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CVS HealthIntegrated payer, PBM, and retail pharmacy (Aetna, Caremark, about 9,000 stores). Caremark holds the strongest single lever over US GLP-1 access: it made Wegovy the preferred weight-management drug from July 2025 and removed Zepbound, then added Zepbound back at the same tier effective October 1, 2026.
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