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Head-to-head · WeighScore

1st Optimal vs RxSpan MD

1st Optimal
Graded #291

Lower grade

vs+25.199999999999996
RxSpan MD
Graded #4

Higher grade

The verdict

RxSpan MD takes it — 86.8/100 to 61.6/100.

RxSpan MD grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. A physician-led telehealth under board-certified founder Dr. John Diaz with a broad GLP-1 menu — compounded semaglutide and tirzepatide by injection or oral capsule, plus a brand-name lane and microdosing — on transparent all-inclusive pricing to all 50 states.

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 valueRxSpan MD +41
45
86
Dose & formulationRxSpan MD +38
51
89
Clinical oversightRxSpan MD +11
77
88
Labs & monitoring1st Optimal +14
97
83
FulfillmentRxSpan MD +29
60
89
Contract termsRxSpan MD +48
37
85
1st Optimal · left barRxSpan MD · right bar

The numbers

Metric1st OptimalRxSpan MD
WeighScore61.6/10086.8/100
GradeCB
Scorecard rank#291#4
SemaglutideNot disclosedFrom $194/mo
TirzepatideNot disclosed$329/mo
CoverageCoverage not publishedAll 50 states
Brand-name accessCompounded onlyYes
Oral / sublingualYesYes
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
RxSpan MD

Graded #4 · B

Strengths

  • Available in all 50 states
  • Transparent, all-inclusive published pricing — consult, medication, supplies, shipping and support, cancel anytime, from ~$194/mo compounded semaglutide on an annual plan
  • Both injectable and a real oral (capsule) route, plus compounded and an advertised brand-name lane
  • Physician-led by a named, board-certified founder (Dr. John Diaz) with 24/7 messaging and coaching

Where it loses points

  • Compounded semaglutide/tirzepatide are not FDA-approved (not the same as Wegovy/Ozempic/Zepbound)
  • Published pricing is for the compounded line — brand-name pricing isn’t itemized
  • A prescription isn’t guaranteed — a provider reviews eligibility after checkout

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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