Esperion Therapeutics, Inc. Q1 FY2024 earnings call

• FDA approved broad new labels for NEXLETOL and NEXLIZET for cardiovascular risk reduction and expanded LDL-cholesterol lowering in primary and secondary prevention patients, positioning them as non-statins of first choice.
• U.S. net revenue grew 46% y-o-y, with retail prescription equivalents up 43% y-o-y and 6% q-o-q.
• International growth: DSE's territories had strong sales growth, Europe had ~255,000 patients treated with sequential 3-month growth of 26% since November, and Asia partner gained approvals in Myanmar and Thailand.
• Commercial initiatives in place: lipid lurkers consumer campaign launched, field teams trained, partnerships for patient services initiated, and some payers updated utilization management criteria aligning to new labels.

In the first quarter, Esperion delivered total revenue of $137.7 million. U.S. net product revenue was $24.8 million, representing a 46% increase year-over-year. Collaboration revenue, including combined royalty and partner revenue, was $113 million, a 1,148% year-over-year increase, which included a $100 million litigation-related settlement received in January. Excluding the settlement, total revenue grew 65% year-over-year. Cost of goods sold for the quarter was $10.1 million, a decrease of 14% year-over-year. R&D expense was $13.4 million, a decrease of 57% year-over-year. SG&A expense was $42 million, an increase of 40% year-over-year. Retail prescription equivalents increased 43% year-over-year and 6% quarter-over-quarter. Growth outside the U.S. continued, with DSE's territories showing sales growth and European treatments increasing to ~255,000 patients with sequential 3-month growth of 26% since November.

• Reiterate 2024 expense guidance: R&D expense expected to be between $45 million and $55 million, SG&A expense between $180 million and $190 million, and total OpEx expense between $225 million and $245 million.
• Confidence in continued growth as they move through quarters with the new label, expecting meaningful growth as they progress.

• Uncertainties in payer utilization management criteria changes that could affect prescription growth.
• Potential delays or issues in the international manufacturing and supply process with DSE, expected to be complete in the second half of next year.

Q: Comment on prescription habits from doctors since the label update and if there's enthusiasm among primary prevention doctors.

A: There's strong enthusiasm for the new label, including for primary prevention. Prescribing is balanced between primary care and cardiologists, with expectation of increasing primary care prescribing as payer utilization management criteria change.

Q: On scripts being flat since label update, when to expect script growth to reaccelerate?

A: Expected to take time but see week-over-week growth, with progressive increases as payer changes occur.

Q: Role of patients in driving treatment decisions?

A: Consumers play a significant role with the lipid lurkers consumer campaign, seen to prompt patients to ask doctors about the product.

Q: Volume trends and inflection?

A: Expect continued growth with the new label, not a quick inflection but meaningful growth as they move through quarters.