Earnings Call Insights: ACADIA Pharmaceuticals (ACAD) Q2 2025
Management View
- Catherine E. Owen Adams, CEO, stated that “Our second quarter performance reinforces the momentum we’re building across all facets of our business from commercial strength to our clinical pipeline and global expansion.” She highlighted total revenue of $264.6 million, with $96.1 million from DAYBUE and $168.5 million from NUPLAZID. Adams emphasized that DAYBUE “has now passed stabilization, moved into growth and is entering a new phase, expansion and acceleration,” and noted the impact of patient support and field expansion efforts. For NUPLAZID, Adams pointed to litigation wins that “validate our long-term strategy and reinforce our ability to deliver NUPLAZID to patients through 2038.”
- Thomas Andrew Garner, Chief Commercial Officer, noted DAYBUE’s Q2 sales of $96.1 million and the increase in unique U.S. patients to 987, up from 954 in Q1. He said long-term persistency remains strong with an 18-month persistency rate above 45%. Garner reported that “one of the most promising indicators in the second quarter is a meaningful uptick in our proportion of new referrals coming outside of Centers of Excellence,” and the direct-to-consumer campaign for DAYBUE launched in July is seeing “positive signs of early engagement.”
- Mark C. Schneyer, CFO, stated, “The second quarter was strong across the board with $264.6 million in total revenues, up 9% year-over-year.” Schneyer announced, “We are raising the low end of our NUPLAZID guidance range, reflecting the strength of the business and its performance to date. We now expect NUPLAZID net product sales for the year to be between $665 million and $690 million.” He added, “We are reiterating all other prior guidance ranges from our Q1 call.”
- Elizabeth H. Z. Thompson, EVP, Head of R&D, described pipeline momentum with “9 disclosed programs in development and 5 Phase II or Phase III data readouts expected through 2027.” Thompson highlighted upcoming milestones, including a Phase II study of ACP-204 in Lewy body dementia psychosis and a Phase III study of trofinetide in Japan beginning in Q3 2025, and top line COMPASS PWS Phase III data for ACP-101 in early Q4 2025.
Outlook
- Management increased 2025 full-year NUPLAZID net product sales guidance to a range of $665 million to $690 million, up from previous guidance of $650 million to $690 million.
- U.S.-only total revenue guidance was adjusted to reflect the change in NUPLAZID guidance. All other prior guidance ranges from Q1 were reiterated.
- The company expects continued acceleration in DAYBUE new patient starts toward the end of the year as field force expansion and DTC campaigns gain traction.
- Thompson stated, “Between 2025 and 2027, we expect 5 Phase II or Phase III readouts.”
Financial Results
- Total revenue for Q2 2025 was reported at $264.6 million, a 9% year-over-year increase.
- DAYBUE net product sales totaled $96.1 million, representing 14% year-over-year growth and 12% volume growth.
- NUPLAZID net product sales reached $168.5 million, a 7% year-over-year increase, with 5% attributable to volume.
- Gross to net adjustment for DAYBUE was 23.3%, and for NUPLAZID was 24.6%.
- R&D expenses were $78 million, up from $76.2 million in Q2 2024; SG&A expenses were $133.5 million, up from $117.1 million in Q2 2024, reflecting increased investment in U.S. commercial operations.
- Cash balance at quarter end was $762 million, up from $681.6 million at Q1 end.
Q&A
- Tessa Thomas Romero, JPMorgan: Asked about ACP-101 top line details and risk management in clinical trials. Thompson responded that the focus would be on the primary endpoint and key safety/tolerability overview, with robust monitoring of assessment variability.
- Ritu Subhalaksmi Baral, TD Cowen: Inquired about DAYBUE community growth and HCP writers. Garner said “the number of referrals that were coming directly from our non-COE accounts actually grew to about 3/4 of our overall number… up from about 2/3 the quarter before.” For new writers, “the vast majority… fell outside of the COEs.”
- Michael H. Riad, Morgan Stanley: Asked about DAYBUE patient growth trajectory. Garner indicated expectations for acceleration as the new customer model takes effect, aiming for continued increases in new patient starts.
- Jason Nicholas Butler, Citizens JMP: Questioned NUPLAZID investment strategy. Adams explained that DTC spend will continue to focus on the short-to-medium term, with longer-term strategy under consideration, supported by ongoing campaign success.
- Brian Corey Abrahams, RBC: Asked about DAYBUE persistency and physician education. Garner reported “12-month persistency remains well above 50%… our 18-month persistency… is above 45%.”
- Ami Fadia, Needham: Sought color on NUPLAZID volume and DAYBUE persistency outside COEs. Garner confirmed “NBRx volume was kind of reflected across all channels,” and real-world 18-month persistency stands at about 45%.
- Marc Harold Goodman, Leerink: Asked about DAYBUE discontinuations and inventory. Garner said discontinuations were “well below 10%.” Schneyer noted no significant inventory changes.
- Ashwani Verma, UBS: Inquired about NUPLAZID IRA eligibility and ACP-101 formulation. Schneyer said “2029 will be the first year that NUPLAZID is eligible for negotiation unless there’s changes in the legislation.”
- Additional questions covered pipeline prioritization, growth drivers for 2026, and upcoming clinical milestones. Management provided detailed responses without deflections, emphasizing confidence in commercial momentum and pipeline breadth.
Sentiment Analysis
- Analysts focused on persistency, patient growth, community penetration, and pipeline milestones, reflecting a slightly positive and constructive tone, with several congratulatory remarks on quarterly progress.
- Management maintained a confident and upbeat tone in both prepared remarks and responses, frequently highlighting momentum and execution. Adams stated, “Our teams are executing with urgency and precision,” and Thompson described pipeline progress as “tangible.”
- Compared to the previous quarter, both analysts and management demonstrated increased confidence and optimism, with less focus on operational risks or competitive threats.
Quarter-over-Quarter Comparison
- The current quarter saw a raised NUPLAZID guidance and a clear acceleration in DAYBUE patient growth, compared to stable guidance and steady growth in Q1 2025.
- Management’s language shifted from a focus on stabilization and foundation-building to expansion, acceleration, and global growth.
- Analysts in Q2 asked more about execution on new field force models and persistency trends, versus earlier questions on post-stabilization growth and guidance sustainability.
- Key metrics such as DAYBUE patient count and persistency rates continued to improve, with stronger topline results and higher cash balances reported.
Risks and Concerns
- Management acknowledged gross to net adjustments, increased SG&A and R&D spending, and ongoing regulatory processes as factors to monitor.
- Questions on IRA price negotiation eligibility for NUPLAZID and trial conduct for ACP-101 indicated continued vigilance on policy and trial execution risks.
- No new material risks or negative surprises were disclosed during the quarter.
Final Takeaway
ACADIA Pharmaceuticals delivered a second quarter marked by revenue growth, improved patient persistency, and expanding community penetration for DAYBUE, alongside increased guidance for NUPLAZID sales. Management highlighted progress across its clinical pipeline with multiple late-stage readouts anticipated through 2027, while maintaining a strong balance sheet and disciplined investment. The company expressed confidence in sustaining commercial momentum and advancing its portfolio, positioning itself for further growth in the second half of 2025 and beyond.
Read the full Earnings Call Transcript