She is 61, in high-risk primary prevention, with type 2 diabetes, hypertension, and obesity. Her LDL-C is 112 mg/dL against a goal of under 70, despite a high-intensity statin plus ezetimibe. She needs substantial additional lowering, and she strongly prefers not to inject herself. Her physician keeps her background therapy, adds the new oral PCSK9 inhibitor LIPFENDRA, and plans to recheck in about three months.
She is one patient from a ZoomRx patient chart audit fielded seven weeks after LIPFENDRA’s approval. She is also a fair picture of who a new oral option reached first.
Why the first patients matter
In the first months of a launch, the patients a new brand reaches are rarely a cross-section of the market. Knowing who they are tells a brand team where the message is landing, which field conversations to prioritize, and which patients to study next. A share number alone cannot show this.
The first patients, side by side
Physicians in the pulse described 85 recent patient charts across three PCSK9-pathway brands.
|
Patient profile |
LIPFENDRA (oral, 25 charts) |
Repatha (injectable, 50 charts) |
|
Mean age |
53 |
60 |
|
Commercially insured |
88% |
56% |
Two more traits stood out among the 25 LIPFENDRA patients: 60% were in primary prevention, and 72% had asked for an oral option or for the brand by name.
Where the first patients came from
Most were new to the pathway. Physicians said 77% of their LIPFENDRA starts had no prior PCSK9-pathway therapy, and 52% came straight from a statin with or without ezetimibe.
Switches were the minority. They made up 23% of starts, and route or patient preference drove 5 of the 6 switches from an injectable recorded in the charts.
Physicians were also asked what each LIPFENDRA patient would otherwise have received. They named Repatha for 17 of 25 and Leqvio for 4. Those answers are physicians’ judgments about what would have happened, but they show the new option still sits in the same consideration set as the established injectables.
Who did not get it, and why
LIPFENDRA was considered and not chosen for 29 patients. Of the 20 who received Repatha instead, 11 went that way because the plan favored Repatha and LIPFENDRA would have cost the patient more. Eight of those 11 were on Medicare or Medicaid. For 5 of the 20, outcomes evidence or longer experience with the alternative decided it.
What field and medical teams can take from this
- The early message lands with younger, commercially insured, primary-prevention patients who ask for a pill.
- For Medicare and Medicaid patients, plan coverage is what most often stops the start.
- Secondary-prevention patients wait on outcomes data. 63% of physicians asked want it before broader use.
How a patient chart audit finds this
A patient chart audit in pharma market research asks physicians to walk through real, recent patients: their clinical picture, insurance, the alternatives considered, and any patient request. An ATU tracker survey shows how many physicians use a brand. The chart audit shows which patients they use it for and why. In this study, physicians also told each patient’s story in their own words, and AI-moderated interviews probed trade-offs, access, and switching. For what a strong chart audit should capture, see how to choose a patient chart audit vendor.
Read the study
The case study, Hyperlipidemia treatment decisions in 2026, shows every patient-level finding with its base.
To find out which patients your own launch is reaching first, explore Patient Chart Audits and Pre-Launch and Launch Insights.
LIPFENDRA is a registered trademark of Merck Sharp & Dohme LLC. Repatha is a registered trademark of Amgen Inc. LEQVIO is a registered trademark of Novartis AG. ZoomRx is not affiliated with, and this paper is not sponsored or endorsed by these companies.
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