CVS Caremark Delivers Affordability and Access to GLP-1 Weight Management Medications with Expanded Coverage Options
Expanded GLP-1 options for members create a path to sustainable coverage of these important medications
What changes is CVS Caremark making to its weight management drug coverage?
CVS Caremark will add Zepbound back to our commercial formularies as an additional preferred option
Over the past year, we've been actively driving change in the GLP-1 weight management space to help lower costs. Our approach has made a real difference, enabling us to now expand options while continuing to make progress on affordability.
We expect these changes to help drive increased savings in the weight management category – after a history of delivering double digit savings for our template formulary customers year over year – while expanding choice for our members.
Why is CVS Caremark adding Zepbound to their formulary?
Simply put, we achieved what our customers asked us for: deliver affordability and optionality in this important class.
"We're creating access and options that would not have existed without our leadership in the market," said
What is CVS Caremark doing to bring down the cost of GLP-1s?
Over the past two years, high prices have put these therapies out of reach for the many people who could benefit from them. Last year, we took the initiative to drive engagement with manufacturers to bend the cost curve — similar to how we've helped improve affordability for drugs used for diabetes, high cholesterol, psoriasis, rheumatoid arthritis and many more.
By acting early, we helped improve affordability and get ahead of a rapidly evolving GLP-1 pipeline. This past year, as this therapy class has continued to evolve, we worked with the manufacturers to secure a more affordable cost with positive results that allow us the flexibility to continue offering our customers more choice and access for their members.
What are the challenges with GLP-1 pricing?
While GLP-1s represent a major clinical advancement, the broad demand for a high-priced medicine creates a level of financial strain that is difficult to absorb at scale. As a result, many of our customers have made tough trade-offs, limiting coverage in order to maintain sustainable, balanced benefit programs. Ongoing collaboration with pharmaceutical companies is helping to make this in-demand drug class more accessible.
How was CVS Caremark able to lower the price of these weight management drugs?
As a pharmacy benefit manager, CVS Caremark is hired by businesses, big and small, health plans, unions, and government entities to negotiate the cost of medications included on formularies elected by plan sponsors that offer a benefit to their members. These negotiations have led us to deliver increased affordability and increased access to GLP-1s across the class.
What is a formulary and how does it impact patients?
A formulary is a list of prescription medications available under a health plan, managed with the support of a pharmacy benefit manager. CVS Caremark regularly evaluates formularies — which plan sponsors may adopt or customize based on the needs of their populations — to help support member access to clinically appropriate treatments as evaluated by an independent Pharmacy & Therapeutics committee while helping manage overall medication costs for customers and the members they serve.
How is CVS Caremark supporting customers and members through these changes?
CVS Caremark will provide advanced communication and/or support to customers, consultants, providers and members to help ensure a smooth transition to covered therapies. These efforts include proactive outreach, educational resources, and clinical support programs.
These formulary updates are one component of
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