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Head-to-head · WeighScore

1st Optimal vs Cost Plus Drugs

1st Optimal
Graded #291

Higher grade

vs+3.1000000000000014
Cost Plus Drugs
Graded #371

Lower grade

The verdict

1st Optimal takes it — 61.6/100 to 58.5/100.

1st Optimal grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. 1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets.

We may earn a commission if you start care through some of these links, at no extra cost to you. It never moves the WeighScore, which is the weighted average of the six factors shown for every provider, and what we write about a provider is the same either way. See our disclosure.

Factor by factor

The same six graded dimensions, side by side. See the methodology.

Cost valueEven
45
45
Dose & formulationCost Plus Drugs +14
51
65
Clinical oversight1st Optimal +10
77
67
Labs & monitoring1st Optimal +46
97
51
FulfillmentCost Plus Drugs +13
60
73
Contract termsCost Plus Drugs +18
37
55
1st Optimal · left barCost Plus Drugs · right bar

The numbers

Metric1st OptimalCost Plus Drugs
WeighScore61.6/10058.5/100
GradeCC
Scorecard rank#291#371
SemaglutideNot disclosed$279/mo (brand Ozempic)
TirzepatideNot disclosedNot disclosed
CoverageCoverage not publishedAll 50 states
Brand-name accessCompounded onlyYes
Oral / sublingualYesInjection only
1st Optimal

Graded #291 · C

Strengths

  • Offers both semaglutide and tirzepatide with injectable and oral formats
  • Functional-medicine approach with at-home labs and blood-work interpretation
  • Unlimited coaching and ongoing support included
  • No long-term contracts
  • Board-certified doctors and nurse practitioners referenced

Where it loses points

  • No public monthly pricing disclosed
  • No published state availability list
  • Compounded vs branded sourcing not clarified on site
  • Pricing only revealed after quiz or consultation
Cost Plus Drugs

Graded #371 · C

Strengths

  • Transparent pricing: wholesale cost + 15% markup + $5 pharmacy fee, the same for everyone
  • Around $279/mo for branded Ozempic — well below typical retail list prices
  • Mark Cuban's PBM-disrupting pharmacy, praised by Forbes Health, Wired, and KFF Health News
  • Ships to all 50 states; genuine FDA-approved Novo Nordisk Ozempic, not compounded
  • Partnered with 9amHealth so you can get prescribed and fill at Cost Plus pricing

Where it loses points

  • Fulfillment only — no telehealth intake; you need a prescription from an outside clinician
  • Ozempic is FDA-indicated for type 2 diabetes, not weight management — weight-loss use is off-label
  • Wegovy availability has been spotty — check current stock before assuming it ships
  • No compounded semaglutide or tirzepatide — brand only
  • No clinical follow-up — side-effect monitoring falls to your prescribing clinician

Also worth a look

Neither is our top-graded pick — CoreAge Rx leads the scorecard

Across all 499 providers, CoreAge Rx grades highest at 91.8/100 (A−). Top of the scorecard: flat transparent pricing, both molecules, nationwide — no teaser-rate games.

Pricing/verification reflect each provider's public disclosures at last grading; the WeighScore is our editorial judgment per the methodology. Prices change — confirm on each provider's site. Not medical advice; see our disclosure.

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