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1st Optimal vs NexLife

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
NexLife logo

NexLife

7.1
★★★3.6/5

Best for: pharmacy-quality-conscious patients seeking LegitScript + NABP-certified compounded GLP-1

Visit NexLife

1st Optimal and NexLife 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, NexLife starts at $145/mo, and NexLife 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

Pricing not publicly listed.

NexLife

Compounded Semaglutide (monthly plan)Compounded
$165/mo
semaglutide
Compounded Semaglutide (12-month plan)Compounded
$145/mo
semaglutide

Plan ladder: $165 monthly, $149/mo 3-mo, $147/mo 6-mo, $145/mo 12-mo. $145 is the 12-month-plan rate, not a promo.

Compounded Tirzepatide (monthly plan)Compounded
$215/mo
tirzepatide
Compounded Tirzepatide (12-month plan)Compounded
$186/mo
tirzepatide

Plan ladder: $215 monthly, $195/mo 3-mo, $190/mo 6-mo, $186/mo 12-mo. $186 is the 12-month-plan rate, not a promo.

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What’s included

1st Optimal

Inclusions not disclosed.

NexLife

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

Overall

NexLife

7.1/10

Value25%

6.5A
vs
B
7.0

Effectiveness25%

7.0A
vs
B
7.0

User Experience15%

6.5A
vs
B
7.0

Trust & Safety15%

6.5A
vs
B
7.3

Accessibility10%

6.5A
vs
B
7.0

Support10%

7.4A
vs
B
7.4

Features & Coverage

Feature1st OptimalNexLife
Starting Price$145/mo
Features8 features5 features
States AvailableNot disclosedNot disclosed
Compounded✓ Yes
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 NexLife

NexLife is a LegitScript-certified telehealth platform offering compounded semaglutide (from $145/mo) and compounded tirzepatide (from $186/mo). Works exclusively with LegitScript-certified, NABP-accredited pharmacies.

Read our full NexLife 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

NexLife

What we like

  • LegitScript certified platform
  • Works exclusively with LegitScript-certified, NABP-accredited pharmacies — strongest pharmacy trust signal in the dataset
  • Both semaglutide and tirzepatide at competitive pricing
  • Semaglutide from $145/mo on the 12-month plan ($165/mo month-to-month) - among the lowest in the dataset

Watch-outs

  • State availability not publicly disclosed
  • Compounded only — no brand-name options
  • Also covers hormone optimization and longevity
  • Lowest advertised rates ($145 sema / $186 tirz) require a 12-month plan commitment

Our Verdict

Winner: NexLife

NexLife edges out 1st Optimal with a higher overall score of 7.1/10 and is particularly strong for pharmacy-quality-conscious patients seeking LegitScript + NABP-certified compounded GLP-1. 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 NexLife if…

You want pharmacy-quality-conscious patients seeking LegitScript + NABP-certified compounded GLP-1 and a starting price around $145/mo.

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7.4

MadeMed

Compounded GLP-1 in both injection and oral forms

8.3

Found

Mainstream telehealth GLP-1 access

7.4

Breeze Meds

Compounded GLP-1 access with named prescribers and 4-pharmacy network

1st Optimal vs NexLife: FAQ

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