CVS Caremark restores Zepbound alongside Wegovy on its template formulary

CVS Caremark's plan to put Zepbound (tirzepatide) back on its most common commercial formularies takes effect October 1, 2026. The pharmacy benefit manager announced the change on May 28, 2026, describing Zepbound as "an additional preferred option" for plan sponsors that choose to cover weight-management drugs ^[1][2].

The move reverses a decision that disrupted treatment for many people. CVS Caremark dropped Zepbound in May 2025 in favor of Novo Nordisk's Wegovy (semaglutide) ^[2]. Under the new setup, both Wegovy injection and the Wegovy pill keep preferred status across CVS Caremark formularies, and patients currently on Wegovy can continue without interruption ^[2].

What else is changing

CVS Caremark also removed its "new-to-market block" on Foundayo (orforglipron), Lilly's oral GLP-1 for weight management, effective June 1, 2026, where plans approve coverage ^[1][2]. A new-to-market block keeps a newly approved drug off the formulary until the PBM reviews it, so lifting it clears the way for coverage decisions by individual plans.

On cost, Managed Healthcare Executive reported that eligible patients with commercial coverage can get both Zepbound and Foundayo for as little as $25 a month ^[2]. Medicare Part D beneficiaries may be eligible to pay $50 per month for obesity medicines starting July 1, 2026 through the Medicare GLP-1 Bridge, a short-term CMS demonstration running from July 1, 2026 through December 31, 2027 ^[2].

CVS Health framed the change as the result of price negotiations. "We acted boldly through active engagement and negotiation with our drug manufacturer partners to tackle affordability and access for our customers and their members," said Ed DeVaney, president of CVS Caremark ^[1]. The company said it worked with Lilly to secure a more affordable cost ^[2].

One important limit: CVS Caremark writes template formularies, but employers, unions, health plans and government purchasers that adopt them "retain discretion to customize coverage for their members" ^[1]. CVS did not specify what tier Zepbound will sit on or what a member will pay at the counter; those details are set by the plan sponsor and were not detailed in the announcement ^[1]. CVS Caremark's PBM served approximately 88 million plan members as of March 31, 2026 ^[1].

What the 2025 switch looked like in the data

Researchers using Truveta data, presented at the AMCP Annual Meeting in Nashville in April 2026, tracked what happened after the May 2025 change. The analysis included 700,907 patients — adults 18 and older with a body mass index of 27 or higher who had two consecutive GLP-1 fills between January and September 2025 ^[2].

Before May 2025, monthly switching away from tirzepatide ran at about 0.6%. Between June and July 2025, it rose to 10.2% — a 17-fold increase ^[2]. A second analysis looking at prescribing share from January 2024 through September 2025 found the surge in switching leveled off afterward, which researchers described as transient disruption following a coverage policy shift ^[2].

Why it matters for patients

For people who were moved from tirzepatide to semaglutide in 2025 because of the formulary change, October 1 reopens the possibility of tirzepatide coverage — but only if their specific plan adopts the CVS Caremark template formulary without customizing it away ^[1]. Whether an individual plan does that is not something the announcement answers.

The broader lesson is that formulary position moves in both directions. A drug that is preferred this year can be non-preferred next year, and vice versa, based on negotiations that happen between the PBM and manufacturers well before members hear about them. The Truveta numbers show how quickly those decisions translate into real switching: from under 1% a month to more than 10% in a matter of weeks ^[2].

CVS Caremark said it will provide advance communication and support to customers, consultants, providers and members, including proactive outreach, educational resources and clinical support programs ^[1]. It is not yet known how many plan sponsors will adopt the expanded template, what prior authorization requirements will apply, or which patients qualify for the $25 and $50 copay programs, since eligibility criteria were not detailed in the sources.

What happens next

• June 1, 2026: New-to-market block on Foundayo removed, where plans approve coverage ^[1][2].
• July 1, 2026: Medicare GLP-1 Bridge demonstration opens for eligible Part D beneficiaries ^[2].
• October 1, 2026: Zepbound returns to CVS Caremark commercial template formularies as an additional preferred option ^[1][2].
• December 31, 2027: Scheduled end of the Medicare GLP-1 Bridge demonstration ^[2].

People whose coverage may be affected can check their own plan's 2026 formulary documents, since template adoption varies by employer and health plan ^[1].