1st Optimal vs Open Water Rx
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
1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Open Water Rx starts at $249/mo, and Open Water Rx finishes ahead, 6.7 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.
Open Water Rx
Regular $249/mo; $159/mo shown on /pricing and /get-started with code SEMASUMMER. All-inclusive of provider review, medication if prescribed and shipping.
Regular $339/mo; $219/mo with code FOUNDER, which the site describes as locked in 'for life'. A lower-dose titration program is $179/mo and an oral GLP-1 option $279/mo; neither names its molecule, so neither is recorded as a drug row.
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
Open Water 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
Open Water Rx
6.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Open Water Rx |
|---|---|---|
| Starting Price | — | $249/mo |
| Features | ✓8 features | 0 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
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 Open Water Rx
Open Water Rx describes itself as a telehealth platform for GLP-1 weight loss and longevity, per its own site. Nothing else is surfaced publicly: not the medications, the pricing, the states served, the pharmacy partner or the clinical leadership. This entry exists mainly to confirm the brand and its category. Verify specifics directly with the seller before enrolling.
Read our full Open Water 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
Open Water Rx
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
- 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
Open Water Rx takes it, 6.7 against 3.9, and it is especially strong on compounded semaglutide at $249/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 Open Water Rx if…
You want compounded semaglutide at $249/month and an opening price near $249 a month.
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
YourEra
Semaglutide at $99/month, 63% under the register median
From $99/mo
Get started →Gala
Moving between compounded and brand without changing seller
From $129/mo
Get started →Trimi Health
Knowing which pharmacy fills the vial — it names VialsRx
From $99/mo
Get started →1st Optimal vs Open Water Rx: FAQ
Glossary
The words sellers use, defined. Tap any term.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
Related comparisons
Continue exploring 1st Optimal and Open Water Rx head-to-heads in the same category.
- 1st Optimal vs Trimi Health
- 1st Optimal vs Embody
- 1st Optimal vs He & She MD
- Open Water Rx vs Lean Meds
- Open Water Rx vs NextMeds
- Open Water Rx vs bmiMD
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.