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    ACOG
    Earnings call· Jun 2026(Q2 FY26)

    Alpha Cognition Q2 FY26 earnings call ACOG

    Aug 13, 2026 Source

    Executive summary

    Alpha Cognition Q2 FY26 — Zunveyl Commercial Trajectory Accelerates

    Alpha Cognition reported strong Q2 FY26 results, with Zunveyl demonstrating accelerating commercial traction driven by increased prescriber adoption and nursing home penetration. Despite slower-than-anticipated payer access expansion, the company remains focused on disciplined execution and evidence generation to support Zunveyl's long-term growth and achieve operating profitability in 2027.

    Highlights

    5

    • Zunveyl net product revenues grew approximately 71% quarter-over-quarter to $6 million.

    • HCP writers increased 27% quarter-over-quarter to 1,347, with 76% placing repeat prescriptions.

    • Homes with Zunveyl prescriptions grew 20% quarter-over-quarter to 1,095, with 81% placing repeat orders.

    • GAAP gross product margin was approximately 94% for the quarter.

    • Full-year 2026 operating expense guidance was lowered from $54M-$58M to $50M-$54M.

    Concerns

    2

    • Payer access expansion is tracking slower than anticipated, with broad formulary activation not yet materialized at scale.

    • The impact of the Inflation Reduction Act (IRA) is having a significant effect on Medicare Part D plans, affecting formulary coverage.

    Guidance & targets

    8
    CategoryTargetConfidence
    Operating profitability
    Achieve operating profitability
    high materiality
    High
    Full-year 2026 Operating Expense
    $50 million to $54 million
    medium materiality
    High
    Cumulative HCP writers
    Approximately 2,000
    medium materiality
    High
    CONVERGE study top-line data
    Available
    medium materiality
    High
    RESOLVE study completion
    Complete
    medium materiality
    High
    RESOLVE study data availability
    Summer or fall
    medium materiality
    Medium
    Sublingual PK study data
    Available
    medium materiality
    High
    Full-year 2027 Operating Expense guidance
    To be provided
    medium materiality
    High

    Segment performance

    1
    SegmentRevenueYoYQoQMargin
    Zunveyl (Long-Term Care Segment)
    Zunveyl's commercial trajectory is tracking well with expectations, showing strong sequential growth in demand, expanded prescriber adoption, and increased nursing home penetration. The high repeat rates for both prescribers and facilities indicate deepening adoption and movement into routine clinical practice.
    Bottles sold: 8,294Bottles sold QoQ growth: 37%Total commercial customers: 8,194Prescribers called on: 3,905HCP writers: 1,347HCP writers QoQ growth: 27%Cumulative life-to-date writers: 1,908Repeat prescribers (of Q2 writers): 76%Productivity per writer: 6 prescriptionsHomes with Zunveyl prescriptions: 1,095Homes with Zunveyl prescriptions QoQ growth: 20%New homes added: 346Homes with repeat orders: 81%
    		$6 million—71%94%

    Operational metrics

    18
    Total revenue
    $6.1 millionvs $1.7 million in prior year period
    Q2 FY26

    Total revenue for the quarter, driven primarily by Zunveyl product sales.

    Total operating expenses
    $13.5 million
    Q2 FY26

    Operating spend reflecting deliberate investment in commercial capabilities and studies.

    SG&A expense
    $11.5 million
    Q2 FY26

    Reflects continued investment behind commercial infrastructure, payer engagement, marketing resources, and public company operations.

    R&D expense
    $2 million
    Q2 FY26

    Reflects continued investment in evidence generation and development programs for Zunveyl.

    Net loss
    $8.8 millionvs $13.2 million in prior year period
    Q2 FY26

    Net loss for the quarter, reflecting intentional scaling and investment.

    Net loss per share
    $0.40vs $0.82 in prior year period
    Q2 FY26

    Diluted net loss per share for the quarter.

    Cash and cash equivalents
    $41.4 million
    as of June 30, 2026

    Company's cash position at the end of the second quarter.

    Total current assets
    $57.9 million
    as of June 30, 2026

    Total current assets at the end of the second quarter.

    Total current liabilities
    $6.4 million
    as of June 30, 2026

    Total current liabilities at the end of the second quarter.

    Working capital
    $51.5 million
    as of June 30, 2026

    Calculated as total current assets minus total current liabilities.

    Gross-to-net ratio
    74%
    Q2 FY26

    The gross-to-net ratio is holding strong, with expectations to remain consistent if no significant formulary adds occur.

    Sales force size
    60
    Q2 FY26

    The sales force is now right-sized and productive, contributing to commercial execution.

    Peer-to-peer programs conducted
    240
    since March

    Number of peer-to-peer programs conducted to educate stakeholders and build physician confidence.

    Peer-to-peer attendees
    1,058
    since March

    Total attendees at peer-to-peer programs.

    Peer-to-peer prescribers reached
    325
    since March

    Number of prescribers reached through peer-to-peer programs.

    Long-term care top-tier homes
    5,000
    current

    Estimated number of highest volume Alzheimer's patient homes in the long-term care market, representing significant opportunity.

    Long-term care top-tier physicians
    3,000
    current

    Estimated number of top-tier physicians in the long-term care market, indicating significant room for prescriber activation.

    Sublingual market opportunity
    10-20%
    current

    Estimated percentage of Alzheimer's patients who have difficulty swallowing, representing the addressable market for a sublingual formulation.

    Industry KPIs

    5
    MetricValueDetails
    Launch access metrics16%%
    Pipeline read out calendarMultiple studies
    Product franchise net sales$6 millionUSD
    Prescription volume new starts8,294 bottlesbottles
    Clinical trial efficacy safety dataPositive top-line results

    Deals & partnerships

    1
    Galantos PharmaEarly settlement of royalty obligation

    During the quarter, we also completed the early settlement of our Galantos Pharma royalty obligation. This transaction simplifies our capital structure, eliminates future royalty burden on the product economics, and increases our long-term participation in the value created by Zunveyl.

    Risks & headwinds

    2
    Slower-than-anticipated payer access expansion and broad formulary activation.Near-term

    Tracking slower than the access curve outlined last quarter.

    Mitigation: Actively engaged with key payers, driving demand to increase likelihood of formulary coverage, leveraging real-world evidence programs (BEACON, CONVERGE, RESOLVE) to support discussions.

    Impact of the Inflation Reduction Act (IRA) on Medicare Part D plans.Ongoing

    Having a significant impact on the plan and the additional cost that they have to pick up.

    Mitigation: Continuing to drive demand, believing that payers recognize demand and growth, and will eventually provide formulary coverage.

    What to watch in Q3 FY26

    5

    CONVERGE study top-line data

    Q3 2026
    CurrentInitiated in Q2 FY26
    TargetAvailable

    Why it matters

    This data will provide quantitative retrospective analysis on the Alzheimer's market, supporting Zunveyl's positioning with payers and healthcare providers.

    We expect CONVERGE top-line data in Q3.

    Q&A highlights

    7

    What drives repeat prescribers to stick with Zunveyl, and what are their characteristics?

    Repeat prescribers (76% of Q2 writers) are driven by positive experience with Zunveyl, specifically its tolerability, efficacy in cognition, and positive impact on behavior. They first confirm tolerability, then observe efficacy, and finally note behavioral improvements.

    “What we're seeing is these are significant repeat rates. 76% of providers are writing again. That's some of the highest I've seen in my experience.”

    asked by Raghuram Selvaraju · answered by Lauren D’Angelo

    2 min read5 chapters

    Detailed Narrative

    01

    Zunveyl Commercial Momentum

    Zunveyl, the first new oral Alzheimer's treatment in over 15 years, demonstrated strong sequential growth in Q2 FY26, with net product revenues reaching $6 million, a 71% increase quarter-over-quarter. This growth was driven by consistent monthly prescription volume increases, expanded prescriber adoption, and deeper nursing home penetration. The company's commercial strategy, supported by a right-sized 60-person sales force, is effectively driving demand and repeat utilization, with 76% of Q2 writers placing repeat prescriptions.

    02

    Clinical Evidence Generation

    Alpha Cognition continues to advance its evidence generation programs to strengthen Zunveyl's positioning. The BEACON study reported positive top-line results, showing improvements in cognition, neuropsychiatric symptoms, activities of daily living, and reductions in polypharmacy. The company initiated CONVERGE, a retrospective data review in long-term care, with top-line data expected in Q3 2026, and RESOLVE, with patient enrollment underway and completion anticipated in Q2 2027.

    03

    Financial Position and Capital Allocation

    The company reported $41.4 million in cash and cash equivalents as of June 30, 2026, and $51.5 million in working capital. Operating spend for the quarter was $13.5 million, reflecting intentional investment in commercial capabilities and evidence generation. Alpha Cognition completed the early settlement of its Galantos Pharma royalty obligation, simplifying its capital structure and improving future cash flows. The company lowered its full-year 2026 operating expense guidance to $50 million to $54 million, reflecting efficiency gains while supporting growth.

    04

    Payer Access Challenges and Outlook

    Payer access remains a significant near-term friction point, with broad formulary activation tracking slower than anticipated. The company views this as a timing dynamic rather than a demand constraint, as underlying prescription growth and high repeat rates are driven by clinical pull. The impact of the Inflation Reduction Act (IRA) on Medicare Part D plans is contributing to the slower access. Management is actively engaged with key payers and expects access to improve, providing significant upside.

    05

    Sublingual Formulation Opportunity

    Alpha Cognition is excited about the sublingual formulation of Zunveyl, which addresses an estimated 10% to 20% of Alzheimer's patients who experience aphasia or dysphagia and have limited treatment options. A comparative PK study for the sublingual product is underway, with data expected in Q3 2026, which will determine the timeline for its clinical program. This formulation is seen as an opportunity to capture significant market share from existing therapies.

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