Key takeaways:
Nexletol (bempedoic acid) is a prescription cholesterol-lowering medication. Most commercial and Medicaid plans cover Nexletol, and many Affordable Care Act and Medicare plans also cover it. But prior authorization may be required.
Without insurance, 30 tablets of Nexletol 180 mg costs an average of $506.05. If you’re eligible, a manufacturer copay savings card can help lower your out-of-pocket cost.
Regardless of insurance status, GoodRx can help you access Nexletol at an exclusive cash price of $231 for a 30-day supply.
Save on related medications
If you’ve been prescribed Nexletol (bempedoic acid) to improve your cholesterol levels, you may have questions about your dosage and potential side effects. But another common question is how much Nexletol is going to cost.
Without insurance, Nexletol can cost hundreds of dollars per month. This may come as a surprise if you’re starting it for the first time. Understanding what affects Nexletol’s price and savings options available to you can help you manage your out-of-pocket costs.
How much does Nexletol cost?
Without insurance or discounts, 30 tablets of Nexletol 180 mg cost an average of $506.05. Nexletol is taken once a day and comes only in 180 mg tablets. So this quantity should provide a 30-day supply of the medication.
Because Nexletol is a newer brand-name medication, there are no lower-cost generic versions available.
Good to know: Bempedoic acid is also available with ezetimibe (Zetia) in a combination pill called Nexlizet. If you take both medications, switching to Nexlizet could cut down on the number of pills you take every day. It could also potentially help reduce your out-of-pocket costs.
Which factors affect the cost of Nexletol?
Several factors can affect how much you’ll pay for Nexletol:
Insurance coverage: Coverage can vary from plan to plan. Many plans require prior authorization before approving Nexletol. You may also be required to try a different medication first (step therapy).
Pharmacy choice: Medication prices can differ by pharmacy — sometimes significantly. Using price comparison tools, such as GoodRx, can help you find the lowest cost in your area.
Quantity and supply: The recommended Nexletol dosage is 180 mg once daily. Your cost can vary depending on whether you get a 30- or 90-day supply.
Discount programs: Manufacturer copay savings cards, patient assistance programs, and GoodRx coupons can help lower what you pay for Nexletol.
Does insurance cover Nexletol?
Most Medicaid and commercial plans cover Nexletol, and many Affordable Care Act (ACA) and Medicare plans also cover it. Before approving Nexletol, your plan may ask your prescriber to confirm that the medication is medically necessary. In some cases, they may require trying other cholesterol-lowering medications, such as a statin, before covering Nexletol.
How different insurance plans cover Nexletol
The table below breaks down the percentage of enrollees who have coverage for Nexletol 180 mg tablets by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.
Insurance type | Enrollees covered for Nexletol | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
77.3% | 65.8% | 57.1% | |
Commercial plans (excluding ACA plans) | 92.4% | 54.8% | 33.6% |
Medicare (Medicare Advantage and Part D plans) | 69.6% | 49.7% | 48.2% |
Medicaid, including state-run and managed care plans | 99.9% | 86.3% | 34.7% |
Source: Managed Markets Insight & Technology, LLC™, as of December 6, 2025 (See methodology below.)
If your insurance doesn’t cover Nexletol, try these options:
Check eligibility for a manufacturer copay savings card. Many people with commercial insurance can save significantly using the card.
Ask your prescriber about alternatives. Depending on your health history, there may be other cholesterol-lowering medications with better coverage.
Request a formulary exception. Your prescriber can submit documentation to your insurance plan explaining why Nexletol is medically necessary for you. If the exception is denied, you can file an appeal.
Ways to save on Nexletol
Without insurance, Nexletol can cost hundreds of dollars per month. But there are savings strategies that can help reduce how much you pay — or even allow you to get Nexletol for free. Here are four options to consider.
Nexletol side effects: Do you experience muscle spasms while taking Nexletol (bempedoic acid)? Here’s what you should know about Nexletol side effects and how to manage them.
Nexletol vs. statins: Read about how these two cholesterol treatments compare.
Tips for success: Making a few changes to your diet can help you meet your cholesterol goals. Find out which foods have the most impact.
1. Use a GoodRx coupon
GoodRx coupons can help lower the price of Nexletol, especially if you’re uninsured or your insurance doesn’t cover it. But regardless of insurance status, GoodRx can help you access Nexletol at an exclusive cash price of $231 for a 30-day supply.
2. See if you qualify for a copay savings card
If you have commercial insurance, you may be able to lower the cost of Nexletol by using a copay savings card through the manufacturer. You could pay as little as $10 for a 30-day supply or $25 for a 90-day supply through the program.
To be eligible, you must:
Be at least 18 years old
Have commercial insurance and not be enrolled in a state-, federal, or government-funded insurance program
Have a prescription for Nexletol
Be a resident of the U.S. (excluding U.S. territories)
If you have questions about the copay savings card, you can call the manufacturer at 1-855-699-8814.
3. Ask about 90-day supplies
If you’re responding well to Nexletol, ask your prescriber and insurance plan about filling a 90-day supply. This may lower your overall monthly costs and save you monthly trips to the pharmacy.
4. Tap into your HSA, FSA, or HRA
If you have a health savings account (HSA), a flexible spending account (FSA), or a health reimbursement arrangement (HRA), you can use pretax dollars to help pay for Nexletol. This can help make your treatment more affordable through tax savings. Just be sure to keep your receipts or other documentation.
The bottom line
Nexletol (bempedoic acid) is a prescription cholesterol-lowering medication. Without insurance, 30 tablets of Nexletol 180 mg cost an average of $506.05. But GoodRx coupons and manufacturer copay cards can help reduce how much you pay for Nexletol.
Many insurance plans cover Nexletol, but prior authorization may be required. In some cases, you may be required to try a different medication, such as a statin, first. Check with your plan for coverage details.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of December 6, 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Esperion Therapeutics. (2025). Nexletol- bempedoic acid tablet, film coated [package insert]. DailyMed.
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Nexlizet and Nexletol. (n.d.). Need help paying for treatment and getting started? Esperion Therapeutics.
