Physician Views snap poll: How will cardiologists utilise Esperion's newly approved Nexletol?

The catalyst: Following FDA approval last week, Esperion will pitch Nexletol (bempedoic acid) as a cholesterol-lowering treatment option that fits somewhere between statins and PCSK9 inhibitors.

Its cost and the convenience of once-daily dosing, in relation to the PCSK9s, could play a key role in driving adoption, though lack of cardiovascular outcomes data (expected in 2022 at the earliest) will also shape early utilisation.

The poll: To better understand how early adoption trends could develop, we are snap-polling US cardiologists with the following questions…

Q. The FDA approved Nexletol (bempedoic acid), an oral, once-daily non-statin LDL-cholesterol lowering medicine indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolaemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C. The effect of Nexletol on cardiovascular morbidity and mortality has not been determined.

The approval of Nexletol is supported by a global pivotal Phase III LDL-C lowering programme conducted in more than 3000 patients. In these studies, Nexletol provided an average of 18% placebo corrected LDL-C lowering when used with moderate or high intensity statins.

Nexletol was generally well tolerated in clinical studies. Label warnings and precautions include hyperuricaemia, with the development of gout in a small percentage of patients, as well as increased risk of tendon rupture or injury. Overall, in Phase III studies, the most frequently reported adverse events were generally reported at similar rates in patients who received placebo. 

Eligible patients with commercial drug insurance coverage for Nexletol may pay as little as $10 per tablet.

How would you describe your awareness of Nexletol at this time?

1 – None             2            3            4            5 – Very high


Q. Nexletol's label stipulates that concomitant use with simvastatin at higher doses than 20mg and pravastatin at higher doses than 40mg should be avoided. To what extent will this drug-drug interaction warning slow or prevent your utilisation of Nexletol?

1 – None             2            3            4            5 – Significant impact


Q. To what extent will a lack of cardiovascular outcomes data slow or prevent your utilisation of Nexletol?

1 – None             2            3            4            5 – Significant impact


Q. How important will the pricing of Nexletol – as little as $10 per tablet - be in driving utilisation?

1 – None             2            3            4            5 – Significant impact


Q. To what percentage of patients who meet the criteria on Nexletol's approved label do you anticipate prescribing the drug to 12 months after launch?



Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions.

Note: FirstWord Physician Views are a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties in major markets. To conduct this poll with a different audience, or an entirely different poll, contact us at

Disclaimer: FirstWord follows market research best practices in conducting its Physician Views polls.  However, Physician Views results should be considered directional and clients should use their market research resources for statistical analysis and conclusions required with very high confidence levels.

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