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1st Optimal vs Apex MD

An in-depth comparison of two leading GLP-1 Providers

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS

Apex MD

7.2
★★★3.6/5

Best for: nationwide access to compounded glp-1 with unlimited visits and labs included

Visit Apex MD

1st Optimal and Apex MD 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 $299/mo, and Apex MD edges ahead overall (7.2 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

Weight Loss Care membership — medication not includedBrand-name
$99/mo
semaglutide

Care membership only — the GLP-1 medication is billed separately and is not priced.

Apex MD

All doses (injection)Compounded
$299/mo
semaglutide

weekly injection, includes NAD/B-12/L-Carnitine, month-to-month

All doses (injection)Compounded
$399/mo
tirzepatide

weekly injection, month-to-month

All doses (oral)Compounded
$349/mo
semaglutide

daily oral

All doses (oral)Compounded
$419/mo
tirzepatide

daily oral

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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

Apex MD

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

Overall

Apex MD

7.2/10

Value25%

6.5A
vs
B
6.8

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.2

Trust & Safety15%

6.5A
vs
B
6.5

Accessibility10%

6.5A
vs
B
8.5

Support10%

7.4A
vs
B
7.5

Features & Coverage

Feature1st OptimalApex MD
Starting Price$99/mo$299/mo
Features8 features8 features
States AvailableNot disclosed51
Compounded✓ Yes
Brand Name✓ Yes
FSA/HSA Accepted
FDA WarningsNoneNone

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 Apex MD

Apex MD is a US virtual telemedicine platform licensed in all 50 states that prescribes compounded GLP-1 medications for weight loss. Weekly injections are 299 dollars per month for compounded semaglutide and 399 dollars per month for compounded tirzepatide; daily oral versions are 349 dollars per month for semaglutide and 419 dollars per month for tirzepatide. Compounds are formulated with added NAD, B-12 and L-Carnitine. Plans include unlimited provider visits and Labcorp labs at no extra fee, with medication delivery typically in under four business days. GLP-1 microdosing is also offered.

Read our full Apex MD 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

Apex MD

What we like

  • Licensed in all 50 states
  • Unlimited provider visits and Labcorp labs included in the plan
  • Both semaglutide and tirzepatide, injectable or oral
  • Medication delivery typically in under four business days

Watch-outs

  • Compounds bundle NAD, B-12 and L-Carnitine rather than a single-ingredient GLP-1
  • Does not publicly name its compounding pharmacy or list an accreditation seal

Our Verdict

Winner: Apex MD

Apex MD edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for nationwide access to compounded glp-1 with unlimited visits and labs included. 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 Apex MD if…

You want nationwide access to compounded glp-1 with unlimited visits and labs included and a starting price around $299/mo.

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6.9

YourEra

$99 first-month entry pricing on compounded GLP-1s

8.2

Gala

Compounded GLP-1/GIP combo on a yearly plan with free shipping

8.3

Found

Mainstream telehealth GLP-1 access

1st Optimal vs Apex MD: FAQ

1st Optimal is cheaper. Its lowest ongoing monthly cash price is $99/mo, compared with $299/mo for Apex MD. We compare standing (not first-month promo) prices so the figures reflect what you'd actually pay month to month.
Apex MD scores higher overall at 7.2/10 versus 6.7/10, and is particularly strong for nationwide access to compounded glp-1 with unlimited visits and labs included. That said, 1st Optimal is a better fit if you want GLP-1 therapy within a lab-driven functional-medicine program.
Apex MD lists availability in 51 states, while 1st Optimal's state list is not publicly listed.
Neither 1st Optimal nor Apex MD is currently an affiliate partner, so we earn no commission from either. We rank all providers editorially using the same six-dimension framework and disclose any commercial relationships.
For Semaglutide, 1st Optimal is cheaper at $99/mo versus $299/mo at Apex MD.

Key terms, explained

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Continue exploring 1st Optimal and Apex MD head-to-heads in the same category.

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