Earnings Call Insights: ACADIA Pharmaceuticals Inc. (ACAD) Q3 2025
Management View
- Catherine Owen Adams, CEO, reported “another strong quarter for ACADIA with solid execution across our commercial portfolio and continued momentum positions us well for a strong finish to 2025 as we lay the foundation for sustained growth into 2026 and beyond.” She highlighted total revenues of $278.6 million, up 11% year-over-year, emphasizing the strength of the commercial portfolio and execution on multiple fronts.
- Adams emphasized DAYBUE’s progress, noting “we achieved our largest sequential increase in referrals since launch” and shipped the highest number of DAYBUE bottles ever in a single quarter, reaching over 1,000 unique patients globally. Patient persistency remains stable.
- For NUPLAZID, Adams stated, “We delivered an exceptional quarter with net sales of $177.5 million, marking our strongest sales quarter ever.” She detailed plans for strategic investments in field force expansion and direct-to-consumer campaigns.
- Thomas Garner, Chief Commercial Officer, reported “DAYBUE sales were $101.1 million in Q3, representing our highest revenue and total prescription volume in any quarter to date since launch.” He noted 956 physicians have now written at least one prescription for DAYBUE, with 74% of new prescriptions coming from community-based physicians.
- Garner highlighted NUPLAZID’s 12% year-over-year growth, driven by 9% volume growth, a 21% increase in referrals, and a 23% rise in new prescription volumes compared to the prior year.
- Elizabeth Thompson, EVP and Head of R&D, announced the initiation of a Phase II study for ACP-204 in Lewy body dementia psychosis, a Phase III study of trofinetide in Japan, and anticipated initiation of a Phase II study for ACP-211 in Q4 2025. She projected “reporting results from 4 Phase II or Phase III studies between now and the end of 2027.”
- Mark Schneyer, CFO, stated, “We delivered an excellent quarter that underscores the robustness of our commercial portfolio, which enables us to generate strong revenue and cash flows while continuing to invest strategically in growth opportunities.”
Outlook
- The company updated its full-year 2025 guidance, with NUPLAZID now expected to deliver $685 million to $695 million in net sales, up from the previous $665 million to $690 million range.
- DAYBUE guidance was modified to include named patient supply programs, narrowing the range to $385 million to $400 million, compared to prior U.S.-only guidance of $380 million to $405 million.
- R&D expenses are now guided to $335 million to $345 million, and SG&A to $540 million to $555 million.
- Adams stated, “our commitment to finishing 2025, getting over $1 billion in total revenues, positioning ACADIA for continued growth in 2026 and beyond.”
Financial Results
- Total revenues for Q3 were $278.6 million, up 11% year-over-year.
- DAYBUE net sales reached $101.1 million, representing 11% year-over-year growth, driven entirely by volume.
- NUPLAZID net sales were $177.5 million, a 12% increase year-over-year, with 9% attributable to volume growth.
- Gross-to-net adjustment for DAYBUE was 22%, and for NUPLAZID, 25%.
- Operating expenses included R&D at $87.8 million, up from $66.6 million in Q3 2024, and SG&A at $133.4 million, essentially flat with the prior year.
- The company ended the quarter with $847 million in cash, compared to $762 million at the end of Q2.
Q&A
- Ritu Baral, TD Cowen: Asked about the NUPLAZID field force expansion. Garner explained investments are targeting both community and long-term care settings, “investing slightly more on a percentage basis in the community, but at the same time, we are going to be modestly increasing our LTC team.”
- Yigal Nochomovitz, Citigroup: Inquired about clinical endpoints for ACP-204. Thompson explained the primary endpoint and trial design, noting, “we’re looking for roughly a moderate effect size, a 0.4 effect size on SAPS-H+D.”
- Tessa Romero, JPMorgan: Queried about DAYBUE referral growth and patient starts. Garner indicated continued growth is expected through Q4 and into 2026.
- Brian Abrahams, RBC: Asked about ACP-204 trial conduct and safety. Adams emphasized focus on appropriate patient selection and ongoing DSM-V monitoring.
- So Youn Shim, UBS: Asked about peak sales guidance. Adams stated the company now aspires to $11 billion in peak sales for the portfolio, and $1.5 billion to $2 billion for NUPLAZID and DAYBUE.
- Additional questions covered NUPLAZID pricing, European DAYBUE launch readiness, investment in NUPLAZID field force, reimbursement strategies in Europe, and pipeline differentiation.
Sentiment Analysis
- Analysts focused on sustainability of momentum, field force expansion, and guidance specificity. The tone was generally positive, with questions delving into growth levers and pipeline opportunities.
- Management maintained a confident and upbeat tone in prepared remarks, using phrases such as “we are confident” and “we believe these trends are an important leading indicator of future prescribing behavior.” During Q&A, management remained detailed, occasionally shifting to a more cautious or nuanced stance when discussing competitive dynamics and pipeline risks.
- Compared to the previous quarter, both management and analysts showed increased confidence and specificity regarding commercial execution and pipeline progress.
Quarter-over-Quarter Comparison
- Q3 guidance for NUPLAZID was raised at both ends, reflecting accelerating momentum; DAYBUE guidance was narrowed and expanded to include international contributions.
- DAYBUE surpassed 1,000 global patients, up from 987 in Q2, and achieved its highest-ever quarterly net sales and prescription volume.
- Persistency rates and prescriber breadth continued to improve, notably with community-based physicians representing a growing majority of new DAYBUE prescriptions.
- The company reiterated and elaborated on its multi-year pipeline milestones, highlighting increased clarity on timing and expected readouts.
- Management’s tone was even more confident than the previous quarter, with a greater focus on near-term and 2026 growth, while analysts maintained an inquisitive but positive approach.
Risks and Concerns
- Management noted that overall market penetration for DAYBUE remains relatively low, at approximately 40% in the U.S. and 27% in the community setting, representing both a risk and an opportunity.
- Thompson acknowledged the unsuccessful outcome of the COMPASS Prader-Willi syndrome study, indicating ongoing knowledge-sharing from the trial.
- Reimbursement in Europe and IRA price negotiations for NUPLAZID were raised as potential future challenges, with management outlining ongoing engagement with payers and regulatory agencies.
Final Takeaway
ACADIA’s management reiterated its confidence in surpassing $1 billion in total revenues for 2025, underpinned by record performance from DAYBUE and NUPLAZID, continued investment in commercial expansion, and a robust R&D pipeline with four major study readouts expected by 2027. The company remains focused on leveraging its commercial momentum, expanding global access, and advancing multiple late-stage clinical programs to drive sustained growth and value for stakeholders.