1st Optimal vs AlyveRx
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 →AlyveRx
Best for: needle-free sublingual GLP-1 options alongside standard compounded injections
Visit AlyveRx →1st Optimal and AlyveRx 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 $183/mo, and AlyveRx edges ahead overall (6.8 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.
AlyveRx
Compounded injection, from 183/mo; billed monthly, lower on longer plans
Compounded injection, standing month-to-month price; from 283/mo on multi-month plans
Needle-free sublingual drops, from 203/mo
Needle-free sublingual drops, from 249/mo
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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
AlyveRx
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
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
AlyveRx
6.8/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | AlyveRx |
|---|---|---|
| Starting Price | ✓$99/mo | $183/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ 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 AlyveRx
AlyveRx (Alyve, Inc.) is a US online telehealth platform connecting patients with licensed providers for GLP-1 weight loss care, no insurance required, with free discreet delivery. It offers compounded semaglutide and tirzepatide as injections and as needle-free sublingual drops using its proprietary PermeAct delivery tech, and also carries brand Ozempic, Wegovy, and Mounjaro. Month-to-month pricing starts near 183 dollars for compounded semaglutide and 329 dollars for compounded tirzepatide, with lower rates on longer plans. Care is fully online after a telehealth assessment.
Read our full AlyveRx 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
AlyveRx
What we like
- Offers compounded semaglutide and tirzepatide as both injections and needle-free sublingual drops for people who dislike needles
- Transparent monthly pricing shown upfront, no insurance required, and free discreet delivery
- Also carries brand-name Ozempic, Wegovy, and Mounjaro through its provider network
Watch-outs
- Does not publicly name its dispensing pharmacy or display a LegitScript seal, so third-party accreditation is unverified
- Sublingual GLP-1 absorption relies on the company proprietary PermeAct technology and is not FDA-reviewed for weight loss
- State availability is not published on the site
Our Verdict
AlyveRx edges out 1st Optimal with a higher overall score of 6.8/10 and is particularly strong for needle-free sublingual GLP-1 options alongside standard compounded injections. 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 AlyveRx if…
You want needle-free sublingual GLP-1 options alongside standard compounded injections and a starting price around $183/mo.
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Get started →1st Optimal vs AlyveRx: 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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Wegovy®, Ozempic®, and Rybelsus® are trademarks of Novo Nordisk A/S. Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. All other product names and trademarks referenced on this page belong to their respective owners. WeightLossRankings.org is not affiliated with any pharmaceutical manufacturer. See trademark disclaimer.