1st Optimal vs RxSpan MD
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 →
RxSpan MD
Best for: physician-led, pharmacy-transparent compounded GLP-1 with brand-name options
Visit RxSpan MD →1st Optimal and RxSpan MD 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 RxSpan MD edges ahead overall (8.1 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.
RxSpan MD
Plan ladder: Monthly $249/mo, 3-mo $219/mo, 6-mo $199/mo, 12-mo $194/mo.
Plan ladder: Monthly $249/mo, 3-mo $219/mo, 6-mo $199/mo, 12-mo $179/mo.
Plan ladder: Monthly $329/mo, 3-mo $309/mo, 6-mo $289/mo, 12-mo $269/mo (Total if prescribed $927 on 3-mo).
Plan ladder: Monthly $349/mo, 3-mo $299/mo, 6-mo $289/mo, 12-mo $269/mo (Total if prescribed $897 on 3-mo).
Monthly plan only ($1,069/mo).
Monthly plan only ($1,299/mo).
Monthly plan only ($1,349/mo).
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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
RxSpan MD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
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
RxSpan MD
8.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | RxSpan MD |
|---|---|---|
| Starting Price | ✓$99/mo | $249/mo |
| Features | ✓8 features | 7 features |
| States Available | Not disclosed | 50 |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | ✓ 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 RxSpan MD
RxSpan MD is a physician-led telehealth practice founded by Dr. John Diaz, a board-certified plastic surgeon, offering compounded GLP-1 weight loss — semaglutide and tirzepatide from $249/mo, as injections or oral capsules — plus brand-name Wegovy, Zepbound and Ozempic. It's unusually transparent: it names its 503A pharmacy partners (Belmar, Strive, Epiq Scripts, Casa Pharma) and medical group, ships free, and includes unlimited 24/7 support. Available in all 50 states.
Read our full RxSpan MD 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
RxSpan MD
What we like
- Physician-led — founded by Dr. John Diaz, a board-certified plastic surgeon with 20+ years' experience
- Compounded semaglutide and tirzepatide from $249/mo (injection or oral capsules), plus brand-name Wegovy, Zepbound and Ozempic
- Names its 503A pharmacy partners (Belmar, Strive, Epiq Scripts, Casa Pharma) and medical group
- LegitScript-certified (#50405601); free expedited shipping and unlimited 24/7 support included
- Available in all 50 states via a 2-minute assessment
Watch-outs
- Compounded pricing ($249 semaglutide / $329 tirzepatide) sits mid-to-high versus the cheapest telehealth options
- Brand-name GLP-1 is priced steeply (Wegovy $1,349, Ozempic $1,299, Zepbound $1,069)
- Multi-vertical practice (also hair, sexual health, longevity), not weight-loss-only
- Legal entity name isn't published on the site
Our Verdict
RxSpan MD edges out 1st Optimal with a higher overall score of 8.1/10 and is particularly strong for physician-led, pharmacy-transparent compounded GLP-1 with brand-name options. 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 RxSpan MD if…
You want physician-led, pharmacy-transparent compounded GLP-1 with brand-name options and a starting price around $249/mo.
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Compounded semaglutide and tirzepatide at a flat monthly price
From $133/mo
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Fitness-brand compounded GLP-1 with hormone and performance programs
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Get started →1st Optimal vs RxSpan MD: 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.