May 28 (Reuters) – CVS Health said on Thursday it will add Eli Lilly’s weight-loss drug Zepbound back to some of its drug lists as an additional preferred option for insurance coverage.
Caremark, CVS’ pharmacy benefit management unit, had dropped Zepbound from coverage on July 1 last year, while continuing to reimburse for rival Novo Nordisk’s Wegovy after negotiating a more favorable price from the Danish drugmaker.
Zepbound will return to CVS Caremark’s commercial formularies, or lists of covered medications, on October 1, CVS said. The move is aimed at giving employers and health plans more access to GLP-1 weight-loss treatments at a more affordable cost.
Caremark will also remove a new-to-market block on Lilly’s recently launched oral pill, Foundayo, effective June 1, where the drug is approved for coverage by health plans. A ‘new-to-market block’ is a policy used by insurers and pharmacy benefit managers to restrict coverage on newly FDA-approved drugs.
Increasing popularity and high prices of GLP-1 drugs have led some employers and health plans to limit or drop coverage for weight-loss use. CVS has previously said a lot of their clients have been discontinuing coverage of GLP-1 drugs for obesity.
Pharmacy benefit managers negotiate rebates and fees with drug manufacturers, and create lists, or formularies, of medications that are covered by insurance, and reimburse pharmacies for patients’ prescriptions.
“We acted boldly through active engagement and negotiation with our drug manufacturer partners to tackle affordability and access for our customers and their members,” said Ed DeVaney, president, CVS Caremark.
(Reporting by Sriparna Roy in Bengaluru; Editing by Sahal Muhammed)
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