Head-to-head · Cost-Efficiency Index
Zealthy vs 1st Optimal
Two GLP-1 programs on the bench, scored on the same six factors. Here's how their real cost of ownership compares — and which one we'd start with.
Zealthy
Shoppers with insurance who want Zealthy's coordination team to chase brand-name coverage, rather than those seeking the lowest simple cash price.
Visit Zealthy1st Optimal
Patients who want a named founding physician and a broader functional-medicine/hormone workup alongside GLP-1s.
Visit 1st OptimalThe verdict
Zealthy takes it, leading the Cost-Efficiency Index 42 to 41. Zealthy is a broad telehealth platform whose weight-loss arm sells GLP-1s three ways: an insurance-routed path for branded Ozempic/Wegovy/Zepbound/Mounjaro (advertised 'as low as $25/month' but dependent on coverage being secured). 1st Optimal still earns a C — Patients who want a named founding physician and a broader functional-medicine/hormone workup alongside GLP-1s.
Worth knowing either way: our overall #1 pick is CoreAge Rx (Cost-Efficiency Index 94/100 — the top of the ranking). See how it stacks up: CoreAge Rx vs Zealthy.
Factor by factor
Both providers scored on our six Cost-Efficiency Index factors. The stronger side on each row is marked in teal.
Normalized Cost/Month
Price Transparency
Nationwide Access
Formulation Options
Clinical Oversight
Contract Flexibility
Pricing, coverage & formulary
The disclosed facts behind the scores. Lower price wins its row (teal).
| Spec | Zealthy | 1st Optimal |
|---|---|---|
| Cost-Efficiency Index | 42/100 | 41/100 |
| Semaglutide / mo | $297/mo (bundle, plus a separate fee, compounded) | Not disclosed |
| Tirzepatide / mo | $449/mo (bundle, plus a separate fee, compounded) | Not disclosed |
| Semaglutide / yr (modeled) | $3,564 | — |
| Tirzepatide / yr (modeled) | $5,388 | — |
| Coverage | 34 states | Coverage not published |
| Oral / sublingual | No | Yes |
| Brand-name access | Yes | Compounded only |
| Rank here | #517 | #518 |
Zealthy
42/100Where the value is
- Offers a genuine insurance-coordination path for branded Wegovy/Zepbound/Ozempic/Mounjaro, unlike most other companies in this batch which are cash-pay compounded-only
- The all-in 'Doctor + GLP-1' bundle is transparent about being all-in and includes a stated full-refund policy 'no questions asked' if a patient is found clinically ineligible
- Broader platform than a single-purpose GLP-1 shop — primary care, mental health, and other services are available under the same account
The tradeoffs
- The site's most prominent headline price ($151/month semaglutide, $216/month tirzepatide) requires a 3-month prepay AND excludes a separate membership fee whose dollar amount is not disclosed anywhere in the weight-loss FAQ — a naive reader would not know a second charge exists
- The true all-in monthly cost is $297 (semaglutide) or $449 (tirzepatide) via the bundled plan, roughly double the advertised a la carte headline figure
Regulatory note: the FDA issued a warning letter to FitRX, LLC dba Zealthy in September 2025. We still list and link to Zealthy; you should know the letter is on the public record before you decide.
1st Optimal
41/100Where the value is
- Named founder and clinical lead: Dr. Amber Miller, a functional medicine physician
- LegitScript verification badge displayed
- No credit card required to start the intake quiz
The tradeoffs
- No GLP-1 pricing published anywhere on the public site
- No compounding pharmacy partner named
Assume any provider we list may compensate us — we may earn a commission, at no cost to you. It never changes the Cost-Efficiency Index. Pricing, states and verification reflect each provider's public disclosures at last review; prices change — confirm on the provider's site. Not medical advice. See our disclosure.