UPDATE 3-CVS brings back coverage for Lilly's obesity drug Zepbound

CVS Health Corporation
Eli Lilly and Company

CVS Health Corporation

CVS

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Eli Lilly and Company

LLY

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All major U.S. pharmacy benefit managers now cover Lilly's obesity treatments

CVS includes Foundayo as a co-preferred weight-loss drug starting Monday

It will restart Zepbound coverage on October 1

Adds shares in paragraph 3

By Sriparna Roy

- CVS Health CVS.N will restore Eli Lilly's LLY.N weight-loss injection Zepbound to its list of covered drugs and also add the drugmaker's newly approved obesity pill, Foundayo, it said on Thursday.

CVS Caremark, one of the largest U.S. pharmacy benefit managers, had dropped Zepbound on July 1 last year, while continuing to reimburse for rival Novo Nordisk's NOVOb.CO Wegovy after negotiating a better price from the Danish drugmaker.

Lilly's shares rose more than 5% in morning trade.

Zepbound will return to CVS Caremark's commercial formularies, or lists of covered medications, as an additional preferred option on October 1. The move is aimed at giving employers and health plans more affordable access to GLP-1 weight-loss treatments.

"What this change means is that, for those clients that do (choose to provide coverage), they will have equal access to both the Novo and Lilly products, and consumers will have the same copays for each," a CVS spokesperson said.

Eligible patients with commercial coverage can get Lilly's Zepbound and Foundayo for as little as $25 a month, about the same for Novo's weight-loss drugs.

EXPANDED ACCESS FOR LILLY'S WEIGHT-LOSS DRUGS

CVS also said its standard commercial formulary template will include Foundayo as a co-preferred weight-loss drug starting Monday, after the removal of a new-to-market block.

For newly approved drugs, CVS said there is typically a brief lag as it evaluates whether they should be added to its formularies and negotiates discounts with manufacturers.

Pharmacy benefit managers negotiate rebates and fees with drugmakers, create formularies and reimburse pharmacies for patients' prescriptions.

All three of the nation's largest pharmacy benefit managers now cover Lilly's full obesity medicine portfolio.

BMO Capital Markets analyst Evan Seigerman said Lilly's products could benefit from more affordable access for CVS's roughly 90 million patients, which could drive Foundayo sales in the second half of the year.