Lipfendra (Enlicitide) Pricing 2026: $315 a Month Oral PCSK9 vs Repatha, Praluent, and Leqvio

Lipfendra is a branded prescription pill, not a compounded peptide. The FDA approved Merck's Lipfendra (enlicitide) on July 16, 2026, and it is the first PCSK9 inhibitor you can swallow. It is a 20 mg tablet taken once a day, where every earlier drug in the class was an injection. Enlicitide is a macrocyclic peptide, a ring-shaped chain of amino acids built to survive the stomach. That chemistry is why it sits in this site's peptide pricing section rather than the GLP-1 section. Nothing in this guide is compounded or sold for research, and every price below is for the FDA-approved product at a licensed pharmacy.

The list price is $10.50 a tablet, or $315 for a 30-day supply. A Merck spokesperson gave those figures to Healthline on July 20, 2026, and they work out to $3,780 a year before insurance, coupons, or rebates. The list price is also called the wholesale acquisition cost, or WAC. It is the sticker price a drugmaker charges wholesalers, and almost nobody pays it directly. Retail chains were quoting cash buyers $327 to $356 a month by August, while Merck's copay card cuts the cost to $15 a prescription for people with commercial insurance.

A few terms, defined once. PCSK9 is a protein your liver makes that destroys the receptors pulling LDL cholesterol (the harmful kind) out of your blood. Block PCSK9 and more receptors survive, so LDL falls. In its two Phase 3 trials, Lipfendra lowered LDL by 56% and 59% versus placebo in people already on a statin. A formulary is an insurer's list of covered drugs. A pharmacy benefit manager, or PBM, is the company that builds that list and negotiates rebates; CVS Caremark, Express Scripts, and Optum Rx handle most Americans. Prior authorization means your doctor must get the plan's approval before the pharmacy can fill the prescription. Step therapy means the plan makes you try a cheaper drug first, usually a statin and sometimes ezetimibe.

Against the injectables, Lipfendra is the cheapest PCSK9 drug on list price. Repatha (evolocumab) has a WAC of $584.16 a month. Praluent (alirocumab) has carried a $5,850-a-year list price since 2019. Leqvio (inclisiran) costs $3,587.73 per dose, with two doses a year after the starting doses. Lipfendra still costs far more than generic ezetimibe or atorvastatin, which run under $15 a month with a discount card. One caution: it is not yet known whether Lipfendra prevents heart attacks or strokes, and the 14,500-patient CORALreef Outcomes trial is running to answer that.

For the clinical case and the questions to bring to your doctor, see Lipfendra for statin patients. For how prior authorization plays out at the pharmacy counter, see GLP-1 insurance coverage and prior authorization. Prices below were checked on September 2, 2026.