Summary of Esperion Therapeutics Conference Call Company Overview - **Company**: Esperion Therapeutics (NasdaqGM:ESPR) - **Event**: Key opinion leader-investor event focused on statin intolerance and cardiovascular health - **Date**: November 11, 2025 Key Points Financial Performance - **Q3 Total Revenue**: $87.3 million, representing a nearly 70% year-on-year growth [3] - **Q3 US Net Product Sales**: $40.7 million, indicating a 31% year-on-year growth [3] - **Retail Prescription Equivalents**: 9% increase quarter-over-quarter [4] Product Development and Market Position - **Nexletol and Nexlizet**: Outpacing the broader lipid-lowering market and exceeding growth of other non-statin therapies [4] - **Statin Intolerance**: Approximately 50% of patients starting statin therapy discontinue or have significant gaps in treatment within two years, highlighting a market opportunity for Nexletol and Nexlizet [5] - **Direct-to-Consumer Advertising**: Launched on platforms like Disney+ and Hulu, achieving over 6 million impressions since October [7] Clinical Insights - **Statin Intolerance Definition**: Up to 30% of US adults experience some degree of statin intolerance, which can lead to non-adherence and increased cardiovascular risk [10][12] - **Bempedoic Acid**: Developed to address statin intolerance, it is a pro-drug that targets the liver, avoiding muscle-related side effects associated with statins [15] - **Clinical Trials**: Bempedoic acid has shown significant LDL cholesterol reduction and hsCRP lowering, with the Clear Outcomes trial being the only outcomes study in statin-intolerant patients [19][22] Market Access and Awareness - **Medicare and Commercial Approval Rates**: 87% for Medicare and 86% for commercial plans, indicating improved access for patients [8] - **Patient Copays**: Average copays are $29 and $36 for a 30-day supply, reflecting growing payer confidence [8] - **Awareness Challenges**: There is a significant gap in awareness among healthcare professionals regarding non-statin therapies, which affects adoption rates [52][56] Physician Perspectives - **Patient Characteristics**: Females and older individuals are at higher risk for statin intolerance, and many patients are unwilling to start statin therapy due to perceived side effects [12][14] - **Combination Therapy**: There is a growing trend towards using combination therapies to achieve LDL targets, especially in high-risk patients [40][41] - **Imaging Tools**: Physicians are increasingly using imaging to educate patients about their cardiovascular risk and the importance of LDL-lowering therapies [48] Future Outlook - **Guideline Updates**: Recent ESC guidelines emphasize the importance of non-statin therapies, with bempedoic acid receiving high recommendations for statin-intolerant patients [22] - **Educational Commitment**: Esperion is dedicated to educating both healthcare providers and patients about statin intolerance and available alternatives [23] Additional Insights - **Patient Education**: There is a need for better education regarding the risks of high LDL cholesterol and the importance of treatment adherence [56] - **Market Potential**: The potential market for bempedoic acid is significant, especially among primary care populations and patients with diabetes [58] This summary encapsulates the key insights and data presented during the conference call, highlighting Esperion Therapeutics' performance, product positioning, and the broader implications for cardiovascular health management.

Core Insights - Esperion Therapeutics (ESPR) reported a loss of $0.16 per share in Q3 2025, which was wider than the Zacks Consensus Estimate of a loss of $0.09 and compared to a loss of $0.15 per share in the same quarter last year [1][8] - The company generated total revenues of $87.3 million in Q3, marking a 69% year-over-year increase and surpassing the Zacks Consensus Estimate of $83 million [1][8] Financial Performance - Product revenues from the United States totaled $40.7 million in Q3, reflecting a 31% year-over-year increase but missing the Zacks Consensus Estimate of $42.9 million [7] - Collaboration revenues reached $46.7 million in Q3, up 128% year-over-year, driven by increased royalty sales and product sales to collaboration partners, beating the Zacks Consensus Estimate of $40.5 million [9] - Research and development expenses increased by 36% year-over-year to $14.1 million, while selling, general, and administrative expenses rose by 5% to $41.8 million due to higher legal and media costs [10] Future Outlook - Esperion expects operating expenses for 2025 to be in the range of $215-$235 million, including $15 million in non-cash stock compensation expenses, and aims for sustainable profitability by Q1 2026 [12] - The company has nominated ESP-2001, an allosteric ATP citrate lyase inhibitor, for preclinical development targeting primary sclerosing cholangitis, with plans to initiate IND-enabling studies and submit an IND application in 2026 [13] Recent Developments - Esperion reached a settlement with Dr. Reddy's regarding patents for Nexletol and Nexlizet, preventing the launch of generic versions in the U.S. before April 19, 2040, under certain conditions [14][15] - The company has two FDA-approved drugs, Nexletol and Nexlizet, for treating elevated LDL-C and cardiovascular risk reduction, marketed as Nilemdo and Nustendi in ex-U.S. markets [5][6] Stock Performance - Shares of Esperion fell by 15% on November 6, likely due to mixed Q3 results, despite a year-to-date increase of 13.7%, outperforming the industry average rise of 3.7% [2][4]

Financial Data and Key Metrics Changes - Total revenue for Q3 2025 grew 69% year over year to $87.3 million [4][18] - U.S. net product revenue increased 31% year over year to $40.7 million [4][18] - Collaboration revenue rose approximately 128% to $46.7 million compared to the same period in 2024 [18] Business Line Data and Key Metrics Changes - U.S. prescription growth saw nearly double-digit sequential growth, contributing to the overall revenue increase [4] - Average approval rate for Medicare coverage reached 87%, with out-of-pocket costs reduced significantly [10][11] - Total retail prescription equivalents increased by 9% from Q2 2025, with a 7% increase in the number of healthcare professionals prescribing Nexletol and Nexlizet [12] Market Data and Key Metrics Changes - The company outpaced the broader adjunct lipid-lowering market, achieving growth that exceeded all other non-statin products [6] - Royalty revenue from Daiichi Sankyo Europe increased 21% sequentially to $16.4 million [14] Company Strategy and Development Direction - The company is focused on expanding patient access programs and enhancing marketing strategies to drive future growth [4][5] - Strategic agreements with four generic manufacturers were finalized to protect the long-term value of its products [5] - The inclusion of bempedoic acid in ESC/EAS guidelines is expected to support expanded utilization and reinforce the company's market position [13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving sustainable profitability by Q1 2026, despite one-time costs impacting net income [24] - The company anticipates continued growth momentum driven by strong execution and strategic investments [21][31] Other Important Information - The company closed a $75 million follow-on equity offering to ensure adequate capital for future developments [20] - The launch of Nexletol in Japan is expected to occur shortly after final pricing approval, which is anticipated within weeks [31][15] Q&A Session Summary Question: What were the drivers behind the gross margins for this quarter? - Gross margin drivers included low-margin tablet sales to partners, with expectations for improvement in 2026 as manufacturing is transferred [22] Question: Can you comment on achieving sustainable profitability in Q1 of 2026? - Management confirmed tracking in line with forecasts for sustainable ongoing profitability, with many Q3 expenses being one-time or non-recurring [24] Question: Regarding reimbursement per script, why were U.S. revenues flat despite a 9% increase in scripts? - One-time investments were made to secure preferred access with Medicare plans, impacting short-term revenue but expected to benefit future growth [25][27] Question: What feedback has been received regarding the ESC/EAS guidelines? - Positive feedback from partners indicates excitement among physicians regarding the guidelines, which are expected to enhance market reception [30] Question: What is the status of the 340B utilization of Nexletol and Nexlizet? - 340B utilization is minimal and not expected to impact revenue outlook [33] Question: What is the plan for the PSC pipeline and IND filing? - The company is in the planning phase for the PSC pipeline and aims to move quickly due to the high unmet need [34]

Core Insights - Esperion Therapeutics (ESPR) has nominated ESP-2001, a specific allosteric ATP citrate lyase (ACLY) inhibitor, as a new preclinical development candidate for treating primary sclerosing cholangitis (PSC), a rare autoimmune liver disease with no approved treatments [1][7] - The company plans to initiate IND-enabling studies for ESP-2001 and submit an IND application to the FDA, aiming to start clinical studies in 2026 [2] - ESP-2001 has shown potential in reducing liver and bile duct injury, inflammation, and fibrosis in preclinical studies, indicating its ability to impact PSC progression [3] Company Developments - Esperion's stock rose by 5.2% following the announcement of ESP-2001 [2] - The collaboration with Evotec (EVO) was crucial in discovering ESP-2001, combining Esperion's expertise in ACLY therapy with Evotec's drug discovery platform [2][3] - The nomination of ESP-2001 triggered an undisclosed payment to Evotec [3] Financial Performance - Esperion's net product sales of Nexletol and Nexlizet in the U.S. grew by 42% in the first half of 2025, reaching $75.2 million, driven by increased prescription volumes [10] - Esperion aims to diversify its portfolio beyond cardiovascular diseases into the liver disorder market, targeting a potential market opportunity exceeding $1 billion annually with ESP-2001 [10] Market Position - Esperion currently holds a Zacks Rank of 3 (Hold) [11] - The company has two FDA-approved drugs, Nexletol and Nexlizet, which are marketed under different names in ex-U.S. markets [8][9]

Core Insights - Esperion Therapeutics (ESPR) is conducting a secondary offering of 30 million shares at $2.50 per share, aiming to raise approximately $75 million in gross proceeds [1][7] - The stock price fell nearly 17% following the announcement due to the discounted pricing, which was 19% below the previous closing price of $3.09 [2][7] - The proceeds from the offering will be used to expand the commercial reach of marketed drugs Nexletol and Nexlizet, support clinical development, and for general corporate purposes [4][7] Financial Details - The secondary offering is expected to close today, with net proceeds estimated at $70.2 million after expenses [1] - The underwriters have an option to purchase an additional 4.5 million shares at the same price [1] Product Information - Nexletol and Nexlizet are marketed for treating elevated LDL-C and cardiovascular risk reduction, with Nexlizet being a combination of bempedoic acid and ezetimibe [5] - The company has settled patent litigation with Dr. Reddy's Laboratories, preventing the launch of generic versions of its drugs until April 19, 2040 [6] Legal Context - Esperion has signed similar agreements with other generic drugmakers, ensuring that they cannot market generics of Nexletol or Nexlizet until 2040 [8] - Ongoing patent litigation remains with other generic challengers, including Sandoz, Aurobindo Pharma, and MSN Pharmaceuticals [8] Market Performance - Year-to-date, ESPR's stock has gained 17%, outperforming the industry average growth of 10% [2]

Core Insights - Esperion Therapeutics (ESPR) has reached a settlement with Dr. Reddy's Laboratories (RDY) regarding patents for Nexletol and Nexlizet, preventing RDY from launching generic versions in the U.S. before April 19, 2040, under certain conditions [1][6] - Following the announcement, Esperion's shares increased by 13.8%, and the stock has risen 50% year-to-date, outperforming the industry growth of 14.1% [2] Patent and Litigation Summary - The settlement resolves patent litigation initiated by Esperion against RDY's abbreviated new drug application (ANDA) for generic versions of Nexletol and Nexlizet [2][5] - All disputes concerning the validity or infringement of U.S. Patent No. 7,335,799 have been resolved with this settlement [5][6] - Other patents involved in ongoing litigation are set to expire in March 2036 and June 2040 [7] Product Performance - Nexletol and Nexlizet are marketed as Nilemdo and Nustendi in international markets, with Esperion earning royalties from these sales [8] - In the first half of 2025, net product sales of Nexletol and Nexlizet in the U.S. grew by 42%, indicating strong prescription growth [9]

Summary of Esperion Therapeutics (ESPR) Conference Call Company Overview - **Company**: Esperion Therapeutics (ESPR) - **Focus**: Commercialization of life-saving medications, specifically Nexlizet and Nexletol, with ongoing development of new compounds [7][8][60] Key Points Industry Context - **Cardiovascular Disease**: Identified as the number one killer globally, emphasizing the need for effective lipid-lowering therapies [10][12][43] - **Statin Intolerance**: Approximately 30% of patients cannot tolerate statins, creating a significant market opportunity for alternative therapies like Nexlizet [19][36] Product Performance - **Growth Metrics**: Double-digit growth reported in all metrics for Q2, indicating strong market momentum [7] - **Combination Therapy**: Emphasis on the need for combination therapies to achieve LDL-C goals, with Nexlizet showing 38% additional efficacy when added to statins [19][28] Market Strategy - **Geographic Expansion**: Strong traction in Europe, with potential for similar success in the U.S. and Japan, where statin intolerance is prevalent [31][32] - **Guideline Influence**: Received a Class 1A recommendation in new guidelines, positioning bempedoic acid as a foundational therapy [34][35][49] Financial Outlook - **Positive Financial Trajectory**: Achieved positive operating income for the first time from ongoing operations, with expectations for full profitability by Q1 2026 [67][68] - **Cash Position**: Ample cash reserves and reduced debt profile, supporting ongoing growth initiatives [69] Future Developments - **New Indications**: Exploring treatment for primary sclerosing cholangitis (PSC), with confidence in the unique mechanism of action of their compounds [60][62] - **Triple Oral Combination**: Development of a triple oral combination therapy expected to enhance LDL-C reduction efficacy [38][39] Consumer Engagement - **Marketing Initiatives**: Upcoming consumer-directed commercials aimed at educating patients about heart health and the importance of treatment adherence [25][27] Competitive Landscape - **Market Positioning**: While competition exists, the unique efficacy and combination potential of Nexlizet provide a strong market position [45][46] Additional Insights - **Patient Education**: Importance of educating patients about their cardiovascular risk to encourage adherence to treatment [21][22] - **Regulatory Milestones**: Anticipated regulatory approvals in Japan tied to significant financial milestones, indicating a robust partnership with Otsuka [70][71] This summary encapsulates the key insights from the conference call, highlighting Esperion Therapeutics' strategic focus, market opportunities, and financial health.

Financial Performance - Esperion Therapeutics (ESPR) reported a loss of $0.02 per share in Q2 2025, significantly better than the Zacks Consensus Estimate of a loss of $0.17 and an improvement from a loss of $0.05 in the same quarter last year [1][6] - Total revenues for Q2 reached $82.4 million, marking a 12% year-over-year increase and surpassing the Zacks Consensus Estimate of $66 million [1][6] - U.S. product revenues totaled $40.3 million, up 42% year-over-year, exceeding the Zacks Consensus Estimate of $35.1 million [4][6] Revenue Breakdown - Collaboration revenues, which include royalties and partner revenues, amounted to $42.1 million, down nearly 7% year-over-year due to a milestone payment recorded in the previous year, but excluding this, collaboration revenues surged approximately 105% year-over-year [7][8] - The company achieved its first-ever operating income from ongoing business operations in Q2 2025 [9] Cost Management - Research and development expenses decreased by 37% year-over-year to $7.2 million, reflecting reduced costs in ongoing clinical studies [8] - Selling, general, and administrative expenses fell by 11% year-over-year to $39.5 million due to lower media and marketing costs [8] Future Outlook - Esperion expects operating expenses for 2025 to be in the range of $215-$235 million, including $15 million in non-cash stock compensation expenses [10] - The company anticipates achieving sustainable profitability starting in Q1 2026 [10] Recent Developments - Esperion reached settlement agreements with three ANDA filers regarding patents for Nexletol, preventing the marketing of generic versions until 2040, which is expected to protect future U.S. sales [11]

Core Insights - Esperion Therapeutics reported a loss of 21 cents per share in Q1 2025, which was wider than the Zacks Consensus Estimate of a loss of 18 cents, compared to earnings of 34 cents per share in the same quarter last year [1] - Total revenues for Esperion in Q1 2025 were $65 million, reflecting a 53% year-over-year decline, primarily due to a one-time milestone payment received in Q1 2024; however, revenues exceeded the Zacks Consensus Estimate of $58 million [2] - The company's stock fell 7.1% on May 6 following the earnings announcement and has decreased 55.7% year-to-date, contrasting with a 0.4% decline in the industry [3] Financial Performance - Product revenues from the U.S. totaled $34.9 million in Q1 2025, up 41% year-over-year, driven by expanded label and commercial initiatives; this figure surpassed the Zacks Consensus Estimate of $29.8 million [5] - Collaboration revenues, including royalties and partner revenues, were $30.1 million, down almost 73% year-over-year, but beat the Zacks Consensus Estimate of $27.9 million [8] - Research and development expenses decreased by 6% to $12.6 million, while selling, general, and administrative expenses rose by 2% to $43 million due to increased marketing and consulting costs [8][9] Future Outlook - Esperion expects operating expenses for 2025 to be in the range of $215-$235 million, which includes $15 million in non-cash expenses related to stock compensation [10] - The company is developing two triple combination products with Nexletol/Nexlizet, expected to launch in 2027, which may offer LDL-C lowering of more than 60% [11] - Esperion is also planning to develop ESP-1336 for the treatment of primary sclerosing cholangitis (PSC), a market estimated to exceed $1 billion annually [12]

Summary of the Conference Call Company and Industry - **Company**: Esperion Therapeutics - **Industry**: Cardiovascular Disease Treatment, specifically focusing on lipid-lowering therapies Key Points and Arguments 1. **Unmet Need in Cardiovascular Disease**: Atherosclerotic cardiovascular disease is the leading cause of death globally, with 44% of US adults affected. Over half of these patients do not meet LDL-C goals, and 30% may be unable or unwilling to take statins [7][8][9]. 2. **Clinical Development of Bempedoic Acid**: Esperion's clinical trials for bempedoic acid focused on patients with unmet needs, including those with statin intolerance and primary prevention patients. The trials included a combination of bempedoic acid with low-dose statins and a fixed combination with Ezetimibe [8][10][11]. 3. **Phase Three Trials**: Five placebo-controlled Phase Three trials demonstrated significant reductions in LDL cholesterol and high-sensitivity C-reactive protein (hsCRP) across various patient populations, including those with cardiovascular disease and statin intolerance [11][12][13]. 4. **Clear Outcomes Study**: This unique trial validated that bempedoic acid reduces cardiovascular risk by lowering LDL cholesterol. It included both primary and secondary prevention patients and showed a 13% relative risk reduction in major adverse cardiovascular events (MACE) [12][13][14]. 5. **Safety Profile**: Bempedoic acid was generally well tolerated, with a safety profile similar to placebo. Myalgia was the most common side effect, but the incidence was lower than with statins [22][23]. 6. **Market Positioning**: Bempedoic acid is the only non-statin FDA-approved drug with data in primary prevention patients, addressing a significant unmet need in cardiovascular risk reduction [25][26]. 7. **Real-World Experience**: Doctor Moriarty emphasized the importance of early intervention in atherosclerosis and noted that bempedoic acid has been effective in managing patients with statin intolerance, achieving up to a 40% reduction in LDL [50][52]. 8. **Patient Preferences**: There is a strong preference among patients for oral therapies over injectables due to convenience and cost considerations [55][56]. 9. **Future Directions**: The potential for combining bempedoic acid with statins and other therapies is being explored, with ongoing studies to assess the efficacy of triple combination therapies [86][90]. Other Important but Possibly Overlooked Content 1. **Educational Gaps**: There is a lack of awareness among some healthcare providers regarding the benefits and availability of bempedoic acid, which may hinder its adoption [96][97]. 2. **Inflammation and Cardiovascular Risk**: The discussion highlighted the importance of addressing inflammation in cardiovascular disease, with bempedoic acid showing promise in lowering inflammatory markers like hsCRP and RDW [46][48][49]. 3. **Cost Considerations**: The cost of therapies remains a significant factor in prescribing practices, with generics being preferred due to their affordability [76][90]. This summary encapsulates the key insights from the conference call, focusing on the clinical development, market positioning, and real-world application of bempedoic acid in treating cardiovascular disease.