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Below we review the public information on the three largest PBM entities (CVS Caremark, Cignas Express Scripts/Evernorth, and UnitedHealths OptumRx) as of 2026, along with illustrative plan examples

GLP-1 agonists, such as semaglutide or tirzepatide, act on the GLP-1 receptor to suppress appetite and to regulate glycemia

The most clinically rigorous is Form Health, which uses board-certified obesity specialists and requires more upfront labs

Research-Use Labelling and Canadian Compliance Requirements Canadian regulatory framing for injectable peptides has tightened throughout 2025 and 2026, and BPC-157 in particular has been named in multiple Health Canada advisories

This is particularly the case for people who have diabetic retinopathy , which is damage to the eyes blood vessels caused by diabetes