CVS Health to Cover Eli Lillys Zepbound and New Obesity Pill on Standard Drug Plans Starting June 1
CVS Health on Thursday announced it will restore coverage of Eli Lilly's blockbuster weight loss injection Zepbound and begin covering Lilly's newly approved obesity pill Foundayo on its standard drug plans, a move that puts both Lilly and Novo Nordisk on equal footing in major pharmacy benefit plans. The coverage changes take effect June 1 for Foundayo and October 1 for Zepbound.
Coverage Shift and Market Impact
The decision reverses CVS's previous policy, which had made Novo Nordisk's Wegovy the preferred obesity treatment on standard plans while dropping Zepbound coverage a year ago. Under that arrangement, patients on those plans faced higher out-of-pocket costs or additional hurdles to access Lilly's drug. Now, glucagon-like peptide-1 (GLP-1) medications from both Lilly and Novo will be co-preferred options on CVS Caremark's standard commercial formulary template — a list of covered drugs that insurers and employers can adopt. This template represents 25 million to 30 million Americans.
Caremark, one of the nation's largest pharmacy benefit managers, serves employers, government entities, unions, and other health plans by negotiating medication costs. Plan sponsors that adopt Caremark's standard formulary retain the ability to opt out of covering GLP-1s for weight loss, meaning coverage for Lilly and Novo treatments is not guaranteed for all patients.
Pricing and Negotiations
CVS expects the changes to generate 10% to 15% additional savings across the weight management category. The company said both Lilly and Novo responded to last year's agreement with Novo by partnering with CVS to make GLP-1s for weight loss more affordable, citing "successful continued pricing negotiations" with both drugmakers.
In a statement, Novo Nordisk said it is "pleased" that Wegovy injection and its newly launched pill with the same name will retain preferred status on CVS formularies. Novo added that Caremark patients can remain on those drugs "without interruption." Eli Lilly did not immediately respond to requests for comment.
Ed DeVaney, CVS Caremark president, said in a release: "We're creating access and options that would not have existed without our leadership in the market. We acted boldly through active engagement and negotiation with our drug manufacturer partners to tackle affordability and access for our customers and their members."
Market Context
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