• CVS Caremark will make Wegovy the preferred GLP-1 obesity drug on its standard formulary, effective July 1, 2025.
• This decision could save health plans 10% to 15% on anti-obesity medication costs but may complicate patient access to Zepbound.
• Eli Lilly's stock fell nearly 11% following the announcement, despite Zepbound's $2.3 billion in sales in the first quarter.

CVS Caremark, the largest pharmacy benefit manager (PBM) in the United States, has decided to make Novo Nordisk's Wegovy the preferred GLP-1 (glucagon-like peptide-1) medication for obesity on its standard formulary, effective July 1, 2025. This decision means that Wegovy will be more readily covered for millions of people under CVS Caremark's prescription drug plans. This move is a blow to Eli Lilly's Zepbound, which will be excluded from the standard formulary, potentially complicating access for patients who rely on it. The formulary decision allows CVS to negotiate better discounts. This could save health plans money but also raises concerns about patient choice and access to specific medications. The news has already impacted the stock market, with Eli Lilly experiencing a significant drop in share value following the announcement.

• What: CVS Caremark, a major PBM, will make Wegovy the preferred drug for obesity on its standard formulary, excluding Zepbound.
• Who: Key players include CVS Caremark, Novo Nordisk (Wegovy manufacturer), Eli Lilly (Zepbound manufacturer), employers, insurers, and patients.
• When: The change is effective July 1, 2025. The announcement was made on May 1, 2025.
• Where: The decision impacts the United States, where CVS Caremark manages prescription drug benefits for millions of people.

CVS Caremark's decision highlights the intense competition in the obesity drug market and the significant negotiating power of PBMs. By favoring Wegovy, CVS Caremark aims to leverage discounts and potentially reduce costs for health plans. However, this could limit patient choice and access to Zepbound, a drug that Lilly claims helped patients lose more weight in head-to-head studies. The market reaction, with Lilly's stock price plummeting, underscores the financial implications of formulary decisions. The availability of Wegovy at a discounted price may help offset access concerns for some patients, but the long-term impact on both companies and patient outcomes remains to be seen. The evolving dynamics between drug manufacturers, PBMs, and payers will continue to shape the landscape of obesity treatment.

"We believe in the unique benefits of Wegovy® and the difference this medicine can make for patients seeking treatment...it is our responsibility to continue to work with others across the US healthcare system to find innovative opportunities to meet the needs of these patients and connect them with authentic, FDA-approved Wegovy® in a convenient and affordable way."

CVS Caremark's decision to prioritize Wegovy over Zepbound reflects a strategic move to manage costs within its prescription drug benefits program. While health plans may benefit from potential savings, the change introduces uncertainty for patients currently prescribed Zepbound. Eli Lilly faces the challenge of negotiating for formulary access or potentially losing market share. The ongoing competition between Wegovy and Zepbound will likely drive further innovation and pricing adjustments in the obesity drug market. Future developments will hinge on how employers and insurers customize their coverage plans and how effectively both Novo Nordisk and Eli Lilly can demonstrate the value and affordability of their respective medications.