1st Optimal vs Alloy
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Alloy
Best for: Menopause Society-certified care with the broadest GLP-1 formulary
Visit Alloy →1st Optimal and Alloy are both GLP-1 Providers competing for the same patients, but they make different trade-offs on price, coverage, and what's included. In our scoring, 1st Optimal starts lower at $99/mo versus $169/mo, and Alloy edges ahead overall (7.5 vs 6.7 out of 10). Below we break down pricing, what each plan covers, the six-dimension score, pros and cons, and exactly who should pick which.
Pricing
1st Optimal
Care membership only — the GLP-1 medication is billed separately and is not priced.
Alloy
$70 medication + mandatory $99/mo Alloy Weight Care fee = $169/mo effective
$100 medication + mandatory $99/mo Alloy Weight Care fee = $199/mo effective
$115 medication + mandatory $99/mo Alloy Weight Care fee = $214/mo effective
$199-$499 medication + mandatory $99/mo Alloy Weight Care fee; $298/mo effective at the $199 starting dose
$299 medication + mandatory $99/mo Alloy Weight Care fee = $398/mo effective
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What’s included
1st Optimal
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
Alloy
Inclusions not disclosed.
Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
6.7/10
Alloy
7.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Alloy |
|---|---|---|
| Starting Price | ✓$99/mo | $169/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | ✓ Yes |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets. Its model pairs prescription GLP-1 therapy with at-home lab testing, blood-work interpretation, unlimited coaching, and personalized protocols framed around long-term weight loss and longevity. Care is delivered virtually by credentialed providers, and treatments ship to the home with no long-term contracts. The site does not publish monthly pricing or a state list.
Read our full 1st Optimal review →About Alloy
Alloy is a menopause-focused telehealth brand whose Weight Care program runs the broadest GLP-1 formulary in our catalog — brand Wegovy, brand Zepbound, oral Wegovy, plus compounded semaglutide, tirzepatide and liraglutide. Every consulting doctor is certified by The Menopause Society. Pricing spans brand Wegovy from $199/mo to compounded liraglutide from $80/mo, with a $49 initial consult and a STARTGLP1 promo for $50 off the first month.
Read our full Alloy review →Pros & Cons
1st Optimal
What we like
- Offers both semaglutide and tirzepatide with injectable and oral formats
- Functional-medicine approach with at-home labs and blood-work interpretation
- Unlimited coaching and ongoing support included
- No long-term contracts
- Board-certified doctors and nurse practitioners referenced
Watch-outs
- No public monthly pricing disclosed
- No published state availability list
- Compounded vs branded sourcing not clarified on site
- Pricing only revealed after quiz or consultation
Alloy
What we like
- Broadest GLP-1 formulary here: brand Wegovy and Zepbound, oral Wegovy, plus compounded semaglutide, tirzepatide, and liraglutide
- All consulting doctors are certified by The Menopause Society — a rare credential
- STARTGLP1 promo code takes $50 off the first month
- Spans the price range: compounded semaglutide from $70/mo, brand Wegovy from $199/mo (each plus the $99/mo Weight Care fee)
Watch-outs
- Menopause-focused — best for women in menopause or perimenopause, not men or younger patients
- A mandatory $99/mo Alloy Weight Care fee sits on top of every medication price (so the true minimum is ~$169/mo, not $70)
- Compounded semaglutide not available in AL, AR, CA, NV, LA, MS or DC
Our Verdict
Alloy edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for Menopause Society-certified care with the broadest GLP-1 formulary. 1st Optimal remains a solid alternative, especially if you're looking for GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Alloy if…
You want Menopause Society-certified care with the broadest GLP-1 formulary and a starting price around $169/mo.
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From $99/mo
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Get started →1st Optimal vs Alloy: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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