Head-to-head · WeighScore
1st Optimal vs Kova
The verdict
1st Optimal takes it — 61.6/100 to 44.3/100.
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.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | Kova |
|---|---|---|
| WeighScore | 61.6/100 | 44.3/100 |
| Grade | C | C |
| Scorecard rank | #291 | #498 |
| Semaglutide | Not disclosed | Not disclosed |
| Tirzepatide | Not disclosed | Not disclosed |
| Coverage | Coverage not published | Coverage not published |
| Brand-name access | Compounded only | Compounded only |
| Oral / sublingual | Yes | Injection only |
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
Graded #498 · C
Strengths
- Publishes the full price ladder for all three plan terms — intro month and renewal rate — directly in its FAQ
- Medication is included in the plan price, with no separate pharmacy charge
- States plainly that its compounded GLP-1s are 'not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality'
- Companion app tracks weight, protein and side effects, with medication schedule reminders
- You are not charged unless a provider approves treatment
Where it loses points
- At $449 per 4 weeks, the standing 1-month plan is among the most expensive compounded GLP-1 options we track
- The advertised $129 is the 6-month plan's intro month only — that plan then renews at $1,794 every 24 weeks
- Billed every 4 weeks rather than monthly, which is 13 charges a year instead of 12
- Never names which GLP-1 molecule is dispensed — only 'compounded, non-FDA-approved GLP-1 medications'
- No pharmacy or prescribing medical group is named anywhere on the site
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.