| Familial hypercholesterolemia - heterozygous
Nextletol vs Repatha
Side-by-side clinical, coverage, and cost comparison for familial hypercholesterolemia - heterozygous.Deep comparison between: Nexletol vs Repatha with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRepatha has a higher rate of injection site reactions vs Nexletol based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Repatha but not Nexletol, including UnitedHealthcare
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Category
Nexletol
Repatha
At A Glance
Oral
Daily
ACL inhibitor
SC injection
Every 2 weeks or monthly
PCSK9 inhibitor
Indications
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 180 mg orally once daily with or without food; analyze lipid levels within 8 to 12 weeks after initiation.
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 140 mg every 2 weeks or 420 mg once monthly administered subcutaneously.
Homozygous Familial Hypercholesterolemia 420 mg once monthly subcutaneously; may increase to 420 mg every 2 weeks if a clinically meaningful response is not achieved in 12 weeks.
Contraindications
- Prior serious hypersensitivity reaction to bempedoic acid or any excipient in NEXLETOL
- History of serious hypersensitivity reaction to evolocumab or any excipient in REPATHA
Adverse Reactions
Most common (>=2%) Upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, elevated liver enzymes
Serious Hyperuricemia, tendon rupture
Postmarketing Angioedema, wheezing, rash, urticaria
Most common (>=3%) Nasopharyngitis, upper respiratory tract infection, influenza, back pain, injection site reactions, cough, urinary tract infection, sinusitis, headache, myalgia, dizziness, musculoskeletal pain, hypertension, diarrhea, gastroenteritis
Serious Hypersensitivity reactions including angioedema
Postmarketing Angioedema, influenza-like illness
Pharmacology
Bempedoic acid is an ACL inhibitor that lowers LDL-C by inhibiting cholesterol synthesis in the liver upstream of HMG-CoA reductase; it requires CoA activation by ACSVL1 (expressed primarily in the liver) and upregulates LDL receptors to reduce circulating LDL-C.
Evolocumab is a human monoclonal IgG2 antibody that inhibits PCSK9, thereby increasing LDL receptor availability on hepatocytes and lowering LDL-C levels.
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Most Common Insurance
Anthem BCBS
Nexletol
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (11/12)
Repatha
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Nexletol
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Repatha
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (7/8)
Humana
Nexletol
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Repatha
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Nexletol.
Cost estimate not availableAmgen Safety Net Foundation: Repatha
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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NexletolView full Nexletol profile
RepathaView full Repatha profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.