1st Optimal vs BiltRx
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 →BiltRx
Best for: low-cost compounded glp-1 from a legitscript-verified provider
Visit BiltRx →1st Optimal and BiltRx 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 $125/mo, and BiltRx edges ahead overall (7.6 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.
BiltRx
starting price per month
starting price per month
flat rate, brand Zepbound
flat rate, brand Wegovy
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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
BiltRx
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
BiltRx
7.6/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | BiltRx |
|---|---|---|
| Starting Price | ✓$99/mo | $125/mo |
| Features | ✓8 features | 7 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 BiltRx
BiltRx is a US health-optimization telehealth platform spanning men's health, women's health, aesthetics and weight loss that offers compounded and brand-name GLP-1 medications. Compounded semaglutide starts at 125 dollars per month and compounded tirzepatide at 129 dollars, among the lowest published prices. Brand options include Ozempic at 1,449 dollars, Zepbound and Mounjaro from 1,499 dollars and Wegovy at 1,849 dollars. Medication is compounded by licensed US 503A pharmacies (the site names Boothwyn and Southend Pharmacy). BiltRx is LegitScript verified and HIPAA compliant.
Read our full BiltRx 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
BiltRx
What we like
- Very low starting prices (semaglutide from 125 dollars, tirzepatide from 129 dollars)
- LegitScript verified and HIPAA compliant
- Names its 503A compounding pharmacies (Boothwyn and Southend)
- Offers both compounded and brand-name GLP-1 options
Watch-outs
- Covered states are behind a check-availability gate, not listed
- Starting prices may rise depending on plan and dose
Our Verdict
BiltRx edges out 1st Optimal with a higher overall score of 7.6/10 and is particularly strong for low-cost compounded glp-1 from a legitscript-verified provider. 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 BiltRx if…
You want low-cost compounded glp-1 from a legitscript-verified provider and a starting price around $125/mo.
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TMates
Nationwide compounded GLP-1 availability including Puerto Rico
From $249/mo
Get started →Trimi Health
Budget-conscious shoppers
From $99/mo
Get started →ShedRx
Mainstream telehealth GLP-1 access
From $149/mo
Get started →1st Optimal vs BiltRx: 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.