Understanding Zepbound and its Place in Weight Management
Zepbound, with the active ingredient tirzepatide, is a once-weekly injectable prescription medication approved by the FDA for chronic weight management [1.10.3]. It is indicated for adults with obesity (BMI ≥ 30) or those who are overweight (BMI ≥ 27) with at least one weight-related health condition like high blood pressure [1.5.3]. In late 2024, it also gained FDA approval for treating moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity [1.10.2, 1.10.4]. Zepbound works by mimicking two gut hormones, GIP and GLP-1, to help regulate appetite and food intake, leading to significant weight loss [1.8.3, 1.10.3]. Its effectiveness has made it a popular choice, with studies showing an average weight loss of up to 50 pounds [1.7.3].
CVS Pharmacy vs. CVS Caremark: A Crucial Distinction
The central point of confusion for many patients is the difference between CVS Pharmacy and CVS Caremark.
- CVS Pharmacy is the retail store where you pick up medications. You can still get your Zepbound prescription filled at a physical CVS Pharmacy location [1.2.4].
- CVS Caremark is a Pharmacy Benefit Manager (PBM), the part of CVS Health that manages prescription drug coverage for many insurance plans [1.2.4].
Effective July 1, 2025, CVS Caremark removed Zepbound from its standard formularies, making Novo Nordisk's Wegovy the preferred GLP-1 medication for obesity management [1.3.2, 1.4.2]. This was a business decision aimed at lowering drug costs through competition [1.2.5, 1.4.3]. This formulary change means that for many patients whose insurance is managed by CVS Caremark, Zepbound is no longer covered, or will require a much higher out-of-pocket payment [1.3.3].
Navigating Insurance and Formulary Changes
If your prescription drug plan is managed by CVS Caremark, you were likely notified of this change. Existing prior authorizations for Zepbound under these plans were canceled as of June 30, 2025 [1.2.4]. However, coverage is not universally eliminated. Some employer-specific plans may have chosen to continue covering Zepbound, making coverage highly individualized [1.4.5].
If you are affected, you have a few options:
- Switch to the Preferred Alternative: Your doctor can prescribe Wegovy, which is the preferred and covered alternative on the CVS Caremark formulary [1.4.2].
- Appeal the Decision: You have the legal right to request a formulary exception for Zepbound based on medical necessity. This is a viable path if Zepbound has been particularly effective for you or if you have specific medical reasons for not switching to Wegovy [1.3.1]. You and your healthcare provider can submit a new prior authorization, and it is recommended to contact CVS Caremark beforehand to understand the specific information required for approval [1.2.4].
- Pay Out-of-Pocket with Savings Programs: If you choose to stay on Zepbound without insurance coverage, you can still fill it at CVS Pharmacy but will face higher costs. The list price for a one-month supply is over $1,000 [1.5.3]. However, the manufacturer, Eli Lilly, offers a Zepbound Savings Card. Commercially insured patients whose plan does not cover Zepbound may be able to pay as low as $650 for a one-month supply [1.6.5]. Patients with commercial insurance that does cover Zepbound can pay as little as $25 [1.6.2].
Zepbound vs. Wegovy: A Comparison
The decision by CVS Caremark to prefer Wegovy over Zepbound has put a spotlight on the differences between these two leading weight-loss drugs.
| Feature | Zepbound (tirzepatide) | Wegovy (semaglutide) |
|---|---|---|
| Mechanism | Dual-agonist: mimics both GIP and GLP-1 hormones [1.8.3]. | Single-agonist: mimics the GLP-1 hormone only [1.7.4]. |
| Effectiveness | Head-to-head trials showed greater weight loss; an average of 20.2% of body weight lost over 72 weeks [1.7.3, 1.7.4]. | Studies show an average weight loss of 13.7% of body weight over 72 weeks in the same trial [1.7.3, 1.7.4]. |
| Additional FDA Approvals | Approved for moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity [1.10.4]. | Approved to reduce the risk of serious cardiovascular events in adults with heart disease and obesity/overweight [1.7.4]. |
| Administration | Once-weekly injection, available in pre-filled pens and vials [1.7.4]. | Once-weekly injection, available only in pre-filled pens [1.7.4]. |
| Common Side Effects | Nausea, diarrhea, vomiting, constipation, stomach pain, hair loss [1.9.1]. | Similar gastrointestinal side effects to Zepbound [1.9.3]. |
Conclusion: Your Path Forward
So, will CVS still fill Zepbound? Yes, CVS retail pharmacies will. The more pertinent question is about insurance coverage, which is dictated by your pharmacy benefit manager, such as CVS Caremark. As of mid-2025, many CVS Caremark plans no longer prefer Zepbound, which means patients may need to switch to Wegovy, appeal for a formulary exception, or prepare to pay a higher cost using savings programs. The most important step is to have a conversation with your healthcare provider and your insurance company to understand your specific plan's coverage, discuss the clinical appropriateness of switching medications, and explore all available financial assistance options to ensure continuous and affordable access to your treatment.
For the most authoritative information on patient access and savings, you can visit Zepbound's official access page [1.2.4].
