Brand Reference: Nexletol
| Metric | Verified Benchmark | Source |
|---|---|---|
| Bempedoic Acid RxNorm Concept ID | 2282405 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $13.4500 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $448.00 / mo | CMS NADAC + U.S. Retail Markup Index |
| Mark Cuban Cost Plus Wholesale Price | $115.00 / mo (Direct TeleMed) | Direct Telehealth Formulary |
| Community Mean Out-of-Pocket Paid | $129.00 / mo | 14 Zero-PHI Verified Patient Logs |
Prodrug activated exclusively by very-long-chain acyl-CoA synthetase-1 (ACSVL1)—an enzyme expressed in liver but absent in skeletal muscle—to inhibit ATP citrate lyase upstream of HMG-CoA reductase, lowering LDL-C/ApoB by ~18%–25% with zero myocyte activation.
For self-pay patients filling Bempedoic Acid (NDC 72426-0180-03), direct wholesale and telehealth fulfillment drops monthly spend from $448.00 retail to $129.00 (71% savings against a $13.4500 CMS pharmacy acquisition baseline).
Clinical clearance of Bempedoic Acid (Hepatocyte-Selective ATP Citrate Lyase (ACL) Inhibitor) relies on hepatic acsvl1 thioester activation and ugt2b7 acyl-glucuronidation; 70% renal excretion with a 21 hours half-life; patients absorbing at > 75% oral bioavailability typically observe target onset around 2–4 weeks ldl-c drop.
FDA clinical labeling for Bempedoic Acid restricts administration in active acute gout flare without urate monitoring; history of achilles tendon rupture across 180 mg PO once daily (alone or with 10 mg ezetimibe), with self-reported patient tracking dominated by serum uric acid +0.8 mg/dl (11% of reports), mild anemia (3% of reports), tendon stiffness (3% of reports).
Across 14 verified cash-pay logs, Bempedoic Acid achieves a 84.80% Worth-It rating with out-of-pocket spend averaging $129.00/mo versus $448.00/mo walk-in retail.
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Switched to Cash Clinic at 180 mg PO once daily (alone or with 10 mg ezetimibe) for Bempedoic Acid; monthly out-of-pocket dropped to $113.52 compared with $448.00 retail.
Completed 10 weeks on Bempedoic Acid (180 mg PO once daily (alone or with 10 mg ezetimibe)). Zero notable side effects on steady dosing.
Consistent biomarker response on 180 mg PO once daily (alone or with 10 mg ezetimibe) Bempedoic Acid sourced via Local Pharmacy ($149.64/mo cash pay without insurance prior authorization).