Convenience Comes at a Price: Lipfendra Hits Pharmacies

The PCSK9 class of cholesterol pills has expanded with the addition of Lipfendra, also known as enlicitide. This once-daily pill is now available at retail and mail-order pharmacies, but its $315 list price may be out of reach for many patients.

Merck set this list price for a 30-day supply, which translates to approximately $3,780 per year before insurance or discounts. GoodRx lists an average retail price near $382, with discounted prices at individual pharmacies ranging from about $309 to $356.

Lipfendra is designed for patients who have trouble managing injectable therapies due to needles, refrigeration requirements, or specialty pharmacy logistics. It can be stored at room temperature and does not require dose titration.

The approval of Lipfendra was based on two clinical trials involving 3,207 adults already on maximally tolerated statin therapy. These trials showed an average LDL reduction of 56% and 59%, respectively. However, it's essential to note that these trials did not measure cardiovascular event outcomes, only LDL reduction.

A separate outcomes trial, CORALreef Outcomes, is currently underway with over 14,500 participants at high cardiovascular risk. This trial will measure time to a first major cardiovascular event and is estimated to complete by late 2029.