1st Optimal vs Sesame Care
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Sesame Care
Best for: Brand-name GLP-1s (Wegovy, Zepbound) at LillyDirect/NovoCare cash prices — no compounding
Visit Sesame Care →1st Optimal and Sesame Care 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, Sesame Care starts at $59/mo, and Sesame Care edges ahead overall (8.0 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
Pricing not publicly listed.
Sesame Care
Month-to-Month $99/mo, 3-Month $39/mo, 6-Month $49/mo, Annual $59/mo; includes video visits, unlimited messaging, follow-ups, labs (savings $60/3mo, $180/6mo, $480/yr)
$199/mo first two months, new self-pay patients, lowest doses (0.25/0.5mg) only; FAQ terms state offer valid through 2026-06-30 but $199 still advertised on 2026-07-14
low doses
high doses; maintenance dose $50/mo cheaper than Wegovy injection
NEW published pricing: $199 first two months (same new-self-pay intro terms as Wegovy); 2mg is $499/mo
$399/mo for 5mg; $449/mo for 7.5mg, 10mg, 12.5mg, 15mg — unchanged vs stored
$399/mo 5mg, $499/mo 7.5mg, $699/mo 10-15mg (program page shows $398/$698 — Sesame's own pages disagree by $1)
NEW row on program page: 'Zepbound® Tirzepatide Starts at $1,086 per / mo' (retail-channel pen, distinct from LillyDirect KwikPen)
NEW published pricing: $199/mo (2.5mg), $299/mo (5.5mg, 9mg), $349/mo (14.5mg, 17.2mg); previously feature-only with no pricing row
'Price with insurance: as low as $25 per / mo.' — copay varies by plan/PA outcome
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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
Sesame Care
8.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Sesame Care |
|---|---|---|
| Starting Price | — | $59/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| 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 Sesame Care
Sesame is a transparent-pricing telehealth marketplace that connects patients directly with independent provider practices — distinct from the stocked-formulary model of most weight-loss platforms. Its weight-loss vertical is brand-name only (no compounding): a $39–$99/month subscription covers clinical care, while medication is billed separately at cash-pay rates, including Zepbound from $299 via LillyDirect and a Wegovy self-pay promo at $199/month.
Read our full Sesame Care 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
Sesame Care
What we like
- 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
- 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
Watch-outs
- 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 8.0/10 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.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Sesame Care if…
You want Brand-name GLP-1s (Wegovy, Zepbound) at LillyDirect/NovoCare cash prices — no compounding and a starting price around $59/mo.
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SkinnyRx
Mainstream telehealth GLP-1 access
From $149.25/mo
Get started →Sunlight
Compounded GLP-1 with unlimited telehealth visits and free shipping
From $159/mo
Get started →MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →1st Optimal vs Sesame Care: 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.