1st Optimal vs OnlyRx
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 →
OnlyRx
Best for: compounded GLP-1 in oral-tablet and injection with named prescribers
Visit OnlyRx →1st Optimal and OnlyRx 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 $179/mo, and 1st Optimal edges ahead overall (6.7 vs 6.4 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.
OnlyRx
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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
OnlyRx
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
OnlyRx
6.4/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | OnlyRx |
|---|---|---|
| Starting Price | ✓$99/mo | $179/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | — |
| 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 OnlyRx
OnlyRx is a cash-pay GLP-1 telehealth platform offering compounded semaglutide and tirzepatide in both injection and oral disintegrating tablet (ODT) forms — an uncommon needle-free option. It names its prescribers and a four-pharmacy fulfillment network, and offers brand-name GLP-1s when prescribed. Available in all 50 states with Buy Now Pay Later; compounded semaglutide injection starts at $179/mo on a summer promo.
Read our full OnlyRx 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
OnlyRx
What we like
- Four-pharmacy network: Belmar, Strive, Epiq Scripts, and Casa Pharma RX
- Named prescribers on the public site: Dr. Carr (MD), Dr. Tenbrink (MD), Dr. Italia (MD), Dr. Mansour (DO)
- Oral disintegrating tablet (ODT) form for both semaglutide and tirzepatide — good for needle-averse patients
- Pricing, drug list, pharmacy partners, and physician roster all visible on the public site
- LegitScript Certified
- Brand-name Ozempic, Wegovy, Zepbound, and Mounjaro available alongside the compounded line
Watch-outs
- Promo pricing ($179 semaglutide injection) is prominent, but post-promo maintenance pricing isn't shown
- No titration-ladder pricing — you can't see costs at 1.0 mg or 2.4 mg maintenance
- Refund / cancellation policy not stated on the homepage
- Lab-work requirement not stated
- Operating corporate entity not disclosed
- Epiq Scripts is the one named pharmacy partner not yet independently verified
Our Verdict
1st Optimal edges out OnlyRx with a higher overall score of 6.7/10 and is particularly strong for GLP-1 therapy within a lab-driven functional-medicine program. OnlyRx remains a solid alternative, especially if you're looking for compounded GLP-1 in oral-tablet and injection with named prescribers.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose OnlyRx if…
You want compounded GLP-1 in oral-tablet and injection with named prescribers and a starting price around $179/mo.
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Try Ageless
Lowest-tier compounded GLP-1 in injection, troche and sublingual forms
From $119/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 OnlyRx: 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.