Eli Lilly secures PBM coverage for obesity drugs, expanding access to millions

Eli Lilly & Co. said all three of the largest US pharmacy benefit managers will cover its full obesity medicine portfolio, a milestone that expands insurance access for millions of Americans to drugs including Zepbound and Foundayo.

"Broadening patient access to obesity medicines is a critical step in addressing the public health crisis," David Ricks, chief executive officer at Eli Lilly, said in a statement. "We are working to ensure that patients who need these therapies can access them through their existing insurance."

CVS Caremark will begin covering Foundayo, Lilly's oral obesity pill, on June 1 and resume coverage of Zepbound, its injectable weight-loss drug, by Oct. 1. Eligible patients may pay as little as $25 a month for their medicine, the Indianapolis-based company said. The move follows similar coverage commitments from the other two largest PBMs, whose names were not disclosed.

The access expansion removes a key barrier in the obesity drug market, where list prices for GLP-1 therapies can exceed $1,000 a month without insurance. Zepbound generated $4.2 billion in first-quarter sales, up 80% from a year earlier, while Mounjaro — a diabetes drug sharing the same active ingredient — posted $8.7 billion, a 125% gain. Foundayo, approved in April, is Lilly's entry in the oral GLP-1 race against Novo Nordisk's oral Wegovy. The coverage milestone positions Lilly to capture a larger share of the obesity market, which analysts project could exceed $100 billion annually by the end of the decade. Investors will watch monthly prescription data for Foundayo and Zepbound to gauge the coverage expansion's impact on revenue growth.

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