1st Optimal vs MDExam
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 MDExam 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 $225/mo, and MDExam 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.
MDExam
⛔ MDEXAM PUBLISHES TWO DIFFERENT PRICES FOR THIS SAME PRODUCT. /injectable-semaglutide renders 'Semaglutide Weight Loss Program | Price | $192' with NO billing period stated anywhere, while /medications/injectable-semaglutide renders 'Price | $225' for the identical product. We record $225 because it is the ONLY figure the site ever attaches to a period: 'Our program is priced as low as $225 per month, which includes telemedicine visits, nutrition and exercise coaching, and medication.' Treat $192 as an unlabelled promotional figure until a checkout can be walked — /checkout renders an empty body without a session.
'Injectable Tirzepatide Program | Price | $258'. ⚠ NO BILLING PERIOD IS STATED ON THIS CARD EITHER. It is recorded as monthly on the strength of the site-wide FAQ, which frames the whole program as 'as low as $225 per month ... includes telemedicine visits, nutrition and exercise coaching, and medication' — $258 sits above that floor, consistent with a monthly tirzepatide rate. That is an inference from the program framing, not a quoted period, and it should be re-checked at checkout.
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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
MDExam
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
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
MDExam
7.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | MDExam |
|---|---|---|
| Starting Price | ✓$99/mo | $225/mo |
| Features | ✓8 features | 2 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ 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 MDExam
Telehealth provider whose GLP-1 program bundles telemedicine visits, nutrition and exercise coaching and the medication into one price — stated as as low as $225 per month for semaglutide and $258 for tirzepatide. Note the site publishes a second, lower figure for semaglutide on a different page without saying what period it covers.
Read our full MDExam 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
MDExam
What we like
- Both semaglutide and tirzepatide available
Watch-outs
- Pricing not publicly disclosed
Our Verdict
MDExam edges out 1st Optimal with a higher overall score of 7.1/10 and is particularly strong for mainstream telehealth GLP-1 access. 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 MDExam if…
You want mainstream telehealth GLP-1 access and a starting price around $225/mo.
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Direct Meds
Listed for disclosure only — see its FDA warning and BBB complaints first
From $249/mo
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From $199.99/mo
Get started →Sesame Care
Brand-name GLP-1s at cash prices, no compounding
From $25/mo
Get started →1st Optimal vs MDExam: 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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