CVS Caremark drops coverage for weight-loss drug Zepbound, affecting millions. Patients, doctors call the move disruptive and damaging to obesity care.
Major Insurance Shakeup Hits Weight-Loss Drug Users
A sweeping change by CVS Caremark, one of the largest pharmacy benefit managers in the U.S., is causing uproar among patients and providers. As of July 1, the company has dropped coverage for Eli Lilly’s Zepbound, a widely used GLP-1 drug for obesity, affecting up to 30 million Americans relying on CVS-managed plans.
CVS Opts for Cheaper Alternative
CVS Caremark announced it will continue to cover Wegovy, a similar GLP-1 medication produced by Novo Nordisk, while excluding Zepbound. In letters sent to patients in May, CVS cited cost-efficiency as the main reason, claiming other covered drugs were “safe and effective” alternatives. The decision is aimed at fostering price competition between drugmakers.
Patients Left Scrambling
Patients like Tara Eacobacci, who spent years finding the right treatment, now face full out-of-pocket costs unless they can secure an exception. “It’s outrageous,” she said. “I’m losing access to the one medication that actually worked for me.” Eacobacci reported significant health setbacks after discontinuing Zepbound, including weight gain and rising A1C levels.
Medical Professionals Warn of Disruption
Endocrinologists are raising alarms over the shift. Dr. Jody Dushay of Harvard Medical School said medication changes disrupt carefully tailored plans. “Patients tolerate drugs differently. Forcing a switch introduces side effects and undermines progress,” she explained. Physicians also note that navigating coverage changes takes valuable time away from actual care.
Long-Term Health Impacts Loom
Medical experts and advocacy groups argue that obesity should be treated as a chronic disease, not a short-term issue. “We don’t place such burdens on patients with other chronic conditions,” said Dr. Tracy Zvenyach of the Obesity Action Coalition. Critics say decisions driven by cost, not care, threaten patient well-being and reinforce outdated stigmas.
Drugmakers Respond with Stopgap Options
While patients can appeal coverage denials, the process is slow and uncertain. The program launches full access for all doses starting July 7.
Future Coverage Cuts Expected
The changes are part of a broader trend. Blue Cross Blue Shield of Massachusetts will eliminate GLP-1 coverage for obesity in January, further narrowing treatment options. Insurers point to low adherence rates and the need for long-term data. Meanwhile, patients and doctors remain concerned about the cost of these shifts—financially and physically.
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