CVS Brings Back Zepbound Coverage, Adds Lilly’s New Obesity Pill to Plans

CNBC, NBC News, Eli Lilly, Reuters, and Bloomberg contributed to this report.

CVS Health said Thursday it will restore coverage of Eli Lilly’s weight-loss injection Zepbound and add Lilly’s new obesity pill, Foundayo, to its standard drug plans – a move that gives Lilly a bigger win in its fight with Novo Nordisk.

Zepbound will return to CVS Caremark’s formulary on Oct. 1, while Foundayo will be covered starting June 1. The change puts Lilly and Novo on more equal footing across major drug plans, after CVS last year made Novo’s Wegovy the preferred obesity treatment on its standard plans and dropped Zepbound.

That earlier decision forced some patients to pay more out of pocket or jump through extra hoops to stay on Lilly’s drug. It also triggered backlash, and a class-action lawsuit filed in September is still active.

CVS said the updated standard commercial formulary template now includes both companies’ GLP-1 drugs as co-preferred options. That template covers about 25 million to 30 million Americans, though employers and plan sponsors can still choose not to cover weight-loss GLP-1s at all.

Even with those limits, CVS expects the move to deliver 10% to 15% more savings in the weight-management category.

Lilly welcomed the change, saying it gives “millions of Americans” access to Zepbound and Foundayo and more choice in how obesity is treated. The company also said Foundayo will now be covered by all three of the nation’s biggest pharmacy benefit managers, including CVS Caremark.

Novo said its Wegovy injection and newly launched pill will keep preferred status on CVS’ formularies, and that patients already using those drugs can stay on them without interruption.

As one of the biggest pharmacy benefit managers in the country, CVS Caremark sits in the middle of a lot of these decisions, negotiating drug costs for employers, unions, government plans and other health insurers. CVS Caremark president Ed DeVaney said the company was trying to widen access while keeping costs down.

“We’re creating access and options that would not have existed without our leadership in the market,” he said.

For Lilly, the timing matters. The company has been pushing hard to protect its lead in the booming obesity-drug market, and getting Zepbound back onto a major formulary removes a major headache. For patients, it could mean more choices – and, in some cases, lower monthly bills.