1st Optimal vs Nova
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 →Nova
Best for: Texas and Florida readers who want needle-free GLP-1 options at an all-in price
Visit Nova →1st Optimal and Nova 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 $156/mo, and Nova edges ahead overall (7.0 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.
Nova
All-in: medication, shipping and the required Nova Care fee.
First 3 months of medication ship and bill together at $269 on provider approval.
Provider picks the strength; sublingual mg are not interchangeable with injectable mg.
All-in: medication, shipping and the required Nova Care fee.
First 2 months of medication ship and bill together at $319 on provider approval.
Daily dual GLP-1 + GIP microdose; sublingual mg are not interchangeable with injectable mg.
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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
Nova
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
Nova
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Nova |
|---|---|---|
| Starting Price | ✓$99/mo | $156/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 2 |
| 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 Nova
Nova (NovaCure LLC) is a Texas- and Florida-only telehealth platform selling compounded semaglutide and tirzepatide in three formats each — weekly injection, weekly needle-free sublingual tablet, and a daily sublingual microdose — alongside hair, sexual-health and peptide programs. Every price is all-in, covering medication, shipping and the required Nova Care fee, and the weight-loss line runs from $156 to $210 a month.
Read our full Nova 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
Nova
What we like
- Every price is all-in — medication, shipping and the required Nova Care fee are in the number you see, with no separate membership line
- Three formats per molecule: weekly injection, weekly needle-free sublingual tablet, and a daily sublingual microdose
- Six compounded GLP-1 options priced $156 to $210 a month, all shown before you pay
- States its service area plainly in the footer — Texas and Florida
- iOS and Android apps for messaging your care team and tracking orders
- Free refrigerated shipping on every order and no separate consultation fee
- Discloses clearly that the FDA does not approve compounded medications
- Tells you plainly that sublingual mg are not interchangeable with injectable mg — a real safety point most sellers skip
Watch-outs
- Only available in Texas and Florida — most readers cannot buy here at all
- The two RDT tablets bundle their first months into one upfront charge: $269 for 3 months of semaglutide, $319 for 2 months of tirzepatide
- Its pricing page splits a $99 membership from medication, but checkout charges a single all-in figure, so the two do not reconcile
- Pricing page says you're only charged if a provider prescribes; the refund policy says membership fees aren't refunded if they decline
- The refund policy still refers to patients 'located outside Texas', so it has not been updated since Florida was added
- The compounding pharmacy is described only as a state-licensed 503A facility and is never named
- Oral daily strengths are provider-selected (36 or 145 mcg) and the site does not say which you will get
Our Verdict
Nova edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for Texas and Florida readers who want needle-free GLP-1 options at an all-in price. 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 Nova if…
You want Texas and Florida readers who want needle-free GLP-1 options at an all-in price and a starting price around $156/mo.
Ready to start? Vetted GLP-1 providers
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Willow
Mainstream telehealth GLP-1 access
From $299/mo
Get started →Sesame Care
Brand-name GLP-1s at cash prices, no compounding
From $25/mo
Get started →Collective
The lowest flat medication price if you can absorb an annual membership fee
From $59/mo
Get started →1st Optimal vs Nova: 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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