CVS Caremark to restore Zepbound coverage Oct. 1 and lift Foundayo block June 1

CVS Caremark will restore Zepbound (tirzepatide) to its standard commercial formularies as an additional preferred option effective Oct. 1, 2026, and will remove the new-to-market block on Foundayo (orforglipron) effective June 1, 2026, CVS Health said on May 28, 2026 ^[1][5]. Both medicines are made by Eli Lilly. Wegovy (semaglutide), made by Novo Nordisk, keeps its preferred status on those lists ^[1][5].

The announcement reverses a decision made a year earlier. On May 1, 2025, CVS Caremark said it would remove Zepbound from its standard preferred formulary effective July 1, 2025 and make Wegovy the preferred obesity treatment ^[2]. CVS Caremark said the earlier change applied to its commercial template formularies, which it says cover an estimated 25 million to 30 million Americans ^[2][3][5]. CVS Caremark members currently taking Wegovy can continue without interruption, and both the Wegovy injection and the newer Wegovy pill keep preferred status ^[1][5]. Lilly said coverage for current Zepbound patients continues uninterrupted, with access broadening across template plans by Oct. 1 ^[4].

Prescribing data from the earlier change show how much switching followed. A Truveta analysis of 700,907 patients found that before May 2025, about 0.6% of tirzepatide patients switched drugs each month; that rose to 10.2% between June and July 2025, a 17-fold increase ^[1]. A separate review of prescribing shares from January 2024 through September 2025 showed an initial surge in GLP-1 switching that later leveled off ^[1]. CVS said it expects the new arrangement to drive 10% to 15% additional savings across the weight management category ^[5].

On cost, CVS Caremark says eligible patients with commercial coverage can get both Zepbound and Foundayo for as little as $25 a month ^[1][4]. Medicare Part D beneficiaries may also be eligible to pay $50 a month for obesity medicines starting July 1 through the Medicare GLP-1 Bridge, a CMS demonstration that runs from July 1, 2026 through Dec. 31, 2027 ^[1][4]. Zepbound's monthly list price is $1,086, and Lilly offers discounts for people paying cash, though those patients can still pay hundreds of dollars a month ^[3].

"We're creating access and options that would not have existed without our leadership in the market," CVS Caremark president Ed DeVaney said in a release ^[5]. Lilly's Ilya Yuffa, executive vice president and president of Lilly USA, said, "Not all medicines work the same way for patients. Broader coverage puts real choice in the hands of millions of Americans and their doctors" ^[4].

Litigation over the 2025 exclusion continues. A proposed class action, Larkin v. Caremark RX, LLC, was filed in the Southern District of New York on Sept. 3, 2025 and remains active as of mid-2026 ^[2]. A narrower case challenging a Zepbound denial for obstructive sleep apnea was dismissed on June 10, 2026 ^[2]. CVS Caremark has called the litigation without merit and says it intends to defend against it ^[2]. Whether the coverage reversal affects either case has not been reported.

Why it matters for patients

The two effective dates are not the same. Foundayo's block comes off June 1, 2026, while Zepbound does not return to the standard commercial formularies until Oct. 1, 2026 ^[1][3][5]. Anyone checking a plan's drug list before those dates may still see the older rules in place.

Being on the list is not the same as being covered. The standard formulary is a template that employers, unions, government entities and other plan sponsors can adopt or reject, and sponsors can still opt out of covering GLP-1s for weight loss ^[3][5]. Which plans will adopt the updated template has not been disclosed. The country's two other largest pharmacy benefit managers, Express Scripts and Optum Rx, already cover Zepbound ^[3], and Lilly said Foundayo will be covered by all three of the largest PBMs ^[4][5].

Formulary changes have also been shown to prompt real-world switching. Truveta's data recorded a sharp jump in tirzepatide patients changing drugs after the 2025 exclusion, followed by stabilization ^[1]. Which medicine a patient takes is a clinical decision between that patient and a prescriber; the coverage change affects what an insurance plan will pay for.

What happens next

• June 1, 2026: CVS Caremark lifts the new-to-market block on Foundayo ^[1][4][5].
• July 1, 2026: The Medicare GLP-1 Bridge demonstration begins for eligible Part D beneficiaries, with $50 monthly cost sharing cited, and runs through Dec. 31, 2027 ^[1][4].
• Oct. 1, 2026: Zepbound returns to CVS Caremark commercial formularies as an additional preferred option, alongside Wegovy's continued preferred status ^[1][5].