Executives from Esperion Therapeutics (NASDAQ:ESPR) highlighted accelerating revenue growth, plans to expand its commercial footprint, and details of a pending acquisition during remarks at the Citizens Life Sciences Conference in Miami, coming a day after the company reported earnings.
2025 results and momentum entering 2026
Chief Executive Officer Sheldon Koenig said Esperion delivered what he described as “one of the best years we’ve ever had” in 2025, citing 38% year-over-year growth in total revenue and 34% year-over-year growth in total prescriptions (TRx). Koenig also pointed to sequential momentum, noting 11% TRx growth from the third quarter to the fourth quarter. He said total revenue for the year was $408 million and added that the company expects growth to continue.
Corstasis acquisition: rationale and integration plans
Koenig and the team spent significant time discussing Esperion’s planned acquisition of Corstasis and its recently approved product, ENBUMYST, a nasal formulation of the loop diuretic bumetanide. Koenig said the acquisition aligns with Esperion’s intent to pursue business development in cardiometabolic areas with overlap to its existing prescriber base, including cardiologists and primary care physicians.
Koenig described heart failure as a large market with significant unmet need, and said Esperion was attracted to ENBUMYST’s delivery approach for patients who do not respond well to oral diuretics due to gut edema. Chief Commercial Officer John Harlow said the company views the product as a way to intervene earlier for worsening patients who otherwise escalate oral dosing and may wind up in the emergency department. Harlow also noted that one in four heart failure patients are readmitted within 30 days, adding that readmissions affect hospital quality metrics and reimbursement.
Harlow said Esperion plans to leverage its existing commercial infrastructure, while also expanding coverage to reach health systems and integrated delivery networks involved in acute care discharge and readmission prevention. He cited an estimated $12,000 to $18,000 cost for a heart failure readmission and said Esperion aims to demonstrate value in that context.
On the nasal delivery format, Harlow said key opinion leaders have emphasized ease of use, describing a simple “puff in the nose” approach. He added that Corstasis is also developing an auto-injector as an additional option, though he expects most physicians to prefer the nasal spray due to convenience. Harlow also emphasized the importance of engaging nurses, who he said can influence or administer treatment in heart failure care pathways.
Esperion expects the transaction to close in the first week of April. Harlow said the teams are in a pre-integration period, working with a small contracted commercial group that previously supported the initial launch and preparing a broader commercialization effort after close. The product is already available, he said, and Esperion plans to ramp awareness and provide updates through the year.
Deal terms and financing
Halladay outlined the acquisition economics, describing the transaction as $75 million upfront plus approximately $180 million in contingent value right (CVR) milestones. He said the milestones include one tied to a new FDA approval and others tied to cumulative sales. He also said there is a low double-digit royalty to CVR holders.
To fund the upfront payment, Halladay said Esperion will use a combination of expanding its existing term loan facility and monetizing a portion of its Japanese royalties. He said the company wanted to avoid significantly releveraging and emphasized Esperion’s efforts to reduce leverage, including paying off a $55 million stub in November. Halladay said Esperion ended the year with $168 million in cash and added that it had more cash at the time of the conference than it did at year-end. He also said the company expects to become cash-generating in 2026 and intends to continue deleveraging.
Koenig added that Esperion has global rights to the Corstasis product, noting that while the discussion focused on the U.S., the company also holds rights in Europe and Asia and could pursue multiple commercialization strategies internationally, including partnering or distribution.
Bempedoic acid franchise: messaging, guidelines, and access
Koenig said Esperion remains focused on maximizing its bempedoic acid franchise, including NEXLIZET and NEXLETOL, and reiterated the company’s view that these products, along with the Corstasis asset, represent $1+ billion opportunities in the United States. Koenig said Esperion expects updated guidelines in the coming weeks and described the anticipated guidance as a potential “tailwind” and awareness event because it would represent third-party direction on where and why to use bempedoic acid.
Harlow said 2026 execution will include continued investment in the field force as well as digital and consumer tactics. When asked about the company’s messaging to providers, Harlow emphasized outcomes data from the CLEAR Outcomes study, including risk reduction in fatal and non-fatal myocardial infarction and close to 20% reduction in revascularization. He also said the company is highlighting high-sensitivity C-reactive protein (hsCRP), citing that Esperion’s therapy reduces hsCRP by 46% and that the American Heart Association has discussed hsCRP as an inflammation biomarker that should be measured for patients.
On payer access, Halladay said Esperion has completed the contracting it needs, with 90% commercial access and 90% Medicare access. He said the company does not expect to enhance or change rebates materially and characterized current access as high quality, with many plans requiring little or no prior authorization.
International partners, exclusivity, and pipeline priorities
Koenig highlighted performance from Esperion’s international partners. In Europe, he said Daiichi Sankyo has treated over 700,000 patients, with Germany, Belgium, and the U.K. contributing to growth. He noted that in Germany, PCSK9 therapies cannot be used unless bempedoic acid has been tried first, and he described the U.K. as a surprising standout due to a full statin-intolerance strategy. Halladay added that Daiichi Sankyo added France in January and received what he called “phenomenal reimbursement.”
In Japan, Koenig said Otsuka is off to a strong start, noting that Otsuka sold more in November than it had predicted for all of 2026 and has a large sales organization supporting the launch. Koenig also referenced launches or planned launches in Canada, Australia and New Zealand, and Israel.
On intellectual property and exclusivity, Halladay said Esperion has begun planning the business beyond 2031 and still has four parties left in the ANDA settlement process, but expressed confidence the company will reach positive resolutions and retain bempedoic acid durability into the 2030s. Koenig referenced the company’s “Vision 2040” framework, which he said is built on three pillars: growing the bempedoic acid franchise, business development (including the Corstasis deal), and advancing its ACLY pipeline.
Koenig said Esperion’s lead pipeline candidate is ESP-2001 for primary sclerosing cholangitis, a condition he said lacks meaningful treatment options beyond symptom management. He said Esperion expects to be in the clinic with ESP-2001 by the end of the year. Koenig also said the company has a kidney program it has not discussed in detail yet, but described it as including areas such as chronic kidney disease and polycystic kidney disease, and noted a relationship between kidney function and heart failure.
About Esperion Therapeutics (NASDAQ:ESPR)
Esperion Therapeutics, Inc is a clinical-stage biopharmaceutical company focused on the discovery, development and commercialization of oral, low–density lipoprotein cholesterol (LDL-C)–lowering therapies. The company’s research and development efforts center on small-molecule compounds designed to address atherosclerotic cardiovascular disease by targeting cholesterol biosynthesis pathways. Esperion seeks to provide novel treatment options for patients who require additional LDL-C reduction beyond what is achieved with statins or who are statin-intolerant.
The company’s lead products include NEXLETOL (bempedoic acid), an oral adenosine triphosphate–citrate lyase (ACL) inhibitor approved by the U.S.
