Look at Roman's sildenafil pricing and a pattern jumps out: ~$4 per dose at 25mg, ~$6 at 50mg, ~$10 at 100mg. The maximum strength costs two and a half times the minimum. If you assumed that reflected the cost of the medication, you'd be wrong — the active ingredient is a small part of a generic tablet's cost, and four times the sildenafil citrate doesn't cost four times as much. This article explains what strength-tiered pricing actually is, where you'll find flat pricing instead, and how to respond to it sensibly. Pricing verified September 2026.
The Numbers
| Strength | Roman per dose | Multiple of 25mg price | Price per mg |
|---|---|---|---|
| 25mg | ~$4 | 1.0x | ~$0.16 |
| 50mg | ~$6 | 1.5x | ~$0.12 |
| 100mg | ~$10 | 2.5x | ~$0.10 |
| 100mg (PeterMD, fixed pack) | $6.00–$6.25 | — | ~$0.06 |
Notice the price-per-milligram column. Roman's pricing is actually cheaper per milligram as strength rises; it's just that the per-dose number climbs steeply. And PeterMD, selling 100mg only at a flat pack price, comes in well under Roman's 100mg rate. Same drug, same strength, ~$6 versus ~$10.
Why Sellers Tier by Strength
It's how the drug is prescribed
Sildenafil is prescribed per dose, and dose is a clinical decision. A provider that prices per dose has a natural reason to price per strength: it maps directly to what the clinician wrote. That makes tiered pricing feel intuitive even though the underlying cost is nearly flat.
It segments the market
Men who need 100mg are, on average, more committed buyers than men trying 25mg for the first time. Charging more at the top tier captures more revenue from customers who are more likely to stay. That's ordinary pricing strategy; airlines and software companies do the same thing with different labels.
It anchors the low headline price
"Sildenafil from $4" is a much better advertisement than "sildenafil $10." Tiering lets the provider lead with the 25mg price while most customers end up paying more. That's not dishonest — the 25mg price is real — but it's worth recognizing when you compare providers on their headline numbers.
The bundled services aren't free
Roman's price includes a video visit, a blood pressure review, clinician messaging and free shipping. Those costs have to be recovered somewhere, and higher tiers carry more of it. PeterMD's leaner intake, without the video visit, is part of why its flat 100mg price is lower.
Where Pricing Is Flat Instead
Fixed-pack sellers like PeterMD tend to sell one strength at one price. Traditional retail pharmacies filling a prescription often price generic sildenafil fairly flat across strengths too, because they're pricing the tablet, not the dose. The telehealth subscription model is where steep tiering is most common. That's useful to know: if you've been prescribed 100mg and the per-dose price stings, the flat-price channel for that strength is cheaper. We compare the two directly in Roman vs PeterMD.
Compare current alternativesThe Wrong Response: Chasing Price Per Milligram
The Right Responses
- Let your clinician set the strength. Start where they recommend, usually 50mg, and adjust based on how it works. Roman's video evaluation is set up for exactly this conversation.
- Then shop for that strength. If you land on 25mg or 50mg, Roman's ~$4–$6 pricing is the best we track. If you land on 100mg, PeterMD's ~$6 flat packs beat Roman's ~$10 by a wide margin.
- Ask about splitting, don't assume it. Some prescribers are fine with splitting scored 100mg tablets to make a 50mg dose. If yours is, a flat-priced 100mg pack becomes a very cheap 50mg supply. If yours isn't, respect that.
- Consider tadalafil. If tiering on sildenafil bothers you, note that Roman's tadalafil starts around ~$8 and PeterMD's 20mg is ~$6.33–$7.25, with a 36-hour window that changes the per-month math. See our monthly cost comparison.
- Use pre-tax money. Whatever strength and provider, HSA/FSA eligibility knocks 20–35% off the effective cost.
What Actually Determines the Cost of a Generic Tablet
A generic sildenafil tablet's cost to produce is dominated by things that don't scale with milligrams: regulatory compliance, quality testing, facility overhead, packaging, distribution and the pharmacy's dispensing labor. The active pharmaceutical ingredient is a small slice, and even quadrupling it from 25mg to 100mg adds only cents. Retail pharmacies that price generics fairly flat across strengths are reflecting that reality. Subscription telehealth providers that tier steeply are reflecting a business decision. Neither is hiding anything; they're just answering different questions, one about cost and one about willingness to pay.
Monthly Impact of Strength
| Prescribed strength | Best price we track | ~8 doses/mo |
|---|---|---|
| 25mg | Roman ~$4 | ~$32 |
| 50mg | Roman ~$6 | ~$48 |
| 100mg | PeterMD ~$6.00–$6.25 | ~$50 |
| 100mg via Roman | ~$10 | ~$80 |
The practical takeaway: strength tiering only really hurts if you buy 100mg from a tiered provider. Buy 25mg or 50mg from Roman, or 100mg from PeterMD, and the monthly cost is in the same ~$30–$50 band regardless of what you were prescribed.
A Note on Starting Strength
Because 50mg is the most common starting dose and Roman prices it at ~$6, most first-time buyers won't feel the 100mg premium at all. The tier becomes relevant only if the clinician moves you up, and by then you'll know whether the medication works for you and how often you use it — which is exactly the information you need to decide whether Roman's ~$10 with the evaluation and free shipping or PeterMD's ~$6 flat pack is the better fit. Don't pre-optimize for a strength you may never need.
Our Verdict — September 2026
100mg sildenafil costs more at subscription providers because of pricing strategy, not manufacturing cost. The fix isn't to game your dose; it's to let a clinician set the strength and then buy that strength from the provider that prices it best. For 25mg and 50mg, that's Roman. For 100mg, it's PeterMD's flat-priced packs.
Frequently Asked Questions
Does 100mg sildenafil cost more to manufacture than 25mg?
Marginally, not meaningfully. The active ingredient is a small fraction of a generic tablet's cost; manufacturing, packaging, distribution and regulatory overhead dominate and don't scale with milligrams. The retail price difference is set by the seller.
Why does Roman charge more for 100mg?
Roman, like most telehealth providers, tiers pricing by strength. It segments customers by dose and captures more revenue from men who need or want the maximum strength. That's a legitimate pricing strategy; it's just not a cost pass-through.
Is 100mg sildenafil better than 50mg?
Not inherently. The right strength is the lowest one that works reliably with tolerable side effects. Many men do well on 50mg; some need 100mg; some do fine on 25mg. Your clinician should set it based on your response.
Can I buy 100mg and split it?
Some clinicians approve splitting scored tablets to lower per-dose cost. This depends on the tablet and your prescriber; don't assume it. Unscored tablets split unevenly, and halving a dose without guidance isn't a good idea.
Where is 100mg sildenafil cheapest?
Among the providers we track, PeterMD's fixed packs at ~$6.00–$6.25 per 100mg tablet are the lowest, versus ~$10 per dose at Roman. PeterMD sells 100mg only.
Do all telehealth providers tier by strength?
Most subscription providers do. Fixed-pack sellers like PeterMD tend to sell a single strength at a flat price. Traditional pharmacies with a prescription often price generics fairly flat across strengths as well.
Should I ask for a higher strength to get better value per milligram?
No. Strength should be set by clinical response, not price. A higher dose than you need raises side effect risk without improving results, and that's not value.