1st Optimal vs Aquivia Health
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 →
Aquivia Health
Best for: clinician-reviewed compounded GLP-1 with optional branded upgrade
Visit Aquivia Health →1st Optimal and Aquivia Health 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 $149/mo, and Aquivia Health edges ahead overall (6.9 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.
Aquivia Health
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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
Aquivia Health
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
Aquivia Health
6.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Aquivia Health |
|---|---|---|
| Starting Price | ✓$99/mo | $149/mo |
| Features | ✓8 features | 7 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | ✓ Yes |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 4 warnings |
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 Aquivia Health
Aquivia Health is a clinician-led, self-pay telehealth platform offering compounded GLP-1 therapy with the option to step up to branded Ozempic or Zepbound — an unusual side-by-side most compounded providers don't carry. Clinical care runs through Open Loop Healthcare Partners, and the founding team is disclosed, led by a Chief Medical Officer and a 503A-background Chief Pharmacist. Compounded semaglutide is $149/mo and tirzepatide $179/mo at every dose.
Read our full Aquivia Health 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
Aquivia Health
What we like
- 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
Watch-outs
- 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 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 Aquivia Health if…
You want clinician-reviewed compounded GLP-1 with optional branded upgrade and a starting price around $149/mo.
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Get started →1st Optimal vs Aquivia Health: 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.