1st Optimal vs Prescriva
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 →
Prescriva
Best for: people who want compounded semaglutide or tirzepatide with the pharmacy names published up front
Visit Prescriva →1st Optimal and Prescriva 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 $249/mo, and Prescriva 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.
Prescriva
Charged every 28 days (13 charges a year). 12, 24 and 48-week supplies cost $657, $1,194 and $2,327, each paid upfront
Charged every 28 days. 12, 24 and 48-week supplies cost $777, $1,434 and $2,717, each paid upfront
Charged every 28 days (13 charges a year). 12, 24 and 48-week supplies cost $927, $1,734 and $3,497, each paid upfront
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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
Prescriva
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
Prescriva
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Prescriva |
|---|---|---|
| Starting Price | ✓$99/mo | $249/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 Prescriva
Prescriva is a Sacramento telehealth platform that sells compounded semaglutide and tirzepatide, with prescribing by OpenLoop Health clinicians and three named compounding pharmacies. Plans cost $249 for semaglutide injections, $279 for semaglutide tablets and $339 for tirzepatide, charged every 4 weeks rather than monthly.
Read our full Prescriva 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
Prescriva
What we like
- Names its medical group, OpenLoop Health, and all three dispensing pharmacies with addresses in its terms
- Injection plan prices are listed on the site before you start the assessment
- The price covers the clinician visit, the medication and free priority shipping, with no separate membership fee
- Offers semaglutide as a weekly injection or a daily dissolving tablet, plus tirzepatide injections
- You get a full refund of the current charge if the clinician decides treatment is not right for you
- You can cancel or pause from your patient dashboard, with no cancellation fee
- Publishes a support phone number, and HSA or FSA cards are accepted
Watch-outs
- Plans are charged every 4 weeks, so a year brings 13 charges rather than 12, though the site says per month
- The $194 semaglutide figure is a 48-week supply paid upfront at $2,327 and divided by 12, not a monthly price
- The pricing page also shows a $109 starting price and a $289 semaglutide price that match no plan in checkout
- You pay at checkout before a clinician reviews your answers
- Refunds stop once a clinician consultation is completed or medication ships, and partial cycles are not refunded
- The intake requires you to agree to text messages before you can continue
- The intake shows an "Excellent 4.9" rating with no source, while the company's review profile has no reviews yet
- The terms say service is offered in all 50 states, but the FAQ says most states
Our Verdict
Prescriva edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for people who want compounded semaglutide or tirzepatide with the pharmacy names published up front. 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 Prescriva if…
You want people who want compounded semaglutide or tirzepatide with the pharmacy names published up front and a starting price around $249/mo.
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Lab-monitored compounded GLP-1 with mandatory video visit
From $112/mo
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Switching between compounded and brand-name GLP-1 through one provider
From $99/mo
Get started →1st Optimal vs Prescriva: 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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