CVS drops Zepbound, prioritizes Wegovy amid pharmacy battles

In the United States, CVS Health has made a significant announcement regarding its pharmacy benefit manager division. On May 1, 2025, CVS confirmed that it would remove Eli Lilly's Zepbound from its preferred formulary list effective July 1, 2025. This decision comes as CVS chooses to focus on Wegovy, a competing GLP-1 medication produced by Novo Nordisk. The shift indicates a growing competition among pharmaceutical companies, pharmacy benefit managers, and telehealth platforms in the overheated market for GLP-1 medications. The decision reflects broader trends within the pharmaceutical industry as CVS joins other pharmacy benefit managers in scrutinizing drug coverage. PBMs, like CVS Caremark, traditionally aimed to lower costs for patients but have faced criticism regarding their role in the pharmaceutical supply chain. With CVS Caremark controlling a substantial share of the market, the move to favor Wegovy may be influenced by favorable negotiations between CVS and Novo Nordisk regarding discounts and rebates. The implications for patients are significant. Many will potentially lose access to Zepbound through their insurance, or they may face increased out-of-pocket expenses if they wish to continue using it. This could place a heavier burden on healthcare providers as they manage prior authorizations necessary for patients seeking to use Zepbound amidst these changes. In response to CVS Caremark's decision, Eli Lilly has been actively working to address patient access to Zepbound. The company has partnered with telehealth platforms like Ro and Hims & Hers to create more direct avenues for patients to obtain this medication. While Eli Lilly is reducing the cash-pay price of Zepbound significantly through its LillyDirect channel, costing between $349 to $499 per month compared to its list price exceeding $1,000, affordability remains an issue for many. As the demand for GLP-1 medications persists, pharmaceutical companies may continue to seek ways to reach consumers directly, bypassing traditional PBM models. This trend may lead to further disruptions in pharmacy benefit systems, particularly for high-demand therapies, revealing the complex interplay of incentives at work in the U.S. healthcare landscape.