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1st Optimal vs MediRX

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
MediRX logo

MediRX

7.7
★★★3.9/5

Best for: compounded semaglutide at $149/month

Visit MediRX

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, MediRX starts at $149/mo, and MediRX finishes ahead, 7.7 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.

MediRX

Injectablecompounded injection
$149/mo
semaglutide

Starting at; $120 off first month, as low as $70 first month on the 6-month plan

Injectablecompounded injection
$199/mo
tirzepatide

Starting at; $239-$249/mo after on shorter plans, $120 off first month

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

MediRX

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

MediRX

7.7/10

Value25%

3.0A
vs
B
7.1

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
8.0

Trust & Safety15%

4.0A
vs
B
6.5

Accessibility10%

5.0A
vs
B
5.0

Support10%

5.0A
vs
B
7.0

Features & Coverage

Feature1st OptimalMediRX
Starting Price$149/mo
Features8 features8 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 MediRX

Injections of compounded semaglutide start at $149/month, tirzepatide at $199/month, and NAD+ plus a name-brand GLP-1 option are also on the list. OpenLoop Health supplies the clinical layer: a licensed provider reads your online intake, writes where appropriate, and OpenLoop's partnered US licensed pharmacies fill it. The site holds LegitScript Certified status and discloses its entity, MediRX, Inc. of Wyoming. Exactly which states it serves goes unpublished.

Read our full MediRX 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

MediRX

What we like

  • Semaglutide at $149 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
  • No FDA warning letter matched this operator when we searched our enforcement register

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
  • 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: MediRX

MediRX takes it, 7.7 against 3.9, and it is especially strong on compounded semaglutide at $149/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 MediRX if…

You want compounded semaglutide at $149/month and an opening price near $149 a month.

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9.4

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 MediRX: FAQ

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