Acadia's DAYBUE surge lifts Q3 revenue 23%, but a tax swing and heavier SG&A cut net income

The quarter in numbers

Acadia reported third-quarter 2026 GAAP total revenues of $342 million, up 23% from $279 million a year earlier. Against non-GAAP adjusted revenues of $281 million in the prior-year quarter, growth was 22%. The adjustment reflects a change in estimate for NUPLAZID IRA rebate accruals, which the company detailed in a February 25, 2026 release. Both products are sold in the U.S. and, in DAYBUE's case, abroad; all revenue is net product sales.

Income from operations reached $71.7 million, against $35.8 million in the third quarter of 2025. Net income nonetheless fell to $53.5 million, or $0.31 per diluted share, from $71.8 million, or $0.42. For the nine months, revenue was $918.3 million versus $787.5 million, while net income was $88.7 million versus $117.4 million.

DAYBUE leads, NUPLAZID follows

DAYBUE net sales of $140 million rose 39% from $101 million. The company attributed the growth to strong uptake of DAYBUE STIX, the formulation approved alongside the original DAYBUE in the U.S. The release does not split DAYBUE sales by region, so the contribution from Canada and the new European launch cannot be isolated.

NUPLAZID net sales were $202 million, up 14% on a GAAP basis from $178 million and up 12% on the non-GAAP adjusted basis from $180 million. The company said growth was driven by underlying demand and continued expansion of its commercial reach. The release gives no price-versus-volume breakdown for either product.

Costs, margins and the tax swing

Operating leverage was visible at the operating line. Using the release's figures, operating income was about 21% of revenue, compared with roughly 13% a year earlier (our calculation). R&D expense fell to $76 million from $88 million. SG&A rose to $159 million from $133 million, though it slipped as a share of revenue, from about 48% to about 46.5% (our calculation).

Cost of product sales, which includes license fees and royalties, rose to $35.1 million from $21.6 million. That is roughly 10% of revenue versus about 8% a year earlier (our calculation). The release does not explain the increase.

The main reason net income fell despite higher operating income is tax. Acadia booked income tax expense of $26.9 million in the quarter, against a benefit of $27.2 million in the third quarter of 2025. Pre-tax income actually rose to $80.4 million from $44.6 million. The release gives no explanation for the swing, so year-over-year net income and EPS comparisons should be read with that in mind.

Cash and investment securities rose to $976 million from $820 million at year-end 2025. Over the same period, accounts receivable rose to $161.0 million from $121.5 million.

Guidance: DAYBUE up, ranges tightened

Acadia raised 2026 DAYBUE net sales guidance, covering all forms of trofinetide, to $505–$520 million from $480–$510 million. It narrowed NUPLAZID to $760–$775 million from $760–$790 million, trimming the top end. Total revenue guidance is now $1.265–$1.295 billion, versus $1.24–$1.30 billion previously, which lifts the low end and lowers the high end.

Spending guidance moved too. R&D is now $325–$340 million, down from $355–$380 million. SG&A is $665–$685 million, narrowed from $660–$700 million. Nine-month R&D of $234.7 million and SG&A of $490.5 million imply fourth-quarter spend of roughly $90–$105 million and $175–$195 million respectively (our arithmetic). Both would be above the third-quarter levels. Likewise, nine-month revenue of $918.3 million implies fourth-quarter revenue of roughly $347–$377 million at the guided range (our arithmetic).

Pipeline and regulatory catalysts

The company announced Phase 3-enabling topline results from the Phase 2 RADIANT study of remlifanserin in Alzheimer's disease psychosis. It cited consistent efficacy trends at the 60 mg dose across all four psychosis scales assessed in the full study population, plus a favorable safety and tolerability profile. Additional data will be presented at the Clinical Trials on Alzheimer's Disease conference in Boston on November 17, 2026. Remlifanserin also received FDA Fast Track designation for Lewy body dementia psychosis.

For 2027, Acadia expects two Phase 2 readouts: ACP-211 in major depressive disorder in the second half, and remlifanserin in Lewy body dementia psychosis in the fourth quarter. The latter timing is guided for the first time.

On DAYBUE, the European Commission approved DAYBU in August 2026 for Rett syndrome patients aged five and older. The company said it launched in Germany in early October, with patients already on commercial product. A new U.S. patent allowance covering weight-banded dosing of trofinetide would extend protection for DAYBUE and DAYBUE STIX by nearly five years, through March 2041. In Japan, a completed Phase 3 trial was consistent with LAVENDER. Acadia is seeking a distribution partner ahead of a 2027 filing and a potential 2028 launch, subject to approval.

What to watch next

Near-term markers are the November 17 RADIANT presentation and the pace of the German DAYBU launch, which began in the fourth quarter and so is outside this quarter's results. Investors and competitors will also track whether the implied step-up in fourth-quarter R&D and SG&A is matched by revenue within the guided range, and how the tax line behaves. Beyond that, the focus shifts to a Japan partnership and the 2027 readouts.