1st Optimal vs Refills
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 programRefills
Best for single account across GLP-1, ED and hair-growth telehealthSide-by-Side Comparison
| Feature | 1st Optimal | Refills |
|---|---|---|
| Overall Score | 6.7/10 | ✓6.9/10 |
| Starting Price | — | — |
| Editorial Rating | 3.4 ★ /5 | ✓3.5 ★ /5 |
| Features | ✓8 features | 6 features |
| States Available | 0 | 0 |
| Compounded | — | — |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| 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
Refills
Pros
- ✓LegitScript Certified online pharmacy
- ✓Claims operation across all 50 states (with some exclusions)
- ✓Multi-category platform (weight loss + ED + hair growth + wellness) — single account for multiple treatments
- ✓Free shipping disclosed publicly
- ✓Cash-pay, no insurance needed
Cons
- ✗Ongoing monthly pricing for compounded semaglutide and tirzepatide not shown until after intake
- ✗Legal entity name and state of incorporation not disclosed
- ✗Compounding pharmacy partner not named
- ✗Excluded states not listed in marketing copy — verify coverage during intake
- ✗Compounded only — no brand-name GLP-1 (Wegovy, Zepbound, Mounjaro, Ozempic, Foundayo)
- ✗Lab work and ongoing-care touchpoints not clearly disclosed
Our Verdict
Refills edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for single account across GLP-1, ED and hair-growth telehealth. 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.