Head-to-head · WeighScore
1st Optimal vs Piper
The verdict
Piper takes it — 81.9/100 to 61.6/100.
Piper grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. Mid-value both-molecule pricing ($135/$199), nationwide, though not verified.
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Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | Piper |
|---|---|---|
| WeighScore | 61.6/100 | 81.9/100 |
| Grade | C | B− |
| Scorecard rank | #288 | #34 |
| Semaglutide | Not disclosed | $135/mo |
| Tirzepatide | Not disclosed | $199/mo |
| Coverage | Coverage not published | All 50 states |
| Brand-name access | Compounded only | Compounded only |
| Oral / sublingual | Yes | Injection only |
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 #34 · B−
Strengths
- $135 sema / $199 tirz
- All 50 states
- Both molecules
Where it loses points
- Not LegitScript-verified
- Injection-only
- Monitoring detail limited
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.