CVS Caremark, one of the largest pharmacy benefit managers in the United States, will resume coverage of Eli Lilly's weight loss drug Zepbound after having removed it from its formulary last year, a decision that had sparked significant patient backlash and a class-action lawsuit filed in September, which remains active [1][2]. The restoration of coverage will take effect by October 1, 2026, and will impact approximately 25 million to 30 million people on CVS Caremark's standard formulary [1][2]. In addition, CVS will begin covering Lilly's newly approved weight loss pill, Foundayo, starting June 1, 2026 [1][2].
The initial removal of Zepbound from CVS Caremark's list of covered drugs had forced patients to switch to Novo Nordisk's rival drug Wegovy, despite some reporting better results with Zepbound [1]. The move did not affect patients taking Lilly’s diabetes drug Mounjaro, which contains the same active ingredient as Zepbound [1]. With the new decision, GLP-1 medications from both Lilly and Novo Nordisk will become co-preferred options on CVS Caremark's standard commercial formulary template, which insurers and employers can choose to adopt [2]. However, coverage is not guaranteed for all patients, as plan sponsors can still opt out of covering GLP-1s for weight loss [1][2].
CVS Health expects the move to drive 10% to 15% additional savings across the weight management category [2]. CVS highlighted that last year's agreement with Novo Nordisk was the first major step to spur competition in the GLP-1 market and reduce costs, and that both Lilly and Novo Nordisk have since engaged in successful pricing negotiations with CVS [2]. According to Ed DeVaney, CVS Caremark president, the company is "creating access and options that would not have existed without our leadership in the market" and is committed to ensuring a smooth transition for all stakeholders [2].
Zepbound has a monthly list price of $1,086, though Lilly offers discounts for cash-paying patients, who may still pay hundreds of dollars per month [1]. Some patients with private insurance could pay as little as a $25 copay [1]. Novo Nordisk stated it is pleased that Wegovy and its newly launched pill will retain preferred status on CVS's formularies, ensuring uninterrupted access for patients [2]. The country’s two other major PBMs, Express Scripts and Optum Rx, already cover Zepbound [1].
CONCLUSION
CVS Caremark's decision to restore coverage for Zepbound and add Foundayo significantly expands access to Eli Lilly's weight loss treatments, positioning them alongside Novo Nordisk's offerings on major drug plans. The move is expected to increase competition, drive cost savings, and provide more options for millions of patients, though final coverage decisions remain with individual plan sponsors.