Lilly's own employee pharmacy benefit sits with Rightway, not CVS Caremark

Eli Lilly switched pharmacy benefit managers for its own workforce, moving from CVS Caremark to Rightway effective January 1, 2026 ^[1]. The change came several months after Caremark removed Zepbound, Lilly's obesity drug, from its standard commercial formulary and kept Novo Nordisk's Wegovy as the preferred option ^[1]. Lilly has not said the formulary decision led to the switch ^[1].

Rightway describes its own model as 100% pass-through, meaning rebates and other negotiated savings go back to the health plan rather than being retained by the PBM ^[1]. Rightway is considerably smaller than CVS Caremark, one of the largest PBMs in the country ^[1]. Then in May 2026, Caremark announced that Zepbound would return to its commercial formularies on October 1, 2026, as an additional preferred option for plan sponsors that choose to cover weight-management drugs ^[1][2]. As of the policy analysis, Lilly had not publicly said whether that reversal would change its arrangement with Rightway ^[1].

The episode sits inside a broader employer trend. According to KFF's 2025 employer benefits survey, only 19% of large employers offering health benefits covered GLP-1 drugs prescribed mainly for weight loss, while 57% did not ^[1]. The Business Group on Health has reported that employers managing GLP-1 coverage often use tools such as verifying clinical eligibility, requiring participation in weight-management programs, limiting which providers can prescribe the drugs, or excluding certain medications from formularies altogether ^[1]. Lilly's move away from Caremark is cited as one example of employers reconsidering standard PBM arrangements, alongside cost-plus pharmacy deals used by companies like Caterpillar and in-house formulary work done by the University of Southern California ^[1].

Separately, federal regulators are pushing for more visibility into how PBMs are paid. The Department of Labor proposed a rule in January 2026 that would require PBMs serving employer-sponsored self-insured plans to disclose more detail about rebates, fees, spread pricing, and other compensation; that rule had not been finalized as of the analysis ^[1].

Why it matters for patients

For people taking Zepbound or Wegovy through an employer plan, which PBM the employer uses can determine whether a drug is covered, what tier it sits on, and what utilization controls like prior authorization or step therapy apply ^[1]. When Caremark dropped Zepbound from its standard commercial formulary earlier in 2026, employees whose plans followed that formulary could have faced higher costs or had to switch to Wegovy to keep coverage ^[1]. Caremark's October 1, 2026 reversal restores Zepbound as an additional preferred option, but only for plan sponsors that elect to cover weight-management medications in the first place ^[1][2]. Whether an individual employee's coverage actually changes depends on choices made by their own employer's plan, not just the PBM's national policy ^[1]. Lilly's silence on whether it will return to Caremark, or stay with Rightway, means employees of Lilly and of other companies watching this decision do not yet know if the underlying dispute over formulary placement has been resolved or simply paused ^[1].

What happens next

Zepbound is scheduled to return to CVS Caremark's commercial formularies on October 1, 2026, as an additional preferred option for employers that choose to cover weight-management drugs ^[1][2]. The Department of Labor's proposed PBM fee disclosure rule, issued in January 2026, has not yet been finalized ^[1]. Lilly has not indicated whether it plans to revisit its PBM arrangement with Rightway in light of Caremark's October change, so it is not yet known whether Lilly's employee plan will shift again ^[1].