Esperion Therapeutics (NASDAQ:ESPR) executives told investors the company delivered its “strongest performance to date” in 2025 and is entering 2026 with what management described as strong commercial momentum, an improving balance sheet, and an agreement to acquire Corstasis Therapeutics and its newly approved heart failure product, Enbumyst.
Management highlights “defining” 2025 and outlines Vision 2040
President and CEO Sheldon Koenig characterized 2025 as a “defining and transformative year,” citing progress in commercial execution, global partnerships, and pipeline development. Koenig pointed to the company’s recently introduced “Vision 2040” as a long-term roadmap and said the planned acquisition of Corstasis is an example of that strategy “in action.”
U.S. commercial update: prescription growth and payer coverage
Koenig said Esperion’s U.S. bempedoic acid franchise posted “strong prescription growth” and broader payer coverage, driven by sales and marketing efforts focused on statin-tolerant patients. For the fourth quarter, management reported:
- Year-over-year U.S. sales growth of 38%
- Retail prescription equivalents up 34%
- Unique healthcare practitioners prescribing NEXLETOL and NEXLIZET up nearly 25%
Looking to 2026, Koenig said the company expects momentum to continue, supported by reimbursement and anticipated positioning in updated U.S. dyslipidemia guidelines, which he said should be released “imminently.” On the call, management said its current “best intelligence” is that the guidelines will be released before the upcoming ACC meeting, potentially about a week prior, based on what they described as online ACC advertisements for satellite symposia around March 19–20.
Koenig also pointed to scientific communications around inflammation and cardiovascular disease. He said an American College of Cardiology scientific statement recognized a link between inflammation measured by hsCRP and ASCVD and called for broad hsCRP screening alongside LDL cholesterol screening. He added that the American Heart Association’s hsCRP toolkit for professionals recognizes bempedoic acid as an agent to reduce hsCRP, and he stated NEXLETOL and NEXLIZET are the only non-statins proven to reduce hsCRP “by up to 46%.”
During Q&A, Koenig said the company does not expect additional pricing “concessions” in 2026, noting Esperion’s existing contracts and stating it has “90% coverage in commercial” and “90% now in Medicare.” He argued competitors would be more likely to make concessions and referenced the company’s outcomes data as an advantage in payer discussions.
Pipeline: triple-combination programs and next-generation ACLY inhibitors
Esperion reiterated plans to advance two triple-combination programs—bempedoic acid plus ezetimibe plus a statin—using atorvastatin and rosuvastatin. Koenig said the company expects to complete clinical and regulatory requirements to commercialize in 2027 and cited published data suggesting triple-combination therapies can reduce LDL cholesterol “up to 70%.”
In response to analyst questions, Koenig said the triple-combination label is not expected to carry outcomes data like NEXLETOL, but would focus on efficacy. He said the company’s market research indicates strong physician interest in both Europe and the U.S., tying the opportunity to a broader shift toward “poly pill” strategies intended to improve compliance and persistence. He also said the triple-combination strategy does not “muddy” the company’s historical messaging around statin intolerance, emphasizing that statin intolerance can include patients who cannot tolerate statins, do not want to take them, or can only take low doses.
Separately, Koenig said Esperion nominated ESP-2001, a highly specific ACLY inhibitor, as its next development candidate for primary sclerosing cholangitis (PSC), which he called a devastating disease with no approved therapies. He said ESP-2001 is in IND-enabling studies and the company plans to be in the clinic by the end of 2026.
International performance: royalties and Japan launch
Koenig said Esperion’s global partners delivered another year of growth. He reported that Daiichi Sankyo Europe increased fourth-quarter royalty revenue by 51% versus the fourth quarter of 2024 and expanded access to 30 countries, including launching in France. He added that more than 700,000 patients have been treated to date.
Koenig also highlighted Japan, where Otsuka launched NEXLETOL following regulatory approval and a national health insurance price listing. He said early market reception has exceeded “even the most optimistic expectations” and argued Japan’s market size and pricing environment could support sustained growth. Management said additional launches and regulatory progress are underway in Canada, Israel, Australia, and New Zealand.
Corstasis acquisition: Enbumyst launch opportunity and timing
Esperion’s planned acquisition of Corstasis would provide global rights to Enbumyst, which Koenig said is an FDA-approved intranasal loop diuretic approved in September 2025 for edema associated with congestive heart failure, hepatic disease, and renal disease. He described Enbumyst as the “only nasal spray loop diuretic,” citing rapid onset, bypass of GI absorption issues, and potential support for at-home management of fluid overload.
Koenig framed the opportunity around heart failure readmissions and hospitalizations, noting that “one in four” heart failure patients are readmitted within 30 days and that “nearly two-thirds” of about 1 million hospitalizations each year are primarily for diuresis. He said the acquisition provides an entry point into a “$4+ billion U.S. outpatient market” and that Esperion plans to leverage its cardiovascular sales presence for cross-selling with physicians already prescribing NEXLETOL and NEXLIZET.
On the call, management said the transaction is expected to close in the second quarter of 2026. In response to questions about supply, Koenig said capacity is “fine” and the company is “in good shape,” with product available. He added that the company plans to provide updates on Corstasis’ subcutaneous pipeline, including an auto-injector option, after the deal closes. CFO Ben Halladay said there are “small” post-market requirement studies, and that they are included in the company’s updated expense guidance.
Financial results and 2026 operating expense outlook
Halladay said 2025 was the company’s “best year on record” and emphasized progress toward sustained profitability. He said Esperion ended the year with $55 million less in debt after paying off the 2025 convertible note stub and closed 2025 with $167.9 million in cash and cash equivalents.
For the fourth quarter of 2025, Esperion reported total revenue of $168.4 million, up 144% year over year. Halladay broke that down as:
- U.S. net product revenue: $43.7 million versus $31.6 million in Q4 2024 (up about 38%)
- Collaboration revenue: $124.7 million versus $37.6 million in Q4 2024 (up about 232%)
Halladay attributed collaboration revenue growth to a one-time $90 million payment from Otsuka related to regulatory approval and the favorable Japan price listing, as well as higher royalty sales in partner territories and product sales to collaboration partners via supply agreements.
On expenses, Halladay reported fourth-quarter R&D expense of $13.9 million versus $11.0 million a year earlier (up about 26%) and SG&A expense of $41.4 million versus $36.9 million (up 12%). He said the SG&A increase was primarily related to higher legal costs associated with ANDA litigation.
Esperion also provided updated 2026 operating expense guidance. Halladay said the company now projects full-year 2026 operating expenses of $225 million to $255 million, including $15 million in non-cash stock compensation, and said the outlook reflects modest increases while incorporating expected synergies between product lines.
In closing remarks, Koenig reiterated that management views Esperion as a “new” company following its 2025 execution and strategic expansion, and said the Corstasis agreement is expected to be a growth accelerant and a foundational element of the Vision 2040 strategy.
About Esperion Therapeutics (NASDAQ:ESPR)
Esperion Therapeutics, Inc is a clinical-stage biopharmaceutical company focused on the discovery, development and commercialization of oral, low–density lipoprotein cholesterol (LDL-C)–lowering therapies. The company’s research and development efforts center on small-molecule compounds designed to address atherosclerotic cardiovascular disease by targeting cholesterol biosynthesis pathways. Esperion seeks to provide novel treatment options for patients who require additional LDL-C reduction beyond what is achieved with statins or who are statin-intolerant.
The company’s lead products include NEXLETOL (bempedoic acid), an oral adenosine triphosphate–citrate lyase (ACL) inhibitor approved by the U.S.
