CVS Caremark ends new-to-market block and covers Foundayo

CVS Caremark began covering Foundayo (orforglipron) on June 1, lifting the new-to-market block that had kept the oral GLP-1 off its commercial template formularies ^[1][3]. CVS Health, which owns the pharmacy benefit manager, announced the change on May 28 ^[3].

The update applies to CVS Caremark's most common commercial formularies. Plan sponsors that adopt those template formularies keep discretion to customize coverage for their members, CVS said ^[3]. CVS Caremark serves about 88 million plan members ^[3].

"We're creating access and options that would not have existed without our leadership in the market," said Ed DeVaney, president of CVS Caremark ^[3].

In the same announcement, CVS said it will add Zepbound (tirzepatide) back to its commercial formularies as an additional preferred option on October 1, 2026 ^[3]. CVS Caremark dropped Zepbound in May 2025 in favor of Novo Nordisk's Wegovy (semaglutide) ^[4]. Both the Wegovy injection and the Wegovy pill keep preferred status, and members currently taking Wegovy can continue without interruption, CVS said ^[4].

On cost, Lilly says eligible patients with commercial coverage can pay as little as $25 a month for Foundayo or Zepbound ^[1]. Medicare Part D beneficiaries may also be eligible to pay $50 a month for their obesity medicines through the Medicare GLP-1 Bridge program, which starts July 1 and runs through Dec. 31, 2027 ^[1][4].

Jefferies analysts had identified the absence of CVS coverage as a key reason Foundayo's launch trailed the Wegovy pill, which had full coverage in its first week on the market ^[2]. CVS was the last of the three largest pharmacy benefit managers to cover Foundayo, starting June 1, the analysts said ^[2]. Foundayo is a once-daily oral GLP-1 that can be taken any time of day without restrictions on food or water intake, according to Lilly ^[1].

How quickly prescriptions shift after this kind of coverage change has not yet been reported. One analysis of 700,907 patients, using Truveta data, found that monthly switching away from tirzepatide rose from about 0.6% before May 2025 to 10.2% in June and July of that year, after CVS Caremark dropped Zepbound — a roughly 17-fold increase — before prescribing trends leveled off ^[4].

Why it matters for patients

Formulary placement helps decide whether a prescription is covered and what a member pays for it ^[3]. Before June 1, the new-to-market block meant Foundayo was not covered on CVS Caremark commercial template plans; now it can be, where the plan sponsor approves coverage ^[3].

Coverage is not the same for every drug in this class. Wegovy keeps preferred status on CVS Caremark formularies, Zepbound returns as an additional preferred option on October 1, and people already taking Wegovy can stay on it without interruption ^[4]. For that reason, the practical effect of the June 1 change depends on the plan a person is enrolled in, not on the announcement alone.

The $25 and $50 monthly figures apply to eligible patients and depend on plan and program rules; the sources do not give cost estimates for people whose plans do not adopt the template formulary ^[1][4]. It has also not been disclosed how many plan sponsors will adopt the updated template formularies, or how many members will gain access to Foundayo as a result.

Coverage decisions have moved real prescribing before. The Truveta analysis found a sharp but temporary jump in patients switching GLP-1 drugs after CVS Caremark dropped Zepbound in 2025 ^[4].

What happens next

• June 1, 2026: CVS Caremark's new-to-market block on Foundayo was removed for commercial template plans where plans approve coverage ^[3].
• July 1, 2026: The Medicare GLP-1 Bridge program begins, offering eligible Part D beneficiaries access to certain GLP-1 drugs for a $50 monthly copay; it runs through Dec. 31, 2027 ^[4].
• October 1, 2026: Zepbound is added back to CVS Caremark commercial formularies as an additional preferred option ^[3].

Whether the added coverage changes Foundayo's prescription trend has not been reported.