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1st Optimal vs FitRx

An in-depth comparison of two leading GLP-1 Providers

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS
FitRx logo

FitRx

7.8
★★★3.9/5

Best for: insured patients seeking brand-name GLP-1 access with compounded fallback

Visit FitRx

1st Optimal and FitRx 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, FitRx starts at $151/mo, and FitRx edges ahead overall (7.8 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

Pricing not publicly listed.

FitRx

Brand GLP-1 with insuranceBrand-name
$25/mo
semaglutide

With insurance coordination

Compounded Semaglutide (quarterly)Compounded
$151/mo
semaglutide

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What’s included

1st Optimal

Inclusions not disclosed.

FitRx

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

Overall

FitRx

7.8/10

Value25%

6.5A
vs
B
8.0

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
7.8

Accessibility10%

6.5A
vs
B
8.5

Support10%

7.4A
vs
B
7.5

Features & Coverage

Feature1st OptimalFitRx
Starting Price$151/mo
Features8 features8 features
States AvailableNot disclosed51
Compounded✓ Yes
Brand Name✓ Yes
FSA/HSA Accepted
FDA WarningsNoneNone

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 FitRx

FitRx offers brand-name GLP-1s (Ozempic, Wegovy, Zepbound, Mounjaro) with insurance coordination as low as $25/month, plus compounded semaglutide from $151/month without insurance. LegitScript certified. Available in all 50 states + DC.

Read our full FitRx 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

FitRx

What we like

  • Insurance coordination for brand-name GLP-1s — as low as $25/mo
  • All four major brand-name GLP-1s available (Ozempic, Wegovy, Zepbound, Mounjaro)
  • LegitScript certified
  • All 50 states + DC coverage
  • Compounded semaglutide from $151/mo quarterly for uninsured patients
  • Free consultations

Watch-outs

  • Insurance coordination may not work for all plans
  • Broader platform (birth control, mental health, hair loss, ED, skincare, primary care)
  • Compounded option is semaglutide only — no compounded tirzepatide

Our Verdict

Winner: FitRx

FitRx edges out 1st Optimal with a higher overall score of 7.8/10 and is particularly strong for insured patients seeking brand-name GLP-1 access with compounded fallback. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose 1st Optimal if…

You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose FitRx if…

You want insured patients seeking brand-name GLP-1 access with compounded fallback and a starting price around $151/mo.

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8.3

Found

Mainstream telehealth GLP-1 access

7.4

Breeze Meds

Compounded GLP-1 access with named prescribers and 4-pharmacy network

7.4

Telos Rx

Needle-free and microdosed compounded GLP-1 options with lab-monitored care

1st Optimal vs FitRx: FAQ

Key terms, explained

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Continue exploring 1st Optimal and FitRx head-to-heads in the same category.

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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.