1st Optimal vs Rex MD
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Rex MD
Best for: coverage in all 50 states, which most of the register will not confirm
Visit Rex MD →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Rex MD starts at $349/mo, and Rex MD finishes ahead, 7.9 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.
Rex MD
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
Rex MD
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
Rex MD
7.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Rex MD |
|---|---|---|
| Starting Price | — | $349/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 50 |
| Compounded | — | — |
| Brand Name | — | ✓ Yes |
| 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 Rex MD
The program is a flat monthly charge of about $199, which takes in the medical intake, consultations with a provider, the prescribed drug, syringes and overnight shipping at no cost; Zepbound vials start at around $349 per month. Rex MD belongs to LifeMD, aims at men's health, and runs its weight-management program 100 percent online, prescribing brand-name semaglutide and Zepbound (tirzepatide) vials that partner pharmacies fill. Its clinicians are US-based and licensed by state, LegitScript certifies the platform, all 50 states are served, and no insurance is billed.
Read our full Rex MD 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
Rex MD
What we like
- Semaglutide at $199 a month, 85% below the $1299 median for the same drug and form across this register
- Tirzepatide at $349 a month, 72% below the $1249 median for the same drug and form across this register
- 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
- Coverage is published for all 50 states
- 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 dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
Our Verdict
Rex MD takes it, 7.9 against 3.9, and it is especially strong on coverage in all 50 states, which most of the register will not confirm. 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 Rex MD if…
You want coverage in all 50 states, which most of the register will not confirm and an opening price near $349 a month.
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Trimi Health
Knowing which pharmacy fills the vial — it names VialsRx
From $99/mo
Get started →Strut Health
Semaglutide at $99/month, 48% under the register median
From $99/mo
Get started →Oak
Semaglutide at $119/month, 37% under the register median
From $119/mo
Get started →1st Optimal vs Rex MD: 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
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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.