1st Optimal vs Rx.com
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 →
Rx.com
Best for: month-to-month compounded GLP-1s at one flat price per dose, with the pharmacy named
Visit Rx.com →1st Optimal and Rx.com 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 $175/mo, and Rx.com edges ahead overall (7.6 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.
Rx.com
'1 month $175 per month'. Longer plans are one upfront charge: 3 months $495 ($165/mo), 6 months $875 ($146/mo). Checkout fine print says billing continues every 28 days.
'1 month $285 per month'. Longer plans are one upfront charge: 3 months $795 ($265/mo), 6 months $1,550 ($259/mo). Checkout fine print says billing continues every 28 days.
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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
Rx.com
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
Rx.com
7.6/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Rx.com |
|---|---|---|
| Starting Price | ✓$99/mo | $175/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 49 |
| Compounded | — | ✓ Yes |
| 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 Rx.com
Rx.com, a San Antonio-based prescription-savings and online-care site, now runs its own GLP-1 program: compounded semaglutide at $175/mo or tirzepatide at $285/mo on a one-month plan, with lower monthly rates on three- and six-month plans paid upfront. One price covers the provider visit, medication at any dose, supplies and shipping. Care comes through the MD Integrations provider network, and Manifest Pharmacy in South Carolina fills prescriptions.
Read our full Rx.com 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
Rx.com
What we like
- Prices are posted before any intake: semaglutide $175/mo and tirzepatide $285/mo month to month, the same at every dose
- Names its dispensing pharmacy (Manifest Pharmacy, Greer, SC) and its provider network (MD Integrations)
- One price covers the provider visit, follow-ups, medication, syringes, alcohol pads and shipping
- No membership, visit, dose-upcharge or shipping fees
- Six-month plans lower the rate to $146/mo for semaglutide and $259/mo for tirzepatide, paid as one charge
- Full refund if the provider decides treatment is not right for you
- Displays a LegitScript seal served from LegitScript's own servers, not a self-hosted image
- Serves 49 states; Alaska is the only state turned away
Watch-outs
- Plan pages promise 'No automatic renewals,' but the checkout fine print says billing continues every 28 days
- On six-month plans that checkout text reads as if the full $875 or $1,550 repeats monthly, an apparent template error
- A second program page still lists older prices ($179.99 first month, then $279.99/mo) that don't match the plan picker
- Medication sales are final once shipped, and no policy covers unshipped months if you cancel a prepaid plan
- No phone number is published, though checkout promises '24/7 support via email or phone'
- The refund policy says Rx.com does not ship refrigerated products, while the program promises cold-packed shipping
- New program with almost no outside review history: its Trustpilot profile has a single review
- Compounded semaglutide and tirzepatide are not FDA-approved
Our Verdict
Rx.com edges out 1st Optimal with a higher overall score of 7.6/10 and is particularly strong for month-to-month compounded GLP-1s at one flat price per dose, with the pharmacy named. 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 Rx.com if…
You want month-to-month compounded GLP-1s at one flat price per dose, with the pharmacy named and a starting price around $175/mo.
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Get started →1st Optimal vs Rx.com: 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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