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1st Optimal vs LevelUp Rx

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
LevelUp Rx logo

LevelUp Rx

6.4
★★★☆☆3.2/5

Best for: compounded semaglutide at $149.97/month

Visit LevelUp Rx

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, LevelUp Rx starts at $149.97/mo, and LevelUp Rx finishes ahead, 6.4 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.

LevelUp Rx

StartingCompounded
$149.97/mo
semaglutide

1-month $149.97/mo; 6-month $809.95; 12-month $1349.97. Verified leveluprx.com/product/glp-1-medications 2026-06-19. Flat across all doses.

StartingCompounded
$249.97/mo
tirzepatide

1-month $249.97/mo; 6-month $1349.82; 12-month $2349.88. Verified leveluprx.com 2026-06-19. Flat across all doses.

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

LevelUp Rx

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

LevelUp Rx

6.4/10

Value25%

3.0A
vs
B
6.7

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
3.0

Trust & Safety15%

4.0A
vs
B
4.0

Accessibility10%

5.0A
vs
B
5.0

Support10%

5.0A
vs
B
7.0

Features & Coverage

Feature1st OptimalLevelUp Rx
Starting Price$149.97/mo
Features8 features8 features
States AvailableNot disclosedNot disclosed
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 LevelUp Rx

Dose does not move the GLP-1 price at LevelUp Rx: $149.97/mo buys compounded semaglutide, $249.97/mo compounded tirzepatide, flat either way. The online consultation costs nothing and goes to physicians board-certified in the US; once approved, accredited partner pharmacies ship without a delivery charge. This telehealth pharmacy also runs a wide catalog covering women's and men's health besides.

Read our full LevelUp Rx 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

LevelUp Rx

What we like

  • Semaglutide at $149.97 a month, within the normal band around this register's $189 median for the same drug and form
  • 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
  • No FDA warning letter matched this operator when we searched our enforcement register

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
  • 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: LevelUp Rx

LevelUp Rx takes it, 6.4 against 3.9, and it is especially strong on compounded semaglutide at $149.97/month. 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 LevelUp Rx if…

You want compounded semaglutide at $149.97/month and an opening price near $149.97 a month.

Ready to start? Vetted GLP-1 providers

Vetted telehealth providers that prescribe GLP-1 online.

No insurance needed · vetted by our editors

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7.9

Oak

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

8.8

Found

Tirzepatide at $169/month, 37% under the register median

8.3

Telos Rx

Starting below a standard dose, with microdose tiers

1st Optimal vs LevelUp Rx: FAQ

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