1st Optimal vs NowPatient
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 →
NowPatient
Best for: Brand-name GLP-1 access without a compounded route
Visit NowPatient →1st Optimal and NowPatient 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, both start around $99/mo, and NowPatient edges ahead overall (6.9 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.
NowPatient
Lowest strength, smallest pack. A separate $75.00 line appears at checkout.
Lowest strength, smallest pack. A separate $75.00 line appears at checkout.
30 tablets at the lowest strength. A separate $20.00 line appears at checkout.
Smallest pack. A separate $75.00 line appears at checkout.
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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
NowPatient
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
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
NowPatient
6.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | NowPatient |
|---|---|---|
| Starting Price | $99/mo | $99/mo |
| Features | ✓8 features | 2 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | — |
| Brand Name | ✓ Yes | ✓ 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 NowPatient
NowPatient is a US-UK telehealth platform offering brand-name GLP-1 weight management access including Mounjaro, Wegovy (injection and oral tablet), and Saxenda. Consultations are free and patients pay only the cost of the prescribed medication, which means out-of-pocket tracks brand list prices (~$1,000-$1,350/mo without insurance). HQ Austin, TX.
Read our full NowPatient 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
NowPatient
What we like
- Free telehealth consultation — you only pay for the medication
- Brand-name Mounjaro, Wegovy injection, Wegovy oral tablet, and Saxenda all available
- One of the few platforms offering Wegovy in both injection and oral pill form
- No compounded options — every drug is FDA-approved brand-name
Watch-outs
- Cash-pay pricing tracks full brand list price (~$1,000–$1,350/mo)
- No compounded semaglutide or tirzepatide (usually the cheaper route)
- State availability determined during intake, not shown upfront
- Does not offer Foundayo (orforglipron)
Our Verdict
NowPatient edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for Brand-name GLP-1 access without a compounded route. 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 NowPatient if…
You want Brand-name GLP-1 access without a compounded route and a starting price around $99/mo.
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SkinnyRx
Mainstream telehealth GLP-1 access
From $149.25/mo
Get started →Sunlight
Compounded GLP-1 with unlimited telehealth visits and free shipping
From $88/mo
Get started →MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →1st Optimal vs NowPatient: 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.