CVS Caremark, one of the largest pharmacy benefit managers in the U.S., has announced it is dropping Zepbound (tirzepatide) from its preferred drug list, replacing it with Wegovy (semaglutide). The change took effect on July 1, 2025, citing rising drug costs as the reason. CVS Caremark stated that it partnered with Novo Nordisk to increase access to Wegovy at an affordable price. However, many patients are upset about the switch, as they are being forced to change medications due to the new policy.
Some patients have reported that Zepbound is more effective and has fewer side effects than Wegovy, and they are worried about losing the benefits they have gained. Others have experienced adverse reactions to Wegovy in the past and are concerned about the possibility of switching to a drug they may not tolerate well. The policy also raises questions about patient choice and the role of insurance companies in determining which medications are covered.
Patients who previously tried Wegovy and experienced severe side effects can request exceptions, but many are unsure of the process. The decision has led to widespread concern among patients and their healthcare providers, who are worried about the potential impact on treatment plans and weight loss progress.
CVS Caremark has stated that the change is meant to lower out-of-pocket drug prices for patients. They argue that drug manufacturers have priced these medications at a high cost, making them unaffordable for many people. The company has noted that they are partnering with Novo Nordisk to increase access to Wegovy at a more affordable price. However, many patients are concerned that this move is not in their best interest and that they are being forced to switch medications without proper consideration of their individual circumstances.
The decision has raised questions about the role of insurance companies in healthcare and the impact of their policies on patient treatment. Patients and healthcare providers are urging for more flexibility and options in medication choices to ensure that patients can receive the best possible care. The situation highlights the challenges faced by patients in navigating the complex world of insurance coverage and medication access in the U.S. healthcare system.