1st Optimal vs RxSpan 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 →
RxSpan MD
Best for: knowing which pharmacy fills the vial — it names Belmar Pharmacy
Visit RxSpan MD →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, RxSpan MD starts at $249/mo, and RxSpan MD finishes ahead, 6.8 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.
RxSpan MD
Plan ladder: Monthly $249/mo, 3-mo $219/mo, 6-mo $199/mo, 12-mo $194/mo. Card labeled '(For the first month)'; plan picker shows flat recurring rates (Total if prescribed $657 on 3-mo).
Plan ladder: Monthly $249/mo, 3-mo $219/mo, 6-mo $199/mo, 12-mo $179/mo.
Plan ladder: Monthly $329/mo, 3-mo $309/mo, 6-mo $289/mo, 12-mo $269/mo (Total if prescribed $927 on 3-mo).
Plan ladder: Monthly $349/mo, 3-mo $299/mo, 6-mo $289/mo, 12-mo $269/mo (Total if prescribed $897 on 3-mo).
Monthly plan only ($1,069/mo).
Monthly plan only ($1,299/mo).
Monthly plan only ($1,349/mo).
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
RxSpan MD
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
RxSpan MD
6.8/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | RxSpan MD |
|---|---|---|
| Starting Price | — | $249/mo |
| Features | ✓8 features | 7 features |
| States Available | Not disclosed | 50 |
| Compounded | — | ✓ Yes |
| 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 RxSpan MD
RxSpan MD prices compounded semaglutide and tirzepatide from $249/mo, as injections or oral capsules, and also carries brand-name Wegovy, Zepbound and Ozempic. It is unusually transparent for the category: it names its 503A pharmacy partners, Belmar, Strive, Epiq Scripts and Casa Pharma, and its medical group. Shipping is free and unlimited 24/7 support is included. The physician-led practice was founded by Dr. John Diaz, a board-certified plastic surgeon, and is available in all 50 states.
Read our full RxSpan 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
RxSpan MD
What we like
- Semaglutide at $249 a month, within the normal band around this register's $189 median for the same drug and form
- The monthly figure covers medication, consult, shipping, coaching
- Coverage is published for all 50 states
- Names 4 dispensing pharmacies, which most sellers in this register do not do
- 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
- 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
RxSpan MD takes it, 6.8 against 3.9, and it is especially strong on knowing which pharmacy fills the vial — it names Belmar Pharmacy. 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 RxSpan MD if…
You want knowing which pharmacy fills the vial — it names Belmar Pharmacy and an opening price near $249 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 RxSpan 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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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.