1st Optimal vs Sesame Care
An in-depth comparison of two leading GLP-1 Providers
WeightLossRankings.org is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more
1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programSesame Care
Best for Brand-name GLP-1s (Wegovy, Zepbound) at LillyDirect/NovoCare cash prices — no compoundingStarting at $25/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Sesame Care |
|---|---|---|
| Overall Score | 6.7/10 | ✓7.5/10 |
| Starting Price | — | $25/mo |
| Editorial Rating | 3.4 ★ /5 | ✓3.8 ★ /5 |
| Features | 8 features | 8 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
Sesame Care
Pros
- ✓Marketplace transparency — pick a named provider with a displayed price before booking, unlike most opaque telehealth intake
- ✓BBB-accredited and LegitScript-verified
- ✓LillyDirect partnership unlocks Zepbound vial and KwikPen cash pricing matching Lilly's lowest direct rates ($299 at lowest dose)
- ✓Wegovy self-pay promo ($199/mo for first two months, lowest dose, new self-pay) — among the lowest brand-Wegovy cash prices, through 2026-06-30
- ✓Honest subscription scope — clinical care only, medication billed separately
- ✓Stocks both Wegovy pill ($149/mo low doses) and Foundayo orforglipron alongside injectables
- ✓Lab work included in subscription for 41 states (excludes AZ/HI/ND/NJ/NY/OK/RI/SD/WY)
- ✓Insurance route ($25/mo possible) is viable — providers assist with prior authorization
Cons
- ✗Marketplace model means clinician credentials and quality vary provider to provider
- ✗Statewide availability can't be listed — it depends on which marketplace providers are licensed in your state
- ✗No in-house pharmacy — fulfillment splits across LillyDirect, NovoCare, and your retail pharmacy
- ✗Restrictive refunds — full refund only if you cancel 3+ hours before the first visit; no refund once the visit occurs
- ✗Subscription commitment required — no genuine pay-per-visit option for weight loss
- ✗Wegovy $199/mo promo applies only to new self-pay patients at the lowest dose; $349/mo after month 2
- ✗Wegovy pill high doses ($299/mo for 9mg/25mg) cost about 2x the low-dose price as you titrate up
- ✗Zepbound KwikPen high doses ($699/mo for 10–15mg) approach Lilly's list price
Our Verdict
Sesame Care edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for Brand-name GLP-1s (Wegovy, Zepbound) at LillyDirect/NovoCare cash prices — no compounding. 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
Related comparisons
Continue exploring 1st Optimal and Sesame Care head-to-heads in the same category.
- 1st Optimal vs CoreAge Rx
- 1st Optimal vs TrimRx
- 1st Optimal vs Amazon One Medical
- Sesame Care vs NovoCare Pharmacy
- Sesame Care vs Vytora Health
- Sesame Care vs Enhance MD
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.