1st Optimal vs Fifty 410
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Fifty 410
Best for: semaglutide at $99/month, 50% under the register median
Visit Fifty 410 →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Fifty 410 starts at $99/mo, and Fifty 410 finishes ahead, 7.9 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.
Fifty 410
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
Fifty 410
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
Fifty 410
7.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Fifty 410 |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | ✓None | 1 warning |
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 Fifty 410
Pricing is public and transparent: compounded semaglutide from 99 dollars a month, a tirzepatide starter at 133 dollars a month, and a high-dose tier above those. There is no membership; billing is pay-as-you-go. Shipping is free and lands in one to two days, after a provider review that takes 24 to 48 hours. Licensed providers prescribe the personalized medication and FDA-registered 503A and 503B pharmacies prepare it. Fifty 410 is cash-pay only and bills no insurance directly, but takes Affirm, Afterpay and FSA/HSA.
Read our full Fifty 410 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
Fifty 410
What we like
- Semaglutide at $99 a month, 48% below the $189 median for the same drug and form across this register
- Tirzepatide at $133 a month, 50% below the $267 median for the same drug and form across this register
- Publishes a price on its own site before the medical questionnaire, so it can be compared without handing over health information
- The monthly figure covers medication, consult, shipping
Watch-outs
- 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
- 1 FDA warning letter matched to this operator in our enforcement register — read what the letter alleges, since a letter discloses a problem rather than disqualifying a seller
- 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
Fifty 410 takes it, 7.9 against 3.9, and it is especially strong on semaglutide at $99/month, 50% under the register median. 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 Fifty 410 if…
You want semaglutide at $99/month, 50% under the register median and an opening price near $99 a month.
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Oak
Semaglutide at $119/month, 37% under the register median
From $119/mo
Get started →Found
Tirzepatide at $169/month, 37% under the register median
From $99/mo
Get started →Telos Rx
Starting below a standard dose, with microdose tiers
From $49/mo
Get started →1st Optimal vs Fifty 410: FAQ
Glossary
The words sellers use, defined. Tap any term.
- 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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Or see the full category ranking.
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