Lipfendra (enlicitide) is the first oral PCSK9 inhibitor, approved by the FDA on July 16, 2026. Lipfendra lowers LDL cholesterol by about 60%, the same range as injected PCSK9 inhibitors, from a daily pill.

What does Lipfendra cost? The list price is $315 per month, roughly half of what the injectable PCSK9 inhibitors list at. What you actually pay depends on insurance coverage (most insurers will need to to try a statin first), insurance plan (for example, Medicare has a hard out-of-pocket cap), the pharmacy you go to.

This article covers Lipfendra’s list price, how it compares to Repatha and the other PCSK9 inhibitors, and what you’ll pay under each kind of coverage.

How much does Lipfendra cost?

Lipfendra’s list price is $10.50 per tablet, or $315 for a 30-day supply, which works out to about $3,780 a year. The list price is what a pharmacy charges before any insurance, rebate, or coupon.

Lipfendra price vs Repatha, Praluent, and Leqvio

Lipfendra is about half the list price of injected PCSK9 inhibitors like Repatha. But it’s quite a bit more expensive than a generic statin, which can cost $4 per month.

Drug	Form	List price
Lipfendra (enlicitide)	Daily pill	$315/mo ($3,780/yr)
Repatha (evolocumab)	Injection, every 2 weeks	$573/mo ($6,900/yr)
Praluent (alirocumab)	Injection, every 2 weeks	~$6,500/yr
Leqvio (inclisiran)	Injection, twice a year	~$6,500/yr
Generic high-intensity statin	Daily pill	~$24–144/yr

Lipfendra’s annual list price is about half the injectable PCSK9 inhibitors, and much higher than a generic statin.

Injectable PCSK9 inhibitors discount routes that narrow the gap. Amgen sells Repatha direct to patients for about $239 a month. As of late July 2026, Merck has not announced a similar cash pay rate for Lipfendra, but we’ll update this article as more information comes out.

What will Lipfendra cost with insurance?

With commercial insurance, you’ll pay a copay or coinsurance set by your plan’s formulary tier, after a prior authorization is approved. Merck has said it plans a coupon program for eligible commercially insured patients, which is how the injectable makers get their brand cost down to as little as $5 a month for people who qualify.

The catch is the prior authorization. Lipfendra is brand-new, so it won’t be on every formulary yet, and insurers are likely to require the same criteria injectable PCSK9 inhibitors have. Our guide to PCSK9 insurance coverage has details, but most insurers require:

• A maximally tolerated high-intensity statin first (atorvastatin ≥40 mg or rosuvastatin ≥20 mg daily), tried for about 8 to 12 weeks, or documented statin intolerance.
• LDL still above goal despite that. “Above goal” generally means ≥70 mg/dL generally and ≥55 mg/dL for people with established cardiovascular disease.
• Established atherosclerotic cardiovascular disease or familial hypercholesterolemia as the qualifying diagnosis.

Whether your plan treats Lipfendra as a preferred oral option or gates it like an injectable will change the out of pocket rate substantially.

How Lipfendra’s list price translates to insurance coverage and cash price.

Lipfendra cost with Medicare

If you have Medicare, your cost has a hard ceiling. Medicare Part D caps your total out-of-pocket drug spending at $2,100 in 2026. That cap applies to all of your Part D drugs together, so if you already take other expensive medications, Lipfendra may add little once you’ve hit the Medicare cap. You can also spread the $2,100 into level monthly payments through the Medicare Prescription Payment Plan. Since copay cards and manufacturer coupons aren’t allowed on Medicare, the commercial coupons won’t apply to you. And a brand-new drug can take time to appear on a given Part D plan’s formulary, so early on, coverage may run through an exception request rather than a standard fill.

How to get Lipfendra without insurance

If you’re paying cash, retail prices are close to the list price. As of late July 2026, a 30-day supply runs roughly $325 to $355 at major pharmacies (Walgreens, CVS, Walmart, and the grocery chains). That’s a different from the injectables, where Amgen’s direct Repatha program runs about 60% below list at $239 a month. Merck also plans to sell Lipfendra direct to consumers through the TrumpRx program, a federal direct-to-patient channel, but it hasn’t announced that price as of late July 2026.

Cash prices for a 30-day supply of Lipfendra at one ZIP code in late July 2026, from a pharmacy discount tool. Prices vary by location and change over time.

Empirical Health will offer Lipfendra as soon as it reaches pharmacies. If you want us to measure your LDL, ApoB, and Lp(a) and work out whether an oral PCSK9 inhibitor fits your plan, you can join the waitlist.

When will Lipfendra be available at pharmacies?

Lipfendra is reaching pharmacies fast after its July 16, 2026 approval. By late July the major chains were already quoting a cash price for Lipfendra. Because it’s a tablet, it goes through ordinary retail and mail-order pharmacies (Walgreens, CVS, Walmart, the grocery chains), with none of the specialty-pharmacy routing the injectables need.

Is Lipfendra worth the cost?

Whether Lipfendra is worth it to you depends on how far you are from your LDL goal, what you’re already taking, and side effects. Lipfendra lowers LDL by 56% to 60% on top of a statin, which is the same territory as the injectable PCSK9 inhibitors and well past what a statin alone reaches. For someone whose LDL or ApoB is still high on a maximally tolerated statin, that reduction is the case for the cost; for someone close to goal on a generic statin, the math is harder to justify. It’s a question worth working through with your clinician, alongside how Lipfendra compares to the injections and how it stacks up against statins.