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1st Optimal vs FitRx

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
FitRx logo

FitRx

7.6
★★★3.8/5

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

Visit FitRx

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, FitRx starts at $151/mo, and FitRx finishes ahead, 7.6 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.

FitRx

Brand GLP-1 with insuranceBrand-name
$25/mo
semaglutide

With insurance coordination

Compounded Semaglutide (quarterly)Compounded
$151/mo
semaglutide

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

FitRx

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

FitRx

7.6/10

Value25%

3.0A
vs
B
6.6

Effectiveness25%

5.0A
vs
B
9.0

User Experience15%

2.0A
vs
B
8.0

Trust & Safety15%

4.0A
vs
B
5.5

Accessibility10%

5.0A
vs
B
10.0

Support10%

5.0A
vs
B
7.0

Features & Coverage

Feature1st OptimalFitRx
Starting Price$151/mo
Features8 features8 features
States AvailableNot disclosed51
Compounded✓ Yes
Brand Name✓ Yes
FSA/HSA Accepted
FDA WarningsNone1 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 FitRx

Insurance coordination at FitRx can bring brand-name GLP-1s down to $25/month, and four are on offer: Mounjaro, Zepbound, Wegovy, and Ozempic. Skip insurance and compounded semaglutide starts at $151/month. DC and all 50 states are covered, and the platform holds LegitScript certification.

Read our full FitRx 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

FitRx

What we like

  • Semaglutide at $151 a month, within the normal band around this register's $189 median for the same drug and form
  • 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
  • Coverage is published for all 50 states

Watch-outs

  • 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 is compounded rather than FDA-approved, so it has not been reviewed by the agency for safety, effectiveness or manufacturing quality

Our Verdict

Winner: FitRx

FitRx takes it, 7.6 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 FitRx if…

You want coverage in all 50 states, which most of the register will not confirm and an opening price near $151 a month.

Ready to start? Vetted GLP-1 providers

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Some of the links on this page earn us money. If you sign up with a provider after following one, that provider may pay GLP Watchdog a commission. Learn more

7.0

MyDrHank

An oral route if you will not self-inject

6.0

SkinnyRx

Starting below a standard dose, with microdose tiers

8.2

YourEra

Semaglutide at $99/month, 63% under the register median

1st Optimal vs FitRx: FAQ

Glossary

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Novo Nordisk A/S owns the Wegovy®, Ozempic® and Rybelsus® marks; Eli Lilly and Company owns Mounjaro® and Zepbound®. Every other product name and mark on this page belongs to whoever owns it. No pharmaceutical manufacturer is affiliated with GLP Watchdog. See trademark disclaimer.