Esperion Therapeutics, Inc. Q2 FY2025 earnings call

Sheldon Koenig highlighted a standout second quarter with double-digit sequential growth, over 42% year-over-year gains in U.S. net product sales, and the first quarter of operating income from ongoing business. Total revenue grew 12% year-over-year to $82.4 million. U.S. net product revenue grew 42% year-over-year to $40.3 million and 15% sequentially. Operating income from ongoing business was approximately $15 million. Clinical adoption of NEXLETOL and NEXLIZET accelerated. Marketing initiatives such as the campaign for statin-intolerant patients were well received, with over 650,000 visits to the consumer statin intolerance website and over 600,000 click-throughs to the physician site. 23% of prescriptions were written by physicians with only digital touch points. The expanded U.S. field reimbursement manager support team educated over 1,100 target prescribers with approval rates over 80%. The consumer marketing program with lipid lurkers won awards and plans to launch a consumer TV ad later. Pipeline progress on primary sclerosing cholangitis (PSC) was noted, along with international partnerships with various companies showing progress in market approvals and milestone payments.

Total revenue for the second quarter 2025 was $82.4 million, up 12% year-over-year. U.S. net product revenue was $40.3 million, representing a 42% year-over-year increase and a 15% sequential increase from the first quarter of 2025, accounting for approximately 48.9% of total revenue. Collaboration revenue was $42.1 million, down 7% year-over-year. Research and development expenses were $7.2 million, a 37% decrease from the comparable period in 2024. Selling, general and administrative expenses were $39.5 million, a 11% decrease from the comparable period in 2024.

Expect to transition to sustainable profitability beginning in the first quarter of 2026. Reiterated the full year 2025 operating expense guidance of approximately $215 million to $235 million. Japanese partner Otsuka Pharmaceuticals is expected to receive milestone payments of up to $120 million upon approval of bempedoic acid products in Japan.

No detailed in-depth risks discussed, but potential competition from other oral non-statin agents entering the market could pose a risk.

Q: Congrats on the progress this quarter. A couple of quick questions on NEXLETOL and NEXLIZET. Can you remind us how many remaining prior auths are relative to the TAM for the product? And I think you mentioned you had over 80% approval rate for these prior auths. So is that a number you expect to continue improving on? And secondly, for Ben, I think you mentioned you expect some of the working capital benefits from the tech transfer to DSE to start occurring later this year. Just curious what that will look like on the balance sheet when it starts coming together?

A: Betty Jean Swartz mentioned approval rates well over 80%, with certain pacesetter regions having higher rates. Ben Halladay stated on the working capital side, as DSE takes over, inventory production on their side is expected to ramp down towards the second half of the year.

Q: Congrats on a strong quarter. So if I look at the graph on Slide 10, where you talk about the growth. Can you -- it looks like the jump from April to May was probably the largest numerical gain in the 2.5 years. So if you can -- I know you talked about several growth levers, but what in particular really like stood out during that transition time?

A: Sheldon Koenig said the strategy of going after statin-intolerant patients and establishing a beachhead was driving growth. Lisa Schafer added strong growth from Medicare and commercial, and out-of-pocket expense improvement for Medicare patients.

Q: How do you view consensus U.S. revenue for the year, which is around $170 million and the underlying script growth required to get there? When will you consider giving revenue guidance? And then our second question is, can you remind us on the cadence of milestone payments from Otsuka? And are there very simple thresholds that need to be met and the contract language is very clear? And then can you reiterate that there won't be any confusion like we saw from Daiichi a few years ago?

A: Ben Halladay said tracking nicely in line with consensus. On the milestone side, Japanese partner Otsuka is expected to receive milestone payments of up to $120 million upon approval, with contract language clear. Sheldon Koenig stated no financial or script guidance has been given but double-digit script growth momentum will continue.

Q: Can you talk about the gross margin trend we should expect in the back half of the year and into '26? I guess I had thought it would kind of start to materialize, but maybe not. So just curious kind of how to think about the back half and then next year and frankly, ultimately, where you land. How should we think about gross to net over the rest of this year? And then it looks like R&D, particularly after this quarter is tracking below the 2025 R&D guidance. Should we expect a significant ramp-up in R&D in the back half to kind of get you into that range? So those are the model questions. And then the last one is just basically I want to ask you to kind of make the case here that NEXLETOL will remain competitive in the non-statin LDL space with additional oral mechanisms coming to market?

A: Ben Halladay said gross margin benefits from tech transfer will kick in early next year, gross to net will be in steady state. R&D Q2 was light but pediatric trial will ramp up in the second half. Sheldon Koenig said from IP perspective, patent protection and unique indications in statin-intolerant patients and primary prevention give NEXLETOL a competitive edge.

Q: On the back end, with regard to PSC and your plans, what would you consider any, if any, rate-limiting steps that might potentially impact your second half of 2016 guidance? And my second question, I will admit is somewhat rhetorical, but I would love your thoughts. So when you look at just the U.S. you talked about currently having about 28,000 health care providers prescribing the drug. Looking at your various marketing campaigns, the new ones coming up, the digital campaigns and what have you, what would you say would be the key inflection areas that would take you more quickly from 28,000 HCPs to say, 50,000 versus, say, 28,000 to 29,000?

A: Benjamin Halladay said no rate-limiting steps impacting second half of 2016 guidance. Sheldon Koenig said TV ad, consumer activation, and benefits in statin-intolerant patients and primary prevention indication are key growth levers.