1st Optimal vs SkyRx
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 →SkyRx
Best for: all-inclusive compounded semaglutide with supplies included
Visit SkyRx →1st Optimal and SkyRx 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 $199/mo, and both land at 6.7/10 overall. 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.
SkyRx
199/mo on a 12-month prepaid subscription; includes med, supplies, visit, shipping
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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
SkyRx
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
SkyRx
6.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | SkyRx |
|---|---|---|
| Starting Price | ✓$99/mo | $199/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | Not disclosed |
| 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 SkyRx
SkyRx (sky-rx.co) is a US telehealth weight-loss program offering compounded semaglutide as an injection or oral drops, with compounded tirzepatide listed as coming soon. Pricing starts at 199 dollars per month on a 12-month subscription paid upfront, and the single monthly price bundles medication, supplies, doctor visit and shipping with no insurance needed. Medication is dispensed by FDA-registered 503B compounding pharmacies. GLP-1s are not yet available in all 50 states. Support is by phone at 855-759-7979 and email; the company is based in Draper, Utah.
Read our full SkyRx 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
SkyRx
What we like
- All-inclusive 199 dollars per month covers medication, supplies, doctor visit and shipping
- Offers both injectable and oral semaglutide, dispensed by FDA-registered 503B pharmacies
- Same-day shipping for orders before 2pm ET in temperature-controlled packaging
Watch-outs
- 199 dollars pricing requires a 12-month subscription paid upfront
- Tirzepatide only listed as coming soon
- GLP-1s not yet available in all 50 states; specific states not listed
Our Verdict
Both 1st Optimal and SkyRx score equally well overall — the right choice depends on your priorities.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose SkyRx if…
You want all-inclusive compounded semaglutide with supplies included and a starting price around $199/mo.
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YourEra
$99 first-month entry pricing on compounded GLP-1s
From $149/mo
Get started →Gala
Compounded GLP-1/GIP combo on a yearly plan with free shipping
From $149/mo
Get started →TMates
Nationwide compounded GLP-1 availability including Puerto Rico
From $249/mo
Get started →1st Optimal vs SkyRx: 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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