Novo Nordisk Hits Bullseye with CVS Caremark, Leaving Lilly Out
- Jennifer Hardy
- May 5
- 4 min read
In a major shake-up that’s bound to impact millions of patients, CVS Caremark is cutting ties with Eli Lilly’s weight loss drug Zepbound—and making Novo Nordisk’s Wegovy the go-to GLP-1 for obesity treatment. If your insurance runs through CVS Caremark, here’s what’s changing, why it’s happening, and what you should do next.
Key Takeaways
CVS Caremark will prefer Wegovy for weight loss starting July 1, 2025.
Zepbound and other Lilly obesity drugs will be removed from standard coverage.
Most patients will be auto-switched to Wegovy, with appeals possible but limited.
Starting July 1: Wegovy Is In, Zepbound Is Out
CVS Caremark—the largest pharmacy benefit manager (PBM) in the country—is making Wegovy (semaglutide) the preferred GLP-1 medication for weight loss on its standard commercial formularies.
Translation? It’ll be easier and more affordable to get Wegovy through insurance if CVS Caremark handles your prescription benefits.
At the same time, Eli Lilly’s Zepbound (tirzepatide) is being dropped from those same plans. Unless your employer or insurer specifically asks to keep covering it—which is unlikely—you’ll lose insurance access to Zepbound for weight loss after June 30.
Why CVS Caremark Made the Switch
At the end of the day, this decision is about two things: cost and consistency.
CVS Caremark, like all pharmacy benefit managers (PBMs), is in the business of negotiating drug prices on behalf of insurers and employers. In this case, Novo Nordisk came to the table with a better offer. Thanks to bulk pricing and rebates, Wegovy ended up being the more affordable choice over Eli Lilly’s Zepbound. That’s a big win for CVS, which is under constant pressure to lower prescription costs.
CVS has also pointed to supply reliability as a factor. While Eli Lilly has publicly stated it has a stable supply for Zepbound, CVS may view Novo’s production as better aligned with its nationwide volume needs, especially after past shortages made headlines. Even if both companies are producing at scale now, it’s possible that Novo Nordisk provided stronger guarantees about availability under pressure.
And clinically, Wegovy and Zepbound aren’t worlds apart. Both are GLP-1 receptor agonists approved for chronic weight management. That clinical overlap gives PBMs the leverage to play them against each other—and this time, Novo came out on top.
How Is Eli Lilly Reacting?
While I've spent an hour in subreddits with Zepbound users frustrated, Eli Lilly is keeping a poker face about the whole thing.
Eli Lilly CEO David Ricks laments he's looking to the future, not sidecar deals.
"We're not interested in exclusive deals. We think innovation and choice are very important. And we're well into the product replacement cycle, and there's more coming," Ricks told Yahoo Finance, the final point referring to oral GLP-1s like orforglipron.
"It feels a little bit like last decade, these sort of lock-up deals." Eli Lilly CEO David Ricks
What Zepbound Users Need to Know
If you’re currently on Zepbound through CVS Caremark insurance, here’s what’s coming:
Your coverage ends June 30. After that, Zepbound is no longer on the list unless your plan makes an exception.
You’ll be switched to Wegovy. CVS will auto-initiate a new prior authorization for Wegovy that mirrors your remaining time on Zepbound. Ideally, no paperwork for you—but double-check with your provider.
Can you stay on Zepbound? Maybe, but it’s a long shot. You’d need to prove a medical reason for why Wegovy isn’t a fit. Think: intolerable side effects or other complications.
Want to pay cash instead? LillyDirect offers Zepbound without insurance for a lower price than retail—currently around $550/month—but that’s still steep for most.
What About New GLP-1 Patients?
If you’re just starting to explore GLP-1 medications for weight loss and your insurance is managed by CVS Caremark, your options just got narrower. Beginning July 1, 2025, Wegovy will be the only GLP-1 covered for obesity treatment on most CVS Caremark plans. That means if you’re newly prescribed a medication in this category, it’s likely going to be Wegovy, or you’ll be paying out of pocket.
The good news? The deal between CVS and Novo Nordisk also brought down the cash price. Wegovy will now be available for $499 per month at CVS pharmacies and through Novo Nordisk’s own NovoCare online pharmacy. That’s a significant drop from typical retail prices and could be a viable option for those without insurance or who don’t meet coverage requirements.
Bottom line: Wegovy just became the default GLP-1 for millions of new patients. If you’re starting this journey, expect that conversation to come up early, and plan for prior authorizations or other paperwork your provider may need to submit.
If You’re Using Mounjaro or Other GLP-1s for Diabetes
This switch only applies to weight loss coverage—not diabetes treatment. If you’re using Mounjaro or another Lilly drug for type 2 diabetes, your coverage should stay the same for now. That said, it’s always smart to check with your insurer to be sure.
Bigger Picture: What This Signals
This isn’t just about two drugs—it’s about how powerful PBMs like CVS Caremark are in deciding which medications patients can actually access.
Zepbound loses major market share. Despite strong demand, it’s now cut off from a huge swath of insured patients.
PBMs are driving the market. These behind-the-scenes negotiations are shaping access based on pricing—not just medical outcomes.
DTC is getting louder. Both Lilly and Novo are expanding direct-to-consumer platforms to sidestep PBMs altogether. Expect more telehealth bundles, cash pricing, and patient-facing marketing.
The Peptide Revolution Gets Even More Competitive
If you’re affected by this change, now’s the time to talk to your doctor. You'll likely be getting a letter via snail mail (sent out May 1). Ask about switching, side effects, or whether there’s any reason to stay on your current med. And if you’re not sure what your insurance covers—ask. This stuff changes fast.
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