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Breaking the Statin Intolerance Barrier: Closing the Care Gap in Cardiovascular Health Virtual KOL Investor Event November 11, 2025 © 2025 Esperion Therapeutics, Inc. All rights reserved.
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© 2025 Esperion Therapeutics, Inc. All rights reserved.2 Forward-looking Statements & Disclosures This investor presentation contains forward-looking statements that are made pursuant to the safe harbor provisions of the federal securities laws, including statements regarding marketing strategy and commercialization plans, current and planned operational expenses, expected profitability, future operations, commercial products, clinical development, plans for potential future product candidates, financial condition and outlook, including expected cash runway and profitability, and other statements containing the words “anticipate,” “believe,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “suggest,” “target,” “potential,” “will,” “would,” “could,” “should,” “continu e,” and similar expressions. Any express or implied statements contained in this investor presentation that are not statements of historical fact may be deemed to be forward-looking statements. Forward-looking statements involve risks and uncertainties that could cause Esperion’s actual results to differ significantly from those projected, including, without limitation, the net sales, profitability, and growth of Esperion’s commercial products, clinical activities and results, supply chain, commercial development and launch plans, the outcomes and anticipated benefits of legal proceedings and settlements, and the risks detailed in Esperion’s filings with the Securities and Exchange Commission. Any forward-looking statements contained in this investor presentation speak only as of the date hereof, and Esperion disclaims any obligation or undertaking to update or revise any forward-looking statements contained in this investor presentation, other than to the extent required by law.
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Speakers © 2025 Esperion Therapeutics, Inc. All rights reserved.3 • Opening and Introduction • When Treatment Becomes the Barrier: Empowering Patients to Stay on Therapy • Question and Answer Session with Dr. Fatima Rodriguez and Dr. Dharmesh S. Patel Agenda Leading Cardiovascular Physician Experts to Explore Real-World Challenges and Impact on Patient Outcomes LeAnne Bloedon, MS, RD Vice President, Head of Development Sheldon Koenig President and Chief Executive Officer Fatima Rodriguez, MD, MPH Section Chief of Preventive Cardiology, Vice Chair of Clinical Research in the Department of Medicine, and Associate Director of the Stanford Center for Digital Health Dharmesh S. Patel, MD, FACC, MBBS (Lon), FACP, FASPC, FNLA, RVPI Lipid Director Stern Cardiovascular Foundation Memphis, TN, Clinical Professor of Cardiology at the Baptist University College of Osteopathic Medicine, Memphis Director Cardiac Rehabilitation, Baptist Desoto Hospital
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Q3 2025: Delivering Consistently Strong Execution © 2025 Esperion. All Rights Reserved – Do not copy or distribute.4 Q3 TOTAL REVENUE $40.7M +31% Y/Y growth Q3 U.S. NET PRODUCT SALES $87.3M +69% Y/Y growth Finalized agreements with four generic manufacturers, including Dr. Reddy’s Bempedoic acid received Level 1a Recommendation in updated ESC/EAS Guidelines for Management of Dyslipidemia Retail Prescription Equivalents Q/Q +9%
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Outpacing the Broader Lipid-Lowering Market Delivering growth that exceeded all other non-statin therapies, including branded competitors 5 • Welcoming John Harlow as Chief Commercial Officer to drive the next phase of commercial growth and execution. • Effective November 17, 2025. Leadership Expansion • Combined progress in marketing and access drove a 9% increase in total retail prescription equivalents and a 7% increase in prescribers in Q3 2025 versus Q2 2025. • Total prescriber base now exceeds 30,000 HCPs. Commercial Performance • Launched “Can’t take a statin? Make NEXLIZET happen!” campaign, targeting statin-intolerant patients. • Quantitative data show strong HCP perception gains and conversion from awareness to use. Brand Momentum • ~50% of individuals who begin statin therapy either discontinue treatment or had over a 6-month gap in therapy within two years – representing a significant opportunity for NEXLETOL® and NEXLIZET®. Market Opportunity © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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• Connected-TV ads launched September 22 on Hulu and Disney+, featuring award- winning “Lipid Lurkers.” • Expanded branded commercials during Grey’s Anatomy starting October 10 to spotlight statin intolerance and position NEXLETOL and NEXLIZET as compelling alternatives. • Campaign expected to deliver ~18 million impressions, targeting adults 50+ with prior statin use, >6 million achieved as of mid- October • Achieved 87% Medicare and 86% commercial approval rates, with average $29/$36 copays for a 30-day supply. • Reflects growing payer confidence and improved access for patients. • Reinforces that getting NEXLETOL and NEXLIZET has never been easier. Access Expansion • Continued investment in targeted digital marketing and access initiatives to expand reach and drive sustained growth in 2026. • Confident these programs will continue to fuel category-leading performance across the bempedoic acid franchise. Consumer Awareness & Engagement Momentum & Outlook 6 Strengthening Patient Reach and Market Access Driving awareness through innovative digital campaigns and broadening reimbursement coverage >80% Commercial lives insuredMedicare lives insured >90% © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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When Treatment Becomes the Barrier: Empowering Patients to Stay on Therapy LeAnne Bloedon, MS, RD VP, Head of Development
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Statin Intolerance is a Spectrum 8 Complete Tolerance: ability to tolerate statin at therapeutic dose Partial Intolerance: inability to tolerate therapeutically required statin dose Complete Intolerance: inability to tolerate statin at any dose Reference: Cheeley MK, et al. J Clin Lipidology. 2022;16:361-375. The National Lipid Association (NLA) defines statin intolerance as one or more adverse effects associated with statin therapy, which resolves or improves with dose reduction or discontinuation. Up to 30% of US adults experience some degree of statin intolerance © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Statin Intolerance May Affect Quality of Life 9 •Female •Increasing age •Asian or Black race •SLCO1B1 gene mutation •Strenuous exercise •Hypothyroidism •Diabetes •Liver disease •Kidney disease •Obesity Risk Factors for Statin Intolerance2,6 References: 1. Stroes ES, et al. Eur Heart J. 2015 May 1;36(17):1012-22. 2. Bytyçi I, et al. Eur Heart J. 2022 Sep 7;43(34):3213-3223. 3. Hovingh GK, et al. Athero. 2016 Feb;245:111- 7. 4. Jose J, et al. J Pharm Bioallied Sci. 2016;8(1):23-28. 5. Thakker D. Pharmacoepi Drug Saf. 2016;25:1131-1149. 6. Tuteja S, et al. Circ Genom Precis Med. 2018;11(9). Elevated liver enzymes 0.5% to 3.0%4 New-onset diabetes 12%5 Most common: statin-associated muscle symptoms (SAMS) 7% to 29%1-3 © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Patients with Statin Intolerance Remain at CV Risk 10 of patients discontinue their statin within the first year2 Patients with statin intolerance are at an increased risk of CVD vs. those with high adherence to statins3: higher rate of recurrent of myocardial infarction (MI)3 50% 51% higher rate of coronary heart disease (CHD)3 References: 1.Kamal-Bahl SJ, et al. Am J Cardiol. 2007;99:530-534. 2. Stroes ES, et al. Eur Heart J. 2015 May 1;36(17):1012-22. 3. Serban MC, et al. J Am Coll Cardiol. 2017;69:1386-1395. 4.Cheeley MK, et al. J Clin Lipidology. 2022;16:361-375 CV= cardiovascular, CVD= cardiovascular disease In high and very high-risk patients who are statin intolerant, clinicians should consider initiating non-statin therapy while additional attempts are made to identify a tolerable statin. 4 – National Lipid Association Statin intolerance contributes to nonadherence1 ~29% © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Statin refusal: when a patient rejects a physician’s statin recommendation, often due to fear of side effects like muscle pain, concerns about long-term safety, and/or disbelief in the benefits of statins.1 Statin Refusal is a Growing Challenge 11 1 in 5 people at high CV risk did not accept the initial HCP recommendation of statin therapy in a large study of ~24,000 statin-naïve patients.2 Not Accepting Recommended Statin Therapy Led to Longer LDL-C Exposure*2 1.5 years 4.4 years 0 1 2 3 4 5 Accepted recommended statin Did not accept recommended statin Median years to achieve LDL-C <100 mg/dL *(P < .001) CV = cardiovascular, HCP = healthcare provider References: 1. Bradley CK, et al. J Am Heart Assoc. 2019;8(7):e011765. 2. Brown CJ, et al. JAMA Netw Open. 2023;6(2):e231047. © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Bempedoic Acid: A Therapy Made to Address Statin Intolerance 12 ACL = ATP-citrate lyase; ACSVL1 = very long-chain acyl-CoA synthetase-1; ATP = adenosine triphosphate; HMG-CoA = 3-hydroxy-3-methylglutaryl-CoA; LDL = low-density lipoprotein cholesterol; LDLR = low-density lipoprotein receptor. Pinkosky SL, et al. Nat Commun. 2016;7:13457. © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Bempedoic Acid Clinical Development Program Evaluated the Full Spectrum of Statin Use 13 CLEAR Harmony1 (N=2230) CLEAR Wisdom2 (N=779) CLEAR Serenity3 (N=345) CLEAR Tranquility4 (N=269) 053 Trial: BA + EZE5 (N=301) CLEAR Outcomes6 (N=13,970) Patient Population History of ASCVD and/or HeFH History of ASCVD and/or HeFH or Primary Prevention History of ASCVD and/or HeFH or Primary Prevention Primary & Secondary Prevention Background Statin 90% Moderate or High Intensity; 10% Partial or Complete Statin Intolerance 18% Partial, 82% Complete Statin Intolerance 59% Moderate or High Intensity, 8% Partial, 33% Complete Statin Intolerance 22% Partial, 78% Complete Statin Intolerance Trial Duration 52 weeks 12 to 24 weeks 12 weeks Median follow up 3.4 yr % Change in LDL-C vs. placebo -17% to -18% -21% to -29% -38% -22% % Change in hsCRP vs. placebo -9 to -22% -24% to -31% -37% -22% 1. Ray KK, et al. N Engl J Med. 2019;380:1022–1032. 2. Goldberg AC, et al. JAMA. 2019;322:1780–1788. 3. Laufs U, et al. J Am Heart Assoc. 2019;8:e011662. 4. Ballantyne CM, et al. Atherosclerosis. 2018;277:195–203. 5. Ballantyne CM, et al. Eur J Prev Cardiol. 2020;27:593–603. 6. Nissen SE, et al. N Engl J Med. 2023;388(15):1353-1364. © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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CLEAR Outcomes Used a Real-World Statin Intolerance Definition • Patient-reported statin intolerance due to an adverse safety effect that started or increased during statin therapy and resolved or improved when statin therapy was discontinued resulting in an inability to tolerate: o 2 or more statins at any dose, or o 1 statin at any dose and unwilling to attempt a second statin or advised by a physician to not attempt a second statin. • Statins were allowed only at stable, average daily doses below the lowest recommended starting dose: 14 rosuvastatin <5 mg pravastatin <40 mg atorvastatin <10 mg fluvastatin <40 mg simvastatin <10 mg pitavastatin < 2 mg © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Strong Efficacy Data Supporting CV Risk Reduction 15 CLEAR Outcomes; data in 13,970 primary or secondary prevention patients with statin intolerance Bempedoic acid (11.7%) vs. Placebo (13.3%) HR 0.87 (95% CI: 0.79-0.96) Number Needed to Treat: 63MACE-4 13% RRR Primary Composite Endpoint (MACE-4): CV death, non-fatal MI, non-fatal stroke, or coronary revascularization MACE-3 (CV death, nonfatal MI, or nonfatal stroke) 15% RRR HR 0.85 (95% CI: 0.76-0.96) Nonfatal Myocardial Infarction 27% RRR HR 0.73 (95% CI: 0.62-0.87) Coronary Revascularization 19% RRR HR 0.81 (95% CI: 0.72-0.92) -20% mean change in LDL-C from baseline vs. placebo at 6 months CI=confidence interval; HR=Hazard Ratio; RRR=Relative Risk Reduction; AE=Adverse Event Nissen SE et al. N Engl J Med. 2023;388-1353-1364 © 2025 Esperion. All Rights Reserved – Do not copy or distribute. CV = cardiovascular; MI= myocardial infarction
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MACE-3 (CV death, non -fatal MI, non -fatal stroke) and Components of Primary Composite Endpoint Placebo (n=2106) NEXLETOL(n=2100) 0.0% 2.0% 4.0% 6.0% MACE-3 HR, 0.61 (95% CI: 0.46-0.80) Nonfatal MI HR, 0.63 (95% CI: 0.39-1.01) Coronary revascularization HR, 0.73 (95% CI: 0.50-1.05) Nonfatal stroke HR, 0.78 (95% CI: 0.47-1.31) Cardiovascular death HR, 0.57 (95% CI: 0.38-0.85) 6.4% 4.0% 2.1% 1.3% 3.2% 2.4% 1.6% 3.1% 1.8% 68 5 0 3 326 1.2% 65 3 7 134 83 44 28 The above data reflect unadjusted efficacy outcomes per the trial statistical analysis plan. The efficacy outcomes presented within the publication were adjusted for baseline characteristics (see publication). Bempedoic Acid: the Only Non-statin FDA Approved to Lower LDL-C and Reduce CV Risk in Primary Prevention Patients © 2025 Esperion. All Rights Reserved. 16 CI=confidence interval; HR=Hazard Ratio; RRR=Relative Risk Reduction; MI=myocardial infarction; CV=cardiovascular 1. Nissen SE, Menon V, Nicholls SJ, et al. Bempedoic acid for primary prevention of cardiovascular events in statin-intolerant patients. JAMA. 2023;330(2):131-140. 2. Nissen SE, Menon V, Nicholls SJ, et al. Bempedoic acid for primary prevention of cardiovascular events in statin-intolerant patients. JAMA. 2023;330(suppl 2):131-140. 3. Data on file. 1002-043 MACE-4, MACE-3, and MACE components for primary prevention patients (full analysis set). March 2024. MACE-4 in Primary Prevention Patients: CV death, non-fatal MI, non-fatal stroke, or coronary revascularization Bempedoic acid (5.3%) vs. Placebo (7.6%) HR 0.68 (95% CI: 0.53-0.87) Number Needed to Treat: 43MACE-4 32% RRR
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Safety Demonstrated in almost 10,000 Bempedoic Acid Treated Patients Across Phase 3 Trials 17 Bempedoic Acid (N=7001) Placebo (N=6964) Any Treatment Emergent Adverse Event 86.3% 85.0% Any Serious Treatment Emergent Adverse Event 25.2% 24.9% Adverse Event Leading to Discontinuation of Study Drug 10.8% 10.4% Myalgia Discontinuation of Study Drug Due to Myalgia 5.6% 1.8% 6.8% 1.9% Gout Discontinuation of Study Drug Due to Gout 3.2% 0.1% 2.2% <0.1% Hyperuricemia 10.9% 5.6% New Onset Diabetes in Patients Without Diabetes at Baseline 16.1% 17.1% Renal impairment 11.5% 8.6% Elevated hepatic-enzyme level 4.5% 3.0% Adjudicated tendon rupture 1.2% 0.9% Tendinopathies 1.7% 1.8% Treatment Emergent Adverse Events in CLEAR Outcomes Nissen SE et al. N Engl J Med. 2023;388-1353-1364 © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Recent ESC/EAS Guideline Update Highlights Bempedoic Acid 18 CV = cardiovascular Mach F, et al. Eur Heart J, 2025. Class I Level B Bempedoic acid recommended for LDL-C reduction in statin intolerant patients Non-statin therapies with proven CV benefit, including bempedoic acid, recommended alone or in combination for patients unable to take statin therapy Class I Level A Average LDL-C reduction with different therapies with proven CV benefit Strike early, strike strong © 2025 Esperion. All Rights Reserved – Do not copy or distribute.
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Statin Intolerant Focused Material for Both Physicians to Use with Patients and Direct to Consumer © 2025 Esperion Therapeutics, Inc. All rights reserved.19 • Over 650,000 visits to our consumer statin intolerance website in Q2 • More than 600,000 click throughs to our HCP statin intolerance site in Q2 Can’t take a statin? Make NEXLIZET happen! Strong engagement underscores the impact of this successful, targeted awareness campaign
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Q&A Session Fatima Rodriguez, MD, MPH Section Chief of Preventive Cardiology, Vice Chair of Clinical Research in the Department of Medicine, and Associate Director of the Stanford Center for Digital Health Dharmesh S. Patel, MD, FACC, MBBS (Lon), FACP, FASPC, FNLA, RVPI Lipid Director Stern Cardiovascular Foundation Memphis, TN, Clinical Professor of Cardiology at the Baptist University College of Osteopathic Medicine, Memphis Director Cardiac Rehabilitation, Baptist Desoto Hospital
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esperion.com
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Important Safety Information
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NEXLETOL® (bempedoic acid) Important Safety Information © 2025 Esperion Therapeutics, Inc. All rights reserved.23 • NEXLETOL is contraindicated in patients with a prior serious hypersensitivity reaction to bempedoic acid or any of the excipients. Serious hypersensitivity reactions, such as angioedema, have occurred. • Hyperuricemia: NEXLETOL may increase blood uric acid levels, which may lead to gout. Hyperuricemia may occur early in treatment and persist throughout treatment, returning to baseline following discontinuation of treatment. Assess uric acid levels periodically as clinically indicated. Monitor for signs and symptoms of hyperuricemia, and initiate treatment with urate-lowering drugs as appropriate. • Tendon Rupture: NEXLETOL is associated with an increased risk of tendon rupture or injury. Tendon rupture may occur more frequently in patients over 60 years of age, in those taking corticosteroid or fluoroquinolone drugs, in patients with renal failure, and in patients with previous tendon disorders. Discontinue NEXLETOL at the first sign of tendon rupture. Consider alternative therapy in patients who have a history of tendon disorders or tendon rupture. • The most common adverse reactions in the primary hyperlipidemia trials of NEXLETOL in ≥2% of patients and greater than placebo were upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, and elevated liver enzymes. • The most common adverse reactions in the cardiovascular outcomes trial for NEXLETOL at an incidence of ≥2% and 0.5% greater than placebo were hyperuricemia, renal impairment, anemia, elevated liver enzymes, muscle spasms, gout, and cholelithiasis. • Discontinue NEXLETOL when pregnancy is recognized unless the benefits of therapy outweigh the potential risks to the fetus. Because of the potential for serious adverse reactions in a breast-fed infant, breastfeeding is not recommended during treatment with NEXLETOL. • Report pregnancies to Esperion Therapeutics, Inc. Adverse Event reporting line at 1-833-377-7633. See full prescribing information here.
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NEXLIZET® (bempedoic acid and ezetimibe) Important Safety Information © 2025 Esperion Therapeutics, Inc. All rights reserved.24 • NEXLIZET is contraindicated in patients with a prior hypersensitivity to ezetimibe or bempedoic acid or any of the excipients. Serious hypersensitivity reactions, such as anaphylaxis, angioedema, rash, and urticaria have been reported with ezetimibe or bempedoic acid. • Hyperuricemia: Bempedoic acid, a component of NEXLIZET, may increase blood uric acid levels, which may lead to gout. Hyperuricemia may occur early in treatment and persist throughout treatment, returning to baseline following discontinuation of treatment. Assess uric acid levels periodically as clinically indicated. Monitor for signs and symptoms of hyperuricemia, and initiate treatment with urate-lowering drugs as appropriate. • Tendon Rupture: Bempedoic acid, a component of NEXLIZET, is associated with an increased risk of tendon rupture or injury. Tendon rupture may occur more frequently in patients over 60 years of age, in those taking corticosteroid or fluoroquinolone drugs, in patients with renal failure, and in patients with previous tendon disorders. Discontinue NEXLIZET at the first sign of tendon rupture. Consider alternative therapy in patients who have a history of tendon disorders or tendon rupture. • The most common adverse reactions in the primary hyperlipidemia trials of bempedoic acid (a component of NEXLIZET) in ≥2% of patients and greater than placebo were upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, and elevated liver enzymes. • Adverse reactions reported in ≥2% of patients treated with ezetimibe (a component of NEXLIZET) and at an incidence greater than placebo in clinical trials were upper respiratory tract infection, diarrhea, arthralgia, sinusitis, pain in extremity, fatigue, and influenza. • In the primary hyperlipidemia trials of NEXLIZET, the most commonly reported adverse reactions (incidence ≥3% and greater than placebo) observed with NEXLIZET, but not observed in clinical trials of bempedoic acid or ezetimibe, were urinary tract infection, nasopharyngitis, and constipation. • The most common adverse reactions in the cardiovascular outcomes trial of bempedoic acid (a component of NEXLIZET) at an incidence of ≥2% and 0.5% greater than placebo were hyperuricemia, renal impairment, anemia, elevated liver enzymes, muscle spasms, gout, and cholelithiasis. • Discontinue NEXLIZET when pregnancy is recognized unless the benefits of therapy outweigh the potential risks to the fetus. Because of the potential for serious adverse reactions in a breast-fed infant, breastfeeding is not recommended during treatment with NEXLIZET. • Report pregnancies to Esperion Therapeutics, Inc. Adverse Event reporting line at 1-833-377-7633. See full prescribing information here.