Esperion at Needham Conference: Strategic Growth and Expansion

On Monday, April 7, 2025, Esperion Therapeutics (NASDAQ: ESPR) participated in the 24th Annual Needham Virtual Healthcare Conference. The discussion, led by CEO Sheldon Konig, highlighted the company's optimistic outlook, focusing on strategic growth and expansion while addressing challenges like market dynamics and leadership changes.

Key Takeaways

• Esperion is strengthening its commercial strategy for NexLazet and NexLetol in the US and Europe.
• The company ended the quarter with a solid cash position of $144 million and expects significant milestone payments from Otsuka in Japan.
• A new Chief Commercial Officer is being sought following a recent departure.
• Esperion aims to achieve profitability sooner than anticipated, driven by strategic business development and expansion efforts.
• An upcoming R&D day on April 24 will showcase the company's pipeline and future direction.

Financial Results

• Cash Position: Esperion ended the quarter with $144 million in cash, marking an improvement over the previous quarter.
• Royalty Rates: The company receives 15-20% royalties from Daichi Sankyo for European and other international sales.
• Milestone Payments: Up to $130 million in milestones are anticipated from Otsuka for the Japanese market launch in late Q3/Q4.
• Debt Obligations: Esperion is managing $50-55 million in remaining convertible debt, with a clear strategy to address it.
• R&D Spend: Regulatory guidance has allowed the company to avoid a costly $30-50 million clinical trial for triple combo products.

Operational Updates

• Formulary Coverage: 95% commercial and 65% Medicare coverage, all with preferred status.
• Prior Authorizations: Optum will remove prior authorization requirements for 8.5 million lives starting in May.
• Sales Force: 55 representatives, including 5 key account managers, are targeting over 20,000 physicians.
• Manufacturing and Expansion: 50% of manufacturing occurs in the US, with expansion deals in Australia and Israel, and potential in Canada.

Future Outlook

• Pipeline Development: The upcoming R&D day will focus on liver and kidney programs, with plans to extend bempedoic acid's intellectual property to 2040.
• Profitability Goals: Esperion is actively pursuing business development opportunities to leverage its infrastructure and achieve profitability.
• International Expansion: Significant growth is seen in Europe, especially in Germany, with a robust launch planned in Japan by Otsuka.

Q&A Highlights

• Market Dynamics: Minimal impact from tariffs due to US manufacturing and alternative sourcing strategies.
• Medicare Confusion: Prescription volumes were impacted in Q1, but momentum is improving.
• Brand Awareness: Unaided awareness for NexLazet and NexLetol is 50% and 60%, respectively, with aided awareness at 95%.

For a detailed understanding, readers are encouraged to refer to the full transcript below.

Full transcript - 24th Annual Needham Virtual Healthcare Conference:

Serge Belanger, Healthcare Analyst, Needham: Morning everybody and happy Monday. I'm Serge Belanger, one of the healthcare analysts at Needham. Welcome to our twenty fourth annual healthcare conference. And for next session, we have Sheldon Koning from Esperion Therapeutics. We're gonna be doing a fireside chat.

So we can take q and a for those listening online. There is a portal to submit questions. I'll ask them as as they come in. So maybe I'll hand it over to to Sheldon to give us a a quick overview of the company and recent developments. Then we'll go to some questions.

Sheldon Konig, Esperion Therapeutics: Yeah. Great, Serge. I don't know if I'm your first one this morning on a Monday morning, but here at Esperion, we really appreciate the opportunity to have this fireside chat. So on behalf of all the employees, thank you. Just really quick about the company, we're currently marketing two products on the market, NexLazette, bempedoic acid plus ezetimibe, and obviously also NexLetal.

In our last quarter, we talked about our strategy moving forward, so '25 and beyond, and that is to maximize this franchise, of course, number one. Number two is our pipeline. Again, just a reminder, April 24 is our research and development day. We might get into that a little bit later. So in a couple weeks, we'll be there in New York.

I would say two a to that is how do we make this company bigger? And we are being very aggressive in our business development and doing a landscape analysis and looking at different opportunities. And the third and final is achieving profitability, which, as my partner, Ben Howe, they would say, our chief financial officer, you know, we're gonna get there sooner than people think, and that will be also another exciting milestone for us. So that's just a a quick snapshot of who we are and, you know, how we're looking forward.

Serge Belanger, Healthcare Analyst, Needham: Great. I guess to to start off with, know, one of the topic to sure the last couple days has been has been tariffs. No pharma products are exempt, at least so far. But curious if we were to see some tariffs on those products, what could be the impact for for Aspiria?

Sheldon Konig, Esperion Therapeutics: Yeah. Definitely the the hot topic. I was at a a birthday party actually this weekend, and people were discussing tariffs. And I think everyone thought that last night, you know, Trump would have come out and maybe rolled some things back, but that hasn't happened. And from looking at the futures, looks like it's gonna be another rough day.

For tariffs, again, to your point, Serge, we currently are being spared the entire pharmaceutical industry. But who knows, this week, next week, we could see tariffs on the pharmaceutical industry. The good news for Esperion is the fact that 50% of our manufacturing is already done in The United States. Now our API is actually sourced from France and India, but we actually have already a US supplier. So if we need to pivot and go to that US supplier for API, that would even limit our exposure even more.

So we feel pretty confident that we have a plan. And we were looking to do these type of steps of the alternative in The US, you know, even before, you know, Trump ran for office and came into office and announced tariffs. So we don't really see any true impact on us as it relates to tariffs. And again, something that like you will be closely monitoring and we'll be able to pivot accordingly.

Serge Belanger, Healthcare Analyst, Needham: Okay. I know one of the big focus for 2024 was on well, first getting your your label expanded to reflect the clear outcomes for all, and then updating the the formulary coverage to to reflect that new label. So maybe just give us an overview of where those efforts are and how that sets up 2025.

Sheldon Konig, Esperion Therapeutics: Yeah. So we've come a long way now that we've been out with our label probably, you know, I guess, as of last week, a year. So a year. Keeping in mind when we did the field expansion last year, people didn't really hit the ground running until June. But we've come a long way.

95% commercial coverage, 65% Medicare coverage, all preferred status, which is extremely important. Just a couple of facts. So we actually have, you know, many plans that have actually moved away from even having prior authorizations, which as you know, was a very big headwind for us. And we might get into some of the step edits also that have been removed. But currently today, Caremark SilverScript, no prior authorization.

Aetna, no prior authorization. Here's a late breaker for you. Optum, starting May, over 8,500,000 lives, no prior authorizations will be necessary. And we're in the middle of negotiating another big one that hopefully we can update you soon, which will also require no prior authorizations. That's a huge step for a branded product.

There's not many branded products out there, and you know you cover a lot of them, that can say they don't have a prior authorization. Just a few more things. You know, it used to be that the physician and the staff had to provide a lot of evidence to patients on our medications. That's not necessary anymore. Now it's more physician attestation.

It's a physician saying a patient's already been on a statin for six months, and we can just move them to Nexlizet or Nexlitol. So that removes a barrier for the office staff. And then the biggest headwind that we had before we had our new label was the fact that, as you know, we had to go through ezetimibe before we were used. That is also gone. So no longer is there a headwind where a physician has to go through that ezetimibe step edit or multiple statins.

It's either a statin, or if a patient cannot take a statin, they can go on our drug alone.

Serge Belanger, Healthcare Analyst, Needham: Okay. So in terms of product positioning, where does that put bempedoic acid? And I think in the past it was like you said, once you were passed ezetimibe, there was either Nexletol, Nexlizet, or one of the PCSK nines. Where is that changed in terms of the the product position?

Sheldon Konig, Esperion Therapeutics: Yeah. So the beauty for us is, again, keep in mind that we are the only oral and only non statin that's both indicated in primary and secondary prevention. Very important. And I think we're going to talk about future products later. We're the only ones that have studied a population in both of those areas and have an indication.

So we obviously are are promoting our primary and also our secondary prevention message. But where does bempedoic acid fit in that journey of physicians? Well, the good news is because of our broad label, they have options. One, if they have patients who can tolerate a statin and they need more efficacy, you can add bempedoic acid. You can add Nexlazet or Nexlitol.

For a patient who cannot take a statin, and by the way, the National Lipid Association just recently came out with a publication that showed up to thirty percent, three zero, thirty percent of patients are statin intolerant. What does that mean? They either cannot take a statin at all, or they can only take a certain dose of their statin. Again, the physician now has the ability to do more. And we found in research even years ago, physicians are frustrated even with the products that are out there that they couldn't do more, and now they can.

And we're seeing that they are responding to that to that message. So again, if you're statin intolerant, you can take this drug. If you wanna add it to a statin. And we've always showed a slide, we're not showing slides today where it was statin was the foundation, and then it was us, we'd say we were next, and then PCSK nine. Why do we say that?

Because 70% of the adjunct market, and the adjunct market is described as anything non statin, seventy percent is ezetimibe. Our whole message is, you know, you can upgrade now to outcomes. You know, we have we have outcomes. Ezetimibe did the improve it trial, but they didn't have the outcomes. Now we've got the best of both worlds combined.

Doctor, why don't you take your patient who's just on the ezetimibe with a statin, upgrade with this other drug where you have proven outcomes, and that's where Nexlazet fits.

Serge Belanger, Healthcare Analyst, Needham: And the treatment guidelines been updated now that the the label of bempedoic acid has been updated, and we have the clear outcomes trial that's been out for almost two years now or three years?

Sheldon Konig, Esperion Therapeutics: So we thought actually treatment guidelines were gonna be updated in November of twenty twenty four, and then we were told that they'd probably be more like the end of twenty twenty five. And now we're being told that it's in 2026. So, you know, we're waiting anxiously like everyone else. But there's smaller associations, for the lack of better word, professional associations that essentially have put out, you know, consensus papers for lack of better words. And I think, you know, what they've noticed is what I've just said is that, you know, we are really the only non statin that's been indicated in primary prevention.

So we're, you know, a first step there along with statins. But, you know, we're anxiously awaiting what those, you know, what those guidelines are going to show. But the good news is is that you've got payers out there that just based upon the clear outcome study alone, they've made these decisions that you and I've just talked about. So they see the value of the clinical message. They're not even waiting for guidelines.

And we have found that with physicians as well. I think lipid lowering, you know, since the introduction of lovastatin in 1991, you know, physicians have an idea of what they need to do. Lower LDL cholesterol, lower events, how can I do that as best as possible?

Serge Belanger, Healthcare Analyst, Needham: In terms of the commercialization focus, so now, like, we've talked about the label and the expanded formulary coverage or or the improved formulary coverage. What is the focus now? Is it just increasing awareness of all these things or yeah. What what is that focus currently?

Sheldon Konig, Esperion Therapeutics: Well, it's definitely just to give you some tidbits on awareness. So unaided awareness right now for for NexLazette is 50%. Unaided awareness for NexLatol is 60%. That's without anyone talking to them. And then when you get to aided awareness, they're both at, you know, at ninety five percentile.

Now it's about prescribing more. It's really about depth of prescribing, and, you know, we talked about the access that we have in managed care. Physicians are realizing that getting this drug is easier. That's extremely important because that was that was a cloud that I think hungover prescribing for a while. Our competition tries to get out there and try to make that it's harder, but that's really not.

As a matter of fact, we pay for a service that looks at prior authorizations. And if you look at the number of prior authorizations needed versus, let's say, for example, a PCSK nine, we're much less than PCSK nine. And that gets back to what I said earlier. That's because a lot of plans are not even requiring prior authorizations. That also has to do with our cost.

We're less expensive than a PCSK9. When you look at co pays on average, we're $46 in Medicare, they're $80 Commercially, we're $35. They're closer to $50 from a co pay perspective. So real advantage for us there also in our messaging to physicians.

Serge Belanger, Healthcare Analyst, Needham: And remind me again the the current size of the Salesforce and and maybe if you can, know, talk about whether this is still a cardiovascular market or, you know, how much of it is lies within the PCP segment.

Sheldon Konig, Esperion Therapeutics: Yeah. So our Salesforce is a 55 representatives. It's a 50 representatives and five key account managers. One new addition I wanna put out there, it's separate from sales, it's firewall, but we also implemented last week 15 field reimbursement managers. We have 15 regions.

We have one field reimbursement manager for each region. And these folks are integral in helping physicians understand the process of how to get our drug, understand the reimbursement dynamics, also get that message out there that it's easier than what it was in the past. From an account perspective, we have basically two key account managers who were successful in getting all those wins for us, only two. But we feel really good about the 155 representatives, just to break down some numbers for you. That allows us to call on over 20,000 physicians, so live promotion.

The majority of those physicians we're calling on are primary care physicians, about 11,000, followed by cardiologists, about 9,000, and then endocrinologists, a thousand. So that's 20,000 physicians, and these are all high prescribers of Ezetimibe and statin. So you can see how we're targeting. If you look at what we're doing from a digital perspective, we're able to reach an additional 70,000 physicians out in The United States. And it's probably that same distribution between primary care and cardiologists.

Now, would say five years ago when you talked about digital promotion, maybe six years ago, it was kind of this pie in the sky, is it really going to work? But ever since COVID in 2019, '20 '20, what we have found, and even looking at our return on investment, digital promotion goes a long way. So we have found that balance. We've said this before, that balance between personal promotion and digital promotion. Those days of having sales forces of a 2,000 people, it's not even worth it because half those people can't even see a physician.

The offices are closed, but they're not closed to digital promotion. And then lastly, because I don't wanna forget it, is consumers are really driven as well. And they're activators for this drug. We've actually found in research, when a consumer hears a message, and they go into their doctor, and they ask for Nexlazet or Nexlitol, they get it every time. So that's another area that we've been focused on.

You'll see our lipid lurkers again in New York when we're there for R and D day, and it's a campaign that we're actively running across social media.

Serge Belanger, Healthcare Analyst, Needham: Okay. And and I know this is not the forum to talk about one q numbers. We'll do that later this month or early next month. But maybe just if you can comment on the prescription volume and, you know, what we've seen recently.

Sheldon Konig, Esperion Therapeutics: Yeah. So I think you put out a a great report every week. And I think what you've seen with not only our drug, but other drugs is, we will show some growth. And first quarter is always somewhat of a difficult quarter because of insurance, etcetera. But we saw a dynamic that was occurring in the first quarter as it relates to confusion around Medicare.

And there was a lot of noise, similar to the noise that you see with tariffs where that was implemented, but the noise around Medicare wasn't implemented. But consumers are really confused as it relates to the Inflation Reduction Act of how much their out of pocket expense was, how much their copay was. And as you know, we're a relatively inexpensive drug, as I said earlier. Many of our patients are Medicare age patients, they're taking six to eight drugs, they have a $2,000 donut hole that they have to go through before their co pays actually come down. So they start prioritizing their medicine.

Some of those medicines get them right through the donut hole. Some of them it takes them two months to get through. We've actually seen the co pays now coming down to the level that I mentioned earlier in our conversation, and we're starting to see that momentum increase now as it relates to patients getting prescribed our drug, paying for their drug, and getting their drug. So I think, you know, one thing that we've always promised is growth. It's always something we've delivered on in every single metric, and we're going to continue to show growth.

We have a lot of momentum for 2025, And a lot of, I would say, internal catalyst to continue our growth as we go through the year.

Serge Belanger, Healthcare Analyst, Needham: Maybe we can talk a little bit about ex US commercialization. Maybe let's start off with Europe and what Daichi Sankyo has been able to do with the with the product.

Sheldon Konig, Esperion Therapeutics: Yeah. Daichi Sankyo continues to show just extraordinary growth and in tough markets too. UK is a market that is always very difficult to grow just because of the way that NICE handles reimbursement. But I can tell you, I believe it's their second largest market next to Germany. You know, keep in mind again, and it really shows how bempedoic acid is becoming, and I think will become a standard of care in physicians paradigm.

In Germany, you cannot use a PCSK9 unless you've tried bempedoic acid no matter what. And that was something that AMNOG, which is division of Equig, which is the HCA for Germany, implemented about a year ago. So they're showing double digit growth in Germany. They're showing double digit growth in Switzerland where they just launched, Italy, Belgium. You know, it's it's really an amazing story what they've been able to do.

And the good news there is we don't operate separately from them. You know, we work as a team. We had a very good meeting in Miami in January, and it was great weather. It wasn't cold in Germany. It wasn't cold on the East Coast, but it was a collaboration around our medical messaging, our promotional messaging, what's working, what's not working.

We had a similar meeting like that with our partners in Japan with Otsuka. The only reason why I bring that up is because I think when folks think about Nexlazet and Nexlitol, they think about it as just Asperion focusing in The US. But the good news is is we have these mindsets in different parts of the world. You know, almost, if you will, a global company, you know, using all of our resources to think about, you know, how do we better position the drug, how do we sell more of the drug, how do we get it to to more patients. But Daichi Sankyo is just doing a great job.

Obviously, you know, we we benefit from that in many ways also. So, you know, very happy to see, you know, what they're what they're being able to accomplish.

Serge Belanger, Healthcare Analyst, Needham: Remind me again what the the arrangement is in terms of royalties, and and I think there was some manufacturing transfer that was underway.

Sheldon Konig, Esperion Therapeutics: Yeah.

Serge Belanger, Healthcare Analyst, Needham: Any update on that?

Sheldon Konig, Esperion Therapeutics: So from a royalty perspective, we would receive anywhere between 1520% royalty from Daichi Sankyo. Now keep in mind, last year in June, we did a deal with Omers where we basically sold the royalty rights. We actually once that is satisfied, we will get those royalties back. I can tell you we are, I think, ahead of schedule as it relates to how well Daichi Sankyo is doing, and what Omer is receiving. So we'll be paying closely attention, because once we reach that payback, those royalties come back to us.

Now keep in mind that's just Europe. We also have the launch of our product in the ASCA region. So these are if you look at South Korea, Taiwan, Philippines, Thailand, Brazil, etcetera, we get 15 to 20% royalty from these markets as as well. So it's a great story there. As it relates to the tech transfer, that is going very well.

We have two teams. Obviously, they have a team. We have a team. Our team was just in Munich, Germany last week going over, you know, all the different stages for the tech transfer. I think we are on target to complete that when we need to be, and, you know, feel really good about the collaboration there.

So that's obviously gonna help us from a financial perspective as well. And, you know, that was a big part of the settlement with Daiichi Sankyo. That wasn't even on the table. Mean, to me, that was just an incremental benefit of doing the tech transfer. So stay tuned for that.

I think by the later half of this year, we'll have an update of exactly where their progress is.

Serge Belanger, Healthcare Analyst, Needham: Okay. And then you also have Otsuka in Japan, and I think we're expecting some important news from them this year.

Sheldon Konig, Esperion Therapeutics: Yeah. We're really excited about that. We had a great visit with them in December. So they will launch their drug probably in the October, November timeline. Keep in mind, Japan is the third largest market in the world, and they're excited.

I mean, they have, like, close to 600 people on this. Keep in mind, Asperion has 305 employees alone in The United States. They have 600 people in Japan working on this product. We actually have been invited to the launch meeting, and, you know, we're we're looking forward to it. So that will be also a gateway for us to receive additional milestones.

So up to a hundred and $30,000,000 in milestones from Otsuka. So again, that's something will take place later, late third quarter, fourth quarter of this year.

Serge Belanger, Healthcare Analyst, Needham: And should we expect any additional international expansion of of the franchise? Whether

Sheldon Konig, Esperion Therapeutics: so we had two exciting deals that we talked about. As you know, we signed an agreement with CSL to actually market the drug in Australia. So CSL Securis, I actually just met with the Securis team about two weeks ago. They're in the process of submitting the application to the TGA, which is the Australian HTA, Healthcare Technology Assessment Group. That's reimbursement market, but they know that market, you know, that's where that company is.

And then in Israel, a small market, but again, just to show our global expansion. In Israel, we struck a deal with NeoPharm, and they actually should be able to launch the drug hopefully by the end of this year. So we're always looking for, you know, there's still a few unpartnered territories. Obviously, Canada is always a big question. We are currently in discussions with,

Serge Belanger, Healthcare Analyst, Needham: I

Sheldon Konig, Esperion Therapeutics: would say, several companies as it relates to Canada. In the meantime, you know, we took the initiative to go ahead and file in Canada, so that we could get a head start on the HTA process, so that a company coming in has a head start in marketing and selling the product. And that's a big market. I mean, we did market research, and that that market is in the hundreds of millions of dollars of opportunity. So it's something that we're working hard on.

And, you know, as always with any deal, you wanna make the right deal.

Serge Belanger, Healthcare Analyst, Needham: Yeah. I think you have kind of an r and d investor event scheduled for for later this month in New York. I don't wanna steal any thunder from from from that upcoming event, but, you know, I've been following the company for for a few years now and it's mostly been a commercial focus story. I think there was always a pipeline

Sheldon Konig, Esperion Therapeutics: Yeah.

Serge Belanger, Healthcare Analyst, Needham: Pipeline work in in the background, but mostly at the early stage. So did we see this r and d day as kind of a a change in strategy for for the company going forward?

Sheldon Konig, Esperion Therapeutics: Yeah. Just just a couple things. I mean, it was always in the background because of our capital structure. Right? We really couldn't do anything.

We were handicapped. And, you know, I think getting out of the RIPA agreement, refinancing the converts create a whole different opportunity for us. Not many small to mid cap companies out there are commercializing drugs and also have a pipeline that they can look look to and and develop. Our strategy is really a simple one. It's grow NexLazette and NexLotol franchise to the blockbuster potential that we know that it is.

That's number one, always. Number two, what's the future of this company? And not to give you any thunder, but maybe to give you

Serge Belanger, Healthcare Analyst, Needham: some

Sheldon Konig, Esperion Therapeutics: lightning, is that the future is really this, you know, these pipeline assets. One asset in particular that we will be talking about on April 24, and we will talk about an asset and a specific indication on April 24. And that will be focused on liver. I'll just keep it at that. It's not NASH.

Then we'll also briefly just talk about our program in kidney. I think these are also very interesting partnering opportunities as well. There's many companies out there interested in what's what are you what are people doing as it relates to fibrosis, liver, kidney disease, etcetera. And there's a nice overlap if we think about our intellectual property. You know, we talk about these products coming in the early 2030s.

As you know, we have intellectual property for the bempedoic acid franchise until February. We think we have a really good strategy to get us to 02/1940, more to come later on that. So it's a real nice positioning of not just thinking about now, but how do we think about the future of Asperion, and how do we keep this company as a, you know, a going entity. And that's why also adding something to the bag could be very important for us.

Serge Belanger, Healthcare Analyst, Needham: Okay. The last quarterly update, you unveiled these new triple combo products, adding NexLizot to to some statins. Maybe just, you know, talk about those those programs. I think the company had previously conducted studies with these triple combos. So here's what you saw back then and and why is it now being Yeah.

I guess more prioritized than it was in the past.

Sheldon Konig, Esperion Therapeutics: Yeah. Well, one, we thought it was gonna be a heavy burden, a heavy lift from a financial perspective. We were actually under the impression that we were gonna have to conduct a a clinical trial for 30 or $50,000,000. And in further research from a regulatory perspective, we don't need to do that. We just need to show bioequivalence of the parts.

To your point, there's a phase two study that was done that looks at the addition of ezetimibe plus bempedoic acid plus atorvastatin, and we showed anywhere between a 6070% LDL reduction. Think about that, that could be one of the most efficacious LDL lowering drugs on the market. And again, it fits nicely, you know, when you think about just Nexlazet alone, you know, we're really looking at two pathways to attack cholesterol. We have the ACLY pathway, and we have the cholesterol absorption inhibitor pathway. That's what really makes, you know, this product unique, is you're going down these two pathways.

If you then even further that, and you look at from a statin perspective, again, you're adding more LDL lowering, you're adding more potentially hSCRP lowering, because we know that statins lower hSCRP, and they also lower LDL. And it's a perfect drug for those patients who can tolerate a statin and need more. Helps them be compliant, it's, you know, possibly two less pills, maybe three less pills if they're taking Nexletol. It's really a nice drug of convenience with with great efficacy. So we're really excited about it.

You know, more to come on that as we continue to go through the development. But it was really we thought it was gonna be cost prohibitive, and we really kind of pushed and found out that it wasn't. So good news for us, and it really opened another door for us.

Serge Belanger, Healthcare Analyst, Needham: Okay. And kinda hinted earlier about some some interest in BD. Would that be another commercial asset, or you'd be willing to get more involved on the r and d side?

Sheldon Konig, Esperion Therapeutics: Yeah. We we definitely for the BD, we're not looking for anything in the clinic. We're looking for something that is either on the market, soon to be on the market, has been filed to be on the market. And, you you know, there's a lot of, I would say, single shingle companies out there that do not have an infrastructure. I think that's the beauty of Asperion.

You know, we have medical affairs, we have a sales force, We have a compliance department. You know, we have all the things that you need to run a company. And for companies out there that file drugs that, especially in this financial environment, do you really wanna spend 50 to a hundred million dollars to stand up a sales force, or to stand up a sales force with medical affairs to do market development? We have that. We can do that.

We can help companies do that. And I would go as far as to say is we've gotten a lot of inbound calls from companies who know that we can do that. And, again, especially in this environment, silver lining for us is we have that ability.

Serge Belanger, Healthcare Analyst, Needham: Okay. Let's talk about financials for a little bit. Maybe where where you stand in terms of cash and the rest of the balance sheet and some of your priorities on the capital allocation front?

Sheldon Konig, Esperion Therapeutics: Yeah. So we ended the quarter with a hundred and $44,000,000 in cash. That was actually more than what we ended with in the third quarter. Obviously, we'll do an update when we do earnings. We feel good about our cash position.

Again, you know, just thinking about what we do with our capital structure last year, I mean, you know, if that was like this year. So again, being ahead of the game has put us ahead of the game. So we feel good about our cash position. I've talked about the milestones, obviously. But, you know, even, you know, putting that aside from a cash perspective, being able to do what we did last year with our capital structure was a game changer for this for this organization.

That has set us up very well from a cash perspective. Now with that said, we are extremely careful with every dollar that we spend. You know? I get all the messages of, why aren't we doing direct to consumer? Why aren't we doing this?

Why aren't we doing That costs a lot of money. We've got to be very careful with each and every dollar. And so you'll you'll still see us being very conservative on our spend, getting the most bang out of our dollar. And, again, as I mentioned at the start of this call, the third objective, you could even make it the first objective because I think that's also true. They're all interchangeable, getting to profitability.

That's where we wanna get to. That's a priority.

Serge Belanger, Healthcare Analyst, Needham: Okay. And you are expecting some additional milestones this year, so that should help addressing some of the debt obligations?

Sheldon Konig, Esperion Therapeutics: Yeah. No question about it. You know, we have a a $55,000,000 50 to $55,000,000 tab left on the convertibles. We have a strategy to address that. And looking at all sources, including our milestones, but we feel good about how to do that.

And as we get later in the year, when that comes due, we'll talk about what that strategy is. But again, we have a path for all these things. And again, the reason why I hesitate a little bit is because last year, you know, while we were doing all the things with the RIPA and also the convertibles, that was a lot of work. And it gave us a lot of freedom to think about, you know, how we can manage, you know, the the debt that we the the debt that we have now.

Serge Belanger, Healthcare Analyst, Needham: Okay.

Sheldon Konig, Esperion Therapeutics: And we'll probably talk about more of that in q one.

Serge Belanger, Healthcare Analyst, Needham: Got it. And then on Friday afternoon, I think you guys put out news that your chief commercial officer was departing. I don't if there's any more color you can provide on that and whether Yeah. Think of that as a sign that maybe other changes could could happen.

Sheldon Konig, Esperion Therapeutics: Yeah. No. I mean, Eric, you know, decided to leave on his own. He's been here for four years and did a great job. Eric really likes to be in a position where he can build, help build companies, which is, you know, what he did here.

So setting up the marketing strategy, setting up the sales force. Hasn't been announced yet where he's going, but he's going to a company that their product is still in development. And, you know, he's gonna go there and help them build, you know, their marketing and and Salesforce capability. So all in good terms, and, yeah, we wish him the best.

Serge Belanger, Healthcare Analyst, Needham: Okay. So he'll be recruiting for a new chief commercial officer?

Sheldon Konig, Esperion Therapeutics: We absolutely will be. We already have our recruiter lined up, and we'll start this week looking for a new chief commercial officer.

Serge Belanger, Healthcare Analyst, Needham: Yeah. And maybe just to to wrap up, you can talk about if there's anything that you feel is underappreciated or or just misunderstood about either the bempedoic acid franchise or or just the company in general?

Sheldon Konig, Esperion Therapeutics: Yeah. I think with the company in general, I think a lot of people, you know you know, look to the past and they think about, you know, when this drug first came out, you know, during the days of COVID. I'm here to say those days are over. You know, we we set that message out when we did fourth quarter earnings. Need to think about this company as the future.

I mean, look at all the things that you and I have just talked about, how far this company has come with these assets, a game changing label, access that I don't think any of us expected the access that we've seen, the growth that we've been able to demonstrate. That's just going to continue. The fact that we can actually have an r and d day and talk about a very exciting asset, which by the way will play in a very large market, even though it will be an orphan indication, is no one had thought, nobody thought that was going to happen. You know, the thing that I get passionate, almost to the point of a little, like, you know, just really get out there. People view it as anger, but passion is they'll never get out of this RIPA agreement.

They'll never be able to refinance the converts. They'll never get primary prevention in their label. They'll never achieve the reimbursement levels that they've done. They'll never show double digit growth. We've done all of that and more.

So why the stock price is where it is today? Well, I think that's just because of the market. And anyone that can forecast it differently, like, let me know. But I think once we get past these clouds, people are going to start realizing that, and you're really going to see the fact that this company is severely undervalued. And, you know, it needs to be a higher value.

We've shown reasons why, and we'll continue to show reasons why it should be.

Serge Belanger, Healthcare Analyst, Needham: Alright. Well, great way to to end this session. So Sheldon, I wanna thank you for spending time with us this morning. We appreciate all of your time. And

Sheldon Konig, Esperion Therapeutics: Thank you, and good luck to the markets. Let's hope this link back in the right direction. But I really appreciate it. Thanks again, sir. I just appreciate your support and all the support in Needham.

Serge Belanger, Healthcare Analyst, Needham: Great. Have a nice day.

Sheldon Konig, Esperion Therapeutics: You too.

This article was generated with the support of AI and reviewed by an editor. For more information see our T&C.