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1st Optimal vs MediRX

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
MediRX logo

MediRX

7.3
★★★3.7/5

Best for: people wanting LegitScript-certified compounded GLP-1 with low first-month promo pricing

Visit MediRX

1st Optimal and MediRX 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, MediRX starts at $149/mo, and MediRX 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.

MediRX

Injectablecompounded injection
$149/mo
semaglutide

Starting at; $120 off first month, as low as $70 first month on the 6-month plan

Injectablecompounded injection
$199/mo
tirzepatide

Starting at; $239-$249/mo after on shorter plans, $120 off first month

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What’s included

1st Optimal

Inclusions not disclosed.

MediRX

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

MediRX

7.3/10

Value25%

6.5A
vs
B
7.5

Effectiveness25%

7.0A
vs
B
7.0

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
7.3

Accessibility10%

6.5A
vs
B
7.5

Support10%

7.4A
vs
B
7.4

Features & Coverage

Feature1st OptimalMediRX
Starting Price$149/mo
Features8 features8 features
States AvailableNot disclosedNot disclosed
Compounded
Brand Name
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 MediRX

MediRX is a telehealth weight-loss platform offering compounded GLP-1 injections — semaglutide starting at $149/month and tirzepatide starting at $199/month — plus NAD+ and a name-brand GLP-1 option. Care runs on OpenLoop Health: a licensed provider reviews your online intake and prescribes if appropriate, with fulfillment through OpenLoop's partnered U.S. licensed pharmacies. The site is LegitScript Certified and the operating entity, MediRX, Inc. of Wyoming, is disclosed, though it doesn't publish the exact states it serves.

Read our full MediRX 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

MediRX

What we like

  • LegitScript Certified — a meaningful trust signal for an online pharmacy
  • Named operating entity disclosed (MediRX, Inc., Wyoming)
  • Care and pharmacy fulfillment run on OpenLoop Health's licensed network
  • Low promotional first-month pricing — semaglutide first month as low as $70

Watch-outs

  • Doesn't publish the exact states it serves; telehealth rules vary by state
  • Ongoing monthly price rises after the promotional first month
  • Compounded semaglutide and tirzepatide injections — limited oral options
  • Specific compounding pharmacies aren't named beyond the OpenLoop network

Our Verdict

Winner: MediRX

MediRX edges out 1st Optimal with a higher overall score of 7.3/10 and is particularly strong for people wanting LegitScript-certified compounded GLP-1 with low first-month promo pricing. 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 MediRX if…

You want people wanting LegitScript-certified compounded GLP-1 with low first-month promo pricing and a starting price around $149/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

8.1

GobyMeds

Budget-conscious shoppers

1st Optimal vs MediRX: FAQ

Key terms, explained

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