Head-to-head · WeighScore
1st Optimal vs OnlyRx
The verdict
1st Optimal takes it — 61.6/100 to 60.9/100, but only just.
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. OnlyRx is close behind and may still be the better fit — see the factor split below.
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.
The numbers
| Metric | 1st Optimal | OnlyRx |
|---|---|---|
| WeighScore | 61.6/100 | 60.9/100 |
| Grade | C | C |
| Scorecard rank | #288 | #309 |
| Semaglutide | Not disclosed | $179/mo (starting dose, promotional rate, compounded) |
| Tirzepatide | Not disclosed | $249/mo (starting dose, compounded) |
| Coverage | Coverage not published | Coverage not published |
| Brand-name access | Compounded only | Yes |
| Oral / sublingual | Yes | Yes |
Graded #288 · 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 #309 · C
Strengths
- Four-pharmacy network: Belmar, Strive, Epiq Scripts, and Casa Pharma RX
- Named prescribers on the public site: Dr. Carr (MD), Dr. Tenbrink (MD), Dr. Italia (MD), Dr. Mansour (DO)
- Oral disintegrating tablet (ODT) form for both semaglutide and tirzepatide — good for needle-averse patients
- Pricing, drug list, pharmacy partners, and physician roster all visible on the public site
- LegitScript Certified
Where it loses points
- Promo pricing ($179 semaglutide injection) is prominent, but post-promo maintenance pricing isn't shown
- No titration-ladder pricing — you can't see costs at 1.0 mg or 2.4 mg maintenance
- Refund / cancellation policy not stated on the homepage
- Lab-work requirement not stated
- Operating corporate entity not disclosed
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.