it is a 12-week prepay divided by three.

The cash-flow shape is the likeliest bill shock. Renewal is anchored "every 12 weeks starting 4 weeks after approval". So on the nasal spray you pay $79, and then four weeks later a single charge of $567 lands. On the injection it is $89 followed by $597. Nothing about that is hidden — Pallas publishes the cadence — but a buyer who reads "$189/mo" and budgets $189 for month two has budgeted for the wrong number by a factor of three.

And 12 weeks is not three months. The renewal recurs every 84 days, which is 4.35 times in a year, not 4 — while the advertised average is computed by dividing the charge by 3. Their own arithmetic, on their own published renewal terms:

| | advertised | year 1 actual | ongoing | |---|---|---|---| | NAD+ spray | $189/mo | $79 + 4×$567 = $2,347 → $195.58/mo | 4.348×$567 = $2,465/yr → ~$205/mo | | NAD+ injection | $199/mo | $89 + 4×$597 = $2,477 → $206.42/mo | 4.348×$597 = $2,596/yr → ~$216/mo |

Year 1 is 52 weeks: one four-week intro period plus four 12-week blocks. Steady state is 365.25 ÷ 84 cycles a year. The advertised average understates the ongoing rate by about 8.7%.

To be fair to Pallas about what that is and is not: "12 weeks ≈ 3 months" is ordinary industry shorthand, and the company publishes the 84-day cadence where you can find it. This is arithmetic on terms it disclosed, not a trick it concealed. It is still eight and a half percent, every year, on a bill that renews.

Why this costs the price factor everything. Our rubric asks for a single all-in figure, visible before you commit, that a buyer with no commitment actually pays. Pallas sells no such thing, so price transparency scores zero. This is MadeMed's pattern exactly — that row publishes every plan length and every exact charge and still scores zero, because the shortest way in is a three-month prepay. For the opposite shape, HealthRX publishes a genuine month-to-month NAD+ rate with no term required to reach it and keeps all four points. That is the whole difference between the rows.

What Pallas does publish, and what we are not allowed to pay it for. The exact charge, the exact 84-day cadence, at least 30 days' notice before any price change, no minimum term with cancellation effective at the end of the current billing period and "canceling is always free", a self-serve cancellation portal, a pre-renewal email before every charge, and a full refund if a clinician declines you. That is a materially better disclosure package than several rows scoring four points on this factor. It does not move the score, because the factor measures whether a no-commitment figure exists and here it does not — and inventing a "publishes its terms well" allowance after seeing which row it lifts is the tuning our published rubric exists to prevent. So it is said here instead, where it is useful to you.

Three costs that are not in the headline. A $60 visit deposit applies in the eight video-visit jurisdictions; it is refunded in full and credited to your first order, but may be retained if you neither attend nor reschedule and then abandon the intake. A $5 fee is deducted per refunded payment on purchases made on or after 14 July 2026 — never on clinician-declined or unfulfilled orders, which refund in full. And whether lab work is included or billed separately is not published anywhere, in either direction. There is also no pre-purchase dose selector, so whether the price holds as a dose rises cannot be checked before you pay. Ask.

The sitewide "Up to $120 off your first month" banner is a discount, not a price. So are $79 and $89.

Clinical oversight, the pharmacy, and who is prescribing

Oversight: two points, earned. No consult fee appears anywhere in the published price structure. In the 43 asynchronous states the clinician review sits inside the medication price; an applicant a clinician declines is refunded in full; and the only visit charge that exists anywhere — the $60 deposit — is refunded and credited to the first order rather than billed on top. The retention condition is real and is listed above, but a conditional deposit that normally becomes part of your order is not a consult billed separately.

Pharmacy: two points, and they undersell it. Pallas publishes six dispensing pharmacies by name — Belmar Pharmacy, Strive Pharmacy, Epiq Scripts, Casa Pharma Rx, The Pharmacy Hub and Foothills Pharmacy — and explains the 503A/503B distinction on the same page. Set that beside the rest of this board, where the standard practice is to name none: Telos Rx prints two pharmacies with street addresses and is the row we previously called the most pharmacy-transparent here. Pallas names six and classifies them. Our rubric has exactly two points for pharmacy disclosure and Pallas takes both, which is all it can take. That is a limit of the rubric, and the honest thing is to say so rather than invent a factor after seeing who it would help.

Name the trade-off that comes with it, though: compounded medications, including the NAD+ this page is about, are not FDA-approved, and FDA's own position is blunt — compounded drugs are not FDA-approved, and the agency does not verify their safety, effectiveness or quality before they are marketed¹. Pallas discloses this properly on its own pages, including that its compounded GLP-1s are not FDA-approved and are not generic equivalents of the brand drugs. The review repeats it because it is the single most important sentence in the category.

Belmar, and the thing you should know in proportion. One of the six named pharmacies, Belmar, received an FDA warning letter issued 31 March 2023 (posted 18 April 2023), addressed to "Belmar Pharma Solutions, Drug Depot, LLC., dba APS Pharmacy", concerning compounding practices — and FDA closed it out on 30 October 2023. We are not going to restate or relitigate the allegations; that is FDA's document to characterise. Two things matter here. First, the letter is closed out, and a page that leaves that off is publishing a false impression. Second, a letter on a partner pharmacy discloses, it does not disqualify — and you only know about it at all because Pallas named the pharmacy. The providers on this board that name nobody could be dispensing through anyone, and you would have no way to check. Pallas Health itself holds no FDA warning letter: a live search of FDA's index for "pallas health", "pallashealth", "Brentmoor" and "CareValidate" returned zero records each, in a pass where a known-lettered company came back positive, so the clean result is a real one and not a broken query.

Two clinicians, and a gap. Pallas names Dr. Ana Lisa Carr, MD (NPI 1689841744) and Dr. Kelly Tenbrink, MD (NPI 1346482684), and volunteers a "Verify NPI in the NPPES registry" link beside them. Both verify as active in NPPES — Carr in family medicine, licensed in 15 states; Tenbrink in emergency medicine, licensed in Tennessee and Florida. Volunteering a checkable identifier is a genuine E-E-A-T signal and vanishingly rare here.

Two caveats, both real. Carr's site-claimed obesity and addiction medicine board certifications are not verifiable through NPPES and we did not check them independently — that is the site's claim, not our finding; NPPES confirms family medicine. And only two clinicians are named site-wide. The actual prescribing network — Lion MD's affiliated professional corporations — is not published, and the footer "Provider directory" link resolves to a section naming only those two. On an intake that is asynchronous in 43 states, the clinician who writes your prescription is very probably not one of the two people you were shown. That is a real gap, and it is the reason the disclosure story here is strong rather than complete.

Support: zero, and it is the second place this row loses points. What Pallas publishes is customer service — hello@ and support@pallashealth.co, +1 (440) 601-3717, Monday to Friday 9–5 ET — plus the cancellation portal and the pre-renewal email. Those are good account mechanics. This factor asks for ongoing clinical support stated as inside the price, the way MyDrHank publishes unlimited messaging with a care team and System Labs publishes ongoing support from a real care team. We looked and found no equivalent statement on any Pallas surface. That is a finding, not an assumption.

The evidence behind what it sells

This board grades providers, not molecules, and Pallas markets within the category's normal register. But you are being asked to commit roughly $2,400 a year, so the state of the evidence belongs in the decision.

The 2026 PRISMA-guided systematic review of NAD+ for anti-aging and wellness screened 113 studies including 33 human intervention trials. Oral precursors reliably engage the target — blood NAD+ rises² — but effects on functional, metabolic and vascular outcomes were "heterogeneous and often null or endpoint-specific," and clinical effectiveness for anti-aging or wellness "remains inconclusive"³. The same review is blunter about the routes Pallas actually sells: no eligible outcomes trial has evaluated injected NAD+ for these indications at all³, and nasal delivery has less human outcome evidence still. A 2025 meta-analysis in adults averaging over 60 found NAD+ precursors did not improve muscle index, grip strength, gait speed or chair-stand time⁴; the strongest randomised trial in the field moved six-minute walk distance by roughly 17.6 metres in peripheral artery disease, a disease endpoint rather than an aging one⁵.

None of that is a mark against Pallas specifically — it is the state of the category. Read NAD+ for longevity, do NAD+ peptides actually work and what's proven versus hyped before you decide a 12-week block is worth it.

One source you should not treat as evidence: theirs. Pallas's own footer states that "Some content on this site is AI-generated; no representation or warranty is made regarding its accuracy, completeness, or reliability." Credit the honesty and then act on it — do not take a clinical claim from its blog. In the same spirit: the advertised "4.8" rating has no published source anywhere we could find, so we are not repeating it as a fact, and the before/after "Verified Customer" stories carry the site's own caveat that individuals shown in marketing may be actors or models.

Where it's weak, and who should skip it

Skip it if you want to try NAD+ for a month and stop, because that is precisely the purchase Pallas does not sell — budget $567 or $597 every 12 weeks, not $189 or $199. Skip it if a single $567 charge four weeks after a $79 one is a problem for your cash flow, which is a different question from whether the annual cost is acceptable. Skip it if you need to know what your prescribed dose will cost, or whether lab work is on the bill, because neither is published. And skip it if you want to know which of the six pharmacies fills your vial, because naming six is not the same as telling you which one.

Buy it if the disclosure is what you are actually shopping for. A named operator, a named clinical group, six named pharmacies with the compounding standard explained, two physicians with checkable NPIs, a LegitScript certification that resolves, a real cancellation portal, a pre-renewal email, no minimum term, and marketing figures that match the checkout is — bluntly — the most complete package on this board. You are simply buying it in 12-week blocks, and you should go in reading $567, not $189.

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). Pallas takes the full four for its longevity line — NAD+ by nasal spray and by injection is exactly what this board exists to rank — two for clinical oversight, because the clinician review sits inside the price and a declined applicant is refunded in full, and two for pharmacy, because it publishes a 503A claim on a surface it controls and names six facilities besides. It takes zero for price transparency, because no month-to-month figure exists and the advertised one is a prepay divided by three, and zero for human support, because ongoing clinical support is not published as part of the service. Eight out of fourteen: a B, at the very bottom of the band.

The fix is two lines. Sell a one-month rung and print its price; publish whether messaging and follow-up are included. Do both and Pallas moves to twelve and an A without changing a single thing about the medicine, the pharmacies or the clinicians — which is a fair summary of where this row's problem actually lives. Until then, the most transparent provider on this board is the one you can least easily try. The full graded field is at our provider rankings, the scoring is set out in how we grade, and what this category costs generally is in longevity clinic cost.