1st Optimal vs Cost Plus Drugs
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 →
Cost Plus Drugs
Best for: the cheapest transparent-pricing brand-name Ozempic channel
Visit Cost Plus Drugs →1st Optimal and Cost Plus Drugs 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 $279/mo, and Cost Plus Drugs edges ahead overall (7.1 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.
Cost Plus Drugs
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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
Cost Plus Drugs
Inclusions 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
Cost Plus Drugs
7.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Cost Plus Drugs |
|---|---|---|
| Starting Price | ✓$99/mo | $279/mo |
| Features | ✓8 features | 5 features |
| States Available | Not disclosed | 50 |
| Compounded | — | — |
| 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 Cost Plus Drugs
Mark Cuban's transparent-pricing online pharmacy. Sells branded Ozempic at the wholesale acquisition cost plus 15% markup plus a flat $5 pharmacy fee — publicly disclosed margin formula. Pharmacy fulfillment only; no telehealth intake. Ships to all 50 states. Distinct from telehealth platforms that route brand-name semaglutide through similar discount channels.
Read our full Cost Plus Drugs 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
Cost Plus Drugs
What we like
- Transparent pricing: wholesale cost + 15% markup + $5 pharmacy fee, the same for everyone
- Around $279/mo for branded Ozempic — well below typical retail list prices
- Mark Cuban's PBM-disrupting pharmacy, praised by Forbes Health, Wired, and KFF Health News
- Ships to all 50 states; genuine FDA-approved Novo Nordisk Ozempic, not compounded
- Partnered with 9amHealth so you can get prescribed and fill at Cost Plus pricing
Watch-outs
- Fulfillment only — no telehealth intake; you need a prescription from an outside clinician
- Ozempic is FDA-indicated for type 2 diabetes, not weight management — weight-loss use is off-label
- Wegovy availability has been spotty — check current stock before assuming it ships
- No compounded semaglutide or tirzepatide — brand only
- No clinical follow-up — side-effect monitoring falls to your prescribing clinician
Our Verdict
Cost Plus Drugs edges out 1st Optimal with a higher overall score of 7.1/10 and is particularly strong for the cheapest transparent-pricing brand-name Ozempic channel. 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 Cost Plus Drugs if…
You want the cheapest transparent-pricing brand-name Ozempic channel and a starting price around $279/mo.
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GobyMeds
Budget-conscious shoppers
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Compounded GLP-1 alongside NAD+, peptide and longevity add-ons
From $197/mo
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Compounded GLP-1 access with oral tablet options across 49 states
From $147/mo
Get started →1st Optimal vs Cost Plus Drugs: 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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