Head-to-head dispatch
1st Optimal vs Telos Rx
Two GLP-1 providers, one scorecard. Both are graded on the same six Desk Score dimensions — here is how they stack up, and which one fits you.
Desk Score
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.
Marked down on: No public monthly pricing disclosed
Desk Score
The broadest published catalog in the ranking — compounded GLP-1s plus oral and microdosed tirzepatide, PT-141, intranasal NAD+, and recovery peptides — all compounded and not FDA-approved.
$99/mo (injectable, month-to-month; the $49 headline is only the FIRST month of the 12-month prepaid ORAL plan, which renews at $129/mo billed every 48 weeks) sema · $139/mo injectable · $129/mo oral · $116/mo microdosed (microdosing is tirzepatide, not semaglutide) tirz
Marked down on: Everything is compounded and not FDA-approved — including all peptides and the NAD+ spray
Telos Rx takes this head-to-head with the higher Desk Score, 85/100 (B) against 41/100 (C) for 1st Optimal. 1st Optimal still holds its ground where its strengths line up with yours.
Desk Score, dimension by dimension
Same six measured dimensions for both. The red flag marks the stronger side. See the methodology.
1st Optimal
41/100
C
Telos Rx
85/100
B
Price transparency
State access
Molecule range
Onboarding speed
Support responsiveness
Licensing & trust
The spec sheet
| Field | 1st Optimal | Telos Rx |
|---|---|---|
| Semaglutide | Not listed on 1st Optimal's site (checked July 26, 2026) | $99/mo (injectable, month-to-month; the $49 headline is only the FIRST month of the 12-month prepaid ORAL plan, which renews at $129/mo billed every 48 weeks) |
| Tirzepatide | Not listed on 1st Optimal's site (checked July 26, 2026) | $139/mo injectable · $129/mo oral · $116/mo microdosed (microdosing is tirzepatide, not semaglutide) |
| Coverage | Not listed on 1st Optimal's site (checked July 26, 2026) | Not listed on Telos Rx's site |
| Brand-name | Compounded only | Compounded only |
| Oral option | Yes | Yes |
| Best for | Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. | Patients who want GLP-1 care alongside peptides, NAD+, and sexual-health options on one certified platform, with a needle-free oral or microdosed route. |
| Desk Score | 41/100C | 85/100B |
The verdict
Desk pick — Telos RxTelos Rx takes this head-to-head with the higher Desk Score, 85/100 (B) against 41/100 (C) for 1st Optimal. 1st Optimal still holds its ground where its strengths line up with yours.
Choose 1st Optimal if…
Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Telos Rx if…
Patients who want GLP-1 care alongside peptides, NAD+, and sexual-health options on one certified platform, with a needle-free oral or microdosed route.
$99/mo (injectable, month-to-month; the $49 headline is only the FIRST month of the 12-month prepaid ORAL plan, which renews at $129/mo billed every 48 weeks) sema · $139/mo injectable · $129/mo oral · $116/mo microdosed (microdosing is tirzepatide, not semaglutide) tirz
Assume any provider we list may compensate us — we may earn a referral commission at no extra cost to you, and what we file on a provider reads the same either way. Read full breakdowns: 1st Optimal · Telos Rx.
Also here
CoreAge Rx tops every dispatch at 94/100
Whichever of these two you lean toward, the Desk's #1-rated provider outscores them both. The Desk's top dispatch: one price at every dose, both molecules, all 50 states — but the $99 and $149 figures are 12-month plans paid up front, not a monthly bill.
More head-to-heads
- 1st Optimal vs CoreAge Rx
- CoreAge Rx vs Telos Rx
- 1st Optimal vs Strut Health
- Strut Health vs Telos Rx
- 1st Optimal vs Tyde Wellness
- BetterMe Rx vs Telos Rx
Or see the full comparison hub and the complete ranking.
Pricing and verification reflect each provider's public disclosures at last scoring; the Desk Score is our editorial judgment per the methodology. Prices change — confirm on each provider's own site. Not medical advice; see our disclosure.