WOONSOCKET, R.I. — CVS Caremark is working to get both Novo Nordisk and Eli Lilly to provide more affordable net prices ($200) in the weight loss category for the employers and unions that pay for pharmacy benefits.
Although $200 is a steep monthly co-pay for a covered brand-name medication, it’s still significantly lower than the $500 price Novo Nordisk charges through its direct-to-consumer platform for uninsured individuals.
Given the strong demand for GLP-1 weight loss treatments, many Caremark members may be willing to pay the $200, which could also reduce costs for insurers.
Separate from those negotiations with the drugmakers, CVS Caremark in 2026 will provide employers and unions additional options around cost-sharing, including establishing copays up to $200 if that enables those plan sponsors to provide access when access previously didn’t exist.
CVS Caremark’s standard formulary template prefers Wegovy and excludes Zepbound. However, as CVS Caremark defers to every single payer about their own plan design, CVS Caremark also manages plans that co-prefer both Wegovy and Zepbound.
In all of these situations, a $200 copay may be available to the plan sponsors if they choose to deploy that option to provide coverage for a therapy class they otherwise would have not.
"It’s important to note that many employers and unions currently do not offer coverage for the weight-loss GLP-1s. For next year, to enable more of these plan sponsors to begin to cover this category, CVS Caremark is providing them the ability to do so at patient copay levels up to $200 — which is far lower than the Eli Lilly and Novo Nordisk’s direct-to-consumer pricing for Zepbound and Wegovy, respectively," said CVS spokesperson David Whitrap.
"Separately, Caremark’s standard formulary template, which represents roughly 1/3 of our members, will continue to prefer Wegovy over Zepbound. This formulary decision has delivered significant cost savings for the clients that participate in this formulary, and the savings will be even larger in 2026. We have other formularies that exclude both products and others that co-prefer both Wegovy and Zepbound. It is up to each individual client which formulary they choose, or if they’d like us to customize one unique to their membership or budget. For all of these formularies, if the weight-loss category is covered, each individual client determines what the member copay will be for that category. What we announced this week is that we are allowing our clients — regardless of what formulary they choose or which weight loss drug(s) are preferred on that formulary — to set that copay level no higher than $200," he added.
