1st Optimal vs Refills
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 →
Refills
Best for: single account across GLP-1, ED and hair-growth telehealth
Visit Refills →1st Optimal and Refills 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 $150/mo, and Refills 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.
Refills
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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
Refills
What the monthly price covers
Medication
Not disclosed
Provider visits
Not disclosed
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
Refills
6.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Refills |
|---|---|---|
| Starting Price | ✓$99/mo | $150/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | — |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| 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 Refills
Refills (refills.com) is a LegitScript-certified online pharmacy and telehealth platform offering compounded GLP-1 weight-loss prescriptions (semaglutide, tirzepatide) alongside ED, hair growth, and daily wellness treatments. Provider claims operation across all 50 US states (with documented exclusion of certain regions). Pricing is gated behind the intake; site is Webflow-hosted with dynamic content. Free shipping; no insurance needed.
Read our full Refills 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
Refills
What we like
- 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
Watch-outs
- 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 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 Refills if…
You want single account across GLP-1, ED and hair-growth telehealth and a starting price around $150/mo.
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Maximus
Men seeking compounded GLP-1 alongside testosterone optimization
From $199.99/mo
Get started →Sesame Care
Brand-name GLP-1s at cash prices, no compounding
From $25/mo
Get started →Try Ageless
Lowest-tier compounded GLP-1 in injection, troche and sublingual forms
From $119/mo
Get started →1st Optimal vs Refills: 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.