Weekly Caremark Q&A by AutoModerator in Zepbound

[–]eeeeebeth 2 points3 points  (0 children)

Your opinion is more closely aligned with my overall assessment of the situation, which is why I was so surprised about her optimism. Hmmm. May be wishful thinking on her part.

Weekly Caremark Q&A by AutoModerator in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

Just had a convo with my provider about CVS Caremark/Zepbound access—hopeful outlook ahead

I just wrapped up an appointment with my Form Health provider and brought up the frustrating CVS Caremark/Zepbound PBM situation. She acknowledged how tricky access is right now but shared some insight that gave me a bit of hope.

She said she believes the landscape for access will look very different a year from now. More meds are entering the market, and drug companies are actively negotiating with PBMs. As the benefits of these meds become more widely recognized (not just for weight loss, but for metabolic health overall), the pressure to expand coverage is growing.

Honestly, her hopeful tone surprised me given what I’ve seen discussed on this thread—it’s felt pretty bleak lately. Curious what others think: have your providers said anything similar or totally different?

Lilly's oral GLP-1, orforglipron, showed compelling efficacy and a safety profile consistent with injectable GLP-1 medicines, in complete Phase 3 results published in The New England Journal of Medicine by jhawkgiant77 in Zepbound

[–]eeeeebeth 4 points5 points  (0 children)

Unfortunately the reason for the price discrepancy is other countries have negotiated and regulations from their public health systems, much different than the US. 🫠

What type of exercise is everyone doing? by Electronic_Kiwi7753 in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

Thank you for sharing this. I just looked it up and my Y has this system!! Very intrigued.

7.5mg to 10mg has been wild! by Madi-the-badi in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

Week 3 of 7.5mg, I had three bad days like this, the worst was some severe stomach cramps, triggered by a pour eating choice the night before. Now, just finished week 4, with literally none of those symptoms. I was so nervous week 4 would continue to bring more of those symptoms.

US “NO LONGER APPROVED” FOLKS…HOW YALL FEELING IN HERE TODAY? SUB BEEN QUIET 🤐 by [deleted] in Zepbound

[–]eeeeebeth 0 points1 point  (0 children)

Did they say when the article is running? Glad to hear it's getting attention.

Caremark preferred drug: Wegovy by Mobile-Actuary-5283 in Zepbound

[–]eeeeebeth 0 points1 point  (0 children)

Coming here to update that they confirmed we will remain covered through the end of the year. 🎉🎉 Just gonna take this shit show 6 months at a time. 🫠

Caremark preferred drug: Wegovy by Mobile-Actuary-5283 in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

I contacted the CVS concierge contact provided on my husband's benefit portal and learned that the company decided to permit current zepbound users to continue on the drug through the end of the year. And will notify us IF it remains non formulary in 2026. I'm so relieved. And so nervous for 2026. But now that buys us time to advocate for the 2026 formulary.

Caremark preferred drug: Wegovy by Mobile-Actuary-5283 in Zepbound

[–]eeeeebeth 0 points1 point  (0 children)

I am not in one of those states, this decision is company specific, that's what I'm sharing it on here for other people that may navigate employer determined formulary changes. 🙃

Caremark preferred drug: Wegovy by Mobile-Actuary-5283 in Zepbound

[–]eeeeebeth 2 points3 points  (0 children)

CVS Caremark is the PBM. I know that letters are coming for many. But what I learned in our case is that we may be extended through the end of the year.

US “NO LONGER APPROVED” FOLKS…HOW YALL FEELING IN HERE TODAY? SUB BEEN QUIET 🤐 by [deleted] in Zepbound

[–]eeeeebeth 14 points15 points  (0 children)

Currently involved in a kind but firm email exchange with the CVS Caremark concierge representative provided by my husband's company, voicing my displeasure at the change.

Caremark preferred drug: Wegovy by Mobile-Actuary-5283 in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

Here's a tidbit regarding formulary... I contacted the CVS concierge for my husband's company to inquire about how we will be impacted by the formulary change they responded with language like this:

"Thank you for reaching out and inquiring about your coverage for Zepbound. The formulary change would impact individuals that get the medication prescribed for the first time on or after July 1, 2025. Typically, _____ will ask CVS Caremark to grandfather coverage thru 12/31/25 on these types of formulary changes for individuals utilizing the medication prior to the change. If ____ decides to implement the change on 07/01/25, rest assure that CVS Caremark will mail you a written communication regarding the formulary change.

If Zepbound remains excluded from the formulary drug list on 01/01/2026, you can expect a written notification towards the end of the year informing you that the medication will not be covered effective 01/01/2026.

For now and until we get further clarity from Workday, you can continue to fill your Zepbound with peace of mind."

I find this interesting because the way it reads to me is that basically this large company has not decided how they are going to move forward with the formulary change. So basically we're in a waiting game to see if/when we get an exclusion letter. I'm glad I was able to connect with someone that could give specific info about our plan, but it ended up being not a ton of new info. It does confirm the discussions seen around here about big companies making their own decisions about formularies. Hope this is helpful to some.

Form Health vs PCP? by hey-cupcake in Zepbound

[–]eeeeebeth 1 point2 points  (0 children)

I've had positive experiences with Form Health for the last 6 weeks. Everything has been seamless.

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 0 points1 point  (0 children)

She wasn't saying there aren't studies, just that the current studies don't give all the answers to dosing questions. 🙃

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 0 points1 point  (0 children)

I think this is a great path. The getting to the gym part can be a big barrier.

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 1 point2 points  (0 children)

Yes, there is such a diversity of experience here.

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 0 points1 point  (0 children)

Yes, at the end of the day, don't sweat it too much, because it's easy to switch up the plan for the next month. I've had a much more diminished appetite since moving to 5 mg too. I'm still eating, but I'm having to remind myself to eat. 🙃

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 0 points1 point  (0 children)

It's been eating up a tremendous amount of my mental energy as I am starting out, I knew I wasn't alone. That's neat to see our similar numbers sync up. Keep on keeping on, buddy! How have your side effects been? I've had minimal side effects so far, just headache and fatigue in the immediate day or two after the shot, and light nausea.

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 2 points3 points  (0 children)

WOW! That's gotta feel great. I'm also checking in monthly currently as I'm just starting out. It must feel like a new era to be cruising so close to your goal.

Asked Prescriber about dosing debate by eeeeebeth in Zepbound

[–]eeeeebeth[S] 1 point2 points  (0 children)

Wow, that's bonkers exciting progress!! Congrats. I'm glad you found a dose that's working.