Key differences

Best forA recognizable provider with broad ED medication choicePeople who prefer a clinician visit and pharmacy prescription rather than a bundled mail-order plan
Treatment modelFDA-approved generics, brand-name drugs, and compounded optionsClinician visits for prescriptions such as sildenafil, tadalafil, vardenafil, avanafil, or alprostadil when appropriate
BillingRecurring plans vary by productPay per visit; medication is generally separate
ConsultationAsynchronous online evaluation in many casesScheduled secure video visit
FulfillmentFree discreet shipping is advertised for many plansPrescription can be sent to a pharmacy; fulfillment depends on the chosen medication and pharmacy
Editorial score89/10087/100

Choose Roman when

  • Large, recognizable telehealth platform
  • Broad selection of standard and compounded formats
  • Publishes unusually detailed medication pricing

Choose Sesame Care when

  • Upfront clinician-visit prices
  • Local-pharmacy flexibility
  • Broader medication discussion than a single-product checkout

Do not ignore the limitations

Roman

  • Many options use recurring plans
  • Compounded products are not FDA-approved
  • The lowest advertised price may reflect dose strength and quantity that do not fit every patient

Sesame Care

  • Medication cost is separate from the visit
  • Requires a scheduled video appointment
  • Provider and prescription availability vary by location

Verdict

Roman is the stronger fit for a recognizable provider with broad ed medication choice. Sesame Care is the stronger fit for people who prefer a clinician visit and pharmacy prescription rather than a bundled mail-order plan. Compare the exact product, dose, quantity, and renewal schedule before deciding.