1st Optimal vs Velvet Rx
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 →
Velvet Rx
Best for: cash-pay compounded GLP-1 with bundled shipping across three SKUs
Visit Velvet Rx →1st Optimal and Velvet Rx 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, Velvet Rx starts at $139/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
Pricing not publicly listed.
Velvet Rx
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What’s included
1st Optimal
Inclusions not disclosed.
Velvet Rx
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
Velvet Rx
6.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Velvet Rx |
|---|---|---|
| Starting Price | — | $139/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 Velvet Rx
Velvet Rx (velvetrx.com) is a cash-pay telehealth platform offering compounded semaglutide, compounded tirzepatide, and an oral GLP-1 across three publicly-listed SKUs ranging from $139 to $199 'today' (first-month promo) with regular monthly prices of $299 / $359 / $349. Plans bundle a doctor consult, written prescription, 4 weeks of medication, free 1-2 day shipping, and 24/7 medical team access. Cash only; FSA/HSA eligible.
Read our full Velvet Rx 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
Velvet Rx
What we like
- Public pricing across 3 SKUs (semaglutide $299, tirzepatide $359, oral GLP-1 $349) — uncommon in compounded telehealth
- First-month promo pricing shown upfront ($139 sema / $199 tirz / $189 oral)
- Single monthly price includes consult, prescription, 4 weeks of medication, and free 1–2 day shipping
- FSA/HSA eligible
- Three options under one roof: injectable sema, injectable tirz, and an oral GLP-1
- Fully cash-pay with no membership fee
Watch-outs
- Oral GLP-1 SKU doesn't name the specific drug — a real gap given Rybelsus, Foundayo, and compounded oral semaglutide differ clinically
- No LegitScript or NABP .pharmacy seal displayed
- No legal entity name disclosed
- No physical address disclosed
- Compounding pharmacy partner not named
- States served not listed
- Pricing display is internally inconsistent — headline promo math doesn't match the pricing card
- Marketing cites unverifiable success percentages with no methodology or sample size
Our Verdict
Both 1st Optimal and Velvet Rx score equally well overall — the right choice depends on your priorities.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Velvet Rx if…
You want cash-pay compounded GLP-1 with bundled shipping across three SKUs and a starting price around $139/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 Velvet Rx: 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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