1st Optimal vs Fifty 410
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 →
1st Optimal and Fifty 410 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, both start around $99/mo, and Fifty 410 edges ahead overall (7.0 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.
Fifty 410
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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
Fifty 410
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
Fifty 410
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Fifty 410 |
|---|---|---|
| Starting Price | $99/mo | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | ✓None | 1 warning |
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 Fifty 410
Fifty 410 is a direct-to-consumer weight-loss telehealth service offering personalized compounded semaglutide and tirzepatide prescribed by licensed providers and prepared by FDA-registered 503A and 503B pharmacies. It uses a no-membership, pay-as-you-go model with transparent public pricing: semaglutide from 99 dollars per month and tirzepatide starter from 133 dollars per month, plus a high-dose tier. Provider reviews finish in 24 to 48 hours and free shipping arrives in one to two days. Cash-pay only; no direct insurance billing, but accepts FSA/HSA, Afterpay, and Affirm.
Read our full Fifty 410 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
Fifty 410
What we like
- Transparent public pricing from 99 dollars per month for semaglutide
- No membership or subscription; pay only for what you need
- Compounded by FDA-registered 503A and 503B pharmacies
- Fast 24 to 48 hour provider review
- Free one to two day shipping
- Accepts FSA/HSA plus Afterpay and Affirm
Watch-outs
- Does not bill insurance directly
- Compounded GLP-1 is not an FDA-approved finished drug
- Specific clinician credentials are not publicly disclosed
- Served-states list is not published on the site
- No branded GLP-1 options
Our Verdict
Fifty 410 edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for transparent no-membership compounded GLP-1 pricing. 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 Fifty 410 if…
You want transparent no-membership compounded GLP-1 pricing and a starting price around $99/mo.
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Found
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From $99/mo
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Get started →1st Optimal vs Fifty 410: 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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