Saw the Bloomberg piece this morning about CVS dropping semaglutide from some 2025 formularies. My A1c went 7.8 to 6.1 over 28 weeks on Ozempic, so I watch this stuff. The article says PBMs are pushing back on $900+ list prices. Curious if anyone else read it—does this actually lower what people pay, or just shift everyone to different brands? I'm not asking for dosing advice, just trying to understand the market side.
CVS formulary drop—are GLP-1 prices finally softening?
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#2
I read that Bloomberg piece too. The list price vs net price gap is the whole story, and it’s the same deal with vendors—prices vary a ton depending on who you’re looking at. PBMs say they’re cutting costs, but rebates often just get pocketed. I wouldn’t trust any static number anyway; just check the live listings when you’re actually comparing.
#3
Right, and the member prmeium doesn't always track the rebate. My employer plan moved Ozempic to tier 3 in January and my copay doubled.
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#4
Doubled? Ouch. Did your PA renewal also get lost twice?
#5
The A1c drop in the OP is impressive, but market access is a different beast. A formulary exclusion can force a switch even if the clinical data looks good.
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#6
Yep. I work in benefits and we got a vendor pitch promising 22% savings by excluding one GLP-1. Nobody could tell us what happens to patients already stable.
#7
That's the part that scares me. Switching isn't always plug-and-play. I've seen people stall for weeks waiting on new PA.
#8
And switching stalls are part of why demand looks inelastic. I've been following the earnings calls, and the message keeps being that demand is still outstripping supply. If that's true, formularies are less about shortage and more about rebate leverage. The news angle is real, but I don't think list prices fall much. They'll just give bigger discounts behind the scenes while cash-pay people still see the scary number. The OP's A1c change is the kind of outcome that makes these decisions politically messy, honestly.
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#9
So what do we watch—net price, not list?
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#10
My scale sat at the same number for almost five weeks and I was ready to swear off my Renpho, but my old jeans went from oh-hell-no to actually-buttoned in that stretch, so now I log waist at the navel every Sunday instead of weighing daily. I'm on this since March, 34 pounds down but the tape has told a better story than the scale for a while now. Point being, if premiums do shift around it's worth tracking the free stuff too, because the mirror moved way before the number did.
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