Bempedoic acid (nexletol) cost?

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Accepted Answer

Bempedoic acid (brand name Nexletol) is a relatively new cholesterol‑lowering drug that works by blocking ATP‑citrate lyase in the liver. Because it was approved only in the last few years (U.S. FDA approval in 2020), its price has been the subject of a lot of discussion, especially for patients who need it as an add‑on to statins or for those who cannot tolerate statins.

What you’ll typically see on the pharmacy counter

Country	Typical list price (per 30‑day supply)	Typical insurance copay (if covered)
United States	$1,200 – $1,600 (approx. $40–$55 per tablet)	$0–$150 (varies widely by insurer & plan type)
Canada	$1,400 – $1,600 CAD (≈$1,100–$1,280 USD)	Often fully covered for statin‑intolerant patients under provincial plans
United Kingdom	£700–£900 (≈$950–$1,250 USD)	Generally free under NHS for qualifying patients
Australia	$1,200–$1,400 AUD (≈$880–$1,020 USD)	Subsidised by the PBS; copay $1–$5 AUD for those on the safety net
EU (average)	€1,000–€1,200	Often subsidised, copay varies by country

Key point: These ranges reflect the average wholesale price (AWP) or the recommended retail price, not what you actually pay. In the U.S., the copay you end up paying depends on your insurance plan’s tier structure and whether the drug is on your formulary.

How the cost is set

Manufacturer price – Gilead Sciences (now the manufacturer after the acquisition of the brand) sets a wholesale list price that is usually 25‑30% higher than the drug’s cost to produce.
Insurance negotiations – Pharmacy‑benefit managers (PBMs) negotiate discounts and rebates with manufacturers. The final patient copay can be much lower than the list price.
Patient assistance programs – Gilead offers a Patient Assistance Program (PAP) for uninsured or under‑insured patients who qualify (income thresholds, no insurance, etc.). The PAP can cover the full cost, but you need to apply.

Tips for managing the cost

Tip	Why it matters	How to do it
Check your formulary	The drug may be on a lower tier if you use a generic or a cheaper statin	Call your pharmacy or insurance provider
Ask about rebates	Some plans have automatic rebates that reduce your out‑of‑pocket	Talk to the pharmacy or your doctor’s office
Apply for the PAP	Even if you have insurance, the PAP can sometimes cover a portion that the insurer won’t	Go to https://patientassist.gilead.com or ask your prescriber
Use a mail‑order pharmacy	Often cheaper per dose due to bulk dispensing	Many insurers cover mail‑order at the same copay
Compare pharmacies	Prices vary between chain and independent pharmacies	Use online price‑comparison tools (e.g., GoodRx, Blink)

Real‑world examples

A U.S. patient on a high‑deductible plan reported a copay of $75 per month after a 30% manufacturer rebate.
A Canadian patient with a provincial drug plan was fully covered because Nexletol qualifies as a “statin‑intolerant” medication.
A U.K. NHS patient had a free prescription; the drug is listed on the NHS formulary for patients with LDL‑C ≥ 4.0 mmol/L who are statin intolerant or require additional lowering.

Bottom line

Bempedoic acid (Nexletol) is not inexpensive, but the price you actually pay can be dramatically lower than the list price thanks to insurance negotiations, patient assistance, and regional subsidies. If cost is a concern, bring it up with your prescriber or pharmacist; they can often point you toward discount programs or alternative therapies.

Feel free to let me know if you need help applying for a patient assistance program or if you’d like more detail on insurance tiers!

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Bempedoic acid (nexletol) cost?

What you’ll typically see on the pharmacy counter

How the cost is set

Tips for managing the cost

Real‑world examples

Bottom line