ACC 2023 – Esperion investors don’t buy medics’ enthusiasm

Medical opinion and investor sentiment are often out of whack. For a case in point see today’s market response to the Clear Outcomes data Esperion unveiled at an American College of Cardiology meeting late-breaker on Saturday, a result described in an NEJM editorial and by an ACC discussant as “compelling”. Yet despite this Esperion stock opened off 20% this morning. One reason might be that the sellside had once hinted at a 25% reduction in Mace-4; this was quietly reined in to 20%, and the eventual benefit of 13% missed even Esperion’s internal expectations of 15%. This is relevant not only in terms of the strength of Nexletol’s potential new label, but also because of Esperion’s financial position. The company has around $167m in cash, and is banking on a $300m milestone from its partner, Daiichi Sankyo, to sustain it beyond the end of this year. The precise trigger for the $300m is secret, but crucially it depends on “the level of risk reduction that is included in the EU label”, according to Esperion. “We know that we will be receiving the milestone,” the company said on an investor call today.