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    ACAD
    Earnings call· Mar 2026(Q1 FY26)

    ACADIA PHARMACEUTICALS Q1 FY26 earnings call ACAD

    May 6, 2026 Source

    Executive summary

    ACADIA Q1 FY26 — Strong DAYBUE Growth and Reaffirmed FY26 Guidance

    ACADIA Pharmaceuticals delivered a solid Q1 FY26, driven by robust DAYBUE sales and the successful launch of DAYBUE STIX, while NUPLAZID demonstrated strong underlying demand despite temporary refill delays that have since normalized. The company reaffirmed its full-year guidance and highlighted significant pipeline catalysts, including the upcoming Phase II readout for remlifanserin in Alzheimer's disease psychosis and accelerated results for trofinetide in Japan, positioning ACADIA for continued growth.

    Highlights

    5
    • Total revenue reached $268 million in Q1 FY26, representing 11% year-over-year growth on an adjusted basis.

    • DAYBUE sales were $101 million, marking an impressive 20% year-over-year growth, the highest since Q3 2024.

    • The launch of DAYBUE STIX saw strong early uptake with over 250 prescriptions in Q1, nearly 30% of which were from treatment-naive or restarting patients.

    • NUPLAZID achieved approximately 11% year-over-year physician referral growth and 8% year-over-year demand growth, despite temporary refill delays.

    • The company reaffirmed its full year 2026 net sales guidance for both DAYBUE and NUPLAZID, and its total revenue guidance of $1.22 billion to $1.28 billion.

    Concerns

    2
    • NUPLAZID's Q1 performance was impacted by a temporary increase in patients taking longer than expected to refill prescriptions in January and early February.

    • SG&A expenses increased to $171 million in Q1 FY26 from $126.4 million in Q1 FY25, reflecting continued investments in commercial franchises and expanded field footprint.

    Guidance & targets

    8
    CategoryTargetConfidence
    Full Year Net Sales
    Reaffirmed
    high materiality
    High
    Full Year Total Revenues
    $1.22 billion to $1.28 billion
    high materiality
    High
    Remlifanserin Phase II Readout (ADP)
    August to October 2026
    high materiality
    High
    Trofinetide Japan Phase III Results
    September to November 2026
    medium materiality
    High
    NUPLAZID Annual Sales
    approximately $1 billion
    high materiality
    Medium
    DAYBUE Annual Sales
    $700 million
    high materiality
    Medium
    Pipeline Studies Initiation
    5 additional Phase II or Phase III studies
    medium materiality
    High
    Pipeline Study Readouts
    4 Phase II or Phase III study readouts
    medium materiality
    High

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    DAYBUE
    Strong performance fueled by robust referral volumes, new patient starts, and reengagement of previously discontinued patients due to DAYBUE STIX launch. STIX uptake is quicker than anticipated, with significant interest from existing liquid formulation patients to switch. The Delphi expert consensus reinforces DAYBUE's position as standard of care for Rett syndrome.
    Unique patients receiving shipments: record quarterDAYBUE STIX prescriptions: >250 individual patientsDAYBUE STIX treatment-naive or restarting patients: nearly 30% of STIX patientsCaregiver satisfaction with STIX: >80% high satisfactionPersistency (liquid formulation) at 12 months: >55%Persistency (liquid formulation) at 18 months: ~50%Active patients on treatment for 12+ months: 74%Penetration within COEs: ~60%Penetration in the community: ~28%
    $101 million20%
    NUPLAZID
    Q1 performance was impacted by temporary increase in patients taking longer to refill prescriptions, which has since normalized. Strong underlying demand and referral growth, even ahead of the anticipated impact from the sales force expansion. The company renewed its partnership with Ryan Reynolds for the unbranded 'More to Parkinson's' campaign.
    Physician referral growth: ~11% year-over-yearDemand growth: 8% year-over-yearGross to net adjustment: 22.1%Sales team expansion: 30% completed in Q1Target universe of HCPs: >10,000Awareness of hallucinations and delusions (Parkinson's community): increased from 8% to >30% (since campaign launch)Patients benefited over 10 years: nearly 100,000
    $167 million6% (adjusted)

    Operational metrics

    10
    Total Revenue (adjusted)
    $268 million11% year-over-year growth
    Q1 FY26

    Total revenue for the quarter, adjusted for 2025 NUPLAZID sales.

    DAYBUE Gross to Net Adjustment
    25.8%
    Q1 FY26

    Gross to net adjustment for DAYBUE sales.

    NUPLAZID Gross to Net Adjustment
    22.1%
    Q1 FY26

    Gross to net adjustment for NUPLAZID sales.

    R&D Expenses
    $76.9 millionvs $78.3 million in Q1 FY25
    Q1 FY26

    Research and development expenses.

    SG&A Expenses
    $171 millionvs $126.4 million in Q1 FY25
    Q1 FY26

    Selling, general, and administrative expenses, reflecting investments in commercial franchises and expanded field footprint.

    Cash and Investments Balance
    $851 millionvs $820 million at Q4 FY25 end
    Q1 FY26 end

    Cash position at the end of the first quarter, reflecting positive operating cash flow generation.

    Pipeline Programs Initiated (Phase II/III)
    5
    by end of 2027

    Number of additional Phase II or Phase III studies anticipated to be initiated.

    Pipeline Readouts (Phase II/III)
    4
    by end of 2027

    Number of Phase II or Phase III study readouts anticipated.

    Combined Full Peak Sales Potential (4 molecules)
    $11 billion
    long-term

    Combined full peak sales potential across 4 molecules in the pipeline.

    Remlifanserin Peak Sales Potential (ADP & LBD)
    $4 billion
    long-term

    Peak sales potential specifically attributable to remlifanserin across Alzheimer's disease psychosis and Lewy body dementia psychosis indications.

    Industry KPIs

    2
    MetricValueDetails
    Peak long term sales guidance$11 billionUSD
    Cumulative patients uptake since launchnearly 100,000patients

    Product announcements

    1
    ProductTypeDetails
    DAYBUE STIXlaunch

    Deals & partnerships

    1
    Ryan ReynoldsRenewed partnership for unbranded More to Parkinson's campaign.

    Partnership for unbranded "More to Parkinson's" campaign, introducing new content and creative to raise awareness of Parkinson's disease psychosis.

    Risks & headwinds

    4
    Temporary NUPLAZID refill delaysJanuary to early February

    Impacted Q1 FY26 performance

    Mitigation: Dynamics have since normalized; patients who were late to fill returned in the latter part of the quarter.

    Increased SG&A expensesQ1 FY26

    $171 million in Q1 FY26 vs $126.4 million in Q1 FY25

    Mitigation: Reflects continued investments in commercial franchises with increased marketing and expanded field footprint for NUPLAZID and DAYBUE, which took place after Q1 FY25.

    Potential for black box warning on remlifanserinFuture regulatory approval

    null

    Mitigation: Collecting data to allow FDA to make a specific decision on remlifanserin, aiming to potentially avoid such a warning.

    Cross-study comparison challenges for remlifanserinUpcoming data readout

    NPIC data not available for all patients in Phase II ADP study

    Mitigation: NPIC is an exploratory endpoint with a subset of patients; caution advised in cross-study comparisons.

    What to watch in Q2 FY26

    5

    Remlifanserin ADP Phase II readout

    August to October 2026
    CurrentEnrollment in final phases
    TargetTop-line results released

    Why it matters

    This represents the most significant near-term catalyst for the company with potential to unlock tremendous value in a market with no approved therapies.

    First and foremost, we're approaching our highly anticipated top line results for remlifanserin in Alzheimer's disease psychosis, which we expect to report in the August to October time frame.

    Q&A highlights

    5

    Seeking more precise enrollment status and data timelines for RADIANT (ADP) and ILLUMERA (LBD) studies.

    Enrollment for the ADP program is in its final phases, confirming the August to October 2026 readout. Enrollment for the Lewy body dementia psychosis study is progressing well, but a public timeline for data is not yet available.

    The Alzheimer's study is still enrolling, and the enrollment dynamics continue to support our expectation for top line results in the August through October 2026 time frame.

    asked by Tessa Romero · answered by Elizabeth Thompson

    3 min read6 chapters

    Detailed Narrative

    01

    DAYBUE STIX Launch Success and Growth Outlook

    The new powder formulation, DAYBUE STIX, launched successfully with strong early uptake, including over 250 prescriptions in Q1 FY26. Nearly 30% of these patients were treatment-naive or restarting therapy, aligning with expectations and supporting DAYBUE's growth outlook. Caregiver response has been particularly positive, with over 80% reporting high satisfaction, reinforcing the value of the new formulation in retaining current patients and growing the treated population. The broader U.S. rollout in early April is expected to further accelerate this momentum.

    02

    NUPLAZID Commercial Dynamics and Expansion

    NUPLAZID delivered $167 million in sales in Q1 FY26, reflecting 6% year-over-year growth on an adjusted basis. The quarter saw strong physician referral growth of approximately 11% and 8% demand growth, despite temporary refill delays in January and early February that have since normalized. The company completed a 30% expansion of its sales team in Q1, increasing its target universe to over 10,000 HCPs, with the full impact of this productivity ramp expected by late 2026 and into next year, supporting the path towards approximately $1 billion in annual sales by 2028.

    03

    Remlifanserin ADP Program Progress and Readout

    The Phase II RADIANT study for remlifanserin in Alzheimer's disease psychosis (ADP) is in its final phases of enrollment, with top-line results anticipated in August to October 2026. The study focuses on biomarker-confirmed Alzheimer's disease patients to future-proof the program and potentially improve technical and regulatory success. Management aims for a 0.4 moderate effect size on SAPS-H+D, powered at 80%, and is collecting data to address potential black box warning concerns, aiming for a path forward without such a warning.

    04

    Trofinetide Japan Development and European Re-examination

    Enrollment in the Phase III trial for trofinetide in Japan has accelerated, now expected to complete this quarter, with top-line results anticipated in September to November 2026. This small study is designed to provide descriptive information for Japanese patients, supporting a regulatory submission in 2027. Concurrently, the trofinetide re-examination process in Europe remains ongoing, with conclusion expected by late June, as the company works with regulators to support the positive benefit-risk profile.

    05

    Pipeline Breadth and Long-Term Value Creation

    ACADIA's pipeline includes 8 disclosed programs, with plans to initiate 5 additional Phase II or Phase III studies and report 4 readouts by the end of 2027. The company projects a combined full peak sales potential of $11 billion across its 4 molecules, with remlifanserin alone contributing $4 billion across ADP and Lewy body dementia psychosis indications. This underscores the transformative potential of its R&D efforts and commitment to addressing significant unmet medical needs in neurological and rare diseases.

    06

    Financial Strength and Strategic Business Development

    The company maintains a strong cash position of $851 million at the end of Q1 FY26, an increase from $820 million at the end of Q4 FY25, reflecting positive operating cash flow. This financial strength provides significant strategic flexibility to pursue business development opportunities, including potential acquisitions, licenses, and partnerships. ACADIA is actively evaluating later-stage assets to complement its commercial franchises and refresh its early-stage pipeline, aiming for long-term value and growth.

    AI-generated summary of the company’s earnings call. Not investment advice.