Coverage Drops Hit Millions
- Insurers cut access to obesity drugs, with about 12 million people losing coverage for Wegovy last year. (npr.org) - The same reporting says roughly 12 million people also lost coverage for Zepbound over the same period. (npr.org) - Patients are switching therapies or seeking compounded alternatives as payer restrictions reshape who can stay on GLP‑1 drugs. (wxxinews.org)
Insurers pulled coverage for popular GLP‑1 obesity drugs, leaving roughly 12 million people without Wegovy last year. (goodrx.com) GoodRx's analysis found that from 2025 to 2026 about 12 million people lost coverage for Wegovy and about 12 million lost coverage for Zepbound. (goodrx.com) CVS Caremark removed Zepbound from many standard formularies effective July 1, 2025, and some employer plans removed Wegovy in October 2025, narrowing options for patients. (business.caremark.com) Meghan Lena, a Massachusetts teacher, said she paid a $30 monthly copay for Zepbound, lost 50 pounds in a year, then had to switch to Wegovy and later lost that coverage while her monthly premium rose 20%. (houstonpublicmedia.org) As coverage narrows, patients are switching therapies, pursuing compounded formulations prescribed by clinicians, or paying hundreds of dollars a month out of pocket to stay on GLP‑1s. GoodRx reports that more than 88% of plans that still cover these drugs now require prior authorization or step therapy, and more than 16 million people lack commercial coverage for any weight‑loss GIP or GLP‑1. Payers and pharmacy benefit managers say formulary shifts are a cost‑control measure; CVS estimated preferring alternatives could save some health plans about 10%–15% on annual anti‑obesity medicine costs. (business.caremark.com) Patients and advocates say the changes are reshaping who can stay on effective treatments; "that really, really made me mad," Lena told NPR after losing coverage. (houstonpublicmedia.org)
