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1st Optimal vs MEDVi

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
MEDVi logo

MEDVi

7.2
★★★3.6/5

Best for: knowing which pharmacy fills the vial — it names Triad Rx

Visit MEDVi

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, MEDVi starts at $249/mo, and MEDVi finishes ahead, 7.2 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.

MEDVi

Compounded GLP-1 Injection (weekly)Compounded
$299$179/mo
Save 40% right now
semaglutide

$299 is the locked-in refill price; $179 first-month 'SUMMER Sale' on the main and affiliate-landing funnels; a $149 first-month variant runs on the ?page=multi3 funnel. Affiliate landing (?page=multi) shows $179.

Compounded GLP-1 Tablets (daily dissolvable)Compounded
$249/mo
semaglutide

Flat 'Starting at $249' — no intro discount shown.

Wegovy Pill / Wegovy Injection (membership fee only; medication cost not published)Brand-name
$99/mo
semaglutide

$99 Membership + Medication Cost — medication cost not published (varies/insurance may reimburse). 'Availability is subject to change.'

Zepbound Injection (membership fee only; medication cost not published)Brand-name
$99/mo
tirzepatide

$99 Membership + Medication Cost — medication cost not published. COMPOUNDED tirzepatide ($349 in our current entry) is no longer published anywhere on glp1.medvi.org, home.medvi.org, or the intake flow (0 mentions) — treat as discontinued/not published, do not carry the $349 row forward.

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

MEDVi

Covered by the monthly price

Medication

In the price

Clinician visits

In the price

Shipping

In the price

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

MEDVi

7.2/10

Value25%

3.0A
vs
B
3.0

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
8.0

Trust & Safety15%

4.0A
vs
B
6.0

Accessibility10%

5.0A
vs
B
9.7

Support10%

5.0A
vs
B
8.5

Features & Coverage

Feature1st OptimalMEDVi
Starting Price$249/mo
Features8 features7 features
States AvailableNot disclosed48
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 MEDVi

Two clinical groups do the treating at MEDVi: CareGLP Affiliated P.C.s, plus clinicians from OpenLoop Health. Its weight-loss menu holds compounded GLP-1s, injections and tablets alike, the molecule being semaglutide, next to Zepbound and Wegovy under their brand names. Licensed US pharmacies fill all of it.

Read our full MEDVi 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

MEDVi

What we like

  • Semaglutide at $249 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, coaching
  • Coverage is published for 48 states
  • Names 3 dispensing pharmacies, which most sellers in this register do not do

Watch-outs

  • 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: MEDVi

MEDVi takes it, 7.2 against 3.9, and it is especially strong on knowing which pharmacy fills the vial — it names Triad Rx. 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 MEDVi if…

You want knowing which pharmacy fills the vial — it names Triad Rx and an opening price near $249 a month.

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8.8

Gala

Moving between compounded and brand without changing seller

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

1st Optimal vs MEDVi: FAQ

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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.