1st Optimal vs Aquivia Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programAquivia Health
Best for clinician-reviewed compounded GLP-1 with optional branded upgradeStarting at $149/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Aquivia Health |
|---|---|---|
| Overall Score | 6.7/10 | ✓6.9/10 |
| Starting Price | — | $149/mo |
| Editorial Rating | 3.4 ★ /5 | ✓3.5 ★ /5 |
| Features | ✓8 features | 7 features |
| States Available | 0 | 0 |
| Compounded | — | — |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 4 warnings |
Pros & Cons
1st Optimal
Pros
- ✓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
Cons
- ✗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
Aquivia Health
Pros
- ✓Clinical care provided by Open Loop Healthcare Partners, PC — a reused, verified MSO network
- ✓Named leadership: Steven Bishop MD (CMO), Phillip Gray PharmD (Chief Pharmacist), Tom Foster (President)
- ✓Itemized public pricing: compounded semaglutide $149/mo, tirzepatide $179/mo, Ozempic $1,299, Zepbound $1,399
- ✓Both compounded and branded GLP-1s offered side by side — unusual for a compounded provider
- ✓Self-pay model with no insurance required and no separate consultation fee
- ✓Multi-month prepay discounts disclosed publicly
- ✓States up front that completing the check doesn't guarantee a prescription — a good safety signal
- ✓Broader clinical scope with metabolic, longevity, and dysautonomia pathways
Cons
- ✗No public list of states served — you must complete intake to learn if your state qualifies
- ✗No named 503A compounding pharmacy partner, limiting licensure verification
- ✗No LegitScript, PCAB, or BBB trust badges visible
- ✗Brand confusion: site schema names 'CatalystMD' while the customer-facing brand is Aquivia Health
- ✗Compounded semaglutide and tirzepatide are not FDA-approved or premarket-reviewed
- ✗Recently launched (April 2026) with no third-party review profile yet
- ✗Two of three programs (longevity, dysautonomia) are waitlist-only — only weight loss is available now
Our Verdict
Aquivia Health edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for clinician-reviewed compounded GLP-1 with optional branded upgrade. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Glossary references
Key terms in this article, linked to their canonical definitions.
- 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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Or see the full category ranking.
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.