Improving access and affordability to high-cost weight management drugs

Weight management drugs can be strongly effective in helping to improve the health of people living with obesity or other weight-related health issues. However, drug manufacturers are solely responsible for setting the price of drugs and have priced these medications at a high cost, making it difficult for many people to access them. 

CVS Caremark® is committed to helping to lower out-of-pocket drug prices and drive better health outcomes for consumers by going head-to-head with drug manufacturers to negotiate discounts, promoting patient safety and supporting the unique needs of our customers.

That's why we recently partnered with Novo Nordisk to significantly increase access to Wegovy for our members at a more affordable price. On July 1, 2025, we will take a formulary action to prefer Wegovy and remove Zepbound. We’re confident our decision to prefer Wegovy on our commercial template formularies will enable wider, more affordable coverage for weight management drugs, while preserving clinical integrity.

Our integrated approach to bringing together pharmacy benefits, pharmacy and health insurance enables us to deliver innovative medicines, including expensive GLP-1 drugs to patients at lower costs.

Frequently asked questions from our members

 

1. If I switch from Zepbound to Wegovy, will I need to go through a Prior Authorization process again?  

No, members with an active prior authorization for Zepbound will not need to obtain a new prior authorization if they move to Wegovy. 

2. How do Wegovy and Zepbound compare for weight management?

Research on the long-term clinical efficacy of GLP-1s is ongoing. In one study, weight loss from semaglutide ranged from 13.2–22 pounds, compared with 15.4–28.6 pounds for tirzepatide.¹ These results show that both medications are effective for weight management. It is important to remember that the health benefits of these medications are not tied to losing the largest amount of weight possible, but helping members achieve a healthy weight and helping them maintain that weight loss over time. 

GLP-1s are intended to be used in conjunction with lifestyle changes. We enhance the impact of these medications by combining them with additional lifestyle clinical support as part of our weight management program offered to CVS Caremark® clients. Participants in the program have achieved more than 15% weight loss on average, including existing anti-obesity medication users who succeeded in nearly doubling their pre-program weight loss while working with program clinicians on diet and lifestyle. 

3. What if I already tried Wegovy and did not achieve sufficient weight loss or experienced intolerable side effects? 

If you have previously tried Wegovy and either experienced severe or intolerable side effects or did not achieve sufficient weight loss, you may request a formulary exception to be covered for a different weight loss drug through CVS Caremark. You or your provider may initiate an exception request, which allows for a case-by-case medical necessity review to determine whether coverage for an alternative therapy is appropriate based on your clinical circumstances.   

The review will consider clinical history/response to prior treatment and will require supportive documentation from your provider. We want patients to be taking medications that are safe and effective.

 

If you're a CVS Caremark member and have additional questions, please sign in to your account at Caremark.com or call CVS Customer Care at 1-800-552-8159. This number is also on the back of members’ ID cards.