1st Optimal vs Nova MD
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programNova MD
Best for lowest 3-month compounded pricing with an explicit microdose programStarting at $125/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Nova MD |
|---|---|---|
| Overall Score | 6.7/10 | ✓7.2/10 |
| Starting Price | — | $125/mo |
| Editorial Rating | 3.4 ★ /5 | ✓3.6 ★ /5 |
| Features | 8 features | 8 features |
| States Available | 0 | 0 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | None | None |
Pros & Cons
1st Optimal
Pros
- ✓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
Cons
- ✗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 MD
Pros
- ✓On-page pricing published for all four SKUs (semaglutide and tirzepatide, 1- and 3-month)
- ✓$125/mo semaglutide and $199/mo tirzepatide 3-month plans rank among the cheapest in the market
- ✓$50 off first tirzepatide order shown publicly
- ✓Explicit microdose / low-dose program for both semaglutide and tirzepatide
- ✓Broader menu (sermorelin, NAD+, glutathione, enclomiphene) for longevity alongside GLP-1
- ✓FSA/HSA eligible and cancel-anytime billing with same-day doctor review
Cons
- ✗Legal entity name and state of incorporation not disclosed
- ✗Compounding pharmacy not named — only 'accredited facilities'
- ✗LegitScript certification not confirmed (only 'Licensed US Providers' claims)
- ✗Per-state availability not listed
- ✗Compounded only — no brand-name Wegovy, Zepbound, Mounjaro, or Ozempic
- ✗Lab work and ongoing monitoring aren't clearly addressed
- ✗Patient count (1,241+) is an unverified marketing claim
Our Verdict
Nova MD edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for lowest 3-month compounded pricing with an explicit microdose program. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Glossary references
Key terms in this article, linked to their canonical definitions.
- 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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Or see the full category ranking.
Wegovy®, Ozempic®, and Rybelsus® are trademarks of Novo Nordisk A/S. Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. All other product names and trademarks referenced on this page belong to their respective owners. WeightLossRankings.org is not affiliated with any pharmaceutical manufacturer. See trademark disclaimer.