CVS Has Wegovy: What Patients Should Know

Beginning July 1, 2025, CVS Caremark will designate Wegovy (semaglutide 2.4 mg) as its preferred GLP-1 therapy for weight management. This formulary change replaces Eli Lilly’s Zepbound and will affect millions of patients enrolled in CVS Caremark’s standard commercial plans. Such shifts are common in pharmacy benefit management and are generally based on negotiated pricing, clinical guidelines, and insurer priorities. Patients should consult with their healthcare providers to understand how this decision may affect ongoing treatment.

CVS Has Wegovy: Here’s What You Need To Know

Why CVS Selected Wegovy

CVS Caremark announced that Wegovy will become the preferred GLP-1 medication on its largest commercial formularies, while Zepbound will lose this designation.

The change takes effect July 1, 2025.
CVS stated the move reflects clinical data and pricing agreements intended to reduce overall drug spending.
Novo Nordisk, Wegovy’s manufacturer, confirmed the formulary update in an official release.

What It Means for Patients

Lower Costs for Wegovy: Patients on CVS Caremark plans may see lower copays or coinsurance for Wegovy compared to alternatives.
Switching from Zepbound: Members currently using Zepbound may face higher costs if they continue with it, though some exceptions may be available with medical justification.
Prior Authorization Transfers: CVS has indicated that existing Zepbound authorizations may transfer to Wegovy to reduce administrative burden.

Cost and Access Considerations

List Price: Wegovy’s monthly cost remains high (over $1,000 without insurance).
Negotiated Discounts: CVS’s preferred formulary status means insurers and employers may pay less, lowering patient out-of-pocket costs.
Direct Programs: Novo Nordisk offers affordability programs, including discounted direct-pay options (around $499/month for eligible patients).

Patient Concerns and Challenges

Nonmedical Switching: Some patients worry about being forced off Zepbound despite responding well to it.
Insurance Barriers: Coverage for weight-management drugs remains inconsistent across the U.S., and many patients still face denials despite clinical eligibility.
Need for Medical Oversight: Patients should not switch medications without consulting a licensed healthcare provider.

Key Takeaways

CVS Caremark will prioritize Wegovy beginning July 1, 2025.
Zepbound will lose preferred formulary status.
Patients may benefit from lower Wegovy costs but should confirm details with their insurer.
Clinical guidance is essential when considering medication changes.

Conclusion

The decision that CVS Has Wegovy: Here’s What You Need To Know highlights the shifting dynamics of insurance coverage for weight-management medications. While the change may improve affordability and access for some, it also raises concerns for patients stable on alternative treatments. Coordination between patients, providers, and insurers will be critical to ensure safe and effective care.