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ACADIA PHARMACEUTICALS INC (ACAD)·Q2 2024 Earnings Summary

Executive Summary

  • Q2 delivered $242.0M total revenues (+46% y/y), driven by NUPLAZID net sales of $157.4M (+11% y/y) and DAYBUE net sales of $84.6M (+11% q/q), with diluted EPS of $0.20 and net income of $33.4M .
  • Guidance shifts: NUPLAZID raised to $590–$610M; DAYBUE lowered to $340–$370M; total revenue narrowed to $930–$980M; R&D to $305–$315M; SG&A to $465–$480M .
  • Management highlighted improved DAYBUE patient dynamics (active patients ~900, discontinuations -46% q/q, new starts +12% q/q) and a strengthened NUPLAZID setup with targeted DTC and disease awareness campaigns (impact expected largely in 2025) .
  • Cash, cash equivalents and investments rose to $500.9M; company emphasized cash flow positivity and no debt as strategic flexibility to fund pipeline and BD .
  • Wall Street consensus from S&P Global was unavailable due to access errors; estimate beat/miss assessments are not provided here.

What Went Well and What Went Wrong

What Went Well

  • NUPLAZID momentum: “Net product sales were up 11%... to $157.4 million... Our NUPLAZID franchise has never been in a stronger position” and annual sales guidance raised to $590–$610M .
  • DAYBUE stabilization: Active patients returned to ~900; weekly discontinuations decreased 46% q/q; weekly new starts +12% q/q; DAYBUE net product sales +11% sequentially to $84.6M .
  • Financial strength: “We are a cash flow positive company and now have over $500 million in cash with no debt,” supporting pipeline and BD opportunities .

What Went Wrong

  • DAYBUE guidance cut: Lowered to $340–$370M (from $370–$420M) as new patient adds grew slower than projected despite improving discontinuation trends .
  • Higher operating spend: SG&A rose to $117.1M in Q2 (up from $96.0M y/y), driven by consumer activation for NUPLAZID, U.S. marketing for DAYBUE, and ex-U.S. trofinetide prep; SG&A guidance narrowed to the high end ($465–$480M) .
  • Medicare Part D headwind ahead: NUPLAZID gross-to-net expected to decline ~300 bps in 2025 due to the IRA “specified small manufacturer” phase-in, tempering forward net pricing tailwinds .

Financial Results

Consolidated P&L (GAAP)

MetricQ4 2023Q1 2024Q2 2024
Total Revenues ($USD Millions)$231.041 $205.831 $241.963
Total Operating Expenses ($USD Millions)$196.097 $190.621 $211.526
Income from Operations ($USD Millions)$34.944 $15.210 $30.437
Net Income ($USD Millions)$45.797 $16.555 $33.389
Diluted EPS ($USD)$0.28 $0.10 $0.20

Segment Net Product Sales

SegmentQ4 2023Q1 2024Q2 2024
NUPLAZID Net Sales ($USD Millions)$143.9 $129.9 $157.4
DAYBUE Net Sales ($USD Millions)$87.1 $75.9 $84.6

Operating Expense Components (Quarterly)

MetricQ4 2023Q1 2024Q2 2024
Cost of Product Sales ($USD Millions)$17.891 $22.951 $18.230
R&D ($USD Millions)$66.741 $59.679 $76.233
SG&A ($USD Millions)$111.465 $107.991 $117.063

KPIs and Commercial Metrics

KPIQ4 2023Q1 2024Q2 2024
DAYBUE Active Patients (approx.)“close to 900” at year-end 862 as of week ending May 3 ~900 as of Aug 1
DAYBUE Persistency (real-world)6-month 68–70% trend 9-month 58% vs 47% LILAC placebo rollover 9-month 58% (durable)
DAYBUE New Starts / DiscontinuationsSeasonal decline in Jan; net adds resumed in Feb/Mar Net patient adds in each of last 6 weeks New starts +12% q/q; discontinuations -46% q/q
NUPLAZID Gross-to-Net (%)27.5% in Q4 33.1% in Q1 23.8% in Q2

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
NUPLAZID Net Sales ($USD Millions)FY 2024$560–$590 $590–$610 Raised
DAYBUE Net Sales ($USD Millions)FY 2024$370–$420 $340–$370 Lowered
Total Revenues ($USD Millions)FY 2024$930–$1,010 $930–$980 Narrowed lower upper bound
R&D Expense ($USD Millions)FY 2024$305–$325 $305–$315 Narrowed to low end
SG&A Expense ($USD Millions)FY 2024$455–$480 $465–$480 Narrowed to high end
NUPLAZID Gross-to-Net (%)FY 202425–29 26–28 Narrowed
Year-End Cash ($USD Millions)FY 2024$585–$655 $575–$625 Lowered

Earnings Call Themes & Trends

TopicPrevious Mentions (Q4 2023, Q1 2024)Current Period (Q2 2024)Trend
DAYBUE real-world evidence & GI managementPersistency improving; caregiver-reported benefits; need for consistent GI strategies GI strategies now more consistently messaged; discontinuations fell 46%; new starts +12% q/q; real-world benefits emphasized Improving execution, stabilizing patient base
DAYBUE market penetration & prescriber mix~25% diagnosed initiated; mix shifting to high-volume/community; 650+ prescribers ~30% diagnosed initiated; 700+ prescribers; 2/3 new scripts from high-volume/community Broader penetration outside COEs
NUPLAZID growth leversReal-world evidence and label clarification; market stabilization; outperforming PD market Share gains; DTC awareness and unbranded disease campaigns starting; guidance raised Strengthening growth setup
Ex-U.S. trofinetide (DAYBUE)EMA PIP aligned; Canada NDS priority review; Japan PMDA meeting OUS commercialization investments cited in SG&A; continued progress Advancing ex-U.S. path
Pipeline (ACP-101 PWS; ACP-204 AD psychosis)ACP-101 Phase 3 initiated; ACP-204 seamless P2/P3 plan; ADVANCE-2 readout timing (schizophrenia) ACP-204 EU master-protocol adjusted; continued enrollment; PWS enrollment ahead of plan Steady progress, regulatory alignment
Pricing/Margin headwinds (IRA)NUPLAZID GtN full-year 24.3% (2023) Expect ~300 bps GtN decline in 2025 Forward net price pressure

Management Commentary

  • “Together, these commercial franchises delivered $242 million in revenues for the second quarter… We are a cash flow positive company and now have over $500 million in cash with no debt.” — Steve Davis .
  • “Our NUPLAZID franchise has never been in a stronger position… we are initiating a targeted campaign to close the hallucinations and delusions awareness gap.” — Steve Davis .
  • “As of August 1, we have 900 active patients on DAYBUE therapy… weekly discontinuations decreasing 46%… weekly starts increasing 12%.” — Brendan Teehan .
  • “We are updating our guidance for DAYBUE net sales to a range of $340 to $370 million… Taking NUPLAZID and DAYBUE together, our guidance for total revenues is $930 million to $980 million.” — Mark Schneyer .
  • “When thinking ahead to 2025… we expect NUPLAZID gross to net to reduce by approximately 300 basis points year-over-year.” — Mark Schneyer .

Q&A Highlights

  • DAYBUE dynamics: Discontinuations broadly similar across COEs vs community; more consistent GI management and titration are improving early persistence; restarts occur, but confirmed discontinuations dominate .
  • Guidance clarifications: DAYBUE tracking toward lower half of revised range; initiatives aim to push to high end; NUPLAZID tracking around midpoint; small fluctuations in GtN and in-channel inventory can impact annual outcome .
  • ACP-204 EU protocol: EU did not accept seamless master protocol; Phase II readout will come while Phase III enrolls; EU to participate in Phase III under separate protocol—no expected regulatory blocker .
  • NUPLAZID DTC ROI: Prior campaigns had positive ROI; new unbranded/branded awareness to target low unaided awareness; benefits expected largely in 2025–2026 .
  • Pricing outlook: NUPLAZID gross-to-net narrowed to 26–28% for FY24; ~300 bps decline expected in 2025 due to IRA .

Estimates Context

  • S&P Global Wall Street consensus (EPS and revenue) for Q2 2024 and prior quarters was unavailable due to data access limitations, so beats/misses vs consensus cannot be assessed here.
  • Where management provided qualitative performance indicators (e.g., 46% y/y revenue growth; segment trends), these are documented above from primary sources.

Key Takeaways for Investors

  • NUPLAZID execution and guidance raise are the principal stock catalysts near-term; awareness campaigns should extend runway into 2025 despite IRA headwinds on gross-to-net .
  • DAYBUE is stabilizing with improving discontinuation trends and broader prescriber penetration; near-term growth moderated, reflected in lowered guidance—watch H2 new start acceleration and persistency .
  • Cash position ($500.9M) and cash-flow positivity with no debt provide ample flexibility to fund late-stage pipeline and BD; monitor ACP-204 Phase II progress and ACP-101 enrollment .
  • Operating spend is elevated (SG&A guiding high-end) to support NUPLAZID DTC and DAYBUE ex-U.S.; expect ROI to show in 2025, but 2024 mix shifts should support overall revenue guidance .
  • Watch regulatory path ex-U.S. for DAYBUE (EMA/Canada/Japan) as incremental revenue drivers; SG&A investments signal commitment to international expansion .
  • Without consensus comparisons available here, focus on trajectory: sequential revenue growth, segment contribution mix, and sustained operating profitability with disciplined guidance management .
  • Risk flags: DAYBUE uptake pace vs expectations, IRA-driven net pricing pressure for NUPLAZID, and execution on awareness campaigns timing (impact skewed to 2025) .