CVS Caremark is putting Eli Lilly’s obesity drug Zepbound back on some commercial formularies starting Oct. 1, reversing a mid-2025 decision that had nudged many patients toward rival GLP-1 medications. The move could re-open doors for employees and health plan members who ran into outright denials, prior-authorization roadblocks or were forced to switch drugs last year. Employers and benefits managers will still decide whether to follow Caremark’s standard playbook, so the real-world impact will vary from plan to plan.
What's changing and when
According to Reuters, CVS Caremark will restore Zepbound as an additional preferred option on certain drug lists as of Oct. 1, 2026. The company will also remove a "new-to-market" block on Lilly’s oral GLP-1 pill Foundayo on June 1. Ed Devaney, president of Caremark, told the outlet, "We acted boldly through active engagement and negotiation with our drug manufacturer partners to tackle affordability and access for our customers and their members."
Why Caremark dropped Zepbound
Caremark initially removed Zepbound from some of its standard formularies effective July 1, 2025, after cutting a deal that broadened access to Novo Nordisk’s Wegovy at a lower net cost. Massachusetts officials and contemporaneous coverage reported that the swap was framed as a cost-control strategy for health plans, but it also sent some patients scrambling to appeal denials or transition to a different therapy.
What it means for patients and employers
Coverage will still hinge on whether an employer adopts Caremark’s standard formulary templates or uses a customized design. For some members, Zepbound will reappear on the preferred drug list on Oct. 1. For others, their plan’s lineup may not change at all. Reuters also notes that Caremark kept reimbursing Novo Nordisk’s Wegovy after negotiating a more favorable price, a deal that influenced earlier formulary decisions and is likely to keep shaping plan design.
Foundayo and the new oral option
The reversal lands just as payers are recalculating around a new wave of lower-cost oral options. The FDA signed off on Lilly’s oral GLP-1 Foundayo (orforglipron) in April, and national reporting on coverage and pricing has already shifted negotiations between drugmakers and pharmacy benefit managers. The Washington Post detailed Lilly’s launch and how the new pill could give payers more leverage at the bargaining table.
PBM scrutiny and the wider fight over access
The back-and-forth on Zepbound is another flashpoint in the growing scrutiny of pharmacy benefit managers by lawmakers and state officials, as coverage decisions ripple through employer budgets and patient access. Reporting such as antitrust heat on CVS Caremark highlights that regulators are watching how formulary choices affect competition and which drugs actually make it to patients’ medicine cabinets.
For now, patients and clinicians will need to confirm the details plan by plan. Checking benefits documents, talking with HR and calling the pharmacy benefit administrator will be key to finding out whether Zepbound returns in October. If coverage is not restored, appeal processes, manufacturer assistance programs and self-pay routes such as LillyDirect remain on the table while PBMs and drugmakers continue to hash out their deals.
