You can get a prescription peptide by telehealth in a given state only if both the prescriber and the dispensing pharmacy are authorized to serve patients there. In the state rules below, the patient's location is what counts, so the question is not where the company is, but whether it can treat you and ship to you where you live.
That applies only to peptides that can be prescribed and dispensed at all. Which ones qualify is covered in whether peptides are legal, and BPC-157, for example, fails before any state question arises, as explained in why you cannot get a BPC-157 prescription.
The prescriber: licensed where the patient is
State law controls who may treat patients in that state, and Florida's telehealth statute frames the question by where the patient is located. A health care professional not licensed in Florida may treat a patient located in Florida by telehealth only after registering with the applicable Florida board [3].
To register, the professional must hold an active, unencumbered license from another state that is substantially similar to the Florida license [3]. They must have had no disciplinary action on that license in the prior five years, and must designate a registered agent in Florida [3].
The same statute holds a telehealth provider to the prevailing standard of care for in-person treatment of patients in Florida [3]. It also counts professionals licensed under a multistate licensure compact that Florida has joined [3]. Registration and compacts are state choices, so the route that works in Florida may not exist in your state.
The pharmacy: authorized in the state it ships to
A telehealth prescription still has to be filled, and a state can regulate the pharmacy that mails into it as well as the state where that pharmacy sits. Florida again states the rule plainly. Any pharmacy outside Florida that ships, mails or delivers a dispensed medicine into the state is a nonresident pharmacy and must register with the Florida board [4].
That registration requires a valid license in the pharmacy's home state and records kept so Florida dispensing can be retrieved [4]. It also requires a toll-free line to a pharmacist at least six days and 40 hours a week, printed on every container label [4]. That number on your label is one way to confirm who actually filled the order.
The extra limit on compounded peptides
Peptides such as sermorelin and NAD+ are dispensed as compounded products, and federal law adds a condition for compounding pharmacies that ship across state lines. Under section 503A, a compounded drug must be made for an identified individual patient on a valid prescription [1].
Section 503A also ties interstate shipping to a memorandum of understanding between the state and FDA. A pharmacy in a state that has signed one is covered by its terms on “inordinate amounts” shipped out of state and on complaint investigation [1]. In a state that has not signed, out-of-state distribution may not exceed 5 percent of the pharmacy's total prescription orders [1].
FDA made a standard memorandum available to states in October 2020. After compounding pharmacies sued, a federal court remanded it to FDA in September 2021, and FDA says it intends to address these provisions through notice-and-comment rulemaking [2].
Which states peptide sellers say they serve
Among sellers that publish an eligible monthly price for a peptide other than a GLP-1, this site's records hold a state list for some and not for others. The figures below count each seller once. “Not recorded” means the list has not been captured, not that the seller serves no states.
51
List all 50 states
25
List fewer than 50 states
120
State list not recorded
Of the 196 sellers counted, 25 list fewer than all 50 states, and the narrowest list covers 2 states. A seller's list is its own claim about where it will treat and ship, so it is the start of the question, not the answer.
What to check before you pay
State availability is one of several things settled during intake. The order in which the visit, labs and pharmacy fill happen is laid out in how online peptide therapy works, and the monthly cost of each prescribable peptide is on the price boards.
If you move, or spend part of the year in another state, check again, because the rules follow where you are at the visit and where the package is delivered. The one question to ask the seller: is your prescriber licensed in my state, and which pharmacy ships here?