CVS Caremark announced it will begin covering Eli Lilly's new obesity drug Foundayo starting June 1 and resume coverage for another Lilly weight loss medication, Zepbound, on October 1. This decision comes about a year after CVS dropped Zepbound from its formulary while continuing to cover Novo Nordisk's competing drug Wegovy.
Key Takeaways
CVS Health will begin covering Eli Lilly's new obesity drug Foundayo on June 1 and restore coverage for Zepbound on October 1. This move offers more treatment options to millions of Americans and levels the playing field between Lilly and Novo Nordisk in the weight loss medication market.
- CVS Caremark to cover Foundayo starting June 1, Zepbound resuming October 1
- Coverage affects 25 million to 30 million people with commercial insurance plans
- Both Lilly's and Novo Nordisk's GLP-1 drugs will be co-preferred options on standard formularies
- CVS expects the move to drive additional savings of 10% to 15% in weight management category
The move is expected to provide more treatment options for an estimated 25 million to 30 million Americans with commercial insurance plans, according to CNBC. Both Lilly's and Novo Nordisk's GLP-1 drugs will be co-preferred options on CVS Caremark's standard commercial formulary template.
According to a press release from Eli Lilly, this expanded coverage puts real choice in the hands of millions of Americans and their doctors. The company stated that not all medicines work the same for all patients, emphasizing the importance of having multiple treatment options available. CVS expects the move to drive additional savings of 10% to 15% across the weight management category.
This decision follows a year after CVS struck a deal with Novo Nordisk to make Wegovy the preferred obesity treatment on its standard plans, which led to Zepbound being dropped from coverage. The restoration of Zepbound and addition of Foundayo levels the playing field between Lilly and Novo Nordisk in the weight loss medication market.
CVS Caremark is one of the nation's largest pharmacy benefit managers, negotiating rebates and fees with drugmakers, creating formularies, and reimbursing pharmacies for patients' prescriptions. The company aims to provide affordable access to GLP-1 weight-loss treatments for employers and health plans.
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