ACADIA Pharmaceuticals Inc. (ACAD) Q2 2026 Earnings: Revenue $308M (+16.4%)
ACAD — Q2 2026 Financial Report Analysis
Q2 · Fiscal year 2026 · Published by Pham Hop
ACADIA's Q2 2026 revenue rose 16.4% to $308.0M as DAYBUE sales jumped 29.9% on the STIX launch, but a 20% rise in selling costs held operating margin flat at 12.3%; full-year revenue guidance was raised to $1.24–1.30B.
Revenue
$308M
+16.4% YoY
Net income
$32M
+18.1% YoY
Diluted EPS
$0.18
+12.5% YoY
Operating margin
12.3%
This period vs a year ago
Same period last year
This period
Revenue▲+16.4%
≈$265M
$308M
Net income▲+18.1%
≈$27M
$32M
Diluted EPS▲+12.5%
≈$0.16
$0.18
Year-ago figures (≈) are worked out from the growth rate the company reported. Each row has its own scale.
ACADIA Pharmaceuticals sells two drugs: NUPLAZID, for hallucinations and delusions in Parkinson's disease, and DAYBUE, the only approved treatment for Rett syndrome (a rare genetic brain disorder that mostly affects girls). In the second quarter of 2026 their combined sales rose 16.4% to $308.0 million, with DAYBUE doing most of the work: its sales jumped 29.9% as a new powder form (DAYBUE STIX) rolled out broadly. Profit grew more slowly than sales, because the company spent heavily on bigger sales teams. Management raised its full-year sales forecast.
At a glance
DAYBUE sales $124.8 million, up 29.9%. The filing credits both more units sold and a higher average net price. DAYBUE supplied about two-thirds of the quarter's $43.4 million revenue increase.
Operating margin 12.3%, flat on a year ago (12.2%). Operating margin is the share of revenue left after running the business, before interest and tax. Sales grew 16.4% but selling and admin costs grew 20.0%, so growth didn't turn into a wider margin.
Cash and investments $956.5 million, up $136.8 million since December, with no debt. All of that increase came from the business's own operating cash flow.
Results for the quarter
Metric
Q2 2026
Q2 2025
YoY Change
Total revenue (net product sales)
$308.0M
$264.6M
+16.4%
NUPLAZID net sales
$183.2M
$168.5M
+8.7%
DAYBUE products net sales
$124.8M
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$96.1M
+29.9%
Gross margin (after cost of product sales)
90.8%
92.2%
-1.4 pts
Research & development
$81.6M
$78.0M
+4.6%
Selling, general & administrative
$160.3M
$133.5M
+20.0%
Operating income
$37.8M
$32.4M
+16.9%
Operating margin
12.3%
12.2%
+0.1 pts
Net income
$31.5M
$26.7M
+18.1%
Diluted EPS
$0.18
$0.16
+12.5%
Source: condensed consolidated statements of operations in the Q2 2026 10-Q. Percentages are calculated from the filing's figures in thousands.
What drove the quarter
DAYBUE is the growth engine. The 10-Q says the $28.7 million DAYBUE increase "was due to the growth in DAYBUE unit sales as well as a higher average net selling price." The FDA approved DAYBUE STIX, a powder form of the same drug (trofinetide), in December 2025. ACADIA made it available on a limited basis in Q1 and launched it broadly in Q2. The earnings release says the quarter was "driven by strong uptake of DAYBUE STIX." Europe could open up next: in June 2026 the EMA's scientific committee recommended approval of the drug (sold there as DAYBU) after a re-examination. The European Commission has not yet made its final decision.
NUPLAZID grew on volume. NUPLAZID sales rose $14.7 million, which the 10-Q attributes to "growth in NUPLAZID unit sales." That is a respectable rate for a drug launched in 2016. The CEO credits new-to-brand prescriptions and "our recently expanded sales force."
Costs grew faster than sales. Selling, general and administrative expense (SG&A: sales force, marketing, head office) rose $26.7 million. The filing says this was "primarily driven by increased expenditures for DAYBUE products and NUPLAZID in the U.S., including the recent expansion of the DAYBUE and NUPLAZID teams." R&D rose only 4.6%, but its mix shifted sharply. Spending on remlifanserin, the lead pipeline drug, rose to $27.9 million from $18.0 million, and early-stage programs rose to $22.0 million from $12.9 million. Spending on ACP-101 (down to $2.2 million from $13.4 million) and on DAYBUE studies (down to $3.3 million from $9.4 million) fell as studies from 2025 wound down.
Cost of product sales edged up. It rose to 9.2% of sales from 7.8%. The company calls this "relatively flat." One likely contributor, which is our inference rather than the filing's explanation: DAYBUE carries royalties to its licensor Neuren at "tiered, escalating, double-digit percentages" of net sales. So every extra dollar of DAYBUE sales comes with a larger cost than a NUPLAZID dollar.
The first half is weaker than the quarter
The strong Q2 follows a weak Q1. For the six months, revenue rose 13.2% to $576.0 million, but operating income fell to $33.2 million from $51.7 million, and net income fell 23.0% to $35.1 million (diluted EPS $0.20 vs $0.27). Subtracting Q2 from the six-month totals shows ACADIA made an operating loss of about $4.6 million in Q1 2026. First-quarter SG&A was about $171.0 million, higher than Q2's $160.3 million. Six-month SG&A was up $71.4 million (+27.5%) on a year earlier. The quarter-on-quarter recovery is real, but at the half-year point 2026 profit is still behind 2025.
What the headline numbers hide
Operating cash flow is far higher than profit, but partly because bills are building up. Six-month cash from operations was $134.8 million against net income of $35.1 million. Part of the gap is ordinary non-cash items: $31.6 million of stock-based compensation and $9.7 million of deferred tax. But $79.8 million came from accrued liabilities (+$46.1 million) and accounts payable (+$33.7 million) rising. Accrued liabilities are costs already booked but not yet paid. The balance of rebates, data fees and returns owed on past sales grew to $187.3 million from $140.4 million. The filing says ACADIA expects the invoice for Medicare Part D rebates under the Inflation Reduction Act, covering October 2025–September 2026, in June 2027. That cash has been counted as a cost but hasn't gone out yet. Cash generation will look weaker when it is paid.
Receivables grew faster than sales. Accounts receivable (money customers owe) rose 24.0% in six months, to $150.6 million from $121.5 million, and took $29.2 million out of operating cash flow. That compares with quarterly revenue up about 15% from Q1 to Q2. It isn't alarming on its own, since wholesalers' payment timing moves around, but it's worth watching in Q3.
The NUPLAZID comparison includes a small restatement. Q2 2025 NUPLAZID sales of $168.5 million included $2.4 million that ACADIA now allocates elsewhere, after a change in its estimate of Inflation Reduction Act rebates. The company's non-GAAP comparison therefore uses $166.1 million, making NUPLAZID growth 10% rather than 8.7% and total growth 17% rather than 16.4%. The underlying reported GAAP numbers are unchanged. Only the growth rate changes, by about a point.
Share dilution cut EPS growth. Net income rose 18.1% but diluted EPS rose 12.5%. The diluted share count grew 2.5% to 172.9 million as employees exercised stock options and awards. There were no share buybacks. The effective tax rate was similar in both years (32.2% vs 33.7%), so the profit growth came from operations, not from lower taxes.
Guidance improved on both revenue and costs. See below.
Takeaway: DAYBUE's 29.9% jump, driven by the STIX launch, is now the main reason ACADIA is growing. So far that growth is paying for a bigger sales force rather than widening margins: operating margin was 12.3% this quarter, flat on a year ago. Six-month profit is still down 23%.
Outlook
Management raised its full-year 2026 guidance with these results:
2026 guidance
Now
Previously
Total revenue
$1.24–1.30B
$1.22–1.28B
NUPLAZID net sales
$760–790M
$760–790M (reaffirmed)
DAYBUE (all forms, global) net sales
$480–510M
$460–490M
R&D expense
$355–380M
$385–410M
SG&A expense
$660–700M
$660–700M
What those ranges imply for the second half:
NUPLAZID needs a big step up. First-half NUPLAZID sales were $350.1 million, so the full-year range requires $410–440 million in H2. That is roughly $205–220 million a quarter, compared with $183.2 million in Q2. This is the most demanding part of the guidance.
DAYBUE needs much less. $226.0 million in H1 implies $254–284 million in H2, or about $127–142 million a quarter, compared with $124.8 million in Q2.
R&D rises and SG&A holds. R&D of $158.4 million so far implies about $197–222 million in H2, a step-up consistent with the remlifanserin Phase 3 now enrolling. SG&A would run at about $329–369 million in H2, roughly the H1 rate. If revenue lands in range while SG&A stays flat, second-half margins should improve on the first half.
Since the quarter ended: on September 24, 2026, ACADIA reported topline Phase 2 results for remlifanserin in Alzheimer's disease psychosis (the RADIANT study). The 60 mg dose narrowly missed its primary endpoint, a hallucinations-and-delusions scale (p=0.0603, just above the usual 0.05 bar for statistical significance). It did reach nominal significance on the key secondary endpoint, a clinician's global rating of severity (p=0.0077). The 30 mg dose showed minimal improvement over placebo, and safety was similar to placebo. The company is continuing into Phase 3 with the 60 mg dose. Remlifanserin is ACADIA's main bet for growth after its current two drugs, so a borderline Phase 2 raises the risk around the largest part of the R&D budget.
Our read: in the near term, the commercial business looks solid. DAYBUE's H2 guidance looks achievable at the current run rate, a possible EU approval of DAYBU adds a new market, and $956.5 million of cash with no debt pays for the pipeline. The two items to watch in Q3 are whether NUPLAZID's quarterly sales start moving toward the ~$205 million-plus run rate the guidance requires, and whether cash flow holds up as rebate accruals keep growing ahead of the mid-2027 Medicare payment. A patent trial against Zydus over a proposed generic NUPLAZID tablet is scheduled to begin on November 2, 2026, and is the main legal event on the calendar.