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Head-to-head · WeighScore

1st Optimal vs SkyRx

1st Optimal
Graded #291

Higher grade

vs+2.700000000000003
SkyRx
Graded #353

Lower grade

The verdict

1st Optimal takes it — 61.6/100 to 58.9/100.

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 valueSkyRx +11
45
56
Dose & formulationSkyRx +20
51
71
Clinical oversight1st Optimal +9
77
68
Labs & monitoring1st Optimal +45
97
52
FulfillmentSkyRx +4
60
64
Contract terms1st Optimal +17
37
20
1st Optimal · left barSkyRx · right bar

The numbers

Metric1st OptimalSkyRx
WeighScore61.6/10058.9/100
GradeCC
Scorecard rank#291#353
SemaglutideNot disclosed$199/mo (all doses, 12-month plan, compounded)
TirzepatideNot disclosedNot disclosed
CoverageCoverage not publishedCoverage not published
Brand-name accessCompounded onlyCompounded only
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
SkyRx

Graded #353 · C

Strengths

  • All-inclusive 199 dollars per month covers medication, supplies, doctor visit and shipping
  • Offers both injectable and oral semaglutide, dispensed by FDA-registered 503B pharmacies
  • Same-day shipping for orders before 2pm ET in temperature-controlled packaging

Where it loses points

  • 199 dollars pricing requires a 12-month subscription paid upfront
  • Tirzepatide only listed as coming soon
  • GLP-1s not yet available in all 50 states; specific states not listed

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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