Expanded GLP-1 Medication Access Through Formulary Updates

By HEOR Staff Writer

May 29, 2026

GLP-1 Medication Access

CVS Caremark’s latest formulary changes are poised to strengthen GLP-1 Medication Access for commercial plan members by restoring coverage for select weight-management therapies.

Effective October 1, 2026, Zepbound returns as a preferred option on template formularies for sponsors that elect coverage, while Foundayo loses its new-to-market block on June 1, 2026. These moves expand GLP-1 Medication Access without removing plan sponsors’ ability to tailor benefits.

Negotiated Savings Drive Affordability

Direct manufacturer negotiations delivered double-digit year-over-year net-cost reductions, allowing the reintroduction of Zepbound and addition of an oral GLP-1 agent. The resulting flexibility helps sponsors balance member needs with overall plan sustainability.

CVS Caremark negotiates acquisition prices and placement decisions on behalf of employers and health plans, using independent Pharmacy & Therapeutics review to weigh clinical value against cost.

Path to Sustainable Reimbursement

Targeted pricing agreements reduce pressure for coverage limits and support more durable market access for high-demand therapies.

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