The CVS-Novo Nordisk Wegovy deal, announced in May 2025, epitomizes a hybrid market access strategy aimed at the in the $150 billion USA obesity drug market. Novo Nordisk secured preferred CVS Caremark formulary status and will be offering Wegovy at $499 for cash-paying patients, blending pharmacy benefit manager (PBM) influence with direct-to-consumer (DTC) models. This flexible hybrid market access strategy may outpace Eli Lilly’s Zepbound, which loses formulary preference. Lilly indicated that it will continue to prioritize its LillyDirect DTC platform. This review examines the deal’s structure, implications, and lessons for market access and commercial teams.

The Deal: A Hybrid Framework

Novo Nordisk’s hybrid market access strategies leverage CVS’s dual PBM and pharmacy roles:

• Cash-Pay Accessibility: CVS sells Wegovy at $499 monthly across 9,000+ locations, a 60% discount from its $1,349 list price. Novo’s NovoCare online pharmacy and telehealth partnerships (e.g., Hims & Hers) expand DTC access for uninsured patients.

• PBM Formulary Positioning: From July 1, 2025, CVS Caremark names Wegovy the preferred GLP-1 for obesity, covering millions. Zepbound loses status, with patients switching or seeking exemptions.

This approach merges PBM-driven coverage with DTC affordability.

Implications of the Hybrid Market Access Strategy

The deal underscores hybrid market access strategies’ impact:

• Patient Access: Wegovy’s affordability rises for cash-pay patients, but Zepbound’s exclusion may limit options for those needing alternatives.

• Competition: Novo’s formulary win boosts Wegovy, with its stock up 2-6.5%. Lilly’s DTC focus mitigates losses.

• PBM Influence: CVS’s cost-driven decisions amplify its market power, raising concerns about therapeutic choice.

• DTC Demand: With 4.9 million patients losing Zepbound coverage in 2025, DTC models meet unmet demand.

Key Insights and Conclusions

The CVS-Novo deal and Lilly’s response highlight hybrid market access strategies’ flexibility:

• Adaptability Drives Success: Hybrid models address PBM restrictions and coverage gaps, ensuring broad access.

• PBMs Shape Markets: Formulary inclusion fuels adoption, but cost-focused decisions may limit choice.

• DTC Fills Gaps: Cash-pay platforms capture uninsured patients, complementing traditional channels.

• Competition Requires Agility: Formulary wins and DTC platforms sustain growth.

Lessons for Market Access and Commercial Teams

The deal emphasizes hybrid market access strategies’ role in navigating evolving markets. Teams should:

• Integrate Channels: Combine PBM negotiations with DTC platforms to maximize reach.

• Prioritize Patients: Advocate for formularies balancing cost and clinical outcomes, ensuring therapy diversity.

• Leverage Partnerships: Use telehealth and online pharmacies to enhance DTC access.

• Stay Flexible: Adapt to PBM shifts, coverage changes, and competition.

• Innovate Continuously: Develop pricing models, digital tools, and pipeline products to differentiate.

The CVS-Novo deal shows how hybrid market access strategies enable pharma companies to overcome PBM barriers, payer restrictions meet patient needs, and succeed in competitive markets. By adopting flexible, patient-centric approaches, teams can drive access and commercial success.