Roman and PeterMD both sell generic sildenafil and tadalafil online with a prescription from a licensed provider. That's where the similarity ends. Roman is a subscription telehealth platform with a full video evaluation and a broad product range. PeterMD is a pay-per-pack model with public pricing, no quiz, and no recurring billing. This comparison uses pricing we verified in September 2026 and is built around the question that actually matters: which one costs less for the way you'll use it?
Pricing Side by Side
| Product | Roman | PeterMD |
|---|---|---|
| Sildenafil 25mg | ~$4/dose | — (100mg only) |
| Sildenafil 50mg | ~$6/dose | — (100mg only) |
| Sildenafil 100mg | ~$10/dose | $6.00–$6.25/tab |
| Tadalafil (as-needed) | $8–$44/dose | $6.33–$7.25/tab (20mg) |
| Tadalafil (daily) | From ~$8/dose; gummies from ~$2+ | — |
| Fast-onset sublingual | Ro Sparks ~$12/dose | — |
| Pack structure | Subscription, quantity-based | Fixed 10/15/20/30 packs, $62.50–$190 |
| Auto-renew | Yes (manage in account) | No |
| Evaluation | ID + history + BP + video visit | Intake reviewed by provider, no quiz gating price |
| Insurance | Cash-pay; FSA/HSA reimbursement | Cash-pay; HSA/FSA cards at checkout |
| Shipping | Free, discreet | Discreet; 48 states |
The Real Difference: How You Buy
PeterMD's model is unusual in telehealth: prices are public before you give any information, packs are fixed-quantity, and nothing renews. You buy 10, 15, 20 or 30 tablets, pay once, and you're done until you decide to order again. That transparency is the whole pitch. There's no waiting until after a questionnaire to find out the price, and no surprise charge in month four because you forgot to pause.
Roman's model is the standard subscription: you pick a quantity and cadence, medication ships on that schedule, and your card is charged accordingly. The upside is that you never run out and your clinician stays attached to your account for follow-up questions or dose adjustments. The downside is that you are managing a subscription, and the best per-dose rates are tied to committing to more.
If you've been burned by recurring billing before, that alone may decide it. If you'd rather never think about reordering, that also may decide it.
Cost at Realistic Usage Levels
Per-dose numbers are only useful once you multiply them by how often you'll actually use the medication. For 100mg sildenafil — the strength where the two providers overlap directly — here is what a month looks like:
| 100mg sildenafil | 4 doses/mo | 8 doses/mo | 12 doses/mo |
|---|---|---|---|
| Roman (~$10/dose) | ~$40 | ~$80 | ~$120 |
| PeterMD (~$6.25/tab, 10-pack) | ~$25 | ~$50 | ~$75 |
| PeterMD (~$6.00/tab, larger pack) | ~$24 | ~$48 | ~$72 |
At the 100mg strength, PeterMD is meaningfully cheaper at every usage level. But that comparison flatters PeterMD because it only sells 100mg. Many men are prescribed 50mg, and at that strength Roman's ~$6 per dose lands right on top of PeterMD's 100mg price. Some men split 100mg tablets on their clinician's advice, which changes the math again — but that's a conversation to have with the prescriber, not a pricing hack to assume.
Evaluation: Thorough vs Fast
Roman requires a government ID, medical history, a blood pressure reading and a video visit with a licensed clinician. PeterMD's intake is reviewed by a licensed provider but skips the video visit and doesn't gate pricing behind a quiz. Both are legitimate prescription pathways; they sit at different points on the thoroughness-versus-friction spectrum.
Our view: if you have any cardiovascular history, take blood pressure medication, or haven't had a checkup in years, Roman's process is worth the extra step. ED is often the first visible symptom of vascular disease, and a blood pressure reading is a cheap, useful data point. If you're a healthy man who has used sildenafil before and just wants a reliable, transparent source, PeterMD's leaner process is perfectly reasonable.
See Roman's Plans & Pricing →Video evaluation · Ro Sparks available · Free shippingProduct Range
This is Roman's clearest advantage. Beyond standard sildenafil and tadalafil at multiple strengths, Roman offers daily tadalafil, a 7mg tadalafil gummy format, and Ro Sparks — a compounded sublingual with a stated ~15-minute average onset. If you want daily coverage, a chewable, or the fastest available onset, PeterMD simply doesn't have those options. PeterMD's catalog is deliberately narrow: FDA-approved generic sildenafil 100mg and tadalafil 20mg, plus TRT services outside the ED category.
Narrow isn't bad. For most men, generic sildenafil or tadalafil at a standard strength is exactly the right treatment, and PeterMD's focus keeps its pricing simple. But if your clinician thinks daily tadalafil is a better fit, or you specifically want Ro Sparks, Roman is the only one of the two that can deliver it.
Paying With HSA/FSA
Prescription ED medication is generally an eligible HSA/FSA expense. The practical difference is how you use the money. PeterMD accepts HSA and FSA cards directly at checkout, so the pre-tax dollars are spent at the point of sale. Roman is cash-pay; you pay with a regular card and submit for reimbursement from your FSA/HSA administrator afterward, if your plan allows. Both routes get you the same tax benefit; PeterMD's is just less paperwork. Full details are in our HSA/FSA guide.
Roman — strengths
- Video evaluation with a licensed clinician
- Ro Sparks fast-onset sublingual
- Daily tadalafil and gummy formats
- 25mg and 50mg sildenafil at $4–$6
- Free shipping, ongoing clinician access
PeterMD — strengths
- Public pricing, no quiz
- Fixed packs, nothing auto-renews
- 100mg sildenafil ~$6/tab vs ~$10
- HSA/FSA cards at checkout
- FDA-approved generics only
Who Should Pick Which
Pick Roman if:
- You want a real medical evaluation, including a video visit and blood pressure check
- You're interested in Ro Sparks or a daily tadalafil format
- You'd rather never think about reordering
- You've been prescribed 25mg or 50mg sildenafil, where Roman's pricing is strongest
Pick PeterMD if:
- You want 100mg sildenafil or 20mg tadalafil at the lowest per-tablet price of the two
- You refuse to enter another subscription
- You want to see the price before you share any health information
- You want to pay directly with an HSA/FSA card
Our Verdict — September 2026
Roman is our overall pick because the clinical process is more complete, the product range is wider, and the pricing at lower sildenafil strengths is genuinely competitive. PeterMD is the better buy for 100mg sildenafil specifically, and for anyone who wants transparent, no-subscription purchasing. Neither is a bad choice; they're built for different buyers. Start with Roman's evaluation if you're new to ED treatment or have any health history worth checking, or go with PeterMD's fixed packs if you already know what you need and just want the cleanest price.
Frequently Asked Questions
Is PeterMD cheaper than Roman?
For 100mg sildenafil, yes: PeterMD's fixed packs work out to roughly $6.00–$6.25 per tablet versus about $10 per dose at Roman. For 25mg or 50mg sildenafil, Roman's $4–$6 per-dose pricing is competitive or lower. Tadalafil pricing is closer, with PeterMD's 20mg at ~$6.33–$7.25 and Roman's as-needed tadalafil starting around $8.
Does either provider take insurance?
Neither bills health insurance. Both are cash-pay. PeterMD accepts HSA and FSA cards directly at checkout; Roman is cash-pay with FSA/HSA reimbursement handled on your side afterward.
Does PeterMD require a video visit?
PeterMD's process is a medical intake reviewed by a licensed provider, without the video visit or blood pressure reading Roman requires. Roman's evaluation is more thorough; PeterMD's is faster and lower-friction.
Are PeterMD's pills FDA-approved?
PeterMD sells FDA-approved generic sildenafil and tadalafil tablets dispensed by licensed pharmacies. Roman's standard sildenafil and tadalafil are also FDA-approved generics; Ro Sparks is a compounded product, which is not FDA-approved as a finished drug.
Which one ships faster?
Both ship after prescription approval. PeterMD's no-video process can move faster from sign-up to approval; Roman's video visit adds a step but is often same- or next-day. Transit time is comparable.
Can I use both?
There's no rule against it, but you should have one prescriber managing your ED medication so dosing and interactions are tracked in one place. If you switch, tell the new provider what you were taking.
Is PeterMD available in every state?
PeterMD lists availability in 48 states as of September 2026. Roman's availability also varies by state depending on clinician licensing. Both show eligibility during sign-up.