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1st Optimal vs Aspen

An in-depth comparison of two leading GLP-1 Providers

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By Ruth Calder · Enforcement Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

3.9
★★☆☆☆2/5

Best for: coaching bundled into the price rather than sold separately

Visit 1st Optimal
VS
Aspen logo

Aspen

7.2
★★★3.6/5

Best for: coverage in all 50 states, which most of the register will not confirm

Visit Aspen

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Aspen starts at $279/mo, and Aspen finishes ahead, 7.2 to 3.9. What follows: the prices, what each plan actually covers, the six-dimension score, where each one is weak, and who should pick which.

Pricing

1st Optimal

Pricing not publicly listed.

Aspen

Weekly injectionCompounded
$279/mo
semaglutide

Month-to-month rate (3-month minimum commitment, 3 months shipped upfront, no credit check); drops to $229/mo (3-mo), $209/mo (6-mo) or $179/mo on the 12-month prepay plan.

Weekly injectionCompounded
$399/mo
tirzepatide

Aspen's "Most Prescribed" option; month-to-month rate drops to $329/mo (3-mo), $309/mo (6-mo) or $299/mo on the 12-month prepay plan. Same price at every dose.

What’s included

1st Optimal

Covered by the monthly price

Medication

Not stated

Clinician visits

In the price

Shipping

In the price

Lab work

Not stated

Coaching

In the price

Aspen

Covered by the monthly price

Medication

In the price

Clinician visits

In the price

Shipping

In the price

Lab work

Not stated

Coaching

Not stated

Score breakdown

Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.

1st Optimal

3.9/10

Overall

Aspen

7.2/10

Value25%

3.0A
vs
B
2.2

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
8.0

Trust & Safety15%

4.0A
vs
B
8.5

Accessibility10%

5.0A
vs
B
10.0

Support10%

5.0A
vs
B
7.0

Features & Coverage

Feature1st OptimalAspen
Starting Price$279/mo
Features8 features8 features
States AvailableNot disclosed51
Compounded✓ Yes
Brand Name
FSA/HSA Accepted
FDA WarningsNoneNone

About 1st Optimal

Neither a monthly price nor a list of states is published. 1st Optimal operates out of Michigan across telehealth and functional medicine, writing the GLP-1s semaglutide and tirzepatide either as a weekly injection or as a daily oral tablet. Around the prescription it stacks at-home lab testing, interpretation of the blood work, coaching without limit and protocols built individually, all framed as long-term weight loss and longevity. Credentialed providers work virtually, treatment goes to the home, and nothing binds you to a long contract.

Read our full 1st Optimal review →

About Aspen

Month-to-month, semaglutide is $279/mo and tirzepatide $399/mo, less on prepay, with flat pricing at every dose. Even the monthly plan requires a 3-month commitment shipped upfront. Aspen Health Systems LLC is LegitScript-certified and sells compounded semaglutide and tirzepatide as physician-chosen weekly injections, filled by Red Rock Compounding Pharmacy, which is NABP-accredited. Shipping is free and expedited, no insurance is needed, and a money-back guarantee applies to patients who complete the 28-week program. Available in all 50 states and DC.

Read our full Aspen review →

Pros & Cons

1st Optimal

What we like

  • The monthly figure covers consult, shipping, coaching
  • No FDA warning letter matched this operator when we searched our enforcement register
  • A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
  • Baseline bloodwork is required before a prescription

Watch-outs

  • No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
  • No state list is on record here, so whether it serves your state cannot be confirmed from this page
  • No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here

Aspen

What we like

  • Publishes a price on its own site before the medical questionnaire, so it can be compared without handing over health information
  • The monthly price is recorded as flat across doses, so it does not climb as the dose is titrated up
  • The monthly figure covers medication, consult, shipping
  • Coverage is published for all 50 states
  • No FDA warning letter matched this operator when we searched our enforcement register

Watch-outs

  • Semaglutide at $279 a month, 48% above the $189 register median for the same drug and form
  • Tirzepatide at $399 a month, 49% above the $267 register median for the same drug and form
  • No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
  • Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality

Our Verdict

Winner: Aspen

Aspen takes it, 7.2 against 3.9, and it is especially strong on coverage in all 50 states, which most of the register will not confirm. 1st Optimal is no weak second and may fit you better on coaching bundled into the price rather than sold separately.

Choose 1st Optimal if…

You want coaching bundled into the price rather than sold separately.

Choose Aspen if…

You want coverage in all 50 states, which most of the register will not confirm and an opening price near $279 a month.

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Trimi Health

Knowing which pharmacy fills the vial — it names VialsRx

8.5

Strut Health

Semaglutide at $99/month, 48% under the register median

7.9

Oak

Semaglutide at $119/month, 37% under the register median

1st Optimal vs Aspen: FAQ

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