1st Optimal vs StackMD
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 →
StackMD
Best for: coverage in all 50 states, which most of the register will not confirm
Visit StackMD →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, StackMD starts at $125/mo, and StackMD finishes ahead, 7.0 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.
StackMD
Published per-dose ladder on /product/semaglutide-compounded-glp-1: 1mg $125, 2mg $149, 4mg $175, 6mg $199, 10mg $225 — all 1ml vials of semaglutide with B12 and glycine, billed as a monthly plan ('Plans starting at just $125/month'). No membership or platform fee on top.
Published per-dose ladder on /product/tirzepatide-compounded-glp-1-gip: 5mg $199, 10mg $249, 15mg $299, 20mg $349, 25mg $399, 30mg $449 — all 2ml vials of tirzepatide with B12 and glycine. A patient titrated to a high dose pays more than double the advertised starting price.
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
StackMD
Covered by the monthly price
Medication
In the price
Clinician visits
Not stated
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
StackMD
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | StackMD |
|---|---|---|
| Starting Price | — | $125/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 50 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 StackMD
Rather than a single starting figure, each strength carries its own: five strengths of semaglutide from $125 to $225 a month, six of tirzepatide from $199 to $449. Membership costs nothing. Out of New York, Medical 360 HC PLLC sells other longevity peptides, sermorelin and NAD+ next to compounded tirzepatide and semaglutide, both carrying glycine and B12, and SamaritanMD, named as its partner, handles the prescribing.
Read our full StackMD 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
StackMD
What we like
- 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 and shipping
- Coverage is published for all 50 states
- No FDA warning letter matched this operator when we searched our enforcement register
Watch-outs
- 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
StackMD takes it, 7.0 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 StackMD if…
You want coverage in all 50 states, which most of the register will not confirm and an opening price near $125 a month.
Ready to start? Vetted GLP-1 providers
Vetted telehealth providers that prescribe GLP-1 online.
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MyDrHank
An oral route if you will not self-inject
From $25/mo
Get started →SkinnyRx
Starting below a standard dose, with microdose tiers
From $149.25/mo
Get started →YourEra
Semaglutide at $99/month, 63% under the register median
From $99/mo
Get started →1st Optimal vs StackMD: 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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