Nexlizet

Indicated For

high LDL cholesterol, hypercholesterolemia, cardiovascular disease risk reduction

About This Medication

# NEXSTEP Patient Support Program Patient Guide: How to Get Nexlizet at Low or No Cost Nexlizet (bempedoic acid and ezetimibe) is a prescription medication used to help lower **bad cholesterol (LDL-C)** in adults, especially those who can't tolerate statins or need additional cholesterol control to reduce cardiovascular risk. The **NEXSTEP Patient Support Program** from Esperion Therapeutics offers a Co-Pay Card to eligible patients with commercial insurance, reducing costs to as little as **$10 for a 30-day supply** or **$25 for a 90-day supply**[1][2][7]. This guide explains everything you need to know about the program in simple terms, from eligibility to applying and what to do if you're denied. It's designed for patients like you—managing high cholesterol while keeping costs down. Note: This is not a free drug program for uninsured or low-income patients; it's primarily a copay savings card for those with commercial (private) insurance[1][7]. ## About Nexlizet: Why You Might Need It **Nexlizet** combines two active ingredients: **bempedoic acid**, which reduces cholesterol production in the liver, and **ezetimibe**, which blocks cholesterol absorption in the intestines. It's an oral non-statin option FDA-approved to lower LDL-C and reduce heart risks in primary or secondary prevention for adults with **statin intolerance** (e.g., muscle pain from statins)[2]. Common uses include: - Patients with high LDL-C despite lifestyle changes. - Those with atherosclerotic cardiovascular disease (ASCVD) or at high risk. - Heterozygous familial hypercholesterolemia (HeFH). It's taken as one tablet daily, with or without food. **Important safety note**: Do not take if allergic to bempedoic acid, ezetimibe, or ingredients. Watch for serious allergic reactions like swelling, rash, or breathing issues—seek emergency help immediately[3]. Always follow your doctor's instructions and report side effects to Esperion at 1-833-377-7633[4]. Nexlizet is covered by >90% of commercial and Medicare plans, with Medicare approving 8/10 prescriptions. Average Medicare copay is ~$43 for 30 days (Q3 2024 data)[2]. Some plans need prior authorization (PA)—your doctor can include diagnosis, statin history, and LDL-C levels to help[2]. ## Who Qualifies for the NEXSTEP Co-Pay Card? The program targets **commercially insured adults** struggling with out-of-pocket costs. You **do not** qualify if on government insurance like Medicare, Medicaid, or VA—using the card with these is not allowed[1][7]. **Key eligibility criteria**[1]: - 18 years or older. - Valid U.S. prescription for Nexlizet (or Nexletol). - Commercial prescription drug insurance (employer, marketplace, etc.). - U.S. resident (excluding territories like Puerto Rico). If your insurance changes to government coverage, notify the program immediately—you'll lose eligibility[1]. No income limits are mentioned; it's not a low-income assistance program[1][7]. ## Income Eligibility Breakdown The NEXSTEP Co-Pay Card has **no income thresholds**—eligibility focuses on insurance type and age, not household income. This differs from traditional patient assistance programs (PAPs) that use Federal Poverty Level (FPL) guidelines. | Household Size | Income Threshold | FPL % | Notes | |---------------|------------------|-------|-------| | Individual | None | N/A | Based on commercial insurance only[1] | | Couple | None | N/A | No income test required | | Family of 3 | None | N/A | Report insurance changes promptly[1] | | Family of 4 | None | N/A | Excludes government insurance | If uninsured or on Medicare/Medicaid, explore third-party options like Simplefill for Nexletol/Nexlizet, but Esperion doesn't offer a direct free drug PAP[8]. ## Insurance Requirements **Commercial insurance required**—the card reduces your copay but cannot be used with government programs (Medicare Part D, Medicaid, etc.), even if processed as commercial[1][7]. - **Medicare**: Nexlizet often covered (8/10 approvals), average $43 copay/30 days. No copay card[2][7]. Contact your plan. - **Commercial**: Eligible for $10/30-day or $25/90-day[1][2]. - **Prior Authorization**: Common; doctor submits with clinical details[2]. Nexlizet/Nexletol covered by >90% of payers[2]. ## Step-by-Step Application Process 1. **Get Prescribed**: Discuss with your doctor if Nexlizet fits your needs. 2. **Enroll in NEXSTEP**: Visit nexlizet.com or nexstep program page. Fill out form (name, DOB, address, insurance details). Must be 18+ and U.S. resident[3]. Or call 855-699-8814[5]. 3. **Activate Co-Pay Card**: Online at www.NexCopay.com or phone. Get digital/physical card[1][5]. 4. **Fill Prescription**: Present card at pharmacy. Savings apply instantly if eligible[1]. 5. **Need Help?**: Contact NEXSTEP Navigator via Esperion rep or 1-833-377-7633 (M-F, 8am-8pm ET)[2][4]. No paper forms or extensive docs needed—just basic enrollment[3][5]. ## Timeline and Delivery - **Processing**: Instant activation upon eligibility check (online/phone)[5]. - **Delivery**: Digital card immediate; physical mailed (days). Bring to pharmacy[5]. - **Refills**: Card valid for ongoing fills; report insurance changes[1]. No set expiration mentioned, but monitor eligibility. Pharmacy handles savings at point-of-sale[1]. ## Alternatives if Denied or Ineligible - **Government Insurance**: Use plan coverage; appeal denials or request PA[2][7]. - **Uninsured/Low-Income**: Try Simplefill (1-877-386-0206)—they apply to PAPs for you[8]. Or GoodRx/discount cards (not manufacturer). - **Other Options**: Nexletol (bempedoic acid alone), statins, or PCSK9 inhibitors. Discuss with doctor. - **Appeal**: Contact program at 855-699-8814 if denied[5]. No biosimilars available[provided data]. ## Disclaimer This guide is for informational purposes based on publicly available data as of 2026. Eligibility determined by Esperion/program reps[2]. Terms can change—verify at nexlizet.com or 1-833-377-7633. Not medical/financial advice. Consult your doctor/pharmacist. Report AEs/pregnancies to Esperion[2][4]. Program excludes government insurance[1]. (Word count: 1028)

Program information last verified: March 30, 2026