Eli Lilly has secured nationwide PBM formulary coverage for its obesity portfolio, including Zepbound and Foundayo, expanding access to FDA‑approved GLP‑1 therapies with new affordability programs for commercial and Medicare patients.
By: Regulatory Desk
Eli Lilly and Company has secured formulary coverage for its full obesity medicine portfolio across all three of the largest U.S. pharmacy benefit managers (PBMs), marking a major reimbursement milestone in the rapidly growing obesity treatment market. The expanded access includes Zepbound (tirzepatide) and Foundayo, Lilly’s once-daily oral GLP-1 therapy for weight management.
Under the updated coverage framework, CVS Caremark Commercial Template plans will begin covering Foundayo on June 1, while existing Zepbound coverage will continue without interruption. Lilly said Zepbound access will expand across additional template plans by October 1.
The announcement strengthens commercial access to FDA-approved obesity medicines at a time when payer restrictions, high out-of-pocket costs, and inconsistent reimbursement continue to limit treatment uptake despite rising obesity prevalence in the United States.
Zepbound, a dual GIP and GLP-1 receptor agonist, has become the most-prescribed injectable obesity therapy in the U.S. The therapy demonstrated substantial weight reduction in the SURMOUNT clinical trial program, helping establish incretin-based therapies as a leading pharmacologic approach in obesity management.
Foundayo expands Lilly’s obesity portfolio into the oral treatment segment. The once-daily GLP-1 pill can be taken without food or water restrictions, offering a more flexible administration profile compared with earlier oral incretin therapies. Lilly positioned the therapy as an alternative for patients who prefer non-injectable treatment options.
Obesity remains a major chronic disease burden globally and is associated with increased cardiovascular, metabolic, and renal complications. Although GLP-1-based therapies have reshaped obesity treatment, access barriers and reimbursement limitations have slowed broad adoption across insured populations.
Ilya Yuffa, executive vice president and president of Lilly USA and global customer capabilities, said broader reimbursement gives physicians and patients greater flexibility to select therapies based on individual treatment needs rather than insurance constraints.
Lilly also expanded affordability initiatives alongside the PBM agreements. Eligible commercially insured patients may access both therapies for as little as $25 per month. Beginning July 1, eligible Medicare Part D beneficiaries may qualify for obesity medicines through the company’s Medicare GLP-1 Bridge program at approximately $50 per month.
The reimbursement expansion positions Lilly to further strengthen its leadership in the obesity market as competition intensifies across injectable and oral incretin therapies. The company continues to scale manufacturing capacity and broaden payer adoption to support long-term commercial growth in obesity and metabolic disease treatment.
Reference
Foundayo and Zepbound now covered for millions of Americans | Eli Lilly and Company