1st Optimal vs Metabolic Rx
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 →
Metabolic Rx
Best for: people who want a flat price at every dose and can prepay for compounded semaglutide or tirzepatide
Visit Metabolic Rx →1st Optimal and Metabolic Rx 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 $229/mo, and 1st Optimal edges ahead overall (6.7 vs 6.3 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.
Metabolic Rx
$159 first month, then $259. A 3-month plan is $449 and a 6-month plan $849, each charged upfront
$149 first month, then $329. A 3-month plan is $597 and a 6-month plan $1,099, each charged upfront
$149 first month, then $229. Prepaid plans are shown at $166 a month for 3 months and $149 a month for 6 months
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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
Metabolic Rx
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
Metabolic Rx
6.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Metabolic Rx |
|---|---|---|
| Starting Price | ✓$99/mo | $229/mo |
| Features | ✓8 features | 7 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 Metabolic Rx
Metabolic Rx is a telehealth platform launched in 2026 that sells compounded semaglutide and tirzepatide injections and a daily oral semaglutide, with one flat price at every dose. Monthly plans renew at $259 for semaglutide and $329 for tirzepatide after a discounted first month of $159 or $149. The company does not name its medical group, pharmacies or the business behind it.
Read our full Metabolic Rx 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
Metabolic Rx
What we like
- One flat price at every dose, with medication, physician review, coaching and shipping included
- Discounted first month: $159 for semaglutide and $149 for tirzepatide
- Prepaying lowers semaglutide to about $142 to $150 a month and tirzepatide to $183 to $199 a month
- Offers a daily oral semaglutide option as well as weekly injections
- Refund if the prescribing clinician declines treatment or the order has not shipped
- Publishes a support phone number with weekday hours
Watch-outs
- The site does not name the company behind it, its medical group or the pharmacies that fill prescriptions
- Its privacy policy lists a placeholder mailing address rather than a real one
- Monthly plans renew at $259 for semaglutide and $329 for tirzepatide after the discounted first month
- The intake says you are approved before any clinician reviews it, then runs a 15-minute countdown at checkout
- You pay at checkout before a physician reviews your answers, and you must agree to calls and texts to continue
- The 3- and 6-month plans are charged upfront, though checkout says you pay one month at a time
- Its Trustpilot and Google rating badges could not be traced; there is no Trustpilot profile or LegitScript seal
- The cancellation notice period is unclear: 48 hours in the terms but 30 days in the FAQ
Our Verdict
1st Optimal edges out Metabolic Rx with a higher overall score of 6.7/10 and is particularly strong for GLP-1 therapy within a lab-driven functional-medicine program. Metabolic Rx remains a solid alternative, especially if you're looking for people who want a flat price at every dose and can prepay for compounded semaglutide or tirzepatide.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Metabolic Rx if…
You want people who want a flat price at every dose and can prepay for compounded semaglutide or tirzepatide and a starting price around $229/mo.
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Get started →1st Optimal vs Metabolic Rx: 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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