CVS Caremark, one of the largest pharmacy benefit managers in the US, announced that it will stop covering Eli Lilly’s Zepbound, a popular medication for weight loss, starting next week. The decision means patients who rely on Zepbound to manage their weight will have to pay full cost out-of-pocket.
CVS claims the change is intended to encourage Eli Lilly and Novo Nordisk to lower prices for GLP-1 medications in the US. However, doctors say this move could have a devastating impact on patients’ health and well-being. The decision is part of a broader trend by pharmacy benefit managers to control costs, often at the expense of patient access.
GLP-1 medications are highly effective in treating obesity and approved by the FDA for chronic weight management in adults with obesity or overweight. However, insurance coverage can be volatile, making it difficult for patients to maintain treatment regimens.
Dr. Tracy Zvenyach, director of policy strategy at the Obesity Action Coalition, warns that exclusionary policies like CVS’s can set up barriers for people seeking care. “We don’t do that with other chronic diseases,” she said.
Other experts share concerns about the impact of insurance changes on patient care. Dr. Jody Dushay, an endocrinologist, notes that adapting to a new medication can be stressful and disrupt treatment progress.
Patients who had been relying on Zepbound are now facing uncertainty about their access to the medication they need. CVS Caremark offers limited options for patients seeking coverage exceptions, leaving many frustrated with the lack of clarity in the appeals process.
Eli Lilly has expanded access to its medications through a company platform that coordinates telehealth services and fills prescriptions for out-of-pocket patients. However, the high cost of these services may still be unaffordable for some individuals.
Source: https://edition.cnn.com/2025/07/01/health/zepbound-wegovy-insurance-cvs-bcbs-weight-loss