Starting July 1, 2025, CVS Caremark—the largest pharmacy benefit manager in the U.S.—will list Novo Nordisk’s Wegovy as the preferred GLP-1 treatment for obesity on its standard commercial formularies. This change will lower costs for many patients covered under these plans and expand access to Wegovy through CVS Pharmacy locations nationwide, where it will be available for $499 per month for those paying out of pocket.

The decision removes Eli Lilly’s Zepbound from the preferred list, potentially affecting treatment plans for patients currently using it. However, those already prescribed Zepbound may be able to continue with prior authorization. While both medications are GLP-1 therapies with similar clinical profiles, the change reflects a growing focus on affordability and insurer preference for lower-cost options.

Eli Lilly, whose Zepbound generated $2.31 billion in quarterly revenue, responded by emphasizing its direct-to-consumer access channel, LillyDirect. CEO David Ricks noted the company’s preference for expanding choice rather than limiting it through exclusive deals. “We’re not interested at all in deals reducing access and choice for doctors and patients,” he said.

Wegovy’s appeal has also been strengthened by an FDA-approved label expansion to include the reduction of major cardiovascular events in adults with obesity or overweight and known heart disease. With insurers historically reluctant to cover anti-obesity medications, CVS’s move may mark a shift toward broader adoption—though the long-term impact on patient access, pricing, and provider flexibility remains to be seen.

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