CVS Caremark to Re-Add Lilly’s Zepbound and Open Access to Oral GLP-1 Pill Foundayo

CVS Health (NYSE: CVS) said its pharmacy benefits manager, CVS Caremark, will expand coverage for Eli Lilly’s chronic weight-management medicines, a move that is likely to improve patient access to GLP-1–based therapies through employer and health plan drug formularies. A pharmacy benefit manager, or PBM, administers prescription coverage for insurers and employers by negotiating which drugs are covered, and under what conditions, on a plan’s formulary. The key changes announced Thursday affect both Lilly’s injectable and oral products. CVS Caremark will add Zepbound (tirzepatide) back to its commercial formularies as an additional preferred option on Oct. 1, 2026. Separately, CVS Caremark will remove a “new-to-market block” on Foundayo (orforglipron), effective June 1, 2026, where the drug is approved for coverage by individual plans. CVS described the new-to-market block as a tool used by insurers and PBMs to restrict access to newly approved drugs while coverage and contracting terms are finalized.

CVS said the adjustment is intended to increase “affordability and optionality” for members, while helping plan sponsors manage drug spending in a category with broad and sustained demand. In its statement, CVS pointed to pricing pressures in GLP-1 weight management as the reason many customers have limited coverage choices to keep benefit programs financially sustainable. The decision also appears to unwind part of a prior coverage stance. Reuters reported that Caremark had dropped Zepbound from coverage on July 1 of the prior year, while continuing to reimburse Novo Nordisk’s Wegovy after negotiating a more favorable price from the Danish drugmaker. With Zepbound returning on Oct. 1, CVS is effectively giving Lilly’s medicine an additional preferred position again, though the company emphasized that plan sponsors still retain discretion to customize coverage.

CVS’s announcement comes as Lilly pushes beyond the injectable GLP-1 category. Lilly described Foundayo as a once-daily oral GLP-1 receptor agonist that can be taken at any time of day without food or water restrictions. Zepbound, by comparison, is an injectable medicine that acts as a dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptor agonist, which Lilly said helps reduce appetite and how much patients eat, along with supporting long-term weight reduction when used with a reduced-calorie diet and increased physical activity. Lilly also framed the coverage changes as part of a broader access milestone for obesity care. In its announcement, the company said CVS Caremark Commercial Template coverage begins June 1 for Foundayo, and that Zepbound access would broaden across template plans by Oct. 1. Lilly further stated that for eligible patients with commercial coverage, both medicines may be available for as low as $25 per month, and that Medicare Part D beneficiaries may qualify for $50 per month beginning July 1 through a Medicare GLP-1 Bridge program. Lilly did not provide CVS’s underlying negotiated price terms in the access announcement.

CVS said the changes build on its efforts over the past year to negotiate with drug manufacturers to “bend the cost curve” for GLP-1 therapies. In its investor-facing release, CVS also provided context on its PBM scale, saying it has approximately 88 million plan members as of March 31, 2026, and described template formularies as a baseline that plan sponsors can adopt or customize. The company did not disclose specific rebate levels, contract values, or the exact financial mechanism used to achieve affordability, beyond stating that it negotiated with manufacturers and expected the changes to drive increased savings in the weight management category. Even with a template formulary update, individual employers and health plans may still choose different coverage settings, which can affect whether a patient actually sees reduced copays or access in their specific plan.

What to watch next is whether CVS Caremark’s formulary update translates into measurable utilization changes for Zepbound and Foundayo across affected populations, particularly as coverage timing differs between the two drugs (June 1 for Foundayo and Oct. 1 for Zepbound). Industry monitoring will also likely focus on how competing GLP-1 weight-loss options are positioned on formularies, and whether additional PBMs and plan sponsors expand access to Lilly’s obesity portfolio on similar timelines.

SourceTrail includes the original reporting and the relevant company releases used to document the coverage dates, product definitions, and stated access goals.