CVS Caremark Expands Obesity Drug Access with Zepbound Reinstatement

CVS Health will restore coverage for Eli Lilly’s weight-loss injection Zepbound and add its new pill, Foundayo, to standard pharmacy benefit plans, marking a significant shift in the competitive landscape for GLP-1 treatments.

Starting October 1, CVS Caremark will reinstate Zepbound on its standard commercial formulary, while the newly approved Foundayo pill will be added on June 1. This strategic pivot places Eli Lilly’s portfolio on equal footing with Novo Nordisk’s Wegovy, which previously held a preferred status following a 2023 agreement. The formulary update affects a template covering approximately 25 million to 30 million Americans, though individual plan sponsors retain the final authority to opt out of weight-loss medication coverage.

Strengthening Market Competition

CVS officials stated that this expansion stems from successful pricing negotiations intended to drive 10% to 15% in savings across the weight management category. By positioning GLP-1 medications from both Lilly and Novo Nordisk as co-preferred options, the pharmacy benefit manager aims to foster price competition and improve long-term affordability.

• Zepbound coverage begins October 1, 2024.
• Foundayo pill coverage begins June 1, 2024.
• Co-preferred status applies to both Lilly and Novo Nordisk GLP-1 therapies.

"We acted boldly through active engagement and negotiation with our drug manufacturer partners to tackle affordability and access," said Ed DeVaney, president of CVS Caremark. While the move signals a broader availability of options for patients and providers, the ultimate access remains subject to the specific choices made by employers and health plan sponsors.