1st Optimal vs Nova MD
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 MD
Best for: lowest 3-month compounded pricing with an explicit microdose program
Visit Nova MD →1st Optimal and Nova MD 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 $125/mo, and Nova MD edges ahead overall (7.3 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 MD
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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 MD
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 MD
7.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Nova MD |
|---|---|---|
| Starting Price | ✓$99/mo | $125/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | ✓None | 1 warning |
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 MD
Nova MD is a telehealth platform offering compounded semaglutide and tirzepatide on 1-month and 3-month plans, with an uncommon explicit microdose program for both molecules. All four GLP-1 prices are posted publicly, alongside sermorelin, NAD+, glutathione, and enclomiphene. Compounded semaglutide runs as low as $125/month on the 3-month plan and tirzepatide $199/month, with $50 off the first tirzepatide order.
Read our full Nova MD 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 MD
What we like
- 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
Watch-outs
- 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 7.3/10 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 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 MD if…
You want lowest 3-month compounded pricing with an explicit microdose program and a starting price around $125/mo.
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MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →Breeze Meds
Compounded GLP-1 access with named prescribers and 4-pharmacy network
From $199/mo
Get started →1st Optimal vs Nova MD: 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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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.