CVS Caremark Faces Lawsuit for Favoring Wegovy Over Zepbound (1)

CVS Caremark was sued Wednesday by two health plan participants who say the pharmacy benefit manager wrongly refuses to cover weight-loss drug Zepbound because of its arrangement with Wegovy maker Novo Nordisk A/S.

The proposed class action says the company—formally known as Caremark RX LLC—stopped covering Eli Lilly & Co.'s Zepbound earlier this year, after it entered into a rebate agreement with Novo Nordisk that caused it to favor Wegovy. The plaintiffs, two patients who were prescribed Zepbound to treat obesity and other symptoms, say this violates the terms of their employer-sponsored health plans, which include coverage for medically necessary prescription drugs.

Both Wegovy and Zepbound cost more than $1,000 for a one-month supply. The medications received approval from the US Food & Drug Administration in 2021 and 2023, respectively.

Caremark’s decision to favor Wegovy overlooks important differences in the two drugs, including Zepbound’s ability to effectively treat sleep apnea, the patients said.

“Because of their different methods of action, different clinical outcomes, and different side effects for individual patients, Zepbound and Wegovy are not clinically interchangeable,” the patients said in a complaint filed in the US District Court for the Southern District of New York. “And as studies have proven, Zepbound is more effective than Wegovy in achieving weight loss, and only Zepbound has been proven effective and approved by the FDA for treating sleep apnea in patients with obesity.”

Plaintiffs Dennis Larkin and Danielle Gosline bring claims under the Employee Retirement Income Security Act on behalf of a proposed class of thousands of health plan participants whose requests for Zepbound coverage have been denied since July.

“This suit is without merit, and we’ll defend ourselves vigorously against these claims,” a CVS Health spokesperson said in an emailed statement.

Larkin and Gosline are represented by Berger Montague PC and Hufford Law Firm PLLC.

The case is Larkin v. Caremark RX, LLC, S.D.N.Y., No. 1:25-cv-07307, complaint 9/3/25.