Stock Markets July 16, 2026 09:24 AM

Merck Secures FDA Clearance for Lipfendra, First Oral PCSK9 Cholesterol Therapy

Enlicitide pill offers an oral alternative to injectable PCSK9 drugs and brings a new revenue line ahead of Keytruda patent expirations

By Caleb Monroe
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Merck announced Thursday that the U.S. Food and Drug Administration has approved Lipfendra (enlicitide), the first oral PCSK9 inhibitor authorized to treat hypercholesterolemia. Priced at $10.50 per day on a 30-day supply, the drug provides an alternative to established injectable PCSK9 inhibitors and adds a potential revenue source as Merck's Keytruda faces patent expirations beginning in 2028. Merck's shares rose 1.1% in premarket trading following the announcement.

Merck Secures FDA Clearance for Lipfendra, First Oral PCSK9 Cholesterol Therapy
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Key Points

  • Lipfendra (enlicitide) is the first oral PCSK9 inhibitor to receive FDA approval for treating hypercholesterolemia.
  • Merck set a list price of $10.50 per day for a 30-day supply; shares rose 1.1% in premarket trading after the announcement.
  • The approval provides a new revenue opportunity as Keytruda faces patent expirations starting in 2028, potentially allowing biosimilar competition.

Merck said Thursday that the U.S. Food and Drug Administration has granted approval to Lipfendra, an oral formulation of the PCSK9 inhibitor class also known as enlicitide. The company describes the medication as intended for patients with hypercholesterolemia, a condition defined by elevated low-density lipoprotein (LDL) cholesterol levels that can contribute to arterial plaque buildup.

As the first pill of its kind to receive regulatory clearance, Lipfendra introduces an oral option in a space long dominated by injectable PCSK9 inhibitors. Those injectables have been the prevailing approach for this mechanism of action. Lipfendra acts by inhibiting the PCSK9 protein, which plays a role in regulating cholesterol levels in the bloodstream. This mechanism is distinct from oral statins, an older class of cholesterol-lowering drugs that work by blocking an enzyme the liver uses to produce cholesterol.

Merck said the list price for Lipfendra will be $10.50 per day, based on a 30-day supply, a figure the company provided to Reuters. The firm's shares moved higher in premarket trading on Thursday, advancing 1.1% after the announcement.

Beyond its clinical positioning, the approval has strategic implications for Merck's product portfolio. The company noted that Lipfendra will add a source of revenue as its cancer immunotherapy Keytruda faces patent expirations beginning in 2028, a development that is expected to permit entry of lower-cost biosimilar competitors. In that context, Lipfendra represents both a new offering in cardiovascular therapeutics and a commercial diversification as pricing pressure on existing blockbuster drugs may increase.

Information about projected sales, uptake among prescribers, or payer coverage for Lipfendra was not provided in the announcement. Likewise, while the approval establishes an oral alternative to injectable PCSK9 therapy, the long-term market dynamics between the oral and injectable approaches remain to be seen.


Quick facts

  • Drug name: Lipfendra (enlicitide)
  • Indication: Hypercholesterolemia (elevated LDL cholesterol)
  • Mechanism: PCSK9 protein inhibition
  • List price: $10.50 per day, based on a 30-day supply
  • Market reaction: Merck shares rose 1.1% in premarket trading on Thursday

Risks

  • Keytruda faces patent expirations beginning in 2028, which could open the door for lower-cost biosimilars and pressure Mercks revenues.
  • Injectable PCSK9 inhibitors have dominated the cholesterol-lowering market, creating an established competitive landscape for Lipfendra to enter.
  • The announcement did not include projections for sales, payer coverage, or clinician uptake, leaving uncertainty about commercial performance.

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