Price and states served both move. Read them off the seller's own site before you enroll.How our reviews work →

1st Optimal vs MDExam

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

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

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
MDExam logo

MDExam

4.1
★★☆☆☆2.1/5

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

Visit MDExam

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, MDExam finishes ahead, 4.1 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.

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

MDExam

Covered by the monthly price

Medication

In the price

Clinician visits

In the price

Shipping

Not stated

Lab work

Not stated

Coaching

In the price

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

MDExam

4.1/10

Value25%

3.0A
vs
B
3.0

Effectiveness25%

5.0A
vs
B
5.0

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
5.0

Features & Coverage

Feature1st OptimalMDExam
Starting Price
Features8 features2 features
States AvailableNot disclosedNot disclosed
Compounded
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 MDExam

MDExam is a telehealth seller offering GLP-1 medications alongside other prescription services.

Read our full MDExam 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

MDExam

What we like

  • The monthly figure covers medication, consult, coaching
  • 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

Our Verdict

Winner: MDExam

MDExam takes it, 4.1 against 3.9, and it is especially strong on coaching bundled into the price rather than sold separately. 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 MDExam if…

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

Ready to start? Vetted GLP-1 providers

Vetted telehealth providers that prescribe GLP-1 online.

No insurance needed · vetted by our editors

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 MDExam: FAQ

Glossary

The words sellers use, defined. Tap any term.

Continue exploring 1st Optimal and MDExam head-to-heads in the same category.

Or see the full category ranking.

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.