1st Optimal vs Nex Gen Health 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 →
Nex Gen Health Rx
Best for: a GLP-1 plus TRT, peptides and sexual wellness from one platform
Visit Nex Gen Health Rx →1st Optimal and Nex Gen Health 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 $190/mo, and Nex Gen Health Rx edges ahead overall (7.5 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.
Nex Gen Health Rx
Verbatim: 'Doctor-led weight loss plans starting at $190' with '0.5 mg · 30 Day Supply' selected. Longer supplies quote $171 (90-day), $426 (180-day) and $1,092 (360-day), but the site never states whether those are totals or per-month rates, so they are not recorded.
Verbatim: 'Doctor-led weight loss plans starting at $239' with '2.5 mg · 30 Day Supply' selected; the semaglutide page cross-references 'Tirzepatide Weekly dosing From $239'.
Verbatim from the product grid: 'Metformin Improves insulin sensitivity From $25'. An adjunct oral, not a GLP-1.
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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
Nex Gen Health Rx
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
Nex Gen Health Rx
7.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Nex Gen Health Rx |
|---|---|---|
| Starting Price | ✓$99/mo | $190/mo |
| Features | ✓8 features | 5 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 Nex Gen Health Rx
Nex Gen Health Rx (nexgenhealthrx.com) is a broad-menu telehealth platform selling compounded semaglutide and tirzepatide alongside metformin, injectable and oral TRT, sermorelin, NAD+, glutathione, sexual-wellness and hair-loss treatments. GLP-1 plans are flat-rate as the dose titrates and include the consultation, medication and shipping.
Read our full Nex Gen Health 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
Nex Gen Health Rx
What we like
- Flat monthly rate as the dose titrates — 'Your dose, one price — flat monthly rate with no surprises'
- One all-in price covers the online consultation, medication, syringes and alcohol pads kit, and shipping
- Unusually broad menu beyond GLP-1s: TRT, sermorelin, NAD+, glutathione, sexual wellness and hair loss
- Metformin offered from $25 as a low-cost adjunct
- Longer 90, 180 and 360-day supplies are available for patients who want fewer reorders
Watch-outs
- The 90, 180 and 360-day supply prices are shown without stating whether they are totals or per-month rates
- Compounding pharmacies are described only as 'accredited' and are never named
- No state-availability list is published
- Disputes are governed by Georgia law with arbitration in San Diego, an unusually split arrangement
Our Verdict
Nex Gen Health Rx edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for a GLP-1 plus TRT, peptides and sexual wellness from one platform. 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 Nex Gen Health Rx if…
You want a GLP-1 plus TRT, peptides and sexual wellness from one platform and a starting price around $190/mo.
Ready to start? Vetted GLP-1 providers
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Sprout Health
LegitScript-verified compounded GLP-1 via named pharmacies
From $149/mo
Get started →PeterMD
Men wanting flat-priced compounded GLP-1 with TRT or peptides
From $215.67/mo
Get started →Enhance MD
Lab-monitored compounded GLP-1 with mandatory video visit
From $112/mo
Get started →1st Optimal vs Nex Gen Health 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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