By Andrew Hewitt
A big pharmacy benefit manager (PBM), CVS Caremark, has made big changes to how it covers GLP-1 drugs, especially those used for weight loss, as of July 1, 2025.
In particular:
CVS Caremark has stopped covering Zepbound, an Eli Lilly GLP-1 drug that is approved for long-term weight control. Why did they make this change? Because there are other successful and maybe even less expensive options available. If a Zepbound patient refills their medication on or after July 1, 2025, they will have to pay the full cost.
Prioritizing Wegovy: On the other hand, CVS Caremark is putting Novo Nordisk’s Wegovy (semaglutide), a GLP-1 drug, at the top of its usual weight loss formularies. This means that under many CVS Caremark plans, Wegovy is the best GLP-1 drug for weight loss.
Inventory Problems in the Past: It’s also important to note that CVS Caremark’s Mail Service Pharmacy had trouble getting some GLP-1s, like Mounjaro, Trulicity, Wegovy, and Saxenda, in the past, which made it harder for them to give out these medicines. But the change on July 1st is only about how Zepbound for weight loss is covered by the protocol.
Why Make the Change?
CVS Caremark said that the change in Zepbound was made because of other covered medicines that are thought to be safer, more effective, and possibly less expensive. Some reports also say that the “unsustainably” high prices of some GLP-1s are a reason why they are no longer covered. It looks like the move to give Wegovy more attention is also connected to a new partnership between Novo Nordisk and CVS Caremark.
Effects on the Patients:
Patients who used to be covered for Zepbound will need to find new ways to get their medicine and pay for it. For example, they could look at other covered options on their plan’s formulary, use savings programs from manufacturers, or look into direct-to-consumer sales options offered by manufacturers. A big pharmacy benefit manager (PBM), CVS Caremark, recently changed how they cover GLP-1 drugs, especially those used to lose weight.
Important Points:
Coverage of Zepbound dropped: As of July 1, 2025, CVS Caremark no longer covered Eli Lilly’s weight loss drug Zepbound under its basic plans.
Reason given: CVS Caremark said this change is happening because there are other weight control drugs that are covered that are safe, effective, and may cost less. They also said that stopping coverage for some GLP-1s would cost a lot of money.
Wegovy liked best: At the same time, CVS Caremark is making Novo Nordisk’s Wegovy (semaglutide) the GLP-1 drug for obesity that it recommends the most as part of its regular formularies.
Effects on the patients: If a person who was taking Zepbound needs to refill their medication on or after July 1, 2025, they will have to pay the full price. They might need to look into other medicines that their plan covers or manufacturer savings.
Limitations on mail orders in the past: It’s important to remember that CVS Caremark Mail Service Pharmacy had supply problems with several GLP-1s in the past, hurting their mail order availability. These included Mounjaro, Trulicity, Wegovy, and Saxenda. But the change that happened on July 1st is only about how Zepbound for weight loss is covered by the protocol.
People have talked about how this change will affect those who depend on Zepbound and the bigger issue of whether or not weight loss drugs are covered by insurance. Some sources say that makers are selling more directly to consumers, which could mean that there are more ways to get these medicines.
