Nexletol

Indicated For

hypercholesterolemia, heterozygous familial hypercholesterolemia, cardiovascular disease risk reduction

About This Medication

# NEXSTEP Patient Support Program Guide: How to Get Nexletol (bempedoic acid) at Low or No Cost Nexletol (bempedoic acid) is a prescription medication used to lower bad cholesterol and reduce the risk of heart attacks and certain heart procedures in adults who can't take statins. The **NEXSTEP Patient Support Program** from Esperion Therapeutics helps eligible patients access Nexletol through a co-pay card, reducing costs to as little as **$10 for a 30-day supply** or **$25 for a 90-day supply** if you have commercial insurance[1][2][3]. ## About Nexletol and Why You Might Need It Nexletol contains **bempedoic acid**, a non-statin cholesterol-lowering medicine. It's FDA-approved to reduce the risk of myocardial infarction (heart attack) and coronary revascularization (procedures like stents or bypass surgery) in adults with: - Established cardiovascular disease (CVD), or - High risk for a CVD event but without established CVD, who are unable to take recommended statin therapy (including those not taking a statin)[2][3][8]. Unlike statins, Nexletol works by inhibiting cholesterol production in the liver and is taken as an oral tablet once daily. It's often prescribed for people with **statin intolerance**, meaning they experience side effects like muscle pain from statins. Common side effects include upper respiratory infections, muscle spasms, back pain, and increased uric acid levels (which may lead to gout). Always tell your doctor about other medications, especially simvastatin, pravastatin, cyclosporine, fibrates, or cholestyramine, as interactions can occur[1][3]. Nexletol is part of a broader treatment plan that may include diet, exercise, and other therapies. It's covered by over 90% of national commercial and Medicare payers, with Medicare approving 8 out of 10 prescriptions. Medicare patients paid an average of $43 for a 30-day supply in Q3 2024[2]. Some plans require **prior authorization (PA)**; your doctor can include details like diagnosis, statin history, and LDL-C levels to support approval[2][9]. ## Who Qualifies for NEXSTEP? The NEXSTEP program primarily offers a **co-pay card** for commercially insured patients. You qualify if you: - Are at least **18 years old**, - Have a valid prescription for Nexletol, - Have **commercial prescription drug insurance** (not government programs like Medicare or Medicaid), - Are a resident of the United States (including DC, but excluding territories like Puerto Rico)[1][3][5]. **Government insurance note**: Patients in government programs (e.g., Medicare, Medicaid) cannot use the co-pay card, even if processed as commercial[1]. For uninsured or low-income patients, third-party options like Simplefill or PAN Foundation may help apply to patient assistance programs (PAPs)[4][6]. ## Income Eligibility Breakdown NEXSTEP's co-pay card does not have specific income thresholds—eligibility is based on commercial insurance, not income. However, for broader assistance like Medicare Extra Help or PAPs: | Household Size | Income Threshold (e.g., ~400% FPL, varies by program) | Notes | |---------------|---------------------------------------------|-------| | Individual | ~$60,000/year (approx., check current FPL) | For PAPs like Simplefill; co-pay card has no income limit[4][7] | | Couple | ~$80,000/year | Varies; Medicare Extra Help has asset tests[7] | | Family of 3 | ~$100,000/year | Third-party PAPs; not required for NEXSTEP co-pay[6] | | Family of 4 | ~$120,000/year | Consult programs for exact 2026 figures | *These are estimates based on federal poverty level (FPL) guidelines for similar programs. NEXSTEP co-pay has **no income eligibility**—just commercial insurance[1][4].* ## Insurance Requirements - **Commercial insurance**: Required for co-pay card. Reduces cost to $10/30-day or $25/90-day supply[1][2][5]. - **Medicare**: Widely covered (90%+ plans), average copay $43/30-day. Extra Help program for low-income: no premiums/deductibles, low copays if income/assets qualify[2][7][10]. - **Medicaid/Uninsured**: Not eligible for co-pay card. Use PAPs via Simplefill (call 1-877-386-0206) or PAN Foundation (up to $3,800/year copay grant)[4][6]. - **Prior Authorization**: Often needed; doctor submits with clinical details[2][9]. ## Step-by-Step Application Process 1. **Get Prescribed**: Talk to your doctor about Nexletol if you have high cholesterol, CVD, or statin issues. They may handle PA[2]. 2. **Enroll in NEXSTEP**: Visit nexletol.com or nexlizet.com, fill out the form (name, DOB, address, insurance details). Must be 18+ and US resident[1][3]. 3. **Activate Co-Pay Card**: If eligible, get card at NexCopay.com or via phone support. Present at pharmacy[2][5]. 4. **For Uninsured/Low-Income**: Apply to Simplefill online/phone; they match you to PAPs and handle paperwork[4]. Or check NeedyMeds/Medicine Assistance Tool[10]. 5. **Pharmacy Fill**: Use mail-order for 90-day supply to save time/money[10]. Representatives in NEXSTEP can guide activation and provide heart health info[1][3]. ## Timeline and Delivery - **Approval**: Co-pay card activates instantly upon eligibility check. PA may take days-weeks (doctor-dependent)[2]. Simplefill processes applications quickly, with ongoing refill monitoring[4]. - **Delivery**: Fill at any pharmacy; opt for mail-order (e.g., 90-day via insurance). No specific program shipping[10]. - **Supply Duration**: Co-pay good per fill; check card terms for annual max (varies)[5]. ## Alternatives if Denied or Ineligible - **Switch Insurance Processing**: If government-insured, explore commercial-like options (but co-pay ineligible)[1]. - **Third-Party PAPs**: Simplefill for free/low-cost Nexletol; PAN for copays[4][6]. - **Extra Help**: Apply for Medicare LIS if low-income[7]. - **Discounts**: GoodRx, 90-day mail-order, or generic alternatives (none for Nexletol yet)[7][10]. - **Other Drugs**: Ezetimibe (in Nexlizet combo), PCSK9 inhibitors, or lifestyle changes. Discuss with doctor[2]. ## Important Disclaimer This guide is for informational purposes only and not medical/financial advice. Eligibility, coverage, and costs change; verify with Esperion (nexletol.com), your insurer, doctor, or pharmacist. NEXSTEP co-pay terms subject to change; not for government-insured. Consult healthcare provider before starting Nexletol. Data as of latest available (2024-2026 sources). Word count: 1028.

Program information last verified: March 30, 2026