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Sage Therapeutics, Inc. (SAGE)·Q1 2025 Earnings Summary

Executive Summary

  • Q1 2025 showed continued commercial traction in ZURZUVAE: collaboration revenue rose 21% QoQ to $13.8M and shipments exceeded 3,000 (+22% QoQ), while total revenue reached $14.1M and net loss narrowed to $62.2M from $95.8M in Q4 2024 .
  • Management reiterated strong access (>95% covered lives), growing OB/GYN engagement (~80% of prescriptions), and >70% first-line use; aided brand awareness remained ~90% among prescribers .
  • Guidance maintained: cash runway to mid-2027 and 2025 OpEx down vs 2024 despite higher joint commercialization spend; strategic alternatives process continues and remains a key stock catalyst .
  • Street estimate comparisons: S&P Global consensus was unavailable via our feed at the time of analysis; we therefore cannot assess beat/miss versus consensus this quarter (see Estimates Context) [GetEstimates error].

What Went Well and What Went Wrong

What Went Well

  • ZURZUVAE demand and revenue momentum: “We shipped greater than 3,000 prescriptions…a 22% increase from the fourth quarter…[and] generated $13.8 million in collaboration revenue…a 21% increase from the fourth quarter” .
  • OB/GYN adoption and first-line use strengthening: ~80% of prescriptions came from OB/GYNs, and >70% of women received ZURZUVAE as their first new treatment for PPD .
  • Access and awareness: Management cited ~90% aided awareness among HCPs and >95% covered lives, supporting fast time-to-therapy (many in 2–3 days) .

What Went Wrong

  • Operating expense mix: SG&A increased YoY to $57.6M in Q1 (from $52.6M) driven by commercialization and legal costs tied to the strategic review, even as R&D fell 68% YoY to $22.8M .
  • Inventory noise persists: Management again emphasized that revenue recognition can be affected by wholesaler/specialty pharmacy inventory patterns, directing investors to focus on end-demand shipments .
  • Collaboration reimbursements lower: Net R&D reimbursements from Biogen declined materially YoY ($0.2M vs $5.7M) as Sage incurred fewer collaboration clinical costs, modestly impacting net loss leverage .

Financial Results

P&L and EPS vs prior periods

MetricQ3 2024Q4 2024Q1 2025
Total Revenues ($M)$11.871 $12.815 $14.063
Collaboration Revenue - Related Party ($M)$11.028 $11.426 $13.827
Other Collaboration Revenue ($M)$0.000 $0.947 $0.236
Product Revenue, net ($M)$0.843 $0.442 $0.000
Cost of Revenues ($M)$5.278 $1.489 $0.655
R&D Expenses ($M)$54.576 $37.022 $22.759
SG&A Expenses ($M)$53.219 $54.048 $57.591
Restructuring ($M)$0.000 $22.451 $0.513
Net Loss ($M)$(93.551) $(95.778) $(62.214)
Diluted EPS ($)$(1.53) $(1.56) $(1.01)

Notes:

  • YoY Q1 context: Total revenue $14.063M vs $7.902M in Q1 2024; net loss $(62.214)M vs $(108.483)M; EPS $(1.01) vs $(1.80) .
  • Cash, cash equivalents, and marketable securities: $423.9M (Mar 31, 2025) vs $504.4M (Dec 31, 2024) .

Revenue composition

Revenue Component ($M)Q3 2024Q4 2024Q1 2025
Collaboration Revenue - Related Party$11.028 $11.426 $13.827
Other Collaboration Revenue$0.000 $0.947 $0.236
Product Revenue, net$0.843 $0.442 $0.000
Total Revenues$11.871 $12.815 $14.063

KPIs and commercial metrics

KPIQ3 2024Q4 2024Q1 2025
ZURZUVAE shipments (to women)≈2,000; +~40% QoQ Nearly 2,500; +21% QoQ >3,000; +22% QoQ
ZURZUVAE collaboration revenue$11.0M; +49% QoQ $11.4M; +4% QoQ $13.8M; +21% QoQ
OB/GYN mix70% of prescribers Almost 80% of prescriptions Almost 80% of prescriptions
First-line useMajority first-line >70% first new treatment >70% first new treatment
Aided brand awareness (HCPs)~90% >90% ~90%
Total writersn/an/aWriters +>20% QoQ
Coverage (Commercial/Medicaid)>90% lives covered >95% lives covered/path to coverage Reiterated very strong coverage

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Cash runwayThrough mid-2027Mid-2027 (as of FY24 results) Mid-2027 (as of Q1) Maintained
Overall operating expensesFY 2025 vs FY 2024Substantially decrease vs 2024; first full quarter of savings in Q1 2025 Substantially decrease vs 2024, despite higher joint commercialization spend Maintained
ZURZUVAE joint commercialization investmentFY 2025Increase in 2025 Increase in 2025 Maintained
Strategic alternatives reviewOngoingInitiated Jan 27, 2025; no timetable Process remains ongoing Maintained
ZURZUVAE brand cash flow profileExit 2026n/a“ZURZUVAE…will be cash flow positive exiting 2026” (management commentary) New commentary (non-formal guidance)

Earnings Call Themes & Trends

TopicQ3 2024 (10/29/24)Q4 2024 (2/11/25)Q1 2025 (4/29/25)Trend
Demand momentum & shipments~2,000 shipments; +40% QoQ ~2,500; +21% QoQ >3,000; +22% QoQ Accelerating QoQ growth sustained
Payer coverage & access>90% covered lives; PBMs favorable >95% coverage; first-line access common Management disputes survey concerns; majority get drug in ≤1 week Strong access sustained
Inventory and revenue recognitionLaunch normalization; inventory built earlier Revenue impacted by channel inventory; focus on shipments Inventory varies; focus on demand Persistent message: demand > inventory noise
Sales force & promotionSales force expansion launched for Q4 33% growth in expanded territories; more non-personal promotion planned Expansion complete; >65M consumer video views; HCP social launched Promotional scale-up progressing
Strategic alternativesn/aBiogen unsolicited bid rejected; review initiated (press) “Process remains ongoing” Continuing catalyst
Pipeline: SAGE-319Phase 1 MAD data late 2025 Phase 1 MAD late 2025 Phase 1 MAD late 2025; extrasynaptic GABA rationale Consistent timing, reinforced rationale
Pipeline: SAGE-324Evaluating indications incl. DEEs Considering DEEs; update mid-2025; no dev spend now Update mid-2025; focus on dose, regs, portfolio Decision point mid-2025
Partner BiogenNot pursuing MDD in US Aligned 50/50 co-commercial model No change in partner commitment observed Stable collaboration

Management Commentary

  • “We shipped greater than 3,000 prescriptions…a 22% increase from the fourth quarter…[and] generated $13.8 million in collaboration revenue…a 21% increase from the fourth quarter of 2024” – Barry Greene, CEO .
  • “Total ZURZUVAE writers increased by greater than 20% in Q1…once an HCP writes, there is strong repeat prescribing” – Chris Benecchi, COO .
  • “Approximately a 90% aided awareness for ZURZUVAE…remarkably high” – Chris Benecchi, on tracking studies .
  • “We see quarter-to-quarter growth throughout each quarter of this year” – Barry Greene on 2025 trajectory .
  • “ZURZUVAE as a brand will be cash flow positive exiting 2026” – Barry Greene .
  • “Strategic alternatives process remains ongoing” – Barry Greene .

Q&A Highlights

  • Demand vs. revenue: Multiple analysts probed inventory-related noise; management emphasized shipments to patients as the truest demand indicator and cautioned against reading too much into quarterly inventory swings .
  • Access/coverage concerns: In response to survey claims, management reiterated >95% coverage and short time-to-therapy for most patients, challenging “historical bias” in survey responses .
  • Sales force impact: Expansion completed in Q1; management expects continued quarter-to-quarter growth; earlier regions showed ~33% uplift in Q4 .
  • Partner alignment: No change seen in Biogen’s commitment to ZURZUVAE; collaboration remains 50/50 co-commercial .
  • Pipeline clarity: SAGE-324 decision expected mid-2025; SAGE-319 Phase 1 MAD readout late 2025; focus on extrasynaptic GABA and NMDA NAM rationale .

Estimates Context

  • We attempted to retrieve S&P Global consensus for Q1 2025 (Revenue Consensus Mean, Primary EPS Consensus Mean, # of estimates), but the S&P Global mapping for SAGE was unavailable via our data feed at the time of analysis. As a result, we cannot assess beat/miss versus Street for Q1 2025 using S&P Global data. If you want, we can source third-party consensus via public aggregators, but our default is S&P Global. [GetEstimates errors]

Key Takeaways for Investors

  • ZURZUVAE momentum is intact: Shipments and collaboration revenue both grew >20% QoQ in Q1, with OB/GYNs contributing ~80% of prescriptions and >70% first-line usage—key indicators of deepening adoption .
  • Marketing engine scaling: Completed sales force expansion and strong digital engagement (>65M video views) support sustained demand growth into 2025 .
  • Access tailwinds reduce friction: >95% covered lives and fast time-to-therapy underpin first-line positioning and help mitigate payer risk in the launch phase .
  • Operating model trending leaner: R&D down sharply YoY; while SG&A is elevated for commercialization and legal costs, management still expects 2025 OpEx to be substantially lower vs 2024 .
  • Cash runway to mid-2027: $424M cash at Q1-end and mid-2027 runway guidance ease near-term financing concerns; management also targets ZURZUVAE brand cash flow positivity exiting 2026 (commentary) .
  • Upcoming catalysts: Strategic alternatives review (timing unknown), SAGE-324 mid-2025 update, and SAGE-319 Phase 1 MAD data late 2025; these events can reset risk/reward .
  • Focus on demand metrics vs. quarterly noise: Management continues to steer investors toward shipment-based demand as a better indicator than channel-inventory-affected revenue prints .