APLOMB Partners | The Side-Effect Protocol Layer for GLP-1 Telehealth

Most patients stop refilling by month six

You spend hundreds of dollars to acquire a GLP‑1 patient. The published persistence data says most of that investment walks out the door in the first six months.

Share of patients who have discontinued GLP‑1 therapy, by time from first fill

100%

75%

50%

25%

~30%

~46%

~54%

64.8%

Day 30

Claims analysis, patients stopping before week 4⁴

Month 5

Semaglutide for weight loss, N=15,811⁵

Month 6

Commercially insured obesity patients, JMCP, N=4,066⁶

Month 12

Obesity patients, JAMA Network Open, N=125,474¹

Figures come from different published cohorts (commercial claims, telehealth channel data, and peer‑reviewed registries), so they are directional rather than a single curve. Every source is cited at the bottom of this page.

Why they actually quit

After cost, the biggest driver of discontinuation is the day‑to‑day experience of the medication: nausea, hair shedding, muscle loss, and changes in the mirror. Most programs leave patients to deal with all of that on their own.

28.2%

of discontinuations cite GI side effects

Nausea affects 20–33% of patients at weight‑management doses, and GI‑driven discontinuations concentrate in the first three months of titration.^2,7

~40%

of weight lost can be lean mass

Body composition data from STEP 1. Muscle loss undermines results, metabolism, and patient confidence in the program.⁸

10–15%

report noticeable hair shedding

Patient surveys report shedding during rapid weight loss; risk rises with more than 20% body‑weight reduction.⁹

~7%

midface volume loss per 10 kg lost

The facial aging effect patients describe in their own words when they cancel. Measured radiographically at Vanderbilt.¹⁰

About cost: 47.6% of discontinuations cite cost or coverage,¹⁴ and a supplement does not change your pricing. This page is about the rest: the patients who leave over side effects and disappointing body composition, and who can be kept.

The medication works. The first ninety days are where you lose patients.

Side‑effect dropouts cluster in the first three months of titration, while the dose is climbing and the nausea is at its worst.² Patients who get real support through that window stay on therapy at much higher rates.¹³

APLOMB covers that window with one product for each documented quit reason, formulated and labeled to clear a telehealth compliance review. Each monthly shipment is also one more touchpoint between your program and the patient, without adding clinical staff.

One product per reason they quit

APLOMB makes products only for GLP‑1 side effects. There are four, one for each of the reasons above, and each is formulated to sit inside your patient experience rather than compete with it. Ingredient lists, COAs, and claims documentation are available on request.

Protein

For muscle loss during GLP-1 weight loss

Once‑daily plant protein, pea and rice, leucine‑fortified, 25 g per scoop. Expert consensus now recommends 1.2–1.6 g/kg/day of protein on GLP‑1 therapy, roughly double standard guidance.¹²

Steady

For GLP-1 nausea support

Steady ginger gummies for GLP-1 nausea support: 1 g ginger root with vitamin B6, dosed on the published evidence base. Useful when nausea becomes part of the patient journey.²

Roots

For hair shedding from rapid loss

Hair, skin and nails gummies for the telogen effluvium that follows rapid weight loss: iron, vitamin D, and zinc. Reported by 10–15% of patients.⁹

Serum

For facial volume changes

A topical peptide serum (Matrixyl 3000 and Synthe’6) for the dermal‑thinning fraction of "GLP‑1 face," measured at roughly 7% midface volume loss per 10 kg lost.¹⁰

Side‑effect support is a retention lever, not a perk

The published evidence is consistent: patients who feel supported through the hard part stay on therapy longer. We will walk your clinical team through every source, and pilots are structured to measure attach and persistence against your own baseline.

67% vs 47%

12‑month persistence for patients in wraparound support programs versus baseline cohorts (Omada Health, real‑world, N=816).¹³

5+ visits

Patients with five or more provider touchpoints in the first 120 days persist at far higher rates. Every monthly kit shipment is a touchpoint you did not have to staff.¹¹

5 / 10 / 15%

Attach sensitivity is shown before NDA. For a 10,000‑patient program at $27 net monthly contribution, those rates imply roughly $162K, $324K, or $486K in annual companion‑line contribution.

What churn costs you, in your numbers

Move the sliders. The model uses published persistence rates and a conservative companion‑product attach assumption. All math is shown below the results.

Active GLP‑1 patients 10,000

Monthly program revenue per patient $99

Cost to acquire each patient $500

Companion line attach rate 10%

–

Annual program revenue lost to discontinuation: patients who quit by month 12, times your fee, times the months they would otherwise have stayed

–

Acquisition spend stranded in patients who quit inside a year

–

New annual revenue from the companion line at your attach rate, $27 net per attached patient per month

–

LTV per patient with companion attach and the persistence lift seen in supported‑care cohorts, versus today

Model assumptions: 64.8% of patients discontinue by month 12¹ with a 4‑month average tenure for those who quit; quitting patients forgo 8 months of program revenue versus a retained patient year. Supported‑care cohorts persist at roughly 67% versus 47‑49% baseline at 12 months,¹³ which we apply as a 6‑point persistence improvement, a deliberately conservative fraction of the published gap. Companion revenue assumes $27 net contribution per attached patient per month. The support data is category context, not APLOMB-specific proof; the founding pilot is designed to isolate the product effect. This is a directional planning model, not a forecast; your unit economics will vary.

A founding pilot with board-ready measurement

The first partner gets the proof package future buyers will ask for: a defined cohort, weekly reporting, and success gates agreed before launch.

Cohort

90 days, 500 to 5,000 patients. Start with new GLP‑1 starts or dose-escalation patients, then compare against your matched baseline.

Metrics

Attach, persistence, support volume, refunds. We report both commercial and patient-experience signals so ops and finance see the same picture.

Cadence

Weekly dashboard, monthly readout. Your team gets SKU attach, reorder behavior, cancellation notes, and any adverse-event intake.

Success gates

Set before launch. Typical gates start with 5 to 10% attach, a 15% stretch target, no support-volume increase, refund rate under 8%, and a measured persistence lift versus baseline.

Pricing shape before the NDA

Use these ranges to decide whether the economics are worth a call. Final pricing depends on SKU mix, monthly volume, fulfillment path, and label ownership.

Program path	Visible range	Use case
Starter wholesale kit	$24 to $39 per patient	Steady plus one companion SKU for nausea-focused cohorts.
Full companion bundle	$48 to $76 per patient	All four side-effect products in a welcome-kit or refill moment.
White-label program	Quoted by SKU and volume	Your label, your margin stack, APLOMB formulation and manufacturing support.
Founding-pilot support	Pilot term can start without a minimum commitment	Defined cohort, reporting cadence, diligence packet, and partner-specific copy.

Attach sensitivity for 10,000 active GLP‑1 patients

5% attach at $27 net/month$162K

10% attach at $27 net/month$324K

15% attach at $27 net/month$486K

These are contribution estimates before any persistence benefit. Bring your patient count, current churn, and monthly program fee to the call and we will map the same math to your base.

Two ways to plug it in

Start with wholesale and a co‑marketed kit, or put your own brand on the line. Both run on the same formulations, the same manufacturing, and the same per‑batch testing.

Wholesale

Stock the APLOMB line inside your program and be in market in weeks.

Wholesale pricing tiered by volume
Dropship or bulk fulfillment to your patients
Co‑branded onboarding inserts for your welcome kit
Compliance‑reviewed product copy ready for your app and checkout
Per-SKU margin sheet before NDA
Founding-pilot reporting pack with attach and persistence readouts
One-page pilot protocol for CEO, clinical, and ops review
Pilot term can start without a minimum commitment

Request partner pricing

White label

We manufacture the line under your brand, and the margin and the customer relationship stay with you.

Your name and label on any or all of the four‑product system
Label design support and regulatory‑reviewed claims language
Protein and Roots manufactured in GMP‑certified US facilities, COA for every batch
Fulfillment integration with your pharmacy or 3PL
Category exclusivity available for anchor partners

Talk white label

Clinical review

We share formulations, evidence files, claims sheets, and COAs with your medical and legal teams under NDA.

Program design

Choose wholesale or white label, select SKUs, and decide where the products live in your patient journey.

Integration

Compliance‑reviewed copy for your app, checkout, and clinician scripts. Fulfillment through your pharmacy, 3PL, or ours.

Pilot and measure

Launch to a defined cohort, track attach and persistence against your baseline, then scale what the data supports.

Where it fits: the highest‑leverage placements we have mapped are the plan review (set expectations about side effects up front), checkout (companion kit as a one‑tap add‑on), the dose log (surface Steady when nausea is reported), and member support (a concrete answer when a patient writes in about hair or muscle). We bring suggested copy for each moment.

Quality and compliance, in writing

Everything below is documented and available to your team before launch.

Manufacturing

Protein and Roots are manufactured in GMP‑certified US facilities. Steady is made by a dedicated gummy manufacturer to our written product specification. The facial serum is a topical cosmetic produced under cosmetic GMP.

Testing

Third‑party testing on Protein and Roots production batches, with certificates of analysis issued per batch and archived for partner audit.

Claims discipline

Structure‑function and cosmetic claims only. No disease claims, no treatment claims, and no medication brand names on any label or marketing asset.

Trademark hygiene

Drug brand names appear only in informational contexts with the required trademark attribution, never in product naming or advertising.

Patient data

We never require patient health information. Wholesale and white label both run without PHI crossing to us.

Audit trail

Facility documentation, testing protocols, and batch records shared under NDA during partner diligence.

The call-prep kit, before the first meeting

Because this is a founding-partner offer, the packet is explicit about what exists now: SKU economics, clinical files, claims language, and the pilot plan your CEO, clinical, legal, and ops teams will review.

Claims sheet

Approved product language, prohibited phrases, label claims, and the patient-facing copy for app, checkout, and support scripts.

Per-SKU margin sheet

Wholesale ranges, fulfillment assumptions, refund handling, and the one-SKU pilot option so finance can test Steady first.

Clinical file

Ingredient panels, dosing logic, allergen notes, manufacturing country, and the evidence cited for each formulation.

One-page pilot protocol

Cohort definition, metrics, data fields, reporting cadence, and success gates for a 90-day founding pilot.

COAs and batch records

Current certificates of analysis, batch testing protocol, and supplier documentation shared under a mutual NDA.

Adverse-event flow

Intake path, escalation timing, documentation fields, and partner notification rules for any product complaint.

Request the call-prep kit

Questions partners ask

Do these products make medical claims we would be liable for?

No. Every product is positioned as a dietary supplement or topical cosmetic with structure‑function claims only. Nothing claims to treat, cure, or prevent any condition, and no product references any medication brand. We supply compliance‑reviewed copy for your app, checkout, and clinician scripts, and your team reviews everything before launch.

Will these products interact with GLP‑1 medications?

The products are dietary supplements and topical cosmetics formulated to avoid known interaction concerns, and every ingredient list is open for your medical team's review before launch. We position all products as supportive care alongside therapy, with standard guidance that patients discuss supplements with their clinician.

Is there published evidence these products improve persistence?

The persistence evidence is for side‑effect management and wraparound support as a category, cited above. APLOMB is building the product-specific evidence through founding pilots with defined cohorts, weekly reporting, and persistence measurement against each partner's baseline. If you want to co‑publish the result, so do we.

How fast can we pilot?

Wholesale founding pilots can ship inside 30 days: pricing, a co‑branded insert, product in your fulfillment flow, and a reporting cadence agreed before launch. White label timelines depend on label design and batch scheduling; we will give you a dated plan on the first call.

What does pricing look like?

The visible range is $24 to $39 per patient for a starter wholesale kit and $48 to $76 per patient for a full companion bundle, depending on SKU mix, volume, and fulfillment path. We share SKU-level pricing and white-label terms under a simple mutual NDA.

Can we start with one product?

Yes. Most partners start with Protein or the nausea kit, since muscle loss and GI effects are the two largest addressable quit reasons, then expand to the full system.

Who is behind APLOMB?

APLOMB is a US company built exclusively for GLP‑1 patients. We run our own direct‑to‑consumer line at getaplomb.com, which means the formulations, claims language, and patient education you would be putting in front of your members are already live in market.

Sources

JAMA Network Open (2025), discontinuation of GLP‑1 receptor agonists, N=125,474; 64.8% of obesity‑only patients discontinued within 1 year, 53.6% overall.
Truveta, ISPOR 2025; gastrointestinal side effects accounted for 28.2% of documented discontinuation reasons, concentrated in early therapy.
Hims & Hers Health 2024 Form 10‑K; blended customer acquisition cost of approximately $929.
Blue Health Intelligence claims analysis (2024); approximately 30% of patients discontinued within the first 4 weeks.
JAMA (2025), Komodo Health claims, N=15,811; 46% of commercially insured semaglutide weight‑loss patients discontinued by month 5.
Journal of Managed Care & Specialty Pharmacy (2024); commercially insured adults with obesity and no diabetes, N=4,066; 46.3% persistence at 6 months.
STEP trial program (semaglutide) and SURMOUNT‑1 (tirzepatide); nausea incidence 20–33% at weight‑management doses.
STEP 1 body composition substudy; approximately 39–40% of total weight lost was lean mass.
Pooled safety reviews and patient surveys (2024–2025); 10–15% of patients report noticeable shedding during rapid weight loss, risk increasing above 20% body‑weight reduction.
Vanderbilt University Medical Center radiographic study (2025); approximately 7% midface volume loss per 10 kg of weight lost (median total decrease 9.0% in the studied cohort).
AMCP 2026 real‑world analysis; markedly higher persistence among patients with 5 or more provider visits in the first 120 days.
American Journal of Clinical Nutrition joint advisory (2025), American College of Lifestyle Medicine, American Society for Nutrition, Obesity Medicine Association, The Obesity Society; protein intake of 1.2–1.6 g/kg/day recommended during GLP‑1 therapy.
Omada Health real‑world data (2025), N=816; 67% 12‑month persistence with wraparound behavioral support versus 47–49% baseline.
Clinical record review of documented GLP‑1 discontinuations in an integrated health system (2024), N=288; cost or insurance coverage cited in 47.6% of cases.