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CVS Health $CVS's pharmacy benefit management unit, CVS Caremark, announced Thursday that it will restore coverage of Eli Lilly $LLY's weight loss injection Zepbound and add the company's new oral weight loss pill Foundayo to its standard commercial formularies.
Oct. 1 is the target date for Zepbound's return to covered status, the company said. For Foundayo, which the FDA cleared in April, formulary inclusion begins June 1 for plans that have elected to cover it.
Roughly 25 million to 30 million people fall under the standard formulary template, NBC News reported. Because employers and health plans make their own final decisions about drug coverage, a spot on the standard template does not translate into a guarantee that either medication will be available to every member.
Thursday's news walks back last year's formulary shake-up, when CVS Caremark struck a pricing arrangement with Novo Nordisk that elevated Wegovy to preferred status and pushed Zepbound off the covered list altogether. Patients who said they fared better on Zepbound than on Wegovy pushed back hard against that change, and a class-action suit filed over the decision is still pending, NBC News reported. Mounjaro, Lilly's diabetes treatment that shares Zepbound's active ingredient, was carved out of the original exclusion and remained covered throughout.
