1st Optimal vs Livbetr
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 →
Livbetr
Best for: people who want compounded semaglutide or tirzepatide with phone support and a flat price at every dose
Visit Livbetr →1st Optimal and Livbetr 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 1st Optimal edges ahead overall (6.7 vs 6.6 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.
Livbetr
Charged every 21 days (up to 18 charges in the first year). Prepaid plans: 3 months $267, 6 months $438, 12 months $588
Charged every 21 days (up to 18 charges in the first year). Prepaid plans: 3 months $378, 6 months $738, 12 months $1,068
Brand price as listed on the home page
Brand price as listed on the home page
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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
Livbetr
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
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
Livbetr
6.6/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Livbetr |
|---|---|---|
| Starting Price | $99/mo | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | ✓ Yes |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 Livbetr
Livbetr is a Miami telehealth company that sells compounded semaglutide and tirzepatide, plus brand Ozempic and Zepbound, with prescribing by OpenLoop Health clinicians. The month-to-month plans cost $99 for semaglutide and $129 for tirzepatide at checkout, but they renew every 21 days rather than once a month. The $49 and $89 home-page prices are 12-month plans paid upfront.
Read our full Livbetr 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
Livbetr
What we like
- Names its medical group, OpenLoop Health, in its terms and privacy notice
- Checkout states the same price at every prescribed dose for both compounded drugs
- The refund policy promises a full automatic refund if the clinician does not approve treatment
- Publishes a phone line and support hours of 9am to 10pm Eastern, Monday through Saturday
- Cancellation works by phone, voicemail, email or portal message, with no retention call required
- Free overnight shipping and a 1:1 care coach are included in every plan
Watch-outs
- The month-to-month plan renews every 21 days, so a year can bring up to 18 charges rather than 12
- The home page says compounded doses ship every 4 weeks, which does not match the 21-day billing in the policy
- The $49 and $89 home-page prices are 12-month plans paid upfront at $588 and $1,068
- The Trustpilot rating shown on the site belongs to a different company, WellMedr, whose intake form Livbetr also uses
- Trustpilot says it removed the Livbetr profile for going against its guidelines
- Checkout promises a refund if you do not reach your goal, but the refund policy excludes lack of results
- The dispensing pharmacy is not named before you buy
- The intake projects a loss of 3.75 to 5 pounds a week, faster than the rapid-loss warning in its own disclosures
Our Verdict
1st Optimal edges out Livbetr with a higher overall score of 6.7/10 and is particularly strong for GLP-1 therapy within a lab-driven functional-medicine program. Livbetr remains a solid alternative, especially if you're looking for people who want compounded semaglutide or tirzepatide with phone support and a flat price at every dose.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Livbetr if…
You want people who want compounded semaglutide or tirzepatide with phone support and a flat price at every dose and a starting price around $99/mo.
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Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →GobyMeds
Budget-conscious shoppers
From $93/mo
Get started →Ivim Health
Budget-conscious shoppers
From $75/mo
Get started →1st Optimal vs Livbetr: 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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