CVS to boost access to weight loss drug Wegovy for Caremark patients

CVS Health on Thursday said it will significantly expand access to the blockbuster weight loss drug Wegovy for patients covered by its pharmacy benefit manager, Caremark. 

Starting July 1, Caremark will prioritize Wegovy on its formularies — or lists of covered drugs — making it the preferred GLP-1 drug for obesity. The move is part of a new partnership between Caremark and Wegovy’s manufacturer, Novo Nordisk, according to CVS’ first-quarter earnings release.

It comes as Novo Nordisk works to boost access to Wegovy now that it is no longer in short supply in the U.S. Partnering with Caremark, one of the nation’s largest pharmacy benefit managers, could help the drugmaker reach even more patients.

Caremark discounts drugs with manufacturers on behalf of insurance plans and creates lists of medications, or formularies, that are covered by insurance and reimburses pharmacies for prescriptions.

Caremark will make the drug available to its members at “a more affordable price.” The PBM negotiated a lower net price for Wegovy over its rival, Eli Lilly‘s weight loss drug Zepbound, on its main formularies, offering savings to clients that opt into those plans, a CVS spokesperson told CNBC.

But Caremark’s clients, which are employers and unions, “individually determine how much of that savings on Wegovy gets shared with its members either via lower premiums or lower copays at the pharmacy counter,” the spokesperson said. 

Separately, any patient who does not have insurance coverage for Wegovy or another GLP-1 can still buy Novo Nordisk’s drug out-of-pocket for $499 at any of CVS’ 9,000 pharmacies nationwide, the spokesperson added. 

In its earnings release, CVS said it is the first retail pharmacy partnering with Novo Nordisk’s new direct-to-consumer online pharmacy, NovoCare, to dispense Wegovy to patients with prescriptions. NovoCare offers Wegovy at that lower price point to cash-paying patients, who may struggle to shoulder the drug’s roughly $1,000 list price before insurance and other rebates.

Caremark will also combine Wegovy with additional lifestyle support, such as personalized nutrition plans, as part of the CVS Weight Management program.

The announcement comes as the Danish drugmaker races to capture more patients now that many compounding pharmacies are legally restricted from making cheaper, unapproved versions of Wegovy, with rare exceptions.

Dave Moore, Novo Nordisk’s executive vice president of U.S. operations, said in a separate release that “it is our responsibility to continue to work with others across the US healthcare system to find innovative opportunities to meet the needs of these patients and connect them with authentic, FDA-approved Wegovy … in a convenient and affordable way.”