CVS Caremark, a pharmacy benefit manager, says it serves about 88 million plan members. In the space of fifteen months it removed Zepbound from its standard commercial formularies and then announced its return. For anyone whose drug card says Caremark, the dates decide what their plan pays for. This page sets out the record in CVS's own published words, dated, as of 28 September 2026.
How prior authorization works, and what one insurer's published criteria require, is on GLP-1 prior authorization. Who pays at all is on GLP-1 insurance coverage.
The timeline
| Date | What CVS published | Source |
|---|---|---|
| April/May 2025 | "CVS Caremark is partnering with Novo Nordisk to significantly increase access to Wegovy … at a more affordable price. The Company is taking a formulary action on July 1, 2025 to prefer Wegovy for its members." CVS Pharmacy also joins the NovoCare pharmacy network. | CVS Health Q1 2025 results release |
| 27 June 2025 | Member notice: Wegovy preferred on commercial template formularies and Zepbound removed, effective 1 July 2025; prior-authorization carry-over; exception route | CVS Health notice |
| 1 July 2025 | Zepbound off the template formularies; Wegovy preferred | — |
| 28 May 2026 | Foundayo's new-to-market block removed from 1 June 2026; Zepbound added back "as an additional preferred option" from 1 October 2026 | CVS Health announcement |
| 1 June 2026 | Foundayo (orforglipron) eligible on the templates | — |
| 1 October 2026 | Zepbound preferred again, alongside Wegovy | — |
Zepbound's absence lasted 15 months — 1 July 2025 to 1 October 2026. Wegovy is not removed by the 2026 change; the two become co-preferred.
What the 2025 switch meant for members
CVS's June 2025 notice answered three practical questions:
- Prior authorization carried over. "Members with an active prior authorization for Zepbound will not need to obtain a new prior authorization if they move to Wegovy."
- An exception route existed. Members who had tried Wegovy and did not achieve sufficient weight loss, or had severe or intolerable side effects, could request a formulary exception; the review considers "clinical history/response to prior treatment and will require supportive documentation from your provider."
- A lifestyle programme was attached. CVS said it would combine the drugs with its CVS Weight Management programme and reported participants achieving "more than 15% weight loss on average". CVS did not publish the population, duration or comparison behind that figure, so it cannot be set beside a trial result.
The same notice cited one study's weight-loss ranges — 13.2 to 22 pounds for semaglutide and 15.4 to 28.6 pounds for tirzepatide. On CVS's own figures, the drug it removed had the higher range. The one head-to-head trial of the two, SURMOUNT-5, is covered on Zepbound vs Wegovy; the choice CVS made was about negotiated price, which its documents say but do not quantify.
What the 2026 reversal says — and does not
The 28 May 2026 announcement states two changes and one limit:
- Foundayo: "effective June 1, 2026, CVS Caremark will remove the new-to-market block on Foundayo (orforglipron)", described as "a new oral GLP-1 therapy". Foundayo's prices outside insurance are on GLP-1 pill cost.
- Zepbound: added back to commercial formularies "as an additional preferred option" on 1 October 2026.
- The limit: "Plan sponsors that adopt CVS Caremark template formularies retain discretion to customize coverage for their members."
It does not state prices, copay tiers, prior-authorization rules, or whether the Wegovy pill and Zepbound vials are included. Anything more specific attributed to the announcement did not come from it.
Why "Caremark covers it" may not apply to a given plan
A PBM's template formulary is a default list. Employers and other plan sponsors choose whether to adopt it and can change it. Three separate decisions sit between the announcement and a pharmacy counter:
- Does the plan cover weight-loss drugs at all? Many employer plans exclude them. A formulary change does not override an exclusion.
- Did the sponsor adopt the template change? CVS says sponsors keep discretion.
- Is there a prior authorization, and is it met? Criteria such as a BMI threshold, a prior lifestyle programme and a 5% weight-loss test at renewal are set per plan — see GLP-1 prior authorization.
The plan's own formulary document and the plan administrator are the only sources that answer these for a particular person.
If coverage is not there
Both manufacturers sell direct to patients at self-pay prices, and the numbers move often. Current dated prices: Zepbound cost, Wegovy cost, and the full comparison on cheapest GLP-1 without insurance. Medicare members are not affected by these commercial templates; their route is on the Medicare GLP-1 Bridge.
This page reports CVS's published statements; it is not advice about a specific plan or which drug to use. Treatment decisions belong with the prescriber.
Sources
- CVS Health Corporation, first-quarter 2025 results release (Exhibit 99.1), cvshealth.com PDF, Health Services and Pharmacy & Consumer Wellness segment notes.
- CVS Health, "Improving access and affordability to high-cost weight management drugs", 27 June 2025, cvshealth.com.
- CVS Health, "CVS Caremark delivers affordability and access to GLP-1 weight management medications with expanded coverage options", 28 May 2026, cvshealth.com.
- All three read 28 September 2026.