Nustendi

Indicated For

Primary hypercholesterolaemia, mixed dyslipidaemia, atherosclerotic cardiovascular disease

About This Medication

# NEXSTEP Patient Support Program Patient Guide: How to Get Nustendi at Low or No Cost Nustendi (bempedoic acid and ezetimibe) is a prescription medication designed to help lower **bad cholesterol (LDL-C)** and reduce the risk of heart attacks and certain heart procedures in adults who cannot take statins or need additional cholesterol control.[1][3] The **NEXSTEP Patient Support Program** from Esperion Therapeutics offers a Co-Pay Card to eligible patients with commercial insurance, potentially reducing costs to as little as **$10 for a 30-day supply** or **$25 for a 90-day supply**.[2][3] ## About Nustendi and Why You Might Need It Nustendi combines two active ingredients: **bempedoic acid**, which lowers cholesterol by targeting production in the liver, and **ezetimibe**, which blocks cholesterol absorption in the intestines. It's specifically for adults with **known heart disease** or who are **at high risk for heart disease** but unable to tolerate recommended statin therapy (common cholesterol-lowering drugs) or not on a statin.[1][3] Clinical studies show the bempedoic acid component reduces the risk of heart attacks and procedures like stents or bypass surgery. It's taken as one tablet daily, with or without food. Common side effects include upper respiratory infections, muscle spasms, back pain, and increased uric acid levels (which may lead to gout). **Important safety note**: Do not take if allergic to bempedoic acid, ezetimibe, or any ingredients. Seek immediate help for serious allergic reactions like swelling, wheezing, or severe itching.[1][3] Always discuss with your doctor if Nustendi is right for you, especially if you have kidney issues, gout history, or take certain other medications. ## Who Qualifies for the NEXSTEP Program? The NEXSTEP Patient Support Program primarily provides a **Co-Pay Card** for **commercially insured patients** (private insurance through an employer or individual plans).[2][3][7] Key eligibility: - Must be **18 years or older** and a **U.S. resident**.[1] - Have a valid prescription for Nustendi (or related drugs like NEXLIZET/NEXLETOL, which share similar components).[1][3] - **Not eligible** if covered by **federal or state healthcare programs** like Medicare, Medicaid, TRICARE, or VA benefits.[3][7] **Patients without commercial insurance** or those uninsured may not qualify for the Co-Pay Card. Third-party services like Simplefill offer alternative assistance by matching to programs, but these are not directly from Esperion.[5] Contact your doctor or social worker for low-income options, as specific free drug programs for uninsured patients are not detailed in manufacturer resources.[1-4] ## Income Eligibility Breakdown NEXSTEP does not have traditional **income thresholds** for its Co-Pay Card; eligibility focuses on insurance type rather than income.[2][3] However, for context in patient assistance landscapes: | Category | Eligibility Details | Max Monthly Out-of-Pocket | |----------|---------------------|---------------------------| | **Commercial Insurance** | Eligible for Co-Pay Card | $10 (30-day) / $25 (90-day) [2][3] | | **Medicare/Medicaid** | Not eligible [3][7] | N/A | | **Uninsured/Low-Income** | No manufacturer free drug program listed; explore Simplefill or doctor assistance [5] | Varies | | **High Deductible Plans** | Co-Pay Card may apply after deductible [7] | $10-$25 per fill | Certain restrictions apply; full terms at activation site.[3][6] ## Insurance Requirements - **Commercial/Private Insurance**: Primary focus—activate Co-Pay Card to cover copays.[2][3][7] - **Government Insurance (Medicare, Medicaid, etc.)**: **Ineligible** for Co-Pay assistance.[3][7] - Nustendi/NEXLIZET is covered on **most insurance plans**, but prior authorizations may be needed.[3] If your plan denies coverage, NEXSTEP Navigator (via Esperion reps) can assist with appeals or access.[2] ## Step-by-Step Application Process 1. **Get Prescribed**: Confirm with your doctor that Nustendi is appropriate.[1] 2. **Enroll in NEXSTEP**: Visit the enrollment page or site like nexlizet.com/enroll-today/ (adapt for Nustendi). Fill required fields; must be 18+ U.S. resident.[1] 3. **Activate Co-Pay Card**: Go to **NexCopay.com** or call **1-855-699-8814** (M-F, 8AM-8PM ET). Provide prescription and insurance details.[3][6] 4. **Use at Pharmacy**: Present digital/physical card when filling. Card activates instantly online.[6] 5. **Need Help?** Call support at 1-855-699-8814 or Esperion Medical Info at 1-833-377-7633 (M-F, 8AM-8PM ET).[3][4] No extensive documents typically required beyond prescription and insurance proof at pharmacy.[1][3] ## Timeline and Delivery - **Activation**: Immediate upon online enrollment or call.[6] - **Pharmacy Fill**: Use card right away; savings apply per fill.[2] - **Processing**: No formal 'approval wait' for Co-Pay Card—it's not a pre-approval program.[3] Delivery is standard pharmacy pickup or mail if your pharmacy offers it; program doesn't specify shipping.[1-4] ## Alternatives if Denied or Ineligible - **Appeal Insurance Denial**: Use NEXSTEP Navigator—email navigator@esperion.com or contact rep.[2] - **Third-Party Help**: Simplefill (1-877-386-0206) applies to assistance programs for uninsured/low-income.[5] - **Generic Options**: No biosimilars noted; discuss statin alternatives or ezetimibe alone with doctor. - **Other Savings**: Pharmacy discount cards (e.g., GoodRx), patient access foundations, or state programs. ## Important Disclaimer This guide is for informational purposes only and based on available program details as of latest sources. It is **not medical or financial advice**. Eligibility, terms, and availability can change; always verify with Esperion at 1-855-699-8814 or your healthcare provider. Co-Pay Cards have restrictions and expire (check terms). Report side effects to FDA at 1-800-FDA-1088 or Esperion at 1-833-377-7633. Consult your doctor before starting Nustendi.[1][3][4]

Program information last verified: March 30, 2026