0001628280-23-037195 | 10-Q | XBRL Viewer | Esperion Therapeutics INC

Inventories, net

9 Months Ended

Sep. 30, 2023

Inventories, net consist of the following (in thousands):


	September 30, 2023		December 31, 2022
Raw materials	$	49,158	$	26,558
Work in process	625		6,548
Finished goods	1,652		2,095

	$	51,435	$	35,201

Stock Compensation - RSUs (Details) - RSUs	9 Months Ended
Stock Compensation - RSUs (Details) - RSUs	Sep. 30, 2023 $ / shares shares
Number of RSUs
Outstanding at the beginning of period (in shares) \| shares	1,768,185
Granted (in shares) \| shares	2,290,785
Forfeited (in shares) \| shares	(265,328)
Vested (in shares) \| shares	(610,785)
Outstanding and unvested at the ending of period (in shares) \| shares	3,182,857
Weighted-Average Fair Value Per Share
Outstanding and at the beginning of period (in dollars per share) \| $ / shares	$ 8.80
Granted (in dollars per share) \| $ / shares	3.38
Forfeited (in dollars per share) \| $ / shares	7.65
Vested (in dollars per share) \| $ / shares	8.35
Outstanding and unvested at the at the end of the period (in dollars per share) \| $ / shares	$ 7.71

Investments - Summary of Cash Equivalents and Short-Term Investments (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Investments
Amortized Cost	$ 88,776	$ 152,562
Gross Unrealized Gains	0	3
Gross Unrealized Losses	0	(5)
Estimated Fair Value	88,776	152,560
Money market funds \| Cash Equivalents
Investments
Amortized Cost	88,374	105,078
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	88,374	105,078
Certificates of deposit \| Cash Equivalents
Investments
Amortized Cost	402	401
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	$ 402	401
U.S. treasury notes \| Cash Equivalents
Investments
Amortized Cost		4,994
Gross Unrealized Gains		1
Gross Unrealized Losses		0
Estimated Fair Value		4,995
U.S. treasury notes \| Short-term Investments
Investments
Amortized Cost		42,089
Gross Unrealized Gains		2
Gross Unrealized Losses		(5)
Estimated Fair Value		$ 42,086

Investments

9 Months Ended

Sep. 30, 2023

Investments, Debt and Equity Securities [Abstract]

Investments

The following table summarizes the Company’s cash equivalents and short-term investments (in thousands):


	September 30, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Estimated Fair Value
Cash equivalents:
Money market funds	$	88,374	$	—	$	—	$	88,374
Certificates of deposit	402		—		—		402


Total	$	88,776	$	—	$	—	$	88,776


	December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Estimated Fair Value
Cash equivalents:
Money market funds	$	105,078	$	—	$	—	$	105,078
U.S. treasury notes	4,994		1		—		4,995

Certificates of deposit	401		—		—		401
Short-term investments:

U.S. treasury notes	42,089		2		(5)		42,086

Total	$	152,562	$	3	$	(5)	$	152,560

During the three and nine months ended September 30, 2023, other income, net in the statements of operations includes interest income on investments of $1.2 million and $3.5 million, respectively. During the three and nine months ended September 30, 2022, other income, net in the statements of operations includes interest income on investments of $0.8 million and $1.5 million, respectively. During the three months ended September 30, 2023, there was no accretion of premiums and discounts on investments. During the nine months ended September 30, 2023, other income, net in the statements of operations includes $0.4 million of accretion of premiums and discounts on investments. During the three and nine months ended September 30, 2022, other income, net in the statements of operations includes amortization of premiums and discounts on investments of $0.2 million and $0.6 million, respectively.

There were no unrealized gains or losses on investments reclassified from accumulated other comprehensive income (loss) to other income in the statements of operations during the three and nine months ended September 30, 2023 and 2022.

In the three and nine months ended September 30, 2023 and 2022, there were no allowances for credit losses and all unrealized gains (losses) for available-for-sale securities were recognized in accumulated other comprehensive income (loss). As of September 30, 2023, the Company had no accrued interest receivables.

Collaborations with Third Parties	9 Months Ended
Collaborations with Third Parties	Sep. 30, 2023
Collaborations with Third Parties
Collaborations with Third Parties	Collaborations with Third Parties DSE Agreement Terms On January 2, 2019, the Company entered into a license and collaboration agreement with DSE, which was further amended on June 18, 2020. Pursuant to the amended agreement, the Company granted DSE exclusive commercialization rights to bempedoic acid and the bempedoic acid / ezetimibe combination tablet in the European Economic Area, Turkey, and Switzerland (“DSE Territory”). DSE is responsible for commercialization in the DSE Territory. DSE's designated affiliate in Turkey will be solely responsible, at its sole cost and expense, for all regulatory matters relating to such products in Turkey, including obtaining regulatory approval for such products in Turkey. The Company remains responsible for clinical development, regulatory and manufacturing activities for the licensed products globally, including in the DSE Territory outside of Turkey. Pursuant to the agreement, the Company received upfront cash of $150.0 million in 2019 and a $150.0 million cash milestone payment in 2020 following the completion of the NUSTENDI Marketing Authorisation Applications ("MAA"). The Company is responsible for supplying DSE with certain manufacturing supply of the API or bulk tablets. The Company is also eligible to receive an additional regulatory milestone payment of either $200 million or $300 million upon inclusion of cardiovascular risk reduction data in the EU label, depending on the range of relative cardiovascular risk reduction in the CLEAR Outcomes study. Refer to Note 5 "Commitments and Contingencies" for further information. In addition, the Company is eligible to receive additional sales milestone payments related to total net sales achievements for DSE in the DSE Territory. Finally, the Company receives tiered fifteen percent (15%) to twenty-five percent (25%) royalties on net DSE Territory sales. The agreement calls for both parties to participate in a Joint Collaboration Committee (the “DSE JCC”). The DSE JCC is comprised of executive management from each company and the Company will lead in all aspects related to development and DSE will lead in all aspects related to commercialization in the DSE Territory. Collaboration Revenue In the three and nine months ended September 30, 2023, the Company recognized collaboration revenue of approximately $13.4 million and $25.8 million, respectively, and in the three and nine months ended September 30, 2022, the Company recognized collaboration revenue of approximately $4.4 million and $14.7 million, respectively, related to royalty revenue from DSE from the sales of NILEMDO and NUSTENDI as well as the sales of bulk tablets to DSE pursuant to the supply agreement that was executed with DSE. All remaining future potential milestone amounts were not included in the transaction price, as they were all determined to be fully constrained following the concepts of ASC 606 due to the fact that such amounts hinge on development activities, regulatory approvals and sales-based milestones. Additionally, the Company expects that any consideration related to sales-based milestones will be recognized when the subsequent sales occur. Otsuka Agreement Terms On April 17, 2020, the Company entered into a license and collaboration agreement (the "Otsuka Agreement") with Otsuka. Pursuant to the Otsuka Agreement, the Company granted Otsuka exclusive development and commercialization rights to NEXLETOL and NEXLIZET in Japan. Otsuka will be responsible for all development, regulatory, and commercialization activities in Japan. In addition, Otsuka will fund all clinical development costs associated with the program in Japan. Pursuant to the agreement, the consideration consists of a $60.0 million upfront cash payment and the Company will be eligible to receive additional payments of up to $450.0 million if certain regulatory and commercial milestones are achieved by Otsuka. The potential future milestone payments include up to $20.0 million upon first JNDA submissions in the Otsuka Territory, up to $70.0 million upon the first NHI Price Listing for NEXLETOL in the Otsuka Territory, and following Regulatory Approval and NHI Price Listing, up to $50.0 million upon the achievement of the primary major adverse cardiovascular events (“MACE”) endpoint in the CLEAR Outcomes study and the CV risk reduction rate in the U.S. label, depending on the range of relative risk reduction in the CLEAR Outcomes study. In addition, the Company is eligible to receive additional sales milestone payments up to $310.0 million related to total net sales achievements for Otsuka in Japan. Finally, the Company will receive tiered fifteen percent (15%) to thirty percent (30%) royalties on net sales in Japan. Collaboration Revenue The Company considered the guidance under ASC 606 and concluded that the agreement was in the scope of ASC 606. In the three and nine months ended September 30, 2023, the Company recognized $0.1 million in collaboration revenue related to sales of bulk tablets to Otsuka pursuant to the Otsuka Agreement. In the three and nine months ended September 30, 2022, the Company recognized $0.4 million in collaboration revenue related to sales of bulk tablets to Otsuka pursuant to the Otsuka Agreement. All future potential milestone amounts were not included in the transaction price, as they were all determined to be fully constrained following the concepts of ASC 606 due to the fact that such amounts hinge on development activities, regulatory approvals and sales-based milestones. Additionally, the Company expects that any consideration related to royalties and sales-based milestones will be recognized when the subsequent sales occur. The Company has not yet recognized any revenue for milestone payments as the related regulatory and commercial milestones have not yet been achieved. DS Agreement Terms In April 2021, the Company entered into a license and collaboration agreement with Daiichi Sankyo Co. Ltd (the "DS Agreement"). Pursuant to the DS Agreement, the Company granted DS exclusive rights to develop and commercialize bempedoic acid and the bempedoic acid / ezetimibe combination tablet in South Korea, Taiwan, Hong Kong, Thailand, Vietnam, Brazil, Macao, Cambodia and Myanmar (collectively the "DS Territory"). The agreement allows for potential expansion across geographies including Saudi Arabia, Kuwait, Oman, UAE, Qatar, Bahrain, Yemen, Colombia and other Latin American countries. Except for certain development activities in South Korea and Taiwan, DS will be responsible for development and commercialization in these territories. In addition, DS will fund all development costs associated with the program in the DS Territory. Pursuant to the agreement, the consideration consists of a $30.0 million upfront cash payment that is non-refundable, non-reimbursable and non-creditable. The Company also will be eligible to receive additional one-time payments of up to $175.0 million if certain commercial milestones are achieved by DS. Also, the Company will receive tiered royalties of five percent (5%) to twenty percent (20%) of net sales in the DS Territory. Collaboration Revenue The Company considered the guidance under ASC 606 and concluded that the agreement was in the scope of ASC 606. The Company concluded that the upfront payment of $30.0 million should be included in the transaction price and related to the following performance obligations under the agreement: 1) the license to the Company’s intellectual property and 2) the obligation to provide ongoing development activities. The Company used the adjusted market assessment approach in determining the standalone selling price of the Company’s intellectual property and the expected cost plus margin approach in determining the standalone selling price of the Company’s obligation to provide ongoing development activities. For the three and nine months ended September 30, 2023, the Company recognized $0.2 million and $0.6 million, respectively, of collaboration revenue related to the ongoing regulatory and development activities and for the three and nine months ended September 30, 2022, the Company recognized $0.2 million and $0.6 million, respectively, of collaboration revenue related to the ongoing regulatory and development activities. The remaining $0.1 million of the upfront payment was deferred as of September 30, 2023 due to an on-going performance obligation related to the developmental activities in South Korea and Taiwan. This deferred revenue will be recognized ratably over the period leading up to the completion of these developmental activities. All future potential milestone amounts were not included in the transaction price, as they were all determined to be fully constrained following the concepts of ASC 606 due to the fact that such amounts hinge on development activities, regulatory approvals and sales-based milestones. Additionally, the Company expects that any consideration related to royalties and sales-based milestones will be recognized when the subsequent sales occur. Serometrix Agreement On July 6, 2023, the Company provided notice to Serometrix of its intent to terminate the licensing agreement between the Company and Serometrix dated December 3, 2020. The agreement, which related to the in-license of a series of early stage compounds known as scaffolds related to its oral, small molecule PCSK9 inhibitor program, terminated as of August 5, 2023. The Company expects to continue to advance its internal pipeline assets, including next-generation ACLY inhibitors.

Fair Value Measurements (Details) - USD ($)	3 Months Ended		9 Months Ended
Fair Value Measurements (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Fair value measurements
Transfer of assets between levels	$ 0	$ 0	$ 0	$ 0
Recurring fair value measurement
Fair value measurements
Total assets at fair value	88,776,000		88,776,000		$ 152,560,000
Recurring fair value measurement \| Money market funds
Fair value measurements
Total assets at fair value	88,374,000		88,374,000		105,078,000
Recurring fair value measurement \| Certificates of deposit
Fair value measurements
Total assets at fair value	402,000		402,000		401,000
Recurring fair value measurement \| U.S. treasury notes
Fair value measurements
Total assets at fair value					47,081,000
Recurring fair value measurement \| Level 1
Fair value measurements
Total assets at fair value	88,776,000		88,776,000		152,560,000
Recurring fair value measurement \| Level 1 \| Money market funds
Fair value measurements
Total assets at fair value	88,374,000		88,374,000		105,078,000
Recurring fair value measurement \| Level 1 \| Certificates of deposit
Fair value measurements
Total assets at fair value	402,000		402,000		401,000
Recurring fair value measurement \| Level 1 \| U.S. treasury notes
Fair value measurements
Total assets at fair value					47,081,000
Recurring fair value measurement \| Level 2
Fair value measurements
Total assets at fair value	0		0		0
Recurring fair value measurement \| Level 2 \| Money market funds
Fair value measurements
Total assets at fair value	0		0		0
Recurring fair value measurement \| Level 2 \| Certificates of deposit
Fair value measurements
Total assets at fair value	0		0		0
Recurring fair value measurement \| Level 2 \| U.S. treasury notes
Fair value measurements
Total assets at fair value					0
Recurring fair value measurement \| Level 3
Fair value measurements
Total assets at fair value	0		0		0
Recurring fair value measurement \| Level 3 \| Money market funds
Fair value measurements
Total assets at fair value	0		0		0
Recurring fair value measurement \| Level 3 \| Certificates of deposit
Fair value measurements
Total assets at fair value	$ 0		$ 0		0
Recurring fair value measurement \| Level 3 \| U.S. treasury notes
Fair value measurements
Total assets at fair value					$ 0

Condensed Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
Condensed Statements of Cash Flows - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022
Operating activities
Net loss	$ (152,904)	$ (178,172)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	158	408
Amortization of premiums and discounts on investments	(412)	539
Amortization of debt issuance costs	1,266	1,207
Non-cash interest expense related to the revenue interest liability	34,703	33,323
Stock-based compensation expense	9,038	11,500
Changes in assets and liabilities:
Accounts receivable	(8,894)	(8,555)
Prepaids and other assets	1,556	901
Deferred revenue	16,216	(2,272)
Inventories	(16,234)	4,849
Accounts payable	3,174	1,129
Other accrued liabilities	13,902	2,788
Net cash used in operating activities	(98,431)	(132,355)
Investing activities
Purchases of investments	0	(18,102)
Proceeds from sales/maturities of investments	42,500	38,000
Net cash provided by investing activities	42,500	19,898
Financing activities
Payments on revenue interest liability	(10,908)	(5,678)
Proceeds from issuance of common stock, warrants, and pre-funded warrants, net of issuance costs	52,428	0
Proceeds from issuance of common stock from ATM program, net of issuance costs	4,448	68,861
Proceeds from exercise of pre-funded warrants	21	0
Payment of issuance costs	0	(219)
Net cash provided by financing activities	45,989	62,964
Net decrease in cash and cash equivalents	(9,942)	(49,493)
Cash, cash equivalents and restricted cash at beginning of period	124,775	258,892
Cash, cash equivalents and restricted cash at end of period	114,833	209,399
Supplemental disclosure of cash flow information:
Common stock issuance costs not yet paid	0	15
Non cash right of use asset	$ 62	$ 8

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies On March 4, 2023, the Company announced the full results from its Cholesterol Lowering via Bempedoic acid, an ACL-Inhibiting Regimen (CLEAR) Outcomes trial. Based on the terms of the contract with DSE, the Company is eligible for partner milestone payments upon inclusion of cardiovascular risk reduction data in the EU label, for which payment is tied to the magnitude of the risk percentage reduction included in the label (among other requirements) and ranges from $200 million for the inclusion of cardiovascular risk reduction in the EU label that correlates with a relative risk reduction rate that, based on the CLEAR Outcomes data, is equal or greater than 15% but less than 20%, to $300 million if such risk reduction in the EU label that correlates with a relative risk reduction rate is equal or greater than 20%. Based on the CLEAR Outcomes data, the Company believes it would be entitled to receive $300 million in partner milestone payments upon inclusion of cardiovascular risk reduction data in the EU label. The Company has had communications with DSE regarding potential milestone payments in which DSE has conveyed that it disagrees with the Company’s assessment that the CLEAR Outcomes data would support the Company’s right to receive any milestone payments upon inclusion of certain required cardiovascular risk reduction data in the EU label. Even if the Company is successful in enforcing its rights, there could be a delay in the Company’s receipt of the milestone payments as a result of any dispute relating to such payments. Any failure to receive or any delay in receipt of the milestone payments may significantly impact the Company’s future capital needs, ability to recognize revenue for the milestone upon inclusion of cardiovascular risk reduction data in the EU label, and ability to fund operations. On March 27, 2023, the Company filed a complaint in the United States District Court for the Southern District of New York seeking declaratory judgment against DSE regarding the Company’s right to receive a $300 million milestone payment upon inclusion of cardiovascular risk reduction in the EU label that correlates with a relative risk reduction rate of at least 20%, based on the CLEAR Outcomes trial demonstrating significant cardiovascular risk reductions. On May 4, 2023, the Company filed an amended complaint against DSE in the Southern District of New York. The complaint seeks a judicial declaration, on an expedited basis, that DSE is contractually required to make a $300 million milestone payment to the Company upon applicable regulatory approval. On June 20, 2023, DSE filed a response to the amended complaint.

Fair Value Measurements

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

The Company follows accounting guidance that emphasizes that fair value is a market-based measurement, not an entity-specific measurement. Fair value is defined as “the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.” Fair value measurements are defined on a three level hierarchy:


Level 1 inputs:						Quoted prices for identical assets or liabilities in active markets;

Level 2 inputs:						Observable inputs other than Level 1 prices, such as quoted market prices for similar assets or liabilities or other inputs that are observable or can be corroborated by market data; and

Level 3 inputs:						Unobservable inputs that are supported by little or no market activity and require the reporting entity to develop assumptions that market participants would use when pricing the asset or liability.

The following table presents the Company’s financial assets that have been measured at fair value on a recurring basis (in thousands):


Description	Total		Level 1		Level 2		Level 3

September 30, 2023
Assets:
Money market funds	$	88,374	$	88,374	$	—	$	—
Certificates of deposit	402		402		—		—

Total assets at fair value	$	88,776	$	88,776	$	—	$	—
December 31, 2022
Assets:
Money market funds	$	105,078	$	105,078	$	—	$	—
Certificates of deposit	401		401		—		—

U.S. treasury notes	47,081		47,081		—		—

Total assets at fair value	$	152,560	$	152,560	$	—	$	—

There were no transfers between Levels 1, 2 or 3 during the three and nine months ended September 30, 2023 and 2022.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Condensed Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, authorized (in shares)	5,000,000	5,000,000
Preferred stock, issued (in shares)	0	0
Preferred stock, outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, authorized (in shares)	480,000,000	240,000,000
Common stock, issued (in shares)	114,130,645	76,564,396
Treasury stock (in shares)	1,994,198	1,994,198

Net Loss Per Common Share (Tables)

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Schedule of Shares Excluded From Calculation of Diluted Net (Loss) Income Per Share

The shares outstanding at the end of the respective periods presented below were excluded from the calculation of diluted net loss per share due to their anti-dilutive effect:


	September 30,
	2023	2022
Common shares under option	3,706,191	3,784,955
Common shares under PBSOs	661,850	499,200
Unvested RSUs	3,182,857	1,654,600
Unvested PBRSUs	174,775	461,250
Shares issuable related to the ESPP	—	9,237
Shares issuable upon conversion of convertible notes	8,007,010	8,007,010
Warrants	70,135,033	36,964,286
Total potential dilutive shares	85,867,716	51,380,538

Summary of Significant Accounting Policies (Details) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) customer revenue_source	Sep. 30, 2022 USD ($)	Dec. 31, 2022 customer
Summary of Significant Accounting Policies
Number of revenue sources \| revenue_source			2
Total Revenues	$ 33,969	$ 18,980	$ 84,084	$ 56,657
Product sales, net
Summary of Significant Accounting Policies
Total Revenues	$ 20,251	$ 13,964	$ 57,575	$ 40,896
Trade Receivables \| Customer Concentration Risk
Summary of Significant Accounting Policies
Number of major customers \| customer			11		11

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Section 50
-Paragraph 32
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-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

The Company and Basis of Presentation	9 Months Ended
The Company and Basis of Presentation	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
The Company and Basis of Presentation	The Company and Basis of Presentation Esperion Therapeutics, Inc. ("the Company”) is a pharmaceutical company focused on developing and commercializing accessible, oral, once-daily, non-statin medicines for patients struggling with elevated low-density lipoprotein cholesterol ("LDL-C"). Through commercial execution and completion of the CLEAR Outcomes trial as well as advancing the Company's pre-clinical pipeline, the Company continues to evolve into a differentiated, global cardiometabolic biotech. The Esperion team of lipid experts are dedicated to lowering bad cholesterol through the discovery, development and commercialization of innovative medicines and their combinations with established medicines. The Company's first two products were approved by the U.S. Food and Drug Administration ("FDA"), European Medicines Agency ("EMA") and Swiss Agency for Therapeutic Products ("Swissmedic") in 2020. Bempedoic acid and the bempedoic acid / ezetimibe combination tablet are oral, once-daily, non-statin, LDL-C lowering medicines for patients with atherosclerotic cardiovascular disease ("ASCVD") or heterozygous familial hypercholesterolemia ("HeFH"). The Company completed a global cardiovascular outcomes trial, or CVOT — known as Cholesterol Lowering via BEmpedoic Acid, an ACL-inhibiting Regimen (CLEAR) Outcomes. The trial was designed to evaluate whether treatment with bempedoic acid reduced the risk of cardiovascular events in patients who are statin averse and who have CVD or are at high risk for CVD. The Company initiated the CLEAR Outcomes CVOT in December 2016 and fully enrolled the study with over 14,000 patients in August 2019. The primary endpoint of the study was the effect of bempedoic acid on four types of major adverse cardiovascular events, or MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or coronary revascularization; also referred to as “four-component MACE”). CLEAR Outcomes was an event-driven trial and concluded once the predetermined number of MACE endpoints occurred. On December 7, 2022, the Company announced that the study had met its primary endpoint. On March 4, 2023, the Company announced the full results from the CLEAR Outcomes trial. The study showed that bempedoic acid demonstrated significant cardiovascular risk reductions and significantly reduced the risk of heart attack and coronary revascularization as compared to placebo. These results were seen in a broad population of primary and secondary prevention patients who are unable to maximize or tolerate a statin. The proportions of patients experiencing adverse events and serious adverse events were similar between the active and placebo treatment groups. Bempedoic acid, contained in NEXLETOL® (bempedoic acid) tablets and NEXLIZET® (bempedoic acid and ezetimibe) tablets, became the first LDL-C lowering therapy since statins proven to lower hard ischemic events, not only in those with ASCVD but also in the large number of primary prevention patients for whom limited therapies exist. On March 19, 2023, the Company entered into a Securities Purchase Agreement (the “Purchase Agreement”) with certain purchasers named therein (the “Purchasers”), pursuant to which the Company agreed to issue and sell, in a registered direct offering (the “Offering”), 12,205,000 shares of its common stock, par value $0.001 per share (the “Common Stock”), pre-funded warrants to purchase up to an aggregate of 20,965,747 shares of Common Stock (the “Pre-Funded Warrants”) in lieu of shares of Common Stock, and warrants to purchase up to 33,170,747 shares of Common Stock (the “Warrants”). The combined purchase price of each share of Common Stock and accompanying Warrant is $1.675 per share. The purchase price of each Pre-Funded Warrant and the accompanying Warrant is $1.674 (equal to the combined purchase price per share of Common Stock and accompanying Warrant, minus $0.001). The Purchase Agreement contains customary representations, warranties, covenants and indemnification rights and obligations of the Company and the Purchasers. The Offering closed on March 22, 2023. In connection with the Offering, the Company amended, pursuant to Warrant Amendment Agreements (the “Warrant Amendment Agreements”), certain existing warrants to purchase up to an aggregate of 9,024,212 shares of the Company's common stock that were previously issued in December 2021 at an exercise price of $9.00 per share and had an expiration date of December 7, 2023, effective upon the closing of the Offering, such that the amended warrants have a reduced exercise price of $1.55 per share and expire three and one half years following the closing of the Offering, for additional consideration of $0.125 per amended warrant. The Company received gross proceeds of approximately $55.5 million from the Offering, before deducting placement agent fees and related offering expenses. The net proceeds to the Company from the Offering, after deducting the placement agent fees and expenses and the Company’s estimated offering expenses, are approximately $51.3 million. In addition, the Company received approximately $1.2 million as the gross consideration in connection with the Warrant Amendment Agreements. The net proceeds of the Warrant Amendment Agreements after deducting placement fees were approximately $1.1 million. Refer to Note 13 "Stockholders' Deficit" for further information. On June 1, 2023, the Company announced that it submitted Supplemental New Drug Applications ("sNDAs") to the FDA seeking to add the use of both NEXLETOL and NEXLIZET for cardiovascular risk reduction and also seeking to remove the statin limitation in the LDL-C indication. Subsequently, the FDA accepted the sNDAs with an anticipated Prescription Drug User Fee Act date, or target action date, of March 31, 2024. On June 28, 2023, the Company announced that the application was filed for a Type II(a) variation with the EMA for the Company’s oral non-statin products marketed as NILEMDO® (bempedoic acid) tablets and NUSTENDI® (bempedoic acid and ezetimibe) tablets in Europe. The application asks EMA to approve both NILEMDO and NUSTENDI to reduce cardiovascular risk in patients with or at high risk for atherosclerotic cardiovascular disease. The Company anticipates EMA approval in the first half of 2024. The Company's primary activities since incorporation have been conducting research and development activities, including nonclinical, preclinical and clinical testing, gaining commercial approval of its products, developing a commercial sales team, performing business and financial planning, recruiting personnel, and raising capital. The Company received approval by the FDA in February 2020 to commercialize NEXLETOL and NEXLIZET in the U.S., and accordingly commenced principal operations on March 30, 2020 with the commercialization of NEXLETOL. The Company is subject to risks and uncertainties which include the need to successfully commercialize its products, research, develop, and clinically test therapeutic products; obtain regulatory approvals for its products (or additional or expanded indications for approved products); manage its management, commercial and scientific staff; and finance its operations with an ultimate goal of achieving profitable operations. The Company has sustained annual operating losses since inception and expects such losses to continue over the foreseeable future. While management believes current cash resources and future cash received from the Company's net product sales and collaboration agreements with Daiichi Sankyo Europe GmbH ("DSE"), Otsuka Pharmaceutical Co., Ltd ("Otsuka"), and Daiichi Sankyo Co. Ltd ("DS"), entered into on January 2, 2019, April 17, 2020 and April 26, 2021, respectively, will fund operations for the foreseeable future, management may continue to fund operations and advance the development of the Company's products and product candidates through a combination of collaborations with third parties, strategic alliances, licensing arrangements, permitted debt financings, permitted royalty-based financings, and permitted private and public equity offerings or through other sources. If adequate funds are not available, the Company may not be able to continue the development of its current products or future product candidates, or to commercialize its current or future product candidates, if approved. Basis of Presentation The accompanying condensed interim financial statements are unaudited and were prepared by the Company in accordance with generally accepted accounting principles in the United States of America (“GAAP”). In the opinion of management, the Company has made all adjustments, which include only normal recurring adjustments necessary for a fair presentation of the Company’s financial position and results of operations for the interim periods presented. Certain prior year amounts have been reclassified to conform with current year presentation. Certain information and disclosures normally included in the annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, have been condensed or omitted. These condensed interim financial statements should be read in conjunction with the audited financial statements as of and for the year ended December 31, 2022, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022. The results of operations for the interim periods are not necessarily indicative of the results to be expected for a full year, any other interim periods or any future year or period.

Other Accrued Liabilities

9 Months Ended

Sep. 30, 2023

Payables and Accruals [Abstract]

Other Accrued Liabilities

Other accrued liabilities consist of the following (in thousands):


	September 30, 2023		December 31, 2022
Accrued compensation	$	8,246	$	9,053
Accrued professional fees	6,773		2,547
Accrued interest on convertible notes	3,975		1,325
Accrued other	290		279
Total other accrued liabilities	$	19,284	$	13,204

Statements of Cash Flows and Restricted Cash (Tables)

9 Months Ended

Sep. 30, 2023

Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents [Abstract]

Reconciliation of Cash and Cash Equivalents and Restricted Cash

The following table provides a reconciliation of cash and cash equivalents and restricted cash presented on the balance sheets to the same amounts presented on the statements of cash flows on September 30, 2023 and 2022 and December 31, 2022 and 2021 (in thousands):


	September 30, 2023		September 30, 2022		December 31, 2022		December 31, 2021
Cash and cash equivalents	$	114,833	$	159,399	$	124,775	$	208,892
Restricted cash	—		50,000		—		50,000
Total cash and cash equivalents and restricted cash shown on the condensed statements of cash flows	$	114,833	$	209,399	$	124,775	$	258,892

Collaborations with Third Parties (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended		9 Months Ended
	Apr. 17, 2020	Jan. 02, 2019	Apr. 30, 2021	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Collaborations with Third Parties
Collaboration revenue				$ 33,969	$ 18,980	$ 84,084	$ 56,657
Daiichi Sankyo Europe GmbH ("DSE") \| Royalty revenue and product sales bulk tablets
Collaborations with Third Parties
Collaboration revenue				13,400	4,400	25,800	14,700
Daiichi Sankyo Europe GmbH ("DSE") \| License and Collaboration Agreement
Collaborations with Third Parties
Upfront cash payment received (paid)		$ 150,000
Cash payment to the Company upon first commercial sales in the DSE Territory		150,000
Daiichi Sankyo Europe GmbH ("DSE") \| License and Collaboration Agreement \| Minimum
Collaborations with Third Parties
Additional cash payment to the Company upon grant of marketing authorization		$ 200,000
Percentage of royalties to be received on the net sales		15.00%
Daiichi Sankyo Europe GmbH ("DSE") \| License and Collaboration Agreement \| Maximum
Collaborations with Third Parties
Additional cash payment to the Company upon grant of marketing authorization		$ 300,000
Percentage of royalties to be received on the net sales		25.00%
Otsuka Pharmaceutical Co, Ltd. \| Exclusive Developmental Activities
Collaborations with Third Parties
Upfront cash payment received (paid)	$ 60,000
Potential additional future payments	$ 450,000
Otsuka Pharmaceutical Co, Ltd. \| Exclusive Developmental Activities \| Product Sales Bulk Tablets
Collaborations with Third Parties
Collaboration revenue				100	400	100	400
Otsuka Pharmaceutical Co, Ltd. \| Exclusive Developmental Activities \| Minimum
Collaborations with Third Parties
Percentage of royalties to be received on the net sales	15.00%
Otsuka Pharmaceutical Co, Ltd. \| Exclusive Developmental Activities \| Maximum
Collaborations with Third Parties
Percentage of royalties to be received on the net sales	30.00%
Milestone payment, first JNDA submissions	$ 20,000
Milestone payment, first NHI Price Listing for NEXLETOL in the Otsuka Territory	70,000
Milestone payment, achievement of the primary MACE in the CLEAR Outcomes study and CV risk reduction rate on the U.S. label	50,000
Milestone payments related to total net sales achievements	$ 310,000
Daiichi Sankyo Co. Ltd \| License and Collaboration Agreement
Collaborations with Third Parties
Collaboration revenue				$ 200	$ 200	600	$ 600
Consideration cash payment			$ 30,000
Cash payment to be received upon certain commercial milestones			$ 175,000
Deferred up-front payment						$ 100
Daiichi Sankyo Co. Ltd \| License and Collaboration Agreement \| Minimum
Collaborations with Third Parties
Percentage of royalties to be received on the net sales			5.00%
Daiichi Sankyo Co. Ltd \| License and Collaboration Agreement \| Maximum
Collaborations with Third Parties
Percentage of royalties to be received on the net sales			20.00%

Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2023	Nov. 01, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-35986
Entity Registrant Name	Esperion Therapeutics, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-1870780
Entity Address, Address Line One	3891 Ranchero Drive, Suite 150
Entity Address, City or Town	Ann Arbor
Entity Address, State or Province	MI
Entity Address, Postal Zip Code	48108
City Area Code	734
Local Phone Number	887-3903
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	ESPR
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		113,717,785
Entity Central Index Key	0001434868
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

Inventories, net (Tables)

9 Months Ended

Sep. 30, 2023

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories, net consist of the following (in thousands):


	September 30, 2023		December 31, 2022
Raw materials	$	49,158	$	26,558
Work in process	625		6,548
Finished goods	1,652		2,095

	$	51,435	$	35,201

Investments - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
Investments - Narrative (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Investments
Accretion (amortization) of premiums and discounts on investments			$ 412,000	$ (539,000)
Other income, net	$ 1,278,000	$ 659,000	4,211,000	1,297,000
Allowance for credit loss	0	0	0	0
Accrued interest receivable	0		0
Reclassification out of Accumulated Other Comprehensive Income
Investments
Other income, net	0	0	0	0
Other Nonoperating Income (Expense)
Investments
Interest income on investments	1,200,000	800,000	3,500,000	1,500,000
Accretion (amortization) of premiums and discounts on investments	$ 0	$ (200,000)	$ 400,000	$ (600,000)

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

+ Details

Stock Compensation

9 Months Ended

Sep. 30, 2023

Share-Based Payment Arrangement [Abstract]

Stock Compensation

2022 Stock Option and Incentive Plan

In May 2022, the Company's stockholders approved the 2022 Stock Option and Incentive Plan (the "2022 Plan"). The number of shares of common stock available for awards under the 2022 Plan was set to 4,400,000, with any shares underlying awards that are forfeited, canceled, held back upon exercise of an option or settlement of an award to cover the exercise price or tax withholding, reacquired by the Company prior to vesting, satisfied without the issuance or shares, or otherwise terminated (other than by exercise) under the 2022 Plan may be added back to the shares of common stock available for issuance under the 2022 Plan. The 2022 Plan provides for the award of stock options (both incentive and non-qualified options), stock appreciation rights, restricted stock, restricted stock units, unrestricted stock, cash-based awards, and dividend equivalent rights. Following the approval of the 2022 Plan, no further awards will be issued under the Company’s 2013 Stock Option and Incentive Plan (the “2013 Plan”). In June 2023, the Company's stockholders approved an amendment to the 2022 Plan, which increased the number of shares of common stock reserved for awards under the 2022 Plan to 10,650,000.

Employee Stock Purchase Plan

In April 2020, the Company's board of directors approved the Esperion Therapeutics, Inc. 2020 Employee Stock Purchase Plan (the "ESPP") which was approved by the Company's stockholders on May 28, 2020. The ESPP allows eligible employees to authorize payroll deductions of up to 10% of their base salary or wages up to $25,000 annually to be applied toward the purchase of shares of the Company's common stock on the last trading day of the offering period. Participating employees will purchase shares of the Company's common stock at a discount of up to 15% on the lesser of the closing price of the Company's common stock on the NASDAQ Global Select Market ("Nasdaq") (i) on the first trading day of the offering period or (ii) the last day of any offering period. Offering periods under the ESPP will generally be in six months increments, commencing on September 1 and March 1 of each calendar year with the administrator having the right to establish different offering periods. In the three and nine months ended September 30, 2023, the Company recognized $0.1 million and $0.3 million of stock compensation expense related to the ESPP, respectively. In the three and nine months ended September 30, 2022, the Company recognized approximately $0.1 million and $0.3 million of stock compensation expense related to the ESPP, respectively. As of September 30, 2023, there have been 610,506 shares issued and 214,494 shares reserved for future issuance under the ESPP. The Company paused the ESPP effective as of September 1, 2023, such that the offering period which would otherwise have begun on September 1, 2023 did not commence. The administrator will determine the next offering period, pursuant to the ESPP.

2017 Inducement Equity Plan

In May 2017, the Company's board of directors approved the Esperion Therapeutics, Inc. 2017 Inducement Equity Plan (as amended in November 2019 and August 2023, the "2017 Plan"). The number of shares of common stock available for awards under the 2017 Plan is 2,650,000, with any shares of common stock that are forfeited, cancelled, held back upon the exercise or settlement of an award to cover the exercise price or tax withholding, reacquired by the Company prior to vesting, satisfied without the issuance of common stock, or otherwise terminated (other than by exercise) under the 2017 Plan added back to the shares of common stock available for issuance under the 2017 Plan. The 2017 Plan provides for the granting of stock options, stock appreciation rights, restricted stock awards, restricted stock units ("RSUs"), unrestricted stock awards and dividend equivalent rights.

Stock Options

The following table summarizes the activity relating to the Company’s options to purchase common stock for the nine months ended September 30, 2023:


	Number of Options	Weighted-Average Exercise Price Per Share		Weighted-Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
					(in thousands)
Outstanding at December 31, 2022	3,842,737	$	27.75	4.86	$	1,658
Granted	1,550,200	$	3.53
Forfeited or expired	(1,686,746)	$	36.05
Exercised	—	$	—
Outstanding at September 30, 2023	3,706,191	$	13.84	7.70	$	—
Vested and expected to vest at September 30, 2023	3,706,191	$	13.84	7.70	$	—
Exercisable at September 30, 2023	1,563,571	$	25.48	5.77	$	—

Stock-based compensation related to stock options was $0.9 million and $2.9 million for the three and nine months ended September 30, 2023, respectively, including $0.1 million and $0.2 million that was capitalized into inventory, respectively, and $1.4 million and $4.3 million for the three and nine months ended months ended September 30, 2022, respectively, including $0.2 million and $0.4 million that was capitalized into inventory, respectively. As of September 30, 2023, there was $7.6 million of unrecognized stock-based compensation expense related to unvested options, which will be recognized over a weighted-average period of 2.5 years.

Performance-Based Stock Options ("PBSOs")

In 2021, the Company granted PBSOs from the 2013 Plan that vest upon various performance-based milestones as set forth in the individual grant agreements, such as achievement of predetermined clinical or regulatory outcomes. The actual number of units (if any) received under these awards will depend on continued employment and actual performance over the performance period. Each quarter, the Company updates their assessment of the probability that the performance milestone will be achieved. The Company amortizes the fair value of the PBSOs based on the expected performance period to achieve the performance milestone. The Company expects the performance criteria to be met.

In 2022, the Company granted PBSOs from the 2022 Plan that vest upon various performance-based milestones as set forth in the individual grant agreements, such as achievement of predetermined clinical or regulatory outcomes. The actual number of units (if any) received under these awards will depend on continued employment and actual performance over the performance period. Each quarter, the Company updates their assessment of the probability that the performance milestone will be achieved. The Company amortizes the fair value of the PBSOs based on the expected performance period to achieve the performance milestone. The Company expects the performance criteria to be met.

The following table summarizes the activity relating to the Company’s PBSOs for the nine months ended September 30, 2023:


	Number of Options	Weighted-Average Exercise Price Per Share		Weighted-Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
					(in thousands)
Outstanding at December 31, 2022	499,200	$	6.73	9.32	$	12
Granted	227,900	$	1.62
Forfeited or expired	(65,250)	$	6.76
Exercised	—	$	—
Outstanding at September 30, 2023	661,850	$	4.97	8.88	$	—
Vested and expected to vest at September 30, 2023	661,850	$	4.97	8.88	$	—
Exercisable at September 30, 2023	48,100	$	8.94	6.12	$	—

Stock-based compensation related to PBSOs was $0.2 million and $0.6 million for the three and nine months ended September 30, 2023, respectively, and $0.3 million and $0.5 million for the three and nine months ended September 30, 2022, respectively. As of September 30, 2023, there was approximately $0.8 million of unrecognized stock-based compensation expense related to unvested PBSOs, which will be recognized over a weighted-average period of approximately 0.7 years.

Restricted Stock Units (or RSUs)

The following table summarizes the activity relating to the Company’s RSUs for the nine months ended September 30, 2023:


	Number of RSUs	Weighted-Average Fair Value Per Share
Outstanding and unvested December 31, 2022	1,768,185	$	8.80
Granted	2,290,785	$	3.38
Forfeited	(265,328)	$	7.65
Vested	(610,785)	$	8.35
Outstanding and unvested September 30, 2023	3,182,857	$	7.71

Stock-based compensation related to RSUs was approximately $1.6 million and $4.9 million for the three and nine months ended September 30, 2023, respectively, including $0.2 million and $0.3 million that was capitalized into inventory, respectively, and approximately $1.5 million and $5.1 million for the three and nine months ended September 30, 2022, respectively, including $0.2 million and $0.5 million that was capitalized into inventory, respectively. As of September 30, 2023, there was $15.1 million of unrecognized stock-based compensation expense related to unvested RSUs, which will be recognized over a weighted-average period of 2.7 years.

Performance-based Restricted Stock Units ("PBRSUs")

In 2021, the Company granted PBRSUs from the 2013 Plan that vest upon various performance-based milestones as set forth in the individual grant agreements, such as achievement of predetermined milestones based on the Company's U.S. net product sales or clinical or regulatory outcomes. The actual number of units (if any) received under these awards will depend on continued employment and actual performance over the performance period. Each quarter, the Company updates their assessment of the probability that the performance milestone will be achieved. The Company amortizes the fair value of the PBRSUs based on the expected performance period to achieve the performance milestone. The fair value of the PBRSUs is based on the quoted market price of the Company's common stock on the date of grant. The Company expects the performance criteria to be met.

The following table summarizes the activity relating to the Company's PBRSUs for the nine months ended September 30, 2023:


	Number of PBRSUs	Weighted-average fair value per share
Outstanding December 31, 2022	461,250	$	9.50
Granted	—	$	—
Forfeited	(85,750)	$	11.93
Vested	(200,725)	$	8.94
Outstanding and unvested September 30, 2023	174,775	$	15.21

Stock-based compensation related to the PBRSUs was $0.1 million and $0.3 million for the three and nine months ended September 30, 2023, respectively, including less than $0.1 million and less than $0.1 million that was capitalized into inventory, respectively, and $0.2 million and $1.3 million for the three and nine months ended September 30, 2022, respectively, including less than $0.1 million and $0.1 million that was capitalized into inventory, respectively. As of September 30, 2023, there was approximately $0.4 million of unrecognized stock-based compensation expense related to unvested PBRSUs, which will be recognized over a weighted-average period of approximately 0.7 years.

Stockholders' Deficit

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Stockholders' Deficit

ATM Offering

On April 15, 2022, the Company filed a new registration statement on Form S-3 to replace its prior automatically effective registration statement on Form S-3ASR filed on August 3, 2021, which registers the offering, issuance and sale of up to $239 million of common stock from time to time in “at-the-market” offerings (the “New ATM Program”). On February 21, 2023, the Company terminated the open market sales agreement with Jefferies LLC and entered into a Controlled Equity Offering Sales Agreement with Cantor Fitzgerald & Co., as sales agent, to provide for the issuance and sale by the Company of up to $70 million of common stock from time to time in “at-the-market” offerings (the "2023 ATM Program"), pursuant to its existing Form S-3 and the prospectus supplement filed on February 21, 2023. The Company may continue to use the 2023 ATM Program to address potential short-term or long-term funding requirements that may arise. Such program will continue to be subject to the volatility of the price of the Company's common stock and general market conditions. During the three and nine month periods ended September 30, 2022, the Company issued 6,958,525 and 10,311,525 shares of common stock, respectively, resulting in net proceeds of approximately $48.6 million and $68.8 million after deducting $1.6 million and $2.4 million of underwriting discounts and commissions and other expenses, respectively, pursuant to the New ATM Program. During the three month period ended September 30, 2023, the Company did not issue shares pursuant to the 2023 ATM Program. During the nine month period ended September 30, 2023, the Company issued 3,312,908 shares of common stock resulting in net proceeds of approximately $4.4 million after deducting $0.4 million of underwriting discounts and commissions and other expenses, pursuant to the 2023 ATM Program.

Warrants

In connection with an underwriting agreement with H.C. Wainwright & Co., LLC ("Wainwright") on December 2, 2021, the Company issued warrants to purchase 36,964,286 shares of common stock at an exercise price of $9.00. The warrants will terminate on December 7, 2023. The warrants were recorded at fair value of $61.9 million to additional-paid-in-capital in accordance with ASC 815-10 based upon the allocation of the proceeds between the common shares issued with the Offering and the warrants.

Registered Direct Offering and Warrant Amendment

On March 19, 2023, the Company entered into a Securities Purchase Agreement (the “Purchase Agreement”) with certain purchasers named therein (the “Purchasers”), pursuant to which the Company agreed to issue and sell, in a registered direct

offering (the “Offering”), 12,205,000 shares of its common stock, par value $0.001 per share (the “Common Stock”), pre-funded warrants to purchase up to an aggregate of 20,965,747 shares of Common Stock (the “Pre-Funded Warrants”) in lieu of shares of Common Stock, and warrants to purchase up to 33,170,747 shares of Common Stock (the “Warrants”). The combined purchase price of each share of Common Stock and accompanying Warrant is $1.675 per share. The Warrants expire on September 22, 2026 and have an exercise price of $1.55. The purchase price of each Pre-Funded Warrant is $1.674 (equal to the combined purchase price per share of Common Stock and accompanying Warrant, minus $0.001). The Purchase Agreement contains customary representations, warranties, covenants and indemnification rights and obligations of the Company and the Purchasers. The Offering closed on March 22, 2023. The warrants and pre-funded warrants were recorded at fair value of $22.8 million to additional-paid-in-capital in accordance with ASC 815-10 based upon the allocation of the proceeds between the common shares issued with the Offering and the warrants and pre-funded warrants. The Company estimated the fair value of the warrants using a Black-Scholes option-pricing model, which is based, in part, upon subjective assumptions including but not limited to stock price volatility, the expected life of the warrant, the risk-free interest rate and the fair value of the common stock underlying the warrant. The Company estimates the volatility based on its historical volatility that is in line with the expected remaining life of the warrants. The risk-free interest rate is based on the U.S. Treasury daily rate for a maturity similar to the expected remaining life of the warrants. The expected remaining life of the warrants is assumed to be equivalent to its remaining contractual term. The Company estimated the fair value of the pre-funded warrants based on the market price of the Company's common stock at issuance.

In connection with the Offering, the Company amended, pursuant to Warrant Amendment Agreements (the “Warrant Amendment Agreements”), certain existing warrants to purchase up to an aggregate of 9,024,212 shares of the Company's common stock that were previously issued in December 2021 at an exercise price of $9.00 per share and had an expiration date of December 7, 2023, effective upon the closing of the Offering, such that the amended warrants have a reduced exercise price of $1.55 per share and expire three and one half years following the closing of the Offering, or September 22, 2026, for additional consideration of $0.125 per amended warrant. Based on the change in the fair value of the amended warrants, the Company recorded issuance costs to additional paid-in capital of $2.9 million.

The Company received gross proceeds of approximately $55.5 million from the Offering, before deducting placement agent fees and related offering expenses. The net proceeds to the Company from the Offering, after deducting the placement agent fees and expenses and the Company’s estimated offering expenses of $4.2 million, were approximately $51.3 million. In addition, the Company received approximately $1.2 million as the gross consideration in connection with the Warrant Amendment Agreements. The net proceeds of the Warrant Amendment Agreements after deducting placement fees of $0.1 million were approximately $1.1 million.

During the three and nine month periods ended September 30, 2023, 10,867,000 and 20,965,747 shares of pre-funded warrants were exercised. As of September 30, 2023, no pre-funded warrants were outstanding. The following table summarizes the warrants outstanding for the Company as of September 30, 2023 and December 31, 2022:


	September 30, 2023	December 31, 2022	Weighted average exercise price
Warrants outstanding from 2021 agreement, expiring December 7, 2023	27,940,074	36,964,286	$	9.00
Warrants outstanding from Warrant Amendment Agreements, expiring September 22, 2026	9,024,212	—	$	1.55
Warrants outstanding from Purchase Agreement, expiring September 22, 2026	33,170,747	—	$	1.55
Total warrants outstanding	70,135,033	36,964,286

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

The Company and Basis of Presentation (Details) $ / shares in Units, patient in Thousands, $ in Thousands			1 Months Ended	9 Months Ended		12 Months Ended
	Mar. 22, 2023 USD ($) $ / shares shares	Mar. 19, 2023 USD ($) $ / shares shares	Aug. 31, 2019 patient	Sep. 30, 2023 USD ($) $ / shares shares	Sep. 30, 2022 USD ($)	Dec. 31, 2020 product	Mar. 23, 2023 $ / shares	Dec. 31, 2022 $ / shares shares	Dec. 31, 2021 $ / shares
Collaborations with Third Parties
Products approved \| product						2
Study patients enrolled \| patient			14
Common stock, issued (in shares) \| shares				114,130,645				76,564,396
Common stock, par value (in dollars per share)				$ 0.001				$ 0.001
Proceeds from issuance of common stock, net of issuance costs \| $				$ 4,448	$ 68,861
Securities Purchase Agreement
Collaborations with Third Parties
Common stock, issued (in shares) \| shares		12,205,000
Common stock, par value (in dollars per share)		$ 0.001
Common stock purchasable under prefunded warrants (in shares) \| shares		20,965,747
Common stock purchasable under warrants (in shares) \| shares		33,170,747
Exercise price (in dollars per share)				$ 1.55
Securities Purchase Agreement \| Common Stock And Accompanying Warrant
Collaborations with Third Parties
Purchase price (in dollars per share)		$ 1.675
Securities Purchase Agreement \| Pre Funded Warrant And Accompanying Warrant
Collaborations with Third Parties
Purchase price (in dollars per share)		$ 1.674
Warrant Amendment Agreements
Collaborations with Third Parties
Common stock purchasable under warrants (in shares) \| shares	9,024,212
Exercise price (in dollars per share)	$ 1.55			$ 1.55			$ 1.55		$ 9.00
Expiration term							3 years 6 months
Additional consideration (in dollars per share)	$ 0.125
Gross proceeds \| $	$ 55,500	$ 1,200
Proceeds from issuance of common stock, net of issuance costs \| $		$ 51,300
Proceeds from warrant amendment \| $	$ 1,100

Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Schedule of the Company's Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis

The following table presents the Company’s financial assets that have been measured at fair value on a recurring basis (in thousands):


Description	Total		Level 1		Level 2		Level 3

September 30, 2023
Assets:
Money market funds	$	88,374	$	88,374	$	—	$	—
Certificates of deposit	402		402		—		—

Total assets at fair value	$	88,776	$	88,776	$	—	$	—
December 31, 2022
Assets:
Money market funds	$	105,078	$	105,078	$	—	$	—
Certificates of deposit	401		401		—		—

U.S. treasury notes	47,081		47,081		—		—

Total assets at fair value	$	152,560	$	152,560	$	—	$	—

Liability Related to the Revenue Interest Purchase Agreement (Tables)

9 Months Ended

Sep. 30, 2023

Summary of Revenue Interest Liability Activity During the Period

The following table summarizes the revenue interest liability activity during the nine months ended September 30, 2023:


	(in thousands)
Total revenue interest liability at December 31, 2022	$	243,605
Interest expense recognized	34,703
Revenue Interests payments	(10,908)
Total revenue interest liability at September 30, 2023	$	267,400

Convertible Notes	9 Months Ended
Convertible Notes	Sep. 30, 2023
Debt Disclosure [Abstract]
Convertible Notes	Convertible NotesIn November 2020, the Company issued $280.0 million aggregate principal amount of 4.0% senior subordinated convertible notes due November 2025. The net proceeds the Company received from the offering was approximately $271.1 million, after deducting the initial purchasers’ discounts and commissions and offering expenses payable by the Company (the "Convertible Notes") of $8.9 million. The Company used approximately $46.0 million of the net proceeds from the offering of the notes to pay the cost of the Capped Call (as defined below) and $55.0 million of the net proceeds from the offering of the initial notes to finance the Prepaid Forward (as defined below). The Convertible Notes are the Company's senior unsecured obligations and mature on November 15, 2025 (the “Maturity Date”), unless earlier repurchased or converted into shares of common stock under certain circumstances described below. The Convertible Notes are convertible into shares of the Company’s common stock, can be repurchased for cash, or a combination thereof, at the Company’s election, at an initial conversion rate of 30.2151 shares of common stock per $1,000 principal amount of the Convertible Notes, which is equivalent to an initial conversion price of approximately $33.096 per share of common stock, subject to adjustment. The Company will pay interest on the Convertible Notes semi-annually in arrears on May 15 and November 15 of each year. The Convertible Notes are general unsecured obligations of the Company that are subordinated in right of payment to indebtedness, obligations and other liabilities under the Company’s RIPA, the revenue interests issued pursuant to such agreement, and any refinancing of the foregoing. Holders may convert their Convertible Notes at their option at any time prior to the close of business on the business day immediately preceding August 15, 2025 in the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ended on March 31, 2021 (and only during such calendar quarter), if the last reported sale price per share of the Company’s common stock, par value $0.001 per share (“common stock”), is greater than or equal to 130% of the conversion price for each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter; (2) during the five business days after any five consecutive trading day period (such five consecutive trading day period, the “measurement period”) in which the trading price per $1,000 principal amount of notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price per share of the Company’s common stock and the conversion rate for the notes on each such trading day; (3) if the Company calls such notes for redemption, any such notes that have been called for redemption may be converted at any time prior to the close of business on the second scheduled trading day immediately preceding the redemption date, but only with respect to the notes called for redemption; and (4) upon the occurrence of specified corporate events, as provided in the Indenture. On or after August 15, 2025, to the close of business on the second scheduled trading day immediately before the maturity date, holders may convert all or any portion of their notes at the applicable conversion rate at any time at the option of the holder regardless of the foregoing conditions. In addition, following certain corporate events or following issuance of a notice of redemption, the Company will, in certain circumstances, increase the conversion rate for a holder who elects to convert its notes in connection with such a corporate event or to convert its notes called (or deemed called) for redemption during the related redemption period, as the case may be. The Convertible Notes will be redeemable, in whole or in part, at the Company’s option at any time, and from time to time, on or after November 20, 2023 and before the 41st scheduled trading day immediately before the maturity date, at a cash redemption price equal to 100% of the principal amount of the notes to be redeemed, plus accrued and unpaid interest, if any, but only if the last reported sale price per share of the Company’s common stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date the Company sends the related redemption notice, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company sends such redemption notice. No sinking fund is provided for the notes. If the Company redeems less than all the outstanding notes, at least $125.0 million aggregate principal amount of notes must be outstanding and not subject to redemption as of the relevant redemption notice date. If the Company undergoes a “fundamental change” (as defined in the Indenture), holders may require the Company to repurchase their notes for cash all or any portion of their notes at a fundamental change repurchase price equal to 100% of the principal amount of the notes to be repurchased, plus accrued and unpaid interest, to, but excluding, the fundamental change repurchase date. The Indenture includes customary terms and covenants, including certain events of default. On October 22, 2021, the Company entered into a privately negotiated exchange agreement (the “Exchange Agreement”) with two co-managed holders (the “Holders”) of its Convertible Notes. Under the terms of the Exchange Agreement the Holders agreed to exchange (the “Exchange”) with the Company $15.0 million aggregate principal amount of the Convertible Notes held in the aggregate by them (and accrued interest thereon) for shares of the Company’s common stock. Pursuant to the Exchange Agreement, the number of shares of common stock to be issued by the Company to the Holders upon consummation of the Exchange was determined based upon the volume-weighted-average-price per share of common stock, subject to a floor of $5.62 per share, during the five trading-day averaging period, commencing on the trading day immediately following the date of the Exchange Agreement. The Exchange closed on November 3, 2021, with 1,094,848 shares of the Company's common stock being exchanged. As of September 30, 2023, the principal amount of convertible notes was $265.0 million, and the unamortized debt discount and issuance costs were $3.8 million, for a net carrying amount of $261.2 million. The Company recorded $3.1 million and $9.2 million of interest expense during the three and nine months ended September 30, 2023, respectively, and $3.1 million and $9.2 million of interest expense during the three and nine months ended September 30, 2022, respectively, relating to the cash interest on the convertible notes due semi-annually and amortization of the debt issuance costs. As of September 30, 2023, no Convertible Notes were convertible pursuant to their terms. The estimated fair value of the Convertible Notes was $137.5 million as of September 30, 2023 and $145.9 million as of December 31, 2022. The estimated fair value of the Convertible Notes was determined through consideration of quoted market prices. As of September 30, 2023, the if-converted value of the Convertible Notes did not exceed the principal value of those notes. Capped Call Transactions In connection with the offering of the Convertible Notes, the Company entered into privately-negotiated capped call transactions with one of the initial purchasers of the convertible notes or its affiliate and certain other financial institutions. The Company used approximately $46.0 million of the net proceeds from the offering of the Convertible Notes to pay the cost of the capped call transactions. The capped call transactions are expected generally to reduce potential dilution to the Company’s common stock upon any conversion of the Convertible Notes and/or offset any cash payments the Company is required to make in excess of the principal amount of converted notes, as the case may be, in the event that the market value per share of the Company’s common stock, as measured under the terms of the capped call transactions at the time of exercise, is greater than the strike price of the capped call transactions (which initially corresponds to the initial conversion price of the Convertible Notes, and is subject to certain adjustments), with such reduction and/or offset subject to a cap initially equal to approximately $55.16 (which represents a premium of approximately 100% over the last reported sale price of the Company’s common stock on November 11, 2020), subject to certain adjustments. The capped call transactions are separate transactions, entered into by the Company and are not part of the terms of the Convertible Notes. Given that the transactions meet certain accounting criteria, the convertible note capped call transactions are recorded in stockholders’ equity, and they are not accounted for as derivatives and are not remeasured each reporting period. As of September 30, 2023 and December 31, 2022, the Company had not purchased any shares under the convertible note capped call transactions. Prepaid Forward In connection with the offering of the Convertible Notes, the Company entered into a prepaid forward stock repurchase transaction (“Prepaid Forward”) with a financial institution (“Forward Counterparty”). Pursuant to the Prepaid Forward, the Company used approximately $55.0 million of the net proceeds from the offering of the Convertible Notes to fund the Prepaid Forward. The aggregate number of shares of the Company’s common stock underlying the Prepaid Forward was approximately 1,994,198. The expiration date for the Prepaid Forward is November 15, 2025, although it may be settled earlier in whole or in part. Upon settlement of the Prepaid Forward, at expiration or upon any early settlement, the Forward Counterparty will deliver to the Company the number of shares of common stock underlying the Prepaid Forward or the portion thereof being settled early. The shares purchased under the Prepaid Forward are treated as treasury stock and not outstanding for purposes of the calculation of basic and diluted earnings per share, but will remain outstanding for corporate law purposes, including for purposes of any future stockholders’ votes, until the Forward Counterparty delivers the shares underlying the Prepaid Forward to the Company. As of September 30, 2023, 448,698 shares had been delivered to the Company. The Company’s Prepaid Forward hedge transaction exposes the Company to credit risk to the extent that its counterparty may be unable to meet the terms of the transaction. The Company mitigates this risk by limiting its counterparty to a major financial institution.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 470
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-Section 50
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+ Details

Summary of Significant Accounting Policies	9 Months Ended
Summary of Significant Accounting Policies	Sep. 30, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles in the United States requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, net revenues, expenses and related disclosures. Actual results could differ from those estimates. Cash and Cash Equivalents The Company invests its excess cash in bank deposits, money market accounts, and short-term investments. The Company considers all highly liquid investments with an original maturity of 90 days or less at the time of purchase to be cash equivalents. Cash equivalents are reported at fair value. Investments Investments are considered to be available-for-sale and are carried at fair value. Unrealized gains and losses, if any, are reported in accumulated other comprehensive income (loss). The cost of investments classified as available-for-sale are adjusted for the amortization of premiums and accretion of discounts to maturity and recorded in other income, net. Realized gains and losses, if any, are determined using the specific identification method and recorded in other income, net. Investments with original maturities beyond 90 days at the date of purchase and which mature at, or less than twelve months from, the balance sheet date are classified as current. Investments with a maturity beyond twelve months from the balance sheet date are classified as long-term. Concentration of Risk The Company enters into a limited number of distribution agreements with distributors and specialty pharmacies. The Company's net product sales are with these customers. As of September 30, 2023 and December 31, 2022, eleven customers accounted for all of the Company's net trade receivables. Revenue Recognition In accordance with ASC 606, Revenue from Contracts with Customers, the Company recognizes revenue when a customer obtains control of promised goods or services, in an amount that reflects the consideration the Company expects to receive in exchange for the goods or services provided. To determine revenue recognition for arrangements within the scope of ASC 606, the Company performs the following five steps: identify the contracts with a customer; identify the performance obligations in the contract; determine the transaction price; allocate the transaction price to the performance obligations in the contract; and recognize revenue when or as the entity satisfies a performance obligation. At contract inception the Company assesses the goods or services promised within each contract and determines those that are performance obligations and assesses whether each promised good or service is distinct. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when or as the performance obligation is satisfied. The Company derives revenue through two primary sources: collaboration revenue and product sales. Collaboration revenue consists of the collaboration payments to the Company for collaboration arrangements outside of the United States for the development, manufacturing and commercialization, including royalties, of the Company's product candidates by the Company's partners and product sales consists of sales of NEXLETOL and NEXLIZET. a.Collaboration Revenue The Company has entered into agreements related to its activities to develop, manufacture, and commercialize its product candidates. The Company earns collaboration revenue in connection with a collaboration agreement to develop and/or commercialize product candidates where the Company deems the collaborator to be the customer. Revenue is recognized when (or as) the Company satisfies performance obligations under the terms of a contract. Depending on the terms of the arrangement, the Company may defer the recognition of all or a portion of the consideration received as the performance obligations are satisfied. The collaboration agreements may require the Company to deliver various rights, services, and/or goods across the entire life cycle of a product or product candidate. In an agreement involving multiple goods or services promised to be transferred to a customer, the Company must assess, at the inception of the contract, whether each promise represents a separate performance obligation (i.e., is "distinct"), or whether such promises should be combined as a single performance obligation. The terms of the agreement typically include consideration to be provided to the Company in the form of non-refundable up-front payments, development milestones, sales milestones, and royalties on sales of products within a respective territory. The Company recognizes regulatory and approval milestones as consideration when it is probable that a future reversal is unlikely to occur. For sales-based milestones and royalties based on sales of product in a territory, the Company applies the sales-based royalty exception in ASC 606-10-55-65 to all of these milestones and royalties. At the inception of the contract, the transaction price reflects the amount of consideration the Company expects to be entitled to in exchange for transferring promised goods or services to its customer. In the arrangement where the Company satisfies performance obligation(s) during the regulatory phase over time, the Company recognizes collaboration revenue typically using an input method on the basis of regulatory costs incurred relative to the total expected cost which determines the extent of progress toward completion. The Company reviews the estimate of the transaction price and the total expected cost each period and makes revisions to such estimates as necessary. Under contracted supply agreements with collaborators, the Company, through its third party contract manufacturing partners, may manufacture and supply quantities of active pharmaceutical ingredient (“API”) or bulk tablets reasonably required by collaboration partners for the development or sale of licensed products in their respective territory. The Company recognizes revenue when the collaboration partner has obtained control of the API or bulk tablets. The Company records the costs related to the supply agreement in cost of goods sold on the condensed statements of operations and comprehensive (loss) income. Under the Company's collaboration agreements, product sales and cost of sales may be recorded by the Company's collaborators as they are deemed to be the principal in the transaction. The Company receives royalties from the commercialization of such products, and records its share of the variable consideration, representing a percentage of net product sales, as collaboration revenue in the period in which such underlying sales occur and costs are incurred by the collaborator. b.Product Sales, Net On February 21, 2020, the Company announced that the FDA approved NEXLETOL as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with HeFH or established ASCVD who require additional lowering of LDL-C. On February 26, 2020, the Company announced that the FDA approved NEXLIZET as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with HeFH or established ASCVD who require additional lowering of LDL-C. On March 30, 2020, NEXLETOL was commercially available in the U.S. through prescription and on June 4, 2020, NEXLIZET was commercially available in the U.S. through prescription. Net product sales totaled $20.3 million and $57.6 million for the three and nine months ended September 30, 2023, respectively, and $14.0 million and $40.9 million for the three and nine months ended September 30, 2022, respectively. The Company sells NEXLETOL and NEXLIZET to wholesalers in the U.S. and, in accordance with ASC 606, recognizes revenue at the point in time when the customer is deemed to have obtained control of the product. The customer is deemed to have obtained control of the product at the time of physical receipt of the product at the customers’ distribution facilities, or free on board (“FOB”) destination, the terms of which are designated in the contract. Product sales are recorded at the net selling price, which includes estimates of variable consideration for which reserves are established for (a) rebates and chargebacks, (b) co-pay assistance programs, (c) distribution fees, (d) product returns, and (e) other discounts. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as current contractual and statutory requirements, and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company's best estimates of the amount of consideration to which it is entitled based on the terms of the applicable contract. The amount of variable consideration may be constrained and is included in the net sales price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Given the early stage of the Company’s commercial operations it has provided constraint of its variable consideration due to its potential consumption trends. Actual amounts of consideration ultimately received may differ from the Company's estimates. If actual results in the future vary from estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Liabilities for co-pay assistance, expected product returns, rebates, and distributor fees are classified as “Accrued variable consideration” in the condensed balance sheets. Discounts, such as prompt pay discounts, and chargebacks are recorded as a reduction to trade accounts receivable in the condensed balance sheets. Forms of Variable Consideration Rebates and Chargebacks: The Company estimates reductions to product sales for Public Health Service Institutions, such as Medicaid, Medicare and Veterans' Administration ("VA") programs, as well as certain other qualifying federal and state government programs, and other group purchasing organizations. The Company estimates these reductions based upon the Company's contracts with government agencies and other organizations, statutorily defined discounts and estimated payor mix. These organizations purchase directly from the Company's wholesalers at a discount and the wholesalers charge the Company back the difference between the wholesaler price and the discounted price. The Company's liability for Medicaid rebates consists of estimates for claims that a state will make for a current quarter. The Company's reserve for this discounted pricing is based on expected sales to qualified healthcare providers and the chargebacks that customers have already claimed. Co-pay assistance: Eligible patients who have commercial insurance may receive assistance from the Company to reduce the patient's out of pocket costs. The Company will buy down the difference between the amount of the eligible patient's co-pay when the drug is purchased at the pharmacy at a determined price. Liabilities for co-pay assistance are calculated by actual program participation from third-party administrators. Distribution Fees: The Company has written contracts with its customers that include terms for distribution fees and costs for inventory management. The Company estimates and records distribution fees due to its customers based on gross sales. Product Returns: The Company generally offers a right of return based on the product’s expiration date and certain spoilage and damaged instances. The Company estimates the amount of product sales that may be returned and records the estimate as a reduction of product sales in the period the related product sales is recognized. The Company’s estimates for expected returns are based primarily on an ongoing analysis of sales information and visibility into the inventory remaining in the distribution channel. Discounts: The Company provides product discounts, such as prompt pay discounts, to its customers. The Company estimates cash discounts based on terms in negotiated contracts and the Company’s expectations regarding future payment patterns. Inventories Inventories are stated at the lower of cost or net realizable value and recognized on a first-in, first-out ("FIFO") method. The Company uses standard cost to determine the cost basis for inventory. Inventory is capitalized based on when future economic benefit is expected to be realized. The Company analyzes its inventory levels on a periodic basis to determine if any inventory is at risk for expiration prior to sale or has a cost basis that is greater than its estimated future net realizable value. Any adjustments are recognized through cost of goods sold in the period in which they are incurred. Recently Implemented Accounting Pronouncements There have been no other material changes to the significant accounting policies previously disclosed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022.

Stockholders' Deficit - Summary of Warrants and Pre-funded Warrants Outstanding (Details) - $ / shares	Sep. 30, 2023	Mar. 23, 2023	Mar. 22, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 02, 2021
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)	70,135,033			36,964,286
Wainwright
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)	27,940,074			36,964,286		36,964,286
Exercise price (in dollars per share)	$ 9.00					$ 9.00
Warrant Amendment Agreements
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)	9,024,212			0
Exercise price (in dollars per share)	$ 1.55	$ 1.55	$ 1.55		$ 9.00
Securities Purchase Agreement
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)	33,170,747			0
Exercise price (in dollars per share)	$ 1.55

Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Accrued compensation	$ 8,246	$ 9,053
Accrued professional fees	6,773	2,547
Accrued interest on convertible notes	3,975	1,325
Accrued other	290	279
Total other accrued liabilities	$ 19,284	$ 13,204

Liability Related to the Revenue Interest Purchase Agreement - Narrative (Details) - USD ($)					1 Months Ended	3 Months Ended		9 Months Ended		12 Months Ended
	Nov. 23, 2022	May 16, 2021	Apr. 26, 2021	Jun. 26, 2019	Mar. 31, 2020	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Sep. 30, 2021
Liability Related to the Revenue Interest Purchase Agreement
Restricted cash						$ 0	$ 50,000,000	$ 0	$ 50,000,000	$ 0	$ 50,000,000
One time partial call										50,000,000
Redemption percentage						225.00%		225.00%
Redemption amount						$ 400,000,000		$ 400,000,000
Remaining redemption amount						377,200,000		377,200,000
Interest expense						14,995,000	14,153,000	43,919,000	42,481,000
Revenue Interest Purchase Agreement (RIPA)
Liability Related to the Revenue Interest Purchase Agreement
Revenue interest liability						267,400,000		267,400,000		243,605,000
Capitalized issuance costs								300,000
Interest expense						11,900,000	$ 11,100,000	34,700,000	$ 33,300,000
Revenue Interest Purchase Agreement (RIPA) \| Oberland
Liability Related to the Revenue Interest Purchase Agreement
Gross proceeds from revenue interest liability				$ 125,000,000.0
Total amount of subsequent installment, subject to RIPA terms and conditions				75,000,000.0
Amount of subsequent installment, subject to regulatory approval				25,000,000.0
Amount of subsequent installment, subject to achievement of sales threshold				50,000,000.0
Milestone amount for worldwide sales to receive the third payment				$ 100,000,000.0
Proceeds from Revenue Interest Purchase Agreement			$ 50,000,000		$ 25,000,000.0
Revenue interest rate which will take effect if annual net sales equals or exceeds the sales threshold by December 31, 2021				2.50%
Initial revenue interest rate				7.50%
Percentage of invested capital received by December 31, 2024, to qualify for second reduced revenue interest rate				100.00%
Revenue interest rate if annual net sales equal or exceed the Sales Threshold and if the Purchasers receive 100% of their invested capital by December 31, 2024				0.40%
Minimum amount of annual net sales to qualify for reduced revenue interest rate by December 31, 2021				$ 350,000,000
Percentage of revenue interests payment on which agreement terminates				195.00%
Trailing number of months sales must be at or above milestone amount			6 months
Cumulative purchaser payment adjustment	$ 177,777,778
Percentage of revenues interests payment on which agreement terminates, after third anniversary		225.00%
Maximum amount of US net sales to qualify for the Covered Territory expansion to include worldwide sales by December 31, 2021											$ 350,000,000
Repayment amount expected to pay in next twelve months						$ 37,000,000		$ 37,000,000
Effective annual imputed interest rate (as a percent)								17.90%
Consecutive number of months sales must be at or above milestone amount				6 months
Percentage of increase in royalty rate upon drawdown of third payment				33.33%
Revenue Interest Purchase Agreement (RIPA) \| Oberland \| Net Sales Less Than $250 Million
Liability Related to the Revenue Interest Purchase Agreement
Initial revenue interest rate		10.00%
Minimum amount of annual net sales to qualify for reduced revenue interest rate by December 31, 2021		$ 250,000,000
Hypothetical sales generated amount		100,000,000
Hypothetical repayment obligation		$ 10,000,000
Revenue Interest Purchase Agreement (RIPA) \| Oberland \| Net Sales Greater Than $250 Million But Less Than $350 Million
Liability Related to the Revenue Interest Purchase Agreement
Revenue interest rate which will take effect if annual net sales equals or exceeds the sales threshold by December 31, 2021		3.30%
Minimum amount of annual net sales to qualify for reduced revenue interest rate by December 31, 2021		$ 250,000,000
Hypothetical sales generated amount		100,000,000
Hypothetical repayment obligation		3,300,000
RIPA Amendment
Liability Related to the Revenue Interest Purchase Agreement
Loss on modification of debt										$ 100,000
RIPA Amendment \| Oberland
Liability Related to the Revenue Interest Purchase Agreement
Revenue interest rate which will take effect if annual net sales equals or exceeds the sales threshold by December 31, 2021			3.33%
Initial revenue interest rate			10.00%
Percentage of invested capital received by December 31, 2024, to qualify for second reduced revenue interest rate			100.00%
Minimum amount of annual net sales to qualify for reduced revenue interest rate by December 31, 2024, contingent on 100% invested capital received			$ 350,000,000
Percentage of revenue interest payments to qualify for third payment applicable percentage			100.00%
Percentage of cumulative purchaser payments			100.00%
Percentage of revenue interests payment on which agreement terminates, prior to the third anniversary of the closing date, if put option is exercised			200.00%
Percentage of revenue interests payment on which agreement terminates, after the third anniversary of the closing date, if put option is exercised			225.00%
RIPA Amendment To The Security Agreement And Waiver \| Oberland
Liability Related to the Revenue Interest Purchase Agreement
Specified net revenue		15,000,000
Company deposit value in blocked account		$ 50,000,000
Restricted cash												$ 50,000,000

Stock Compensation - PBRSUs (Details) - PBRSUs	9 Months Ended
Stock Compensation - PBRSUs (Details) - PBRSUs	Sep. 30, 2023 $ / shares shares
Number of PBRSUs
Outstanding at the beginning of period (in shares) \| shares	461,250
Granted (in shares) \| shares	0
Forfeited (in shares) \| shares	(85,750)
Vested (in shares) \| shares	(200,725)
Outstanding and unvested at the ending of period (in shares) \| shares	174,775
Weighted-Average Fair Value Per Share
Outstanding and at the beginning of period (in dollars per share) \| $ / shares	$ 9.50
Granted (in dollars per share) \| $ / shares	0
Forfeited (in dollars per share) \| $ / shares	11.93
Vested (in dollars per share) \| $ / shares	8.94
Outstanding and unvested at the at the end of the period (in dollars per share) \| $ / shares	$ 15.21

Income Taxes (Details) - USD ($)	3 Months Ended		9 Months Ended
Income Taxes (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Provision for income taxes
Provision for income taxes	$ 0	$ 0	$ 0	$ 0

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Condensed Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 114,833	$ 124,775
Short-term investments	0	42,086
Accounts receivable	42,623	33,729
Prepaid clinical development costs	3,049	1,026
Inventories, net	51,435	35,201
Other prepaid and current assets	6,287	9,866
Total current assets	218,227	246,683
Noncurrent assets:
Property and equipment, net	6	164
Right of use operating lease assets	3,016	1,036
Intangible assets	56	56
Total assets	221,305	247,939
Current liabilities:
Accounts payable	26,214	23,040
Accrued clinical development costs	3,454	5,426
Accrued variable consideration	31,102	21,987
Other accrued liabilities	19,284	13,204
Revenue interest liability	37,013	24,760
Deferred revenue from collaborations	19,723	3,507
Operating lease liabilities	918	384
Total current liabilities	137,708	92,308
Noncurrent liabilities:
Convertible notes, net of issuance costs	261,165	259,899
Revenue interest liability	230,387	218,845
Operating lease liabilities	2,049	665
Total liabilities	631,309	571,717
Commitments and contingencies (Note 5)
Stockholders’ equity:
Preferred stock, $0.001 par value; 5,000,000 shares authorized and no shares issued or outstanding as of September 30, 2023 and December 31, 2022	0	0
Common stock, $0.001 par value; 480,000,000 shares authorized as of September 30, 2023 and 240,000,000 shares authorized as of December 31, 2022; 114,130,645 shares issued at September 30, 2023 and 76,564,396 shares issued at December 31, 2022	112	75
Additional paid-in capital	1,137,822	1,071,183
Treasury stock, at cost; 1,994,198 shares at September 30, 2023 and December 31, 2022	(54,998)	(54,998)
Accumulated other comprehensive loss	0	(2)
Accumulated deficit	(1,492,940)	(1,340,036)
Total stockholders’ deficit	(410,004)	(323,778)
Total liabilities and stockholders’ deficit	$ 221,305	$ 247,939

Convertible Notes (Details) $ / shares in Units, $ in Millions				1 Months Ended	3 Months Ended		9 Months Ended
	Nov. 03, 2021 shares	Oct. 22, 2021 USD ($) $ / shares	Nov. 16, 2020 USD ($) $ / shares shares	Nov. 30, 2020 USD ($) day $ / shares	Sep. 30, 2023 USD ($) $ / shares	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) $ / shares shares	Sep. 30, 2022 USD ($)	Dec. 31, 2022 USD ($) $ / shares
Debt Instrument [Line Items]
Purchase of capped call options associated with convertible notes			$ 46.0	$ 46.0
Prepayment of forward stock repurchase transaction			$ 55.0	55.0
Common stock, par value (in dollars per share) \| $ / shares					$ 0.001		$ 0.001		$ 0.001
Underlying common stock (in shares) \| shares			1,994,198
Shares delivered to the company (in shares) \| shares							448,698
Capped Call \| Common stock
Debt Instrument [Line Items]
Exercise price (in dollars per share) \| $ / shares			$ 55.16
Class of warrant or right, premium percentage			100.00%
Convertible Senior Notes Due 2025 \| Convertible Debt
Debt Instrument [Line Items]
Debt instrument, face amount				$ 280.0
Debt instrument, stated interest rate				4.00%
Proceeds from debt, net of issuance costs				$ 271.1
Debt instrument, convertible, conversion ratio				30.2151
Debt instrument, convertible, conversion price (in dollars per share) \| $ / shares				$ 33.096
Debt instrument, redemption price, percentage				100.00%
Exchange Agreement, amount of principal amount converted into common stock		$ 15.0
Exchange Agreement, weighted average price per share floor (in dollars per share) \| $ / shares		$ 5.62
Exchange Agreement, threshold trading days		5 days
Common stock being exchanged (in shares) \| shares	1,094,848
Principal amount of convertible notes					$ 265.0		$ 265.0
Debt issuance costs					3.8		3.8
Long-term debt					261.2		261.2
Debt interest expense					3.1	$ 3.1	9.2	$ 9.2
Debt fair value					$ 137.5		$ 137.5		$ 145.9
Convertible Senior Notes Due 2025 \| Convertible Debt \| Purchaser Discounts And Commissions And Offering Expenses Payable
Debt Instrument [Line Items]
Unamortized debt discount and issuance costs				$ 8.9
Convertible Senior Notes Due 2025 \| Convertible Debt \| Period One
Debt Instrument [Line Items]
Common stock, par value (in dollars per share) \| $ / shares				$ 0.001
Debt instrument, convertible, threshold percentage of stock price trigger				130.00%
Debt instrument, convertible, threshold trading days \| day				20
Average trading-day period \| day				30
Number of business days \| day				5
Number of consecutive trading days \| day				5
Debt instrument, convertible, threshold percentage of last reported sale price				98.00%
Convertible Senior Notes Due 2025 \| Convertible Debt \| Period Two
Debt Instrument [Line Items]
Debt instrument, convertible, threshold percentage of stock price trigger				130.00%
Debt instrument, convertible, threshold trading days \| day				20
Average trading-day period \| day				30
Debt instrument, redemption price, percentage				100.00%
Debt instrument, required amount outstanding				$ 125.0

Statements of Cash Flows and Restricted Cash

9 Months Ended

Sep. 30, 2023

Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents [Abstract]

Statements of Cash Flows and Restricted Cash


	September 30, 2023		September 30, 2022		December 31, 2022		December 31, 2021
Cash and cash equivalents	$	114,833	$	159,399	$	124,775	$	208,892
Restricted cash	—		50,000		—		50,000
Total cash and cash equivalents and restricted cash shown on the condensed statements of cash flows	$	114,833	$	209,399	$	124,775	$	258,892

Condensed Statements of Stockholders' Deficit - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)	Treasury Stock
Beginning balance (in shares) at Dec. 31, 2021		60,879,496
Beginning balance at Dec. 31, 2021	$ (196,944)	$ 61	$ 964,401	$ (1,106,377)	$ (31)	$ (54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		55,286
Vesting of ESPP Shares (in shares)		123,785
Vesting of ESPP Shares	431		431
Stock-based compensation	4,436		4,436
Other comprehensive income (loss)	(232)				(232)
Net loss	(56,731)			(56,731)
Ending balance (in shares) at Mar. 31, 2022		61,058,567
Ending balance at Mar. 31, 2022	(249,040)	$ 61	969,268	(1,163,108)	(263)	(54,998)
Beginning balance (in shares) at Dec. 31, 2021		60,879,496
Beginning balance at Dec. 31, 2021	(196,944)	$ 61	964,401	(1,106,377)	(31)	(54,998)
Increase (Decrease) in Stockholders' Equity
Net loss	(178,172)
Ending balance (in shares) at Sep. 30, 2022		71,745,122
Ending balance at Sep. 30, 2022	(294,100)	$ 72	1,045,468	(1,284,549)	(93)	(54,998)
Beginning balance (in shares) at Mar. 31, 2022		61,058,567
Beginning balance at Mar. 31, 2022	(249,040)	$ 61	969,268	(1,163,108)	(263)	(54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		184,407
Stock-based compensation	3,527		3,527
Issuance of common stock from ATM program, net of issuance costs (in shares)		3,353,000
Issuance of common stock from ATM program, net of issuance costs	20,173	$ 4	20,169
Other comprehensive income (loss)	(34)				(34)
Net loss	(66,324)			(66,324)
Ending balance (in shares) at Jun. 30, 2022		64,595,974
Ending balance at Jun. 30, 2022	(291,698)	$ 65	992,964	(1,229,432)	(297)	(54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		108,200
Vesting of ESPP Shares (in shares)		82,423
Vesting of ESPP Shares	301		301
Stock-based compensation	3,537		3,537
Issuance of common stock from ATM program, net of issuance costs (in shares)		6,958,525
Issuance of common stock from ATM program, net of issuance costs	48,673	$ 7	48,666
Other comprehensive income (loss)	204				204
Net loss	(55,117)			(55,117)
Ending balance (in shares) at Sep. 30, 2022		71,745,122
Ending balance at Sep. 30, 2022	(294,100)	$ 72	1,045,468	(1,284,549)	(93)	(54,998)
Beginning balance (in shares) at Dec. 31, 2022		74,570,198
Beginning balance at Dec. 31, 2022	(323,778)	$ 75	1,071,183	(1,340,036)	(2)	(54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		372,117
Vesting of ESPP Shares (in shares)		95,654
Vesting of ESPP Shares	502		502
Stock-based compensation	2,903		2,903
Issuance of common stock, warrants, and pre-funded warrants, net of issuance costs (in shares)		12,205,000
Issuance of common stock, warrants, and pre-funded warrants, net of issuance costs	52,428	$ 12	52,416
Other comprehensive income (loss)	1				1
Net loss	(61,719)			(61,719)
Ending balance (in shares) at Mar. 31, 2023		87,242,969
Ending balance at Mar. 31, 2023	(329,663)	$ 87	1,127,004	(1,401,755)	(1)	(54,998)
Beginning balance (in shares) at Dec. 31, 2022		74,570,198
Beginning balance at Dec. 31, 2022	(323,778)	$ 75	1,071,183	(1,340,036)	(2)	(54,998)
Increase (Decrease) in Stockholders' Equity
Net loss	(152,904)
Ending balance (in shares) at Sep. 30, 2023		112,136,447
Ending balance at Sep. 30, 2023	(410,004)	$ 112	1,137,822	(1,492,940)	0	(54,998)
Beginning balance (in shares) at Mar. 31, 2023		87,242,969
Beginning balance at Mar. 31, 2023	(329,663)	$ 87	1,127,004	(1,401,755)	(1)	(54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		215,903
Vesting of restricted stock units	1	$ 1
Stock-based compensation	3,160		3,160
Issuance of common stock from ATM program, net of issuance costs (in shares)		3,312,908
Issuance of common stock from ATM program, net of issuance costs	4,448	$ 3	4,445
Exercise of pre-funded warrants (in shares)		10,098,747
Exercise of pre-funded warrants	10	$ 10
Other comprehensive income (loss)	1				1
Net loss	(49,935)			(49,935)
Ending balance (in shares) at Jun. 30, 2023		100,870,527
Ending balance at Jun. 30, 2023	(371,978)	$ 101	1,134,609	(1,451,690)	0	(54,998)
Increase (Decrease) in Stockholders' Equity
Vesting of restricted stock units and performance-based restricted stock units (in shares)		223,490
Vesting of ESPP Shares (in shares)		175,430
Vesting of ESPP Shares	238		238
Stock-based compensation	2,975		2,975
Exercise of pre-funded warrants (in shares)		10,867,000
Exercise of pre-funded warrants	11	$ 11
Net loss	(41,250)			(41,250)
Ending balance (in shares) at Sep. 30, 2023		112,136,447
Ending balance at Sep. 30, 2023	$ (410,004)	$ 112	$ 1,137,822	$ (1,492,940)	$ 0	$ (54,998)

Net Loss Per Common Share

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Net Loss Per Common Share

Basic net loss per share is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Pre-Funded Warrants are included in the weighted-average number of common shares outstanding during the periods. Diluted net loss per share is computed by dividing net loss by the weighted-average number of common stock equivalents outstanding for the period, including shares that potentially could be dilutive if they were exercised or vested during the period, determined using the treasury-stock method. For purposes of this calculation, warrants for common stock, stock options, PBSOs, unvested RSUs and PBRSUs, shares issuable under the ESPP and shares issuable upon conversion of the convertible notes are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive.

The shares outstanding at the end of the respective periods presented below were excluded from the calculation of diluted net loss per share due to their anti-dilutive effect:


	September 30,
	2023	2022
Common shares under option	3,706,191	3,784,955
Common shares under PBSOs	661,850	499,200
Unvested RSUs	3,182,857	1,654,600
Unvested PBRSUs	174,775	461,250
Shares issuable related to the ESPP	—	9,237
Shares issuable upon conversion of convertible notes	8,007,010	8,007,010
Warrants	70,135,033	36,964,286
Total potential dilutive shares	85,867,716	51,380,538

Stockholders' Deficit (Details) - USD ($) $ / shares in Units, $ in Thousands						3 Months Ended		9 Months Ended
	Mar. 22, 2023	Mar. 19, 2023	Feb. 23, 2023	Apr. 15, 2022	Dec. 02, 2021	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Mar. 23, 2023	Dec. 31, 2022	Dec. 31, 2021
Subsidiary, Sale of Stock [Line Items]
Payment of issuance costs								$ 0	$ 219
Total shares of common stock from exercisable warrants outstanding (in shares)						70,135,033		70,135,033			36,964,286
Common stock, issued (in shares)						114,130,645		114,130,645			76,564,396
Common stock, par value (in dollars per share)						$ 0.001		$ 0.001			$ 0.001
Issuance costs to additional paid in capital		$ 2,900
Proceeds from issuance of common stock from ATM program, net of issuance costs								$ 4,448	$ 68,861
The Warrants
Subsidiary, Sale of Stock [Line Items]
Exercise price (in dollars per share)		$ 1.55
Pre Funded Warrant
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)						0		0
Fair value of warrants		$ 22,800
Warrants exercised (in shares)						10,867,000		20,965,747
Wainwright
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)					36,964,286	27,940,074		27,940,074			36,964,286
Exercise price (in dollars per share)					$ 9.00	$ 9.00		$ 9.00
Fair value of warrants					$ 61,900
Securities Purchase Agreement
Subsidiary, Sale of Stock [Line Items]
Total shares of common stock from exercisable warrants outstanding (in shares)						33,170,747		33,170,747			0
Exercise price (in dollars per share)						$ 1.55		$ 1.55
Common stock, issued (in shares)		12,205,000
Common stock, par value (in dollars per share)		$ 0.001
Common stock purchasable under prefunded warrants (in shares)		20,965,747
Common stock purchasable under warrants (in shares)		33,170,747
Securities Purchase Agreement \| Common Stock And Accompanying Warrant
Subsidiary, Sale of Stock [Line Items]
Purchase price (in dollars per share)		$ 1.675
Securities Purchase Agreement \| Pre Funded Warrant And Accompanying Warrant
Subsidiary, Sale of Stock [Line Items]
Purchase price (in dollars per share)		$ 1.674
Warrant Amendment Agreements
Subsidiary, Sale of Stock [Line Items]
Gross proceeds	$ 55,500	$ 1,200
Total shares of common stock from exercisable warrants outstanding (in shares)						9,024,212		9,024,212			0
Exercise price (in dollars per share)	$ 1.55					$ 1.55		$ 1.55		$ 1.55		$ 9.00
Common stock purchasable under warrants (in shares)	9,024,212
Warrants issued for shares of common stock (in shares)		9,024,212
Additional consideration per amended warrant (in dollars per share)	$ 0.125
Estimated offering expenses		$ 4,200
Proceeds from issuance of common stock from ATM program, net of issuance costs		$ 51,300
Placement fees	$ 100
Proceeds from warrant amendment	$ 1,100
At The Market Program
Subsidiary, Sale of Stock [Line Items]
Aggregate offering price shares			$ 70,000	$ 239,000
Issued stock (in shares)						0	6,958,525	3,312,908	10,311,525
Gross proceeds							$ 48,600	$ 4,400	$ 68,800
Payment of issuance costs							$ 1,600	$ 400	$ 2,400

Summary of Significant Accounting Policies (Policies)	9 Months Ended
Summary of Significant Accounting Policies (Policies)	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed interim financial statements are unaudited and were prepared by the Company in accordance with generally accepted accounting principles in the United States of America (“GAAP”). In the opinion of management, the Company has made all adjustments, which include only normal recurring adjustments necessary for a fair presentation of the Company’s financial position and results of operations for the interim periods presented. Certain prior year amounts have been reclassified to conform with current year presentation. Certain information and disclosures normally included in the annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, have been condensed or omitted. These condensed interim financial statements should be read in conjunction with the audited financial statements as of and for the year ended December 31, 2022, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022. The results of operations for the interim periods are not necessarily indicative of the results to be expected for a full year, any other interim periods or any future year or period.
Use of Estimates	Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles in the United States requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, net revenues, expenses and related disclosures. Actual results could differ from those estimates.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company invests its excess cash in bank deposits, money market accounts, and short-term investments. The Company considers all highly liquid investments with an original maturity of 90 days or less at the time of purchase to be cash equivalents. Cash equivalents are reported at fair value.
Investments	Investments Investments are considered to be available-for-sale and are carried at fair value. Unrealized gains and losses, if any, are reported in accumulated other comprehensive income (loss). The cost of investments classified as available-for-sale are adjusted for the amortization of premiums and accretion of discounts to maturity and recorded in other income, net. Realized gains and losses, if any, are determined using the specific identification method and recorded in other income, net. Investments with original maturities beyond 90 days at the date of purchase and which mature at, or less than twelve months from, the balance sheet date are classified as current. Investments with a maturity beyond twelve months from the balance sheet date are classified as long-term.
Concentration of Risk	Concentration of Risk The Company enters into a limited number of distribution agreements with distributors and specialty pharmacies. The Company's net product sales are with these customers. As of September 30, 2023 and December 31, 2022, eleven customers accounted for all of the Company's net trade receivables.
Revenue Recognition	Revenue Recognition In accordance with ASC 606, Revenue from Contracts with Customers, the Company recognizes revenue when a customer obtains control of promised goods or services, in an amount that reflects the consideration the Company expects to receive in exchange for the goods or services provided. To determine revenue recognition for arrangements within the scope of ASC 606, the Company performs the following five steps: identify the contracts with a customer; identify the performance obligations in the contract; determine the transaction price; allocate the transaction price to the performance obligations in the contract; and recognize revenue when or as the entity satisfies a performance obligation. At contract inception the Company assesses the goods or services promised within each contract and determines those that are performance obligations and assesses whether each promised good or service is distinct. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when or as the performance obligation is satisfied. The Company derives revenue through two primary sources: collaboration revenue and product sales. Collaboration revenue consists of the collaboration payments to the Company for collaboration arrangements outside of the United States for the development, manufacturing and commercialization, including royalties, of the Company's product candidates by the Company's partners and product sales consists of sales of NEXLETOL and NEXLIZET. a.Collaboration Revenue The Company has entered into agreements related to its activities to develop, manufacture, and commercialize its product candidates. The Company earns collaboration revenue in connection with a collaboration agreement to develop and/or commercialize product candidates where the Company deems the collaborator to be the customer. Revenue is recognized when (or as) the Company satisfies performance obligations under the terms of a contract. Depending on the terms of the arrangement, the Company may defer the recognition of all or a portion of the consideration received as the performance obligations are satisfied. The collaboration agreements may require the Company to deliver various rights, services, and/or goods across the entire life cycle of a product or product candidate. In an agreement involving multiple goods or services promised to be transferred to a customer, the Company must assess, at the inception of the contract, whether each promise represents a separate performance obligation (i.e., is "distinct"), or whether such promises should be combined as a single performance obligation. The terms of the agreement typically include consideration to be provided to the Company in the form of non-refundable up-front payments, development milestones, sales milestones, and royalties on sales of products within a respective territory. The Company recognizes regulatory and approval milestones as consideration when it is probable that a future reversal is unlikely to occur. For sales-based milestones and royalties based on sales of product in a territory, the Company applies the sales-based royalty exception in ASC 606-10-55-65 to all of these milestones and royalties. At the inception of the contract, the transaction price reflects the amount of consideration the Company expects to be entitled to in exchange for transferring promised goods or services to its customer. In the arrangement where the Company satisfies performance obligation(s) during the regulatory phase over time, the Company recognizes collaboration revenue typically using an input method on the basis of regulatory costs incurred relative to the total expected cost which determines the extent of progress toward completion. The Company reviews the estimate of the transaction price and the total expected cost each period and makes revisions to such estimates as necessary. Under contracted supply agreements with collaborators, the Company, through its third party contract manufacturing partners, may manufacture and supply quantities of active pharmaceutical ingredient (“API”) or bulk tablets reasonably required by collaboration partners for the development or sale of licensed products in their respective territory. The Company recognizes revenue when the collaboration partner has obtained control of the API or bulk tablets. The Company records the costs related to the supply agreement in cost of goods sold on the condensed statements of operations and comprehensive (loss) income. Under the Company's collaboration agreements, product sales and cost of sales may be recorded by the Company's collaborators as they are deemed to be the principal in the transaction. The Company receives royalties from the commercialization of such products, and records its share of the variable consideration, representing a percentage of net product sales, as collaboration revenue in the period in which such underlying sales occur and costs are incurred by the collaborator. b.Product Sales, Net On February 21, 2020, the Company announced that the FDA approved NEXLETOL as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with HeFH or established ASCVD who require additional lowering of LDL-C. On February 26, 2020, the Company announced that the FDA approved NEXLIZET as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with HeFH or established ASCVD who require additional lowering of LDL-C. On March 30, 2020, NEXLETOL was commercially available in the U.S. through prescription and on June 4, 2020, NEXLIZET was commercially available in the U.S. through prescription. Net product sales totaled $20.3 million and $57.6 million for the three and nine months ended September 30, 2023, respectively, and $14.0 million and $40.9 million for the three and nine months ended September 30, 2022, respectively. The Company sells NEXLETOL and NEXLIZET to wholesalers in the U.S. and, in accordance with ASC 606, recognizes revenue at the point in time when the customer is deemed to have obtained control of the product. The customer is deemed to have obtained control of the product at the time of physical receipt of the product at the customers’ distribution facilities, or free on board (“FOB”) destination, the terms of which are designated in the contract. Product sales are recorded at the net selling price, which includes estimates of variable consideration for which reserves are established for (a) rebates and chargebacks, (b) co-pay assistance programs, (c) distribution fees, (d) product returns, and (e) other discounts. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as current contractual and statutory requirements, and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company's best estimates of the amount of consideration to which it is entitled based on the terms of the applicable contract. The amount of variable consideration may be constrained and is included in the net sales price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Given the early stage of the Company’s commercial operations it has provided constraint of its variable consideration due to its potential consumption trends. Actual amounts of consideration ultimately received may differ from the Company's estimates. If actual results in the future vary from estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Liabilities for co-pay assistance, expected product returns, rebates, and distributor fees are classified as “Accrued variable consideration” in the condensed balance sheets. Discounts, such as prompt pay discounts, and chargebacks are recorded as a reduction to trade accounts receivable in the condensed balance sheets. Forms of Variable Consideration Rebates and Chargebacks: The Company estimates reductions to product sales for Public Health Service Institutions, such as Medicaid, Medicare and Veterans' Administration ("VA") programs, as well as certain other qualifying federal and state government programs, and other group purchasing organizations. The Company estimates these reductions based upon the Company's contracts with government agencies and other organizations, statutorily defined discounts and estimated payor mix. These organizations purchase directly from the Company's wholesalers at a discount and the wholesalers charge the Company back the difference between the wholesaler price and the discounted price. The Company's liability for Medicaid rebates consists of estimates for claims that a state will make for a current quarter. The Company's reserve for this discounted pricing is based on expected sales to qualified healthcare providers and the chargebacks that customers have already claimed. Co-pay assistance: Eligible patients who have commercial insurance may receive assistance from the Company to reduce the patient's out of pocket costs. The Company will buy down the difference between the amount of the eligible patient's co-pay when the drug is purchased at the pharmacy at a determined price. Liabilities for co-pay assistance are calculated by actual program participation from third-party administrators. Distribution Fees: The Company has written contracts with its customers that include terms for distribution fees and costs for inventory management. The Company estimates and records distribution fees due to its customers based on gross sales. Product Returns: The Company generally offers a right of return based on the product’s expiration date and certain spoilage and damaged instances. The Company estimates the amount of product sales that may be returned and records the estimate as a reduction of product sales in the period the related product sales is recognized. The Company’s estimates for expected returns are based primarily on an ongoing analysis of sales information and visibility into the inventory remaining in the distribution channel. Discounts: The Company provides product discounts, such as prompt pay discounts, to its customers. The Company estimates cash discounts based on terms in negotiated contracts and the Company’s expectations regarding future payment patterns.
Inventories	Inventories Inventories are stated at the lower of cost or net realizable value and recognized on a first-in, first-out ("FIFO") method. The Company uses standard cost to determine the cost basis for inventory. Inventory is capitalized based on when future economic benefit is expected to be realized. The Company analyzes its inventory levels on a periodic basis to determine if any inventory is at risk for expiration prior to sale or has a cost basis that is greater than its estimated future net realizable value. Any adjustments are recognized through cost of goods sold in the period in which they are incurred.
Recently Implemented Accounting Pronouncements	Recently Implemented Accounting Pronouncements There have been no other material changes to the significant accounting policies previously disclosed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022.

- Definition

Disclosure of inventory accounting policy for inventory classes, including, but not limited to, basis for determining inventory amounts, methods by which amounts are added and removed from inventory classes, loss recognition on impairment of inventories, and situations in which inventories are stated above cost.

+ References + Details

Stockholders' Deficit (Tables)

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Summary of Warrants and Pre-funded Warrants Outstanding

The following table summarizes the warrants outstanding for the Company as of September 30, 2023 and December 31, 2022:


	September 30, 2023	December 31, 2022	Weighted average exercise price
Warrants outstanding from 2021 agreement, expiring December 7, 2023	27,940,074	36,964,286	$	9.00
Warrants outstanding from Warrant Amendment Agreements, expiring September 22, 2026	9,024,212	—	$	1.55
Warrants outstanding from Purchase Agreement, expiring September 22, 2026	33,170,747	—	$	1.55
Total warrants outstanding	70,135,033	36,964,286

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThere was no provision for income taxes for the three and nine months ended September 30, 2023 and 2022, because the Company has incurred annual operating losses since inception. At September 30, 2023, the Company continues to conclude that it is not more likely than not that the Company will realize the benefit of its deferred tax assets due to its history of losses. Accordingly, a full valuation allowance has been applied against the net deferred tax assets.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Other Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2023

Payables and Accruals [Abstract]

Schedule of Other Accrued Liabilities

Other accrued liabilities consist of the following (in thousands):


	September 30, 2023		December 31, 2022
Accrued compensation	$	8,246	$	9,053
Accrued professional fees	6,773		2,547
Accrued interest on convertible notes	3,975		1,325
Accrued other	290		279
Total other accrued liabilities	$	19,284	$	13,204

Stock Compensation - Schedule of Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Number of Options
Outstanding at the beginning of period (in shares)	3,842,737
Granted (in shares)	1,550,200
Forfeited or expired (in shares)	(1,686,746)
Exercised (in shares)	0
Outstanding at the end of the period (in shares)	3,706,191	3,842,737
Vested and expected to vest (in shares)	3,706,191
Exercisable (in shares)	1,563,571
Weighted-Average Exercise Price Per Share
Outstanding at the beginning of period (in dollars per share)	$ 27.75
Granted (in dollars per share)	3.53
Forfeited or expired (in dollars per share)	36.05
Exercised (in dollars per share)	0
Outstanding at the end of the period (in dollars per share)	13.84	$ 27.75
Vested and expected to vest (in dollars per share)	13.84
Exercisable (in dollars per share)	$ 25.48
Weighted-Average Remaining Contractual Term (Years)
Outstanding	7 years 8 months 12 days	4 years 10 months 9 days
Vested and expected to vest	7 years 8 months 12 days
Exercisable	5 years 9 months 7 days
Aggregate Intrinsic Value
Outstanding	$ 0	$ 1,658
Vested and expected to vest	0
Exercisable	$ 0

Stock Compensation (Tables)

9 Months Ended

Sep. 30, 2023

Share-Based Payment Arrangement [Abstract]

Summary of Activity Relating to the Company's Options and Performance-Based Options to Purchase Common Stock

The following table summarizes the activity relating to the Company’s options to purchase common stock for the nine months ended September 30, 2023:


	Number of Options	Weighted-Average Exercise Price Per Share		Weighted-Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
					(in thousands)
Outstanding at December 31, 2022	3,842,737	$	27.75	4.86	$	1,658
Granted	1,550,200	$	3.53
Forfeited or expired	(1,686,746)	$	36.05
Exercised	—	$	—
Outstanding at September 30, 2023	3,706,191	$	13.84	7.70	$	—
Vested and expected to vest at September 30, 2023	3,706,191	$	13.84	7.70	$	—
Exercisable at September 30, 2023	1,563,571	$	25.48	5.77	$	—

The following table summarizes the activity relating to the Company’s PBSOs for the nine months ended September 30, 2023:


	Number of Options	Weighted-Average Exercise Price Per Share		Weighted-Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
					(in thousands)
Outstanding at December 31, 2022	499,200	$	6.73	9.32	$	12
Granted	227,900	$	1.62
Forfeited or expired	(65,250)	$	6.76
Exercised	—	$	—
Outstanding at September 30, 2023	661,850	$	4.97	8.88	$	—
Vested and expected to vest at September 30, 2023	661,850	$	4.97	8.88	$	—
Exercisable at September 30, 2023	48,100	$	8.94	6.12	$	—

Summary of Activity Relating to the Company's RSUs

The following table summarizes the activity relating to the Company’s RSUs for the nine months ended September 30, 2023:


	Number of RSUs	Weighted-Average Fair Value Per Share
Outstanding and unvested December 31, 2022	1,768,185	$	8.80
Granted	2,290,785	$	3.38
Forfeited	(265,328)	$	7.65
Vested	(610,785)	$	8.35
Outstanding and unvested September 30, 2023	3,182,857	$	7.71

Summary of Activity Relating to the Company's PBRSU's

The following table summarizes the activity relating to the Company's PBRSUs for the nine months ended September 30, 2023:


	Number of PBRSUs	Weighted-average fair value per share
Outstanding December 31, 2022	461,250	$	9.50
Granted	—	$	—
Forfeited	(85,750)	$	11.93
Vested	(200,725)	$	8.94
Outstanding and unvested September 30, 2023	174,775	$	15.21

Statements of Cash Flows and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Sep. 30, 2022	Dec. 31, 2021
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents [Abstract]
Cash and cash equivalents	$ 114,833	$ 124,775	$ 159,399	$ 208,892
Restricted cash	0	0	50,000	50,000
Total cash and cash equivalents and restricted cash shown on the condensed statements of cash flows	$ 114,833	$ 124,775	$ 209,399	$ 258,892

Commitments and Contingencies (Details) - USD ($) $ in Millions	May 04, 2023	Mar. 27, 2023	Mar. 04, 2023
Loss Contingencies [Line Items]
Partner milestone payments	$ 300	$ 300	$ 300
Cardiovascular Risk \| Minimum
Loss Contingencies [Line Items]
Percentage of risk reduction		20.00%	15.00%
Cardiovascular Risk \| Maximum
Loss Contingencies [Line Items]
Percentage of risk reduction			20.00%
Cardiovascular Risk Outcome Less than Twenty Percent \| Minimum
Loss Contingencies [Line Items]
Partner milestone payments			$ 200
Cardiovascular Risk Outcome Greater than Twenty Percent \| Maximum
Loss Contingencies [Line Items]
Partner milestone payments			$ 300
Relative Risk
Loss Contingencies [Line Items]
Percentage of risk reduction			20.00%

Stock Compensation - Stock Options Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Apr. 30, 2020	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Aug. 31, 2023	Jun. 30, 2023	May 31, 2022
Stock Option And Incentive Plan 2022
Stock compensation
Number of commons stock shares available for issuance (in shares)							10,650,000	4,400,000
Inducement Equity Plan 2017
Stock compensation
Number of commons stock shares available for issuance (in shares)						2,650,000
ESPP
Stock compensation
Maximum annual contributions per employee, as a percentage of base salary	10.00%
Amount of maximum annual contributions per employee	$ 25
Purchase discount	15.00%
Duration of offering periods	6 months
Stock-based compensation expense		$ 100	$ 100	$ 300	$ 300
Shares issued (in shares)				610,506
Shares reserved for future issuance (in shares)		214,494		214,494
Stock options
Stock compensation
Stock-based compensation expense		$ 900	1,400	$ 2,900	4,300
Stock-based compensation capitalized into inventory		100	200	200	400
Unrecognized stock-based compensation expense, options		7,600		$ 7,600
Weighted-average period over which remaining unrecognized compensation cost will be recognized				2 years 6 months
PBSOs
Stock compensation
Stock-based compensation expense		200	300	$ 600	500
Unrecognized stock-based compensation expense, options		800		$ 800
Weighted-average period over which remaining unrecognized compensation cost will be recognized				8 months 12 days
RSUs
Stock compensation
Stock-based compensation expense		1,600	1,500	$ 4,900	5,100
Stock-based compensation capitalized into inventory		200	200	300	500
Unrecognized stock-based compensation expense, options		15,100		$ 15,100
Weighted-average period over which remaining unrecognized compensation cost will be recognized				2 years 8 months 12 days
PBRSUs
Stock compensation
Stock-based compensation expense		100	200	$ 300	1,300
Stock-based compensation capitalized into inventory		100	$ 100	$ 100	$ 100
Weighted-average period over which remaining unrecognized compensation cost will be recognized				8 months 12 days
Unrecognized stock-based compensation expense, RSUs		$ 400		$ 400

Investments (Tables)

9 Months Ended

Sep. 30, 2023

Investments, Debt and Equity Securities [Abstract]

Schedule of Company's Cash Equivalents and Short-Term Investments

The following table summarizes the Company’s cash equivalents and short-term investments (in thousands):


	September 30, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Estimated Fair Value
Cash equivalents:
Money market funds	$	88,374	$	—	$	—	$	88,374
Certificates of deposit	402		—		—		402


Total	$	88,776	$	—	$	—	$	88,776


	December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Estimated Fair Value
Cash equivalents:
Money market funds	$	105,078	$	—	$	—	$	105,078
U.S. treasury notes	4,994		1		—		4,995

Certificates of deposit	401		—		—		401
Short-term investments:

U.S. treasury notes	42,089		2		(5)		42,086

Total	$	152,562	$	3	$	(5)	$	152,560

Stock Compensation - PBSOs (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Number of Options
Outstanding at the beginning of period (in shares)	3,842,737
Granted (in shares)	1,550,200
Forfeited or expired (in shares)	(1,686,746)
Exercised (in shares)	0
Outstanding at the end of the period (in shares)	3,706,191	3,842,737
Vested and expected to vest (in shares)	3,706,191
Exercisable (in shares)	1,563,571
Weighted-Average Exercise Price Per Share
Outstanding at the beginning of period (in dollars per share)	$ 27.75
Granted (in dollars per share)	3.53
Forfeited or expired (in dollars per share)	36.05
Exercised (in dollars per share)	0
Outstanding at the end of the period (in dollars per share)	13.84	$ 27.75
Vested and expected to vest (in dollars per share)	13.84
Exercisable (in dollars per share)	$ 25.48
Weighted-Average Remaining Contractual Term (Years)
Outstanding	7 years 8 months 12 days	4 years 10 months 9 days
Vested and expected to vest	7 years 8 months 12 days
Exercisable	5 years 9 months 7 days
Aggregate Intrinsic Value
Outstanding	$ 0	$ 1,658
Vested and expected to vest	0
Exercisable	$ 0
PBSOs
Number of Options
Outstanding at the beginning of period (in shares)	499,200
Granted (in shares)	227,900
Forfeited or expired (in shares)	(65,250)
Exercised (in shares)	0
Outstanding at the end of the period (in shares)	661,850	499,200
Vested and expected to vest (in shares)	661,850
Exercisable (in shares)	48,100
Weighted-Average Exercise Price Per Share
Outstanding at the beginning of period (in dollars per share)	$ 6.73
Granted (in dollars per share)	1.62
Forfeited or expired (in dollars per share)	6.76
Exercised (in dollars per share)	0
Outstanding at the end of the period (in dollars per share)	4.97	$ 6.73
Vested and expected to vest (in dollars per share)	4.97
Exercisable (in dollars per share)	$ 8.94
Weighted-Average Remaining Contractual Term (Years)
Outstanding	8 years 10 months 17 days	9 years 3 months 25 days
Vested and expected to vest	8 years 10 months 17 days
Exercisable	6 years 1 month 13 days
Aggregate Intrinsic Value
Outstanding	$ 0	$ 12
Vested and expected to vest	0
Exercisable	$ 0

Condensed Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Revenues:
Total Revenues	$ 33,969	$ 18,980	$ 84,084	$ 56,657
Operating expenses:
Cost of goods sold	13,377	6,506	31,815	22,807
Research and development	14,885	29,143	68,365	85,894
Selling, general and administrative	33,240	24,954	97,100	84,944
Total operating expenses	61,502	60,603	197,280	193,645
Loss from operations	(27,533)	(41,623)	(113,196)	(136,988)
Interest expense	(14,995)	(14,153)	(43,919)	(42,481)
Other income, net	1,278	659	4,211	1,297
Net loss	$ (41,250)	$ (55,117)	$ (152,904)	$ (178,172)
Net loss per common share - basic (in dollars per share)	$ (0.37)	$ (0.81)	$ (1.53)	$ (2.78)
Net loss per common share - diluted (in dollars per share)	$ (0.37)	$ (0.81)	$ (1.53)	$ (2.78)
Weighted-average shares outstanding - basic (in shares)	111,869,478	67,806,292	99,973,647	64,021,248
Weighted-average shares outstanding - diluted (in shares)	111,869,478	67,806,292	99,973,647	64,021,248
Other comprehensive loss:
Unrealized gain (loss) on investments	$ 0	$ 204	$ 2	$ (62)
Comprehensive loss	(41,250)	(54,913)	(152,902)	(178,234)
Product sales, net
Revenues:
Total Revenues	20,251	13,964	57,575	40,896
Collaboration revenue
Revenues:
Total Revenues	$ 13,718	$ 5,016	$ 26,509	$ 15,761

Liability Related to the Revenue Interest Purchase Agreement - Summary of Revenue Interest Liability (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Liability From Sale Of Future Revenues [Roll Forward]
Revenue Interests payments	$ (10,908)	$ (5,678)
Revenue Interest Purchase Agreement (RIPA)
Liability From Sale Of Future Revenues [Roll Forward]
Revenue interest liability, beginning balance	243,605
Interest expense recognized	34,703
Revenue Interests payments	(10,908)
Revenue interest liability, ending balance	$ 267,400

Liability Related to the Revenue Interest Purchase Agreement

9 Months Ended

Sep. 30, 2023

On June 26, 2019, the Company entered into a Revenue Interest Purchase Agreement ("RIPA") with Oberland, as agent for purchasers party thereto (the “Purchasers”), and the Purchasers named therein, to obtain financing in respect to the commercialization and further development of bempedoic acid and the bempedoic acid / ezetimibe combination tablet and other working capital needs. Pursuant to the RIPA, the Company received $125.0 million at closing, less certain issuance costs. The Company was entitled to receive up to approximately $75.0 million in subsequent installments subject to the terms and conditions set forth in the RIPA: (i) $25.0 million upon certain regulatory approval of its product candidates and (ii) $50.0 million, at the Company’s option, upon reaching $100.0 million trailing worldwide six-month net sales any time prior to December 31, 2021 (the “Third Payment”). In March 2020, the Company received $25.0 million from Oberland upon receiving regulatory approval of NEXLETOL.

As consideration for such payments, the Purchasers will have a right to receive certain revenue interests (the “Revenue Interests”) from the Company based upon net sales of the Company’s certain products, once approved, which will be tiered payments initially ranging from 2.5% to 7.5% of the Company’s net sales in the covered territory (the “Covered Territory”); provided that if annual net sales equal or exceed the Sales Threshold and if the Purchasers receive 100% of their invested capital by December 31, 2024, the revenue interest rate will be decreased to a single rate of 0.4% of the Company’s net sales in the Covered Territory beginning on January 1, 2025. If the Third Payment is drawn down by the Company, the applicable royalty rates will increase by one-third. The Covered Territory is the United States, but is subject to expand to include the world-wide net sales if the Company’s annual U.S. net sales are less than $350.0 million for the year ended December 31, 2021. The U.S. net sales milestone thresholds are not to be taken as financial guidance. The Purchasers’ rights to receive the Revenue Interests shall terminate on the date on which the Purchasers have received Revenue Interests payments of 195% of the then aggregate purchase price (the “Cumulative Purchaser Payments”) paid to the Company, unless the RIPA is terminated earlier.

Under the RIPA, the Company has an option (the “Call Option”) to terminate the RIPA and repurchase future Revenue Interests at any time upon advance written notice. Additionally, the Purchasers have an option (the “Put Option”) to terminate the RIPA and to require the Company to repurchase future Revenue Interests upon enumerated events such as a bankruptcy event, an uncured material breach, a material adverse effect or a change of control.

In addition, the RIPA contains various representations and warranties, information rights, non-financial covenants, indemnification obligations and other provisions that are customary for a transaction of this nature.

RIPA Amendments

On April 26, 2021, the Company entered into Amendment No. 2 (the “RIPA Amendment 2”) to the RIPA with Oberland, as agent for the purchaser parties thereto. Pursuant to the RIPA Amendment 2, Oberland waived the original trailing six-month world-wide net sales condition to the third installment payment under the RIPA and released the final $50 million payment payable to the Company under the terms of the RIPA. The Company and Oberland also agreed to amend additional terms of the RIPA such that the purchasers will have a right to receive certain revenue interests (the “Revenue Interests”) from the Company based on net sales of the Company’s certain products, once approved, which will be tiered payments ranging from 3.33% to 10% (the “Third Payment Applicable Percentage”) of the Company’s net sales in the covered territory (the “Covered Territory”); provided that (a) prior to December 31, 2024, with respect to each country defined in the Daiichi Territory, if the percentage of net sales that Company receives from Daiichi (the “Receivables Percentage”) is less than the Third Payment Applicable Percentage, then the Revenue Interest for such country payable to the purchasers will be equal to the Receivables Percentages, (b) if annual net sales equal or exceed $350 million and if the Purchasers receive 100% of their invested capital (Cumulative Purchaser Payments") by December 31, 2024, the revenue interest rate will be decreased to a single rate of 3.33% of the Company’s net sales in the Covered Territory for all subsequent calendar quarters and (c) if the Purchasers receive Revenue Interest payments less than 100% of Cumulative Purchaser Payments by December 31, 2024, the Third Payment Applicable Percentage will be increased to a single rate of the Company’s net sales that would have provided 100% of Cumulative Purchaser Payments had such rate applied from the initial funding by the Purchasers. The Covered Territory was originally the United States, but has been expanded to worldwide for all calendar years beginning on or after January 1, 2022.

Under the RIPA Amendment 2, the Company has an option (the “Call Option”) to terminate the RIPA and repurchase future Revenue Interests at any time upon advance written notice. Additionally, the Purchasers have an option (the “Put Option”) to terminate the RIPA and to require the Company to repurchase future Revenue Interests upon enumerated events such as a bankruptcy event, an uncured material breach, a material adverse effect or a change of control. If the Put Option or the Call Option are exercised, the required repurchase price will be 200% of the Cumulative Purchaser Payments (minus all payments Company has made to the Purchasers in connection with the Revenue Interests), if such option is exercised prior to the third anniversary of the closing date, and 225% of the Cumulative Purchaser Payments (minus all payments Company has made to the Purchasers in connection with the Revenue Interests), if such option is exercised thereafter.

On May 16, 2021, the Company entered into an Amendment to the Security Agreement and Waiver ("Amendment and Waiver") with the same parties to the Security Agreement, by and among the Company, Eiger Partners II LP (the "Purchaser") and Eiger III SA LLC (the "Purchaser Agent"), dated as of June 26, 2019 (the "Security Agreement"). Pursuant to the Amendment and Waiver, if (i) the net revenue from sales of NEXLETOL and NEXLIZET and certain other products in the United States (as reported in the Company’s financial statements as “product sales, net” in accordance with GAAP and excluding, for the avoidance of doubt, upfront or milestone payments and other collaboration revenue) (the “Specified Net Revenue”) for the calendar quarter ended September 30, 2021 does not exceed $15.0 million, or (ii) the Specified Net Revenue for any calendar quarter ending after September 30, 2021 does not exceed $15.0 million, then the Company shall deposit $50.0 million in a deposit account that is subject to a block account control agreement in favor of the Purchase Agent, no later than the earlier of (x) the date the Specified Net Revenue for such calendar quarter has been determined and (y) 45 days after the last day of such calendar quarter. Since the Specified Net Revenue for the calendar quarter ended September 30, 2021 did not exceed $15.0 million, the Company deposited $50.0 million in a deposit account that is subject to a block account control agreement, which is classified as restricted cash on the balance sheets. The Purchaser Agent shall have sole dominion and control over all funds deposited in the deposited account and such funds may be withdrawn therefrom only with the consent of the Purchaser Agent. Upon the occurrence and during the continuance of a Put Option Event, the Purchaser Agent shall have the right to apply amounts held in the deposit account in payment of certain secured obligations in the manner provided for in the Security Agreement. The Amendment and Wavier does not substitute, replace or release the Pledgors from any other obligations under the RIPA or Security Agreement.

On November 23, 2022, the Company entered into Waiver and Amendment No. 3 to Revenue Interest Purchase Agreement and Amendment No. 2 to Security Agreement (the “RIPA Amendment 3”), by and among the Company, the Purchasers and the Purchaser Agent, which amends (i) the Revenue Interest Purchase Agreement, by and among the Company, the Purchasers, and the Purchaser Agent, dated effective as of June 26, 2019 (as amended by Amendment No. 1 to Revenue Interest Purchase Agreement dated as of November 9, 2020 and Amendment No. 2 to Revenue Interest Purchase Agreement dated as of April 26, 2021, and as may be further amended, restated, supplemented or modified from time to time, the “RIPA”) and (ii) the Security Agreement, by the Company in favor of the Purchaser Agent, dated as of June 28, 2019 (as amended by the Amendment to Security Agreement and Waiver by and among the Company, the Purchaser and the Purchaser Agent, effective as of May 16, 2021, and as may be further amended, restated, supplemented or modified from time to time, the “Security Agreement”). Pursuant to the RIPA Amendment 3, among other things, (a) the Company agreed to make a one-time partial call payment with regards to the Revenue Interests (as defined in the RIPA) in an amount equal to $50 million from the restricted cash account (the “Partial Call”), (b) the amount of the Cumulative Purchaser Payments (as defined in the RIPA) was reduced to

$177,777,778, and (c) the Purchasers and Purchaser Agent waived certain claimed defaults, breaches and Put Option Events under the RIPA and other related documents that may have occurred as a result of the Company’s opening of a new bank account.

In accordance with the guidance in ASC 470‑50, “Debt—Modifications and Extinguishments,” the RIPA Amendment 3 was accounted for as a debt modification. The amendment resulted in a less than $0.1 million loss on modification of debt, consisting of third-party fees associated with the transaction, which is included in selling, general, and administrative expenses in the statements of operations for the year ended December 31, 2022.

In connection with the arrangement, as of September 30, 2023, the Company has recorded a liability, referred to as the “Revenue interest liability” on the balance sheet, of $267.4 million, net of $0.3 million of capitalized issuance costs in connection with the RIPA, which will be amortized to interest expense over the estimated term of the RIPA. The total redemption amount is equal to 225% of the Cumulative Purchaser Payments, or $400 million. At September 30, 2023, the remaining redemption amount is $377.2 million. The Company imputes interest expense associated with this liability using the effective interest rate method. The effective interest rate is calculated based on the rate that would enable the debt to be repaid in full over the anticipated life of the arrangement. The interest rate on this liability may vary during the term of the agreement depending on a number of factors, including the level of forecasted net sales. The Company evaluates the interest rate quarterly based on its current net sales forecasts utilizing the prospective method.

A significant increase or decrease in future net sales will materially impact the revenue interest liability, interest expense and the time period for repayment. The Company recorded approximately $11.9 million and $34.7 million in interest expense related to this arrangement for the three and nine months ended September 30, 2023, respectively, and approximately $11.1 million and $33.3 million in interest expense related to this arrangement for the three and nine months ended September 30, 2022, respectively.

The repayment of the RIPA to Oberland does not have a fixed repayment schedule, rather it will be completely repaid and extinguished when the Company has repaid 225% of the Cumulative Purchaser Payments. Since there is not a fixed repayment schedule, the Company does not project its future repayments by year. Each period, the Company estimates the future expected sales of its products in the covered territory and determines the effective annual imputed interest rate, which updates and changes the timing of the Company’s payments. Under the terms of the agreement, every $100 million of net sales generated, less than or equal to $250 million in an annual aggregate year, would result in a repayment obligation of approximately $10.0 million or 10.0% at the stated repayment rate in the first year. Annual net sales for a calendar year exceeding $250 million would result in a repayment obligation of approximately $3.3 million or 3.3% for every $100 million of sales above the threshold. As the U.S. net sales were less than $350 million for the year ended December 31, 2021, the Covered Territory was expanded to include worldwide sales beginning in 2022. The Company’s repayments of the RIPA are directly tied to the growth of its net sales, and as the Company’s net sales grow, the Company expects the related repayments of the RIPA to grow as well. The Company currently expects to repay $37.0 million in the next twelve months.

The effective annual imputed interest rate is 17.9% as of September 30, 2023. Payments made to Oberland as a result of the Company’s net sales will reduce the revenue interest liability.

The following table summarizes the revenue interest liability activity during the nine months ended September 30, 2023:


	(in thousands)
Total revenue interest liability at December 31, 2022	$	243,605
Interest expense recognized	34,703
Revenue Interests payments	(10,908)
Total revenue interest liability at September 30, 2023	$	267,400

Inventories, net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 49,158	$ 26,558
Work in process	625	6,548
Finished goods	1,652	2,095
Total Inventory	$ 51,435	$ 35,201

Net Loss Per Common Share (Details) - shares	9 Months Ended
Net Loss Per Common Share (Details) - shares	Sep. 30, 2023	Sep. 30, 2022
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	85,867,716	51,380,538
Common shares under option
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	3,706,191	3,784,955
Common shares under PBSOs
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	661,850	499,200
Unvested RSUs
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	3,182,857	1,654,600
Unvested PBRSUs
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	174,775	461,250
Shares issuable related to the ESPP
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	0	9,237
Shares issuable upon conversion of convertible notes
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	8,007,010	8,007,010
Warrants
Net (Loss) Income Per Common Share
Total potential dilutive shares (in shares)	70,135,033	36,964,286