CVS brings back Lilly's Zepbound coverage, adds obesity pill Foundayo

CVS Health said yesterday it will restore coverage of Eli Lilly's blockbuster weight loss shot Zepbound and add the pharma giant's recently approved obesity pill, Foundayo, to Caremark's standard formulary.

The move follows a pricing deal Novo reached last year with CVS, which made Wegovy the preferred obesity therapy on standard plans, cutting coverage for Zepbound in July.

Now, both oral and injectable GLP-1 drugs from Lilly and Novo will be offered through CVS Caremark, one of the largest PBMs in the United States, effectively undercutting Novo's competitive advantage over its rival.

Foundayo will be added to Caremark's commercial formularies beginning next month, and Zepbound will make a reappearance on the list of covered medications on Oct. 1, CVS Health said in a statement.

"With this expanded coverage, millions of Americans will have access to Zepbound and Foundayo, giving patients and their doctors a real choice in how obesity is treated," Lilly also said in a press release.

The agreement is expected to help boost earnings for Lilly now that the drugmaker's entire obesity portfolio will be covered by all three of the nation's biggest PBMs -- Caremark, UnitedHealth Group's OptumRx and Cigna's Express Scripts.

On top of that, Caremark provides additional lifestyle clinical support as part of the CVS Weight Management program, which could help attract more patients.

This announcement also comes as insurers have struggled to provide fair access to obesity treatments, causing high prices to put GLP-1 therapies out of reach for many people who could benefit from them.

But now, those with private insurance could pay as little as $25 a month for both Zepbound and Foundayo. Through the Medicare GLP-1 Bridge program, beginning July 1, Medicare Part D beneficiaries could pay up to $50 per month.

Alivia Kaylor is senior editor of Xtelligent's Pharma Life Sciences, which she helped launch in 2023. She has spent nearly five years covering the biopharma industry, with a focus on GLP-1s and other obesity therapies, federal policy, clinical R&D and drug pricing.

 Before becoming a full-time reporter, Alivia worked in drug manufacturing as a quality control microbiologist at a U.S. subsidiary of Daiichi Sankyo specializing in sterile injectables. She holds a bachelor of science in microbiology from Ohio State University and a master of science degree from Ohio University.