Healthy Returns: Novo Nordisk’s Wegovy deal with CVS won’t derail Eli Lilly’s obesity market dominance

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Despite last week’s investor jitters, Eli Lilly is far from losing its strong grip on the booming weight loss market. 

Here’s a recap of what sparked the panic on Thursday if you missed it: CVS Health‘s pharmacy benefit manager Caremark said it will prioritize Novo Nordisk‘s Wegovy on its standard formularies on July 1, making that weekly injection the preferred GLP-1 drug for obesity. 

As part of the move, Caremark will also drop Eli Lilly’s weight loss drug Zepbound from those formularies, which represent tens of millions of patients. Caremark negotiated an undisclosed lower net price for Wegovy over Zepbound on its standard formularies, offering savings on Novo Nordisk’s drug to clients that opt into those plans. 

But employers and unions will ultimately determine how much of those savings on Wegovy get shared with members, CVS said. 

Wegovy’s list price before insurance is $1,349 for a month’s supply, while Zepbound’s is $1,086.

That decision by one of the nation’s largest PBMs triggered fears of a price war in the weight loss drug market and concerns that Zepbound’s sales momentum could stall. Shares of Eli Lilly plunged 11% on Thursday. 

But several Wall Street analysts said the selloff was overblown.

“In our view, the Novo/CVS deal does not represent the beginning of an obesity pricing war between Lilly & Novo,” BMO Capital Markets analyst Evan Seigerman said in a note on Thursday. He added that in discussions with the companies, both Lilly and Novo emphasized they want to expand patient access – not undercut each other on price.

That may be reassuring to investors worried that a price war could hurt profit margins. But the high list price of those weight loss drugs may remain a major barrier for many patients, particularly those whose health plans don’t cover the medications. 

Eli Lilly told the firm it is not interested in exclusive “one-of-one” deals with PBMs, while Novo Nordisk said CVS approached the drugmaker about the Wegovy agreement, according to Seigerman.

On an earnings call on Thursday, Eli Lilly CEO David Ricks said the company has been trying to move away from setting high list prices and paying bigger rebates to PBMs for preferential coverage. Instead, Eli Lilly is trying to set list prices closer to what it expects the plans to pay for its drugs.

“We have been very vocal about trying to move away from that,” Ricks said, referring to deep PBM rebates. 

He added that Zepbound is still growing market share. 

Seigerman agreed, saying that Eli Lilly is “continuing to perform where it matters.” Zepbound and the company’s diabetes drug Mounjaro now make up over half of U.S. GLP-1 prescriptions, outpacing the combined 46% share of Novo Nordisk’s Wegovy and its diabetes treatment Ozempic, according to Seigerman. 

That “market-share traction clearly demonstrates that physicians and patients prefer Zepbound” over Wegovy, Bernstein analyst Courtney Breen wrote in a separate note on Thursday. 

It’s unclear how much the CVS formulary change will appeal to employers, especially given that Zepbound is known to be more effective at promoting weight loss than Wegovy. Some patients on the standard formularies may also try to stay on their current Zepbound prescriptions by requesting exemptions, JPMorgan analyst Chris Schott said in a Thursday note. 

Eli Lilly’s Ricks also said CVS’ move mainly affects smaller employers, who are more likely to stick with Caremark’s standard formularies. Larger companies covering more patients often use customized formularies, meaning they can still decide to include Zepbound. 

Regardless, the CVS-Wegovy deal overshadowed an overall strong quarter for Eli Lilly. 

The company’s first-quarter revenue and earnings topped estimates on skyrocketing demand for Zepbound and Mounjaro, both of which raked in billions of dollars in sales for the period. 

We’ll continue to track Eli Lilly’s performance in the weight loss drug market, so stay tuned!

Feel free to send any tips, suggestions, story ideas and data to Annika at [email protected].

Health-care marketplace Zocdoc has launched an artificial intelligence phone assistant that can help patients schedule appointments using conversational language.

ZocDoc, founded in 2007, helps connect patients to in-network doctors and book appointments for both in person and virtual care. The company’s new AI assistant, called Zo, can handle “unlimited” inbound calls at any hour of the day, eliminating hold times, ZocDoc said in a release. 

The company said Zo can save staffers time and improve patients’ experiences, which can ultimately encourage them to seek out the care they need. The assistant also serves as a major step toward what the company called its goal of aiding scheduling “everywhere patients are seeking care.”

“What’s most exciting about Zo is that it is powered by nearly two decades of Zocdoc’s expertise in facilitating patient-provider interactions, understanding complex healthcare scheduling logic, and integrating with a broad base of [electronic health records],” Zocdoc CEO Oliver Kharraz said in a statement. 

Patients can ask Zo questions like, “Do you take my insurance?,” or “Do you have any offices near the West Village?,” according to a pre-recorded demo.

Health-care organizations can implement Zo without any upfront fees, long-term costs or commitments, and they don’t have to be Zocdoc Marketplace customers, the company said. Providers can try out the assistant for $2 per booked appointment, but organizations that want to roll it out on a larger scale can access discounted pricing. 

Zocdoc said early adopters of Zo have been able to resolve up to 70% of all scheduling calls without staff intervention. The average call lasts around two minutes and 30 seconds. 

While appointment management is Zo’s first use case, Zocdoc said it’s exploring other applications for the assistant, including prescription refills, messaging and outbound calls like appointment reminders or last-minute openings. 

Read the full announcement here. 

Feel free to send any tips, suggestions, story ideas and data to Ashley at [email protected].