1st Optimal vs Sesame Care
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 →
Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Sesame Care starts at $59/mo, and Sesame Care 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.
Sesame Care
Month-to-Month $99/mo, 3-Month $39/mo, 6-Month $49/mo, Annual $59/mo; includes video visits, unlimited messaging, follow-ups, labs (savings $60/3mo, $180/6mo, $480/yr)
$199/mo first two months, new self-pay patients, lowest doses (0.25/0.5mg) only; FAQ terms state offer valid through 2026-06-30 but $199 still advertised on 2026-07-14
low doses
high doses; maintenance dose $50/mo cheaper than Wegovy injection
NEW published pricing: $199 first two months (same new-self-pay intro terms as Wegovy); 2mg is $499/mo
$399/mo for 5mg; $449/mo for 7.5mg, 10mg, 12.5mg, 15mg — unchanged vs stored
$399/mo 5mg, $499/mo 7.5mg, $699/mo 10-15mg (program page shows $398/$698 — Sesame's own pages disagree by $1)
NEW row on program page: 'Zepbound® Tirzepatide Starts at $1,086 per / mo' (retail-channel pen, distinct from LillyDirect KwikPen)
NEW published pricing: $199/mo (2.5mg), $299/mo (5.5mg, 9mg), $349/mo (14.5mg, 17.2mg); previously feature-only with no pricing row
'Price with insurance: as low as $25 per / mo.' — copay varies by plan/PA outcome
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
Sesame Care
Inclusions not disclosed.
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
Sesame Care
6.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Sesame Care |
|---|---|---|
| Starting Price | — | $59/mo |
| Features | 8 features | 8 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 Sesame Care
A subscription running $39-$99/month pays for the clinical care and nothing else; drugs are charged separately at cash rates, which includes Zepbound from $299 through LillyDirect and a Wegovy self-pay promotion at $199/month. Nothing in the weight-loss line is compounded, only branded. Rather than working off a stocked formulary the way most weight-loss platforms do, Sesame prices transparently and puts patients in touch with independent provider practices.
Read our full Sesame Care 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
Sesame Care
What we like
- Semaglutide at $149 a month, within the normal band around this register's $199 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
- 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
- Both oral and injectable options are on record, so the format is a choice rather than a condition
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 orforglipron and 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
Sesame Care takes it, 6.7 against 3.9, and it is especially strong on oral orforglipron alongside the injectables. 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 Sesame Care if…
You want oral orforglipron alongside the injectables and an opening price near $59 a month.
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Oak
Semaglutide at $119/month, 37% under the register median
From $119/mo
Get started →Found
Tirzepatide at $169/month, 37% under the register median
From $99/mo
Get started →Telos Rx
Starting below a standard dose, with microdose tiers
From $49/mo
Get started →1st Optimal vs Sesame Care: 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.