Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health

Eli Lilly's banal wobbled Thursday aft a looming sum deed was elaborate for its blockbuster weight-loss cause Zepbound.

CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk volition go the preferred options connected its modular formulary, oregon database of covered drugs, arsenic of July 1. Zepbound volition beryllium excluded.

This could complicate entree to a cause that galore patients cannot spend to wage for connected their own.

The formulary is maintained by CVS Health’s pharmacy benefits absorption business, which runs medicine cause sum for millions of people. Employers and insurers — who wage astir of the medicine measure — usage the formulary to determine which drugs get coverage.

They tin customize their sum plans to see Zepbound. But CVS Health spokesperson David Whitrap said astir employers upwind up utilizing the modular formulary due to the fact that of the discounts negotiated for them.

Patients taking Zepbound volition beryllium capable to power to Wegovy if the Lilly cause is excluded from their coverage, Whitrap said.

CVS Health besides said Thursday that it volition commencement selling Wegovy astatine a discounted terms of astir $500 monthly astatine thousands of drugstores for radical without coverage. Novo had announced its caller little terms past month.

Wegovy and Zepbound are portion of a question of obesity medications known arsenic GLP-1 receptor agonists that person soared successful popularity owed to the magnitude of value radical suffer portion taking the injections. Coverage of these drugs has been patchy owed to successful portion to their outgo and the wide swath of patients who could instrumentality them.

Shortages of the drugs besides person made entree challenging, but those person eased recently. That allows pharmacy payment managers to pit the products against each different to negociate little prices successful speech for inclusion connected a formulary.

Lilly whitethorn person to marque immoderate terms cuts to reconstruct formulary access, said Daniel Barasa, who follows the institution for Gabelli Funds. But helium said helium thinks large employers volition inactive see some treatments connected their lists of covered drugs, leaving the prime connected what to usage up to patients and doctors.

Lilly said precocious past year that a head-to-head survey of the 2 drugs showed that Zepbound helped patients driblet much pounds.

Zepbound has emerged arsenic 1 of Lilly's apical sellers. Its income jumped to $2.3 cardinal successful the precocious completed archetypal quarter. That’s up from $517 cardinal a twelvemonth ago, during the drug’s archetypal afloat 4th connected the market.

Lilly shares shed much than $90 successful value, falling astir 11% to $804.06 Thursday afternoon. Broader indexes, meanwhile, roseate slightly.

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