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1st Optimal vs ReflexMD

An in-depth comparison of two leading GLP-1 Providers

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS
ReflexMD logo

ReflexMD

7.0
★★★3.5/5

Best for: comprehensive concierge care

Visit ReflexMD

1st Optimal and ReflexMD 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 $297/mo, and ReflexMD 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

Weight Loss Care membership — medication not includedBrand-name
$99/mo
semaglutide

Care membership only — the GLP-1 medication is billed separately and is not priced.

ReflexMD

Compounded (flat-rate, all doses)Compounded
$297/mo
semaglutide
Compounded (flat-rate, all doses)Compounded
$367/mo
tirzepatide
Weight Control oral tablets (flat-rate)oral
$199/mo

ReflexMD calls this its 3-in-1 Weight Control Pill; it does not publish the ingredients.

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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

ReflexMD

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

Overall

ReflexMD

7.0/10

Value25%

6.5A
vs
B
6.0

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.0

Trust & Safety15%

6.5A
vs
B
7.3

Accessibility10%

6.5A
vs
B
7.5

Support10%

7.4A
vs
B
7.4

Features & Coverage

Feature1st OptimalReflexMD
Starting Price$99/mo$297/mo
Features8 features3 features
States AvailableNot disclosedNot disclosed
Compounded✓ Yes
Brand Name✓ Yes
FSA/HSA Accepted
FDA WarningsNoneNone

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 ReflexMD

Telehealth weight loss provider with promotional first-month pricing and flat all-inclusive program rates.

Read our full ReflexMD 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

ReflexMD

What we like

  • Both semaglutide and tirzepatide available
  • Compounded GLP-1 access
  • Flat-rate pricing: same monthly price at every dose

Our Verdict

Winner: ReflexMD

ReflexMD edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for comprehensive concierge care. 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 ReflexMD if…

You want comprehensive concierge care and a starting price around $297/mo.

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7.3

Sunlight

Compounded GLP-1 with unlimited telehealth visits and free shipping

7.4

MadeMed

Compounded GLP-1 in both injection and oral forms

8.3

Found

Mainstream telehealth GLP-1 access

1st Optimal vs ReflexMD: FAQ

1st Optimal is cheaper. Its lowest ongoing monthly cash price is $99/mo, compared with $297/mo for ReflexMD. We compare standing (not first-month promo) prices so the figures reflect what you'd actually pay month to month.
ReflexMD scores higher overall at 7.0/10 versus 6.7/10, and is particularly strong for comprehensive concierge care. That said, 1st Optimal is a better fit if you want GLP-1 therapy within a lab-driven functional-medicine program.
Neither 1st Optimal nor ReflexMD publicly lists its exact state availability. Most national GLP-1 telehealth providers operate in the majority of states — confirm your state is covered during sign-up.
Neither 1st Optimal nor ReflexMD is currently an affiliate partner, so we earn no commission from either. We rank all providers editorially using the same six-dimension framework and disclose any commercial relationships.
For Semaglutide, 1st Optimal is cheaper at $99/mo versus $297/mo at ReflexMD.

Key terms, explained

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Continue exploring 1st Optimal and ReflexMD head-to-heads in the same category.

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