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Is a small company poised to shake up the multibillion-dollar market for cardiovascular drugs, or is it about to descend into irrelevance?

That’s the question hanging over Esperion Therapeutics and its experimental cholesterol-cutting therapy. The drug is being developed as an option for patients who can’t get what they need from cheap, generic statins but who also don’t require pricey injectable medicines called PCSK9 inhibitors, which can cost more than $10,000 a year.

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But the plan only works if Esperion can convince the Food and Drug Administration that its treatment is safe for long-term use.

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