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1st Optimal vs HealthRX

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

HealthRX

7.3
★★★3.7/5

Best for: flat-price compounded semaglutide or tirzepatide from a LegitScript-certified cash-pay program

Visit HealthRX

1st Optimal and HealthRX 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, HealthRX starts at $133/mo, and HealthRX edges ahead overall (7.3 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.

HealthRX

Injectablecompounded injection
$133/mo
semaglutide

Flat rate, same price at every dose; 3-month plan from $133/mo, 12-month plan from $99/mo

Injectablecompounded injection
$209/mo
tirzepatide

Flat rate, same price at every dose; 3-month plan from $209/mo, 12-month plan from $179/mo

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What’s included

1st Optimal

Inclusions not disclosed.

HealthRX

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

HealthRX

7.3/10

Value25%

6.5A
vs
B
7.8

Effectiveness25%

7.0A
vs
B
7.0

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
7.2

Accessibility10%

6.5A
vs
B
6.8

Support10%

7.4A
vs
B
7.0

Features & Coverage

Feature1st OptimalHealthRX
Starting Price$133/mo
Features8 features6 features
States AvailableNot disclosedNot disclosed
Compounded
Brand Name
FSA/HSA Accepted✓ Yes
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 HealthRX

HealthRX is a cash-pay telehealth program offering compounded GLP-1 injections — semaglutide and tirzepatide — at flat, dose-independent pricing with free overnight cold shipping and no insurance. A US-licensed clinician reviews a short online assessment within 24 hours and prescribes if appropriate; medication ships from a licensed 503A compounding pharmacy within 24-48 hours. HealthRX is LegitScript-certified (Cert. 50087439) and posts the FDA compounded disclaimer, but it doesn't publicly name its compounding pharmacy, list the states where it prescribes, or name a medical director.

Read our full HealthRX 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

HealthRX

What we like

  • LegitScript-certified (Cert. 50087439) and posts the FDA compounded disclaimer — real trust signals for a compounded-GLP-1 program
  • Flat, dose-independent pricing — the price doesn't rise as you titrate up; from $99/mo semaglutide and $179/mo tirzepatide on the 12-month plan
  • Free overnight cold shipping, no insurance needed, HSA/FSA eligible, and a full refund if a clinician doesn't approve you
  • One-click cancellation and a refund on any unshipped dose — no phone-call retention wall

Watch-outs

  • Doesn't publicly name its 503A compounding pharmacy — you can't independently verify that part of the supply chain
  • Doesn't list the states where it prescribes (only an 'all 50 states' shipping claim); you learn eligibility after the assessment
  • No named medical director or clinical leadership; clinicians are independent contractors, not HealthRX staff
  • Compounded semaglutide and tirzepatide only — no brand-name (Wegovy/Zepbound) or oral options
  • Compounded GLP-1s are not FDA-reviewed or approved — a different evidence and regulatory tier than brand-name

Our Verdict

Winner: HealthRX

HealthRX edges out 1st Optimal with a higher overall score of 7.3/10 and is particularly strong for flat-price compounded semaglutide or tirzepatide from a LegitScript-certified cash-pay program. 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 HealthRX if…

You want flat-price compounded semaglutide or tirzepatide from a LegitScript-certified cash-pay program and a starting price around $133/mo.

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6.9

TMates

Nationwide compounded GLP-1 availability including Puerto Rico

7.9

Trimi Health

Budget-conscious shoppers

8.0

ShedRx

Mainstream telehealth GLP-1 access

1st Optimal vs HealthRX: FAQ

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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.