How AI Search Is Recommending ED Treatment Pills: Monthly Trends

Executive Summary

The ED treatment category moved sharply in October 2026, and the movement was uneven. Hims remains the coverage leader at 60.8% valid recommendation coverage, leading Ro (55.1%) by 5.7 points, itself a widening from the compressed near-tie of the prior month. Two brands broke away from that cluster on the upside, and two lost ground sharply, a combination that produced a genuinely mixed month rather than a single category-wide trend.

GoodRx Care is the month's clearest advancer on placement, converting broad visibility into first-position recommendations. Its coverage rose 7.0 points from the July baseline (44.0% to 51.0%), and against September it rose 12.0 points, a move classified as significant. Hims posted the largest positive month-over-month swing, up 14.2 points versus September (46.6% to 60.8%, significant), recovering much of the ground it shed over the summer. Ro rose 9.2 points versus September (45.9% to 55.1%, significant), and Lemonaid Health rose 9.1 points (21.3% to 30.4%, significant).

The sharpest decline is a naming event. PlushCare, tracked under its prior casing, fell 25.9 points from the July baseline (25.9% to 0.0%), because the brand now appears in the benchmark under a lower-cased variant, plushcare, which enters at 23.0% coverage. Optum fell 2.4 points from July (3.1% to 0.7%, a significant baseline decline) and Rex MD fell 6.3 points (15.1% to 8.8%, also significant). Blink Health has now declined three consecutive months, from 8.6% in July to 5.1% in October, a cumulative 3.5 points still within normal variation.

The full arc matters here. Across July through October the category's qualified base ran 325, 283, 305, and 296 observations, and the two leaders fell sharply through August and September before recovering in October. Hims is still 4.7 points below its July starting point, and Ro 7.4 points below, even after this month's rebound. What October shows is a partial recovery and a reordering beneath the top two, not a return to July levels.

Each monthly run begins with 800 prompt-surface observations across the benchmark's defined AI/search surface universe. In October, those 800 prompts carried 658 unique questions; all 800 mentioned a tracked brand or competitor; 547 were relevant and 253 were irrelevant. The public metrics use the 296 observations that survive both qualification stages. For comparison, the July run began with 800 prompt-surface observations and 632 unique questions, all 800 mentioning a tracked brand, with 537 relevant and 263 irrelevant, yielding 325 qualified observations.

Key Findings

AI Response Inconsistency Alerts

Questions This Section Answers

• Which brands generated the most factual conflicts across AI platforms, and what did those conflicts involve?
• Where did AI platforms contradict each other on Hims, BlueChew, and Lemonaid Health pricing and product claims?

The benchmark's conflict scan detected 7 critical or high severity factual inconsistencies across 6 AI platforms, concentrated in three companies. These are cases where two platforms gave answers that cannot both be true.

Hims

Hims generated three conflicts, the most of any company, spanning four platforms. The most severe is a critical availability conflict about Zepbound. When asked "How much is zepbound through Hims?", Google AI Overviews stated that Hims offers branded Zepbound (tirzepatide) for $1,899 per month plus membership, while Gemini stated that Hims does not offer brand-name Zepbound or Mounjaro. Google AI Overviews cited the Hims weight-loss page and the Hims shop page; one flagged source, a YouTube video titled "Hims & Hers shares rise as company adds Eli Lilly's Zepbound," carried a confidence of 0.7, and a second flagged source carried a confidence of 0.98.

A second Hims conflict is a high severity pricing conflict about relative cost versus Ro. When asked "Is Hims or Ro more expensive?", ChatGPT stated that Ro is generally cheaper than Hims, especially long-term, while Perplexity stated that Hims is typically a bit cheaper than Ro for similar ED treatments. Perplexity's answer drew on Medical News Today and a Ro comparison page, and two flagged sources carried confidences of 0.95 and 0.7.

The third Hims conflict is a high severity pricing conflict about the cheapest option overall. When asked "Is BlueChew or Hims cheaper?", ChatGPT stated that Hims is generally cheaper, especially for standard sildenafil or tadalafil, while Perplexity stated that BlueChew is generally cheaper per dose, with plans often starting around $25 per month. Perplexity cited Medical News Today and a Ubie Health comparison; three flagged sources carried confidences of 0.95, 0.95, and 0.9.

BlueChew

BlueChew generated two conflicts, both high severity, across three platforms. The first is a factual conflict about BlueChew Gold ingredients. When asked "What is similar to BlueChew gold?", Google AI Mode stated that BlueChew Gold combines sildenafil, tadalafil, apomorphine, and oxytocin, while Copilot stated it combines sildenafil, tadalafil, vardenafil, and apomorphine. The two ingredient lists differ on both oxytocin and vardenafil and cannot both describe the same formulation. Google AI Mode cited the BlueChew Gold page, and three flagged sources carried confidences of 0.95, 1.0, and 0.95.

The second is a pricing conflict about premium and combination plans. When asked "How much is a 6 pack of BlueChew?", Google AI Overviews stated that the BlueChew Gold Plan costs $79 to $139 per month for a 6-pack, while Copilot stated that a 6-pack typically costs about $25 per month, with higher quantities ranging from $35 to $130. One flagged source, a BlueChew cost explainer, carried a confidence of 0.9.

Lemonaid Health

Lemonaid Health generated two conflicts, both high severity, across two platforms. The first is a factual ownership conflict. When asked "Is Lemonaid Health legit?", Gemini stated that Lemonaid Health was acquired by 247id, formerly Truepill, in 2021, while Copilot stated it is owned by 23andMe. Copilot's answer drew on a GLP-1 reviews page and a FormBlends safety-newsroom page; two flagged sources carried confidences of 0.95 and 0.95.

The second is an eligibility conflict about insurance. When asked the same question, Gemini stated that patients should check whether their specific insurance plan covers the consultation, while Copilot stated that no insurance is accepted and patients pay full out-of-pocket costs. Two flagged sources carried confidences of 0.95 and 0.9.

Benchmark Context

The report separates the raw collection universe from the qualified analysis set. Brand-level recommendation percentages are calculated within the qualified benchmark set.

The qualified surface breadth of six spans all canonical AI/search families tracked in this benchmark (ChatGPT, Copilot, Gemini, Perplexity, AI Overviews, and AI Mode), so the coverage shifts described below reflect changes in brand-level output rather than a narrower or wider measurement surface this month. August (283 qualified observations) and September (305) sit between the baseline and current months; both are mentioned here for interpretation but are not shown as comparison columns.

Benchmark-Level Metrics

The October answer mix shifted materially toward recommendations: recommendation-shaped answers rose to 58.8% of qualified observations from 38.2% in July, the highest share in the series. This matters for interpretation, because a larger share of answers now carry a shortlist, which changes what a coverage percentage is measuring even when the underlying prompt set is comparable.

AI Recommendation Trend

Questions This Section Answers

• Who leads AI recommendations for ED treatment pills, and how wide is the gap to the next brand?
• How did the tracked-name casing change affect PlushCare's position in the table?

The category stabilized at the top while a casing change reconfigured the middle of the table.

Hims and Ro both recovered significant ground against September but remain below their July baseline; beneath them, the category-level change came from a combination of a recovering top tier, a broadening middle, and one tracked-name casing shift rather than from a single dominant move.

What Changed This Month

Questions This Section Answers

• Which brand made the strongest commercial move in October on both presence and placement?
• Why did Hims' recovery leave it below its July baseline despite regaining shortlist dominance?
• What does Ro's placement-up, presence-down pattern signal about its shortlist position?

GoodRx Care

GoodRx Care delivered the month's most durable commercial movement, and it did so on both presence and placement. Coverage rose 7.0 points from the July baseline (44.0% to 51.0%), and the September-to-October jump was 12.0 points, classified as significant. That two-month upward streak places GoodRx Care firmly in third, within reach of the top two.

The placement picture is stronger still. Its raw mention presence rate rose 14.2 points from July (55.7% to 69.9%, significant), its top-3 recommendation rate rose 18.0 points (17.5% to 35.5%, significant), and its rank-one rate rose 11.9 points (4.0% to 15.9%, significant). With 151 valid recommendations in October, GoodRx Care is no longer a presence story alone but a recommended-first-choice story.

The distinction to notice is visible versus recommended. GoodRx Care is now converting broad visibility into first-position placements at a rate approaching the leaders, and this is the sharpest divergence in the category. Highest-priority diagnostic: determine which question themes now produce GoodRx Care at rank one and which leader, Hims or Ro, it is displacing on those prompts.

Hims

Hims retained the lead and posted the largest month-over-month recovery in the category. Coverage rose 14.2 points versus September (46.6% to 60.8%, significant), though it remains 4.7 points below the July baseline of 65.5%.

The recovery is partly a placement story. Hims' top-3 recommendation rate rose 9.5 points from July (39.1% to 48.6%, significant), and its raw mention presence rate held essentially flat and dominant at 92.6% versus 92.0%. Its 144 top-3 recommendations and 84 rank-one recommendations in October are the largest counts in the category, and 180 valid recommendations give it the broadest qualified base.

The distinction to notice is that Hims' recovery is real but partial: its rank-one rate of 28.4% is still 4.8 points below its July level of 33.2%, so the brand has regained shortlist dominance without fully restoring its default-answer position. Highest-priority diagnostic: identify which prompts still route the first-position answer away from Hims and whether those are the same prompts now favoring GoodRx Care.

PlushCare and plushcare

The single largest apparent movement this month is a naming event, and it should be read as one. PlushCare, tracked under its prior casing, fell 25.9 points from the July baseline (25.9% to 0.0%), while plushcare, tracked under a lower-cased casing, enters the series at 23.0% coverage and 5th place. These are the same commercial entity appearing under two tracked-name forms; the benchmark treats them as separate series entries.

plushcare's October profile is substantial: a raw mention presence rate of 30.7%, a top-3 rate of 9.8%, a rank-one rate of 1.7%, and 68 valid recommendations. PlushCare's October profile is empty because the brand no longer appears under that casing. The category observation is one of identity consolidation in the tracking layer, not a collapse of the brand's visibility.

The distinction to notice is that a name-form change in the benchmark can produce a 25.9-point decline and a 23.0-point entry in the same month without any change in the underlying market. Highest-priority diagnostic: confirm which casing the brand now presents under across surfaces and whether any residual mentions still resolve to the prior form.

Ro

Ro remains second and posted a significant September-to-October recovery. Coverage rose 9.2 points versus September (45.9% to 55.1%, significant) but sits 7.4 points below the July baseline of 62.5%.

The improvement is concentrated in placement rather than presence. Ro's top-3 recommendation rate rose 11.4 points from July (30.8% to 42.2%, significant) and its rank-one rate rose 5.5 points (4.3% to 9.8%, significant), while its raw mention presence rate slipped 4.7 points (87.1% to 82.4%). Its 180 valid recommendations in October match Hims for the broadest qualified base in the category, with 125 top-3 and 29 rank-one placements.

The distinction to notice is that Ro is being named slightly less but recommended higher, the inverse of a visibility-led decline. Highest-priority diagnostic: determine whether the presence dip is concentrated in specific surfaces where Ro drops out of the shortlist entirely.

Rex MD and Optum

Rex MD is a significant baseline decliner. Coverage fell 6.3 points from July (15.1% to 8.8%), and its raw mention presence rate fell 6.7 points (21.2% to 14.5%, significant), so the brand is being named less often, not only recommended less. Even so, its rank-one rate rose 2.0 points (0.0% to 2.0%, significant), registering 6 first-position placements from a small base of 26 valid recommendations. The small count caveat applies: with 26 valid recommendations, individual placements carry outsized weight. Highest-priority diagnostic: identify which prompt categories drove the loss in mention presence and which brands now appear in Rex MD's place.

Optum is a significant baseline decliner on a very small base. Coverage fell 2.4 points from July (3.1% to 0.7%), with just 2 valid recommendations in October and 1 top-3 placement. Its net sentiment score fell to 0.2 from 0.7 in July, the weakest sentiment reading among tracked brands this month. Highest-priority diagnostic: assess whether Optum's few remaining mentions cluster in cautionary or non-recommendation contexts, given the sentiment drop.

Buyer-Intent Interpretation

Questions This Section Answers

• Which buyer-intent clusters did October's qualified observations actually cover?
• Which commercial questions about pricing and head-to-head comparisons can this month's benchmark not answer?

In October, all 296 qualified observations fell into the brand recommendation cluster. The qualified set again contained no observations for pricing and value or multi-brand comparison prompts. The current public data answers the question of which brand AI systems recommend most often, but it cannot yet speak to price competitiveness, value positioning, or direct head-to-head outcomes. Those commercial questions remain outside the scope of what this month's public benchmark can characterize.

Brand Opportunity Summary

Questions This Section Answers

• Which diagnostics should each brand prioritize based on its October coverage signal?

The benchmark identifies where attention is warranted; a company-level analysis is needed to explain why.

Evidence Behind the Benchmark

The aggregate metrics are built from prompt-level observations (query, surface, recommendation outcome, rank, sentiment, and citations where exposed). Company-level analysis can go deeper into prompt, competitor, surface, and evidence patterns. Source presence is not automatically treated as proof of causation.

Report-Specific Interpretation Notes

• Small-count movement: K Health (7 valid recommendations), Optum (2), and Blink Health (15) have small qualified bases in October, so their percentage movements carry limited weight.
• Qualified denominator versus raw collection: The public percentages are calculated against the 296 eligible observations, not the full 800-prompt raw collection.
• Recommendation-mix shift: Recommendation-shaped answers rose to 58.8% of qualified observations in October from 38.2% in July, which changes what a coverage percentage measures across the two months.
• Tracked-name change: PlushCare and plushcare are the same commercial entity under two tracked casings; their October figures should be read together.
• Directional analysis: Movement between months identifies changes worth investigating; it does not by itself establish the cause of those changes.

Next Step

The Public Benchmark Shows Where a Brand Is Winning or Losing. A Company-Level Audit Shows Why.

Beneath the aggregate percentage are the questions that matter most: which high-intent prompts is a brand winning, which competitor takes the recommendation when a brand loses, what attributes AI systems associate with each option, and which external sources shape those answers. The benchmark shows that GoodRx Care is converting visibility into first-position recommendations, that Hims and Ro have partially recovered while remaining below July, and that a casing change reshaped the middle of the table, but it does not reveal the prompt-level mechanics behind those shifts.

A company-specific AI visibility audit maps those prompt, surface, competitor, ranking, sentiment, and evidence-source patterns into a prioritized visibility strategy. It turns the question "what is our share of AI recommendations" into "which prompts should we win next, and what evidence will move that outcome."

Request an AI visibility audit