CVS Health has announced a significant expansion of its coverage for Eli Lilly's weight-loss medications, reversing a previous decision to exclude the popular injection Zepbound from its formulary. The move, announced on Thursday, will also add the newly approved obesity pill Foundayo to its standard commercial formulary template.
Zepbound is set to return to CVS Caremark's commercial formularies as an additional preferred option starting October 1. Foundayo will be included as a co-preferred weight-loss drug from Monday, following the removal of a new-to-market block. This strategic change aims to provide employers and health plans with more affordable access to GLP-1 weight-loss treatments.
A CVS spokesperson clarified the impact, stating: "What this change means is that, for those clients that do (choose to provide coverage), they will have equal access to both the Novo and Lilly products, and consumers will have the same copays for each." Eligible patients with commercial coverage can expect to pay as little as $25 a month for Lilly's Zepbound and Foundayo, aligning with the cost structure for Novo's competing weight-loss drugs.
Pharmacy benefit managers, which negotiate rebates with drugmakers and manage formularies, play a crucial role in determining drug accessibility. With this development, all three of the largest U.S. pharmacy benefit managers now cover Lilly's complete portfolio of obesity medicines. Following the announcement, Eli Lilly's shares rose over 5% in morning trading.
BMO Capital Markets analyst Evan Seigerman highlighted the potential benefits for Lilly, suggesting that more affordable access through CVS's approximately 90 million patients could significantly boost Foundayo sales in the latter half of the year.
