Collegium's Q3: ADHD growth and AZSTARYS offset a pain decline, but profit falls

The quarter in numbers

Collegium Pharmaceutical reported product revenues, net of $216.3 million for the quarter ended September 30, 2026, against $209.4 million a year earlier, a 3% increase. The company called it a record quarter.

Profit measures moved the other way. GAAP net income was $21.8 million, or $0.60 per diluted share ($0.69 basic), versus $31.5 million and $0.84 diluted ($1.00 basic) in the 2025 quarter. Non-GAAP adjusted net income was $75.2 million, or $1.96 per share, versus $87.3 million and $2.25. Adjusted EBITDA was $121.6 million versus $133.0 million, down 9%.

By our arithmetic, adjusted EBITDA was about 56% of revenue in the quarter, against about 64% a year earlier. The release does not state margins.

ADHD is carrying the growth story

JORNAY PM net revenue reached $51.9 million, up 24%. The company said prescriptions grew 16% year over year, and nearly 33,000 healthcare providers wrote JORNAY PM prescriptions, up 19% to an all-time high. The release does not split the revenue growth into volume, price or mix. Revenue growth of 24% against prescription growth of 16% leaves a gap the company did not explain.

AZSTARYS contributed $26.5 million in what the company described as its first full quarter of sales under Collegium ownership. Prescriptions grew nearly 2% against the 2025 quarter. CEO Vikram Karnani framed that as an improvement on AZSTARYS' annual prescription decline in 2025, before the acquisition.

Together the two ADHD brands total $78.4 million by our sum. CFO Colleen Tupper said the ADHD franchise now contributes more than 36% of total revenue, which is consistent with that figure.

Pain: the foundation is eroding

The pain portfolio generated $138.0 million, down 18%. The release gives these brand-level figures:

Belbuca net revenue was $57.7 million, down 1%. Xtampza ER was $45.8 million, down 9%. The Nucynta franchise was $30.8 million, down 44%, and included $4.2 million from Hikma for sales of the authorized generic versions of Nucynta and Nucynta ER. The release gives no reasons for these declines. The three named brands sum to $134.3 million, and the release does not itemize the remaining difference to $138.0 million.

The 3% headline growth rests on the acquisition. If the 2025 base contained no AZSTARYS revenue, as the "first full quarter" language implies, revenue excluding AZSTARYS would be about $189.8 million, roughly 9% below the prior-year quarter. That is our calculation, not a company figure. Management describes pain as a "strong financial foundation," but the Nucynta decline is the steepest in the portfolio.

Costs and cash

GAAP operating expenses rose 44% to $96.7 million from $67.1 million. Adjusted operating expenses, which exclude stock-based compensation and acquisition-related expenses, rose 25% to $69.4 million from $55.7 million. Costs therefore grew much faster than revenue even on the adjusted measure. That fits the company's comments about expanded commercial efforts ahead of back-to-school and targeted investment behind AZSTARYS, though the release does not break the increase down by cause.

The company generated $86.5 million in cash from operations and ended the quarter with $144.8 million in cash, cash equivalents and marketable securities. It announced a $50 million accelerated share repurchase in the third quarter, with final settlement expected in the fourth quarter. Tupper said the company expects to complete the program before year-end. Her stated capital priorities are business development, paying down debt and opportunistic returns to shareholders. The portion of the release available to us gives no debt balances.

Guidance and catalysts

Collegium reaffirmed full-year 2026 guidance: product revenues, net of $825 to $855 million; JORNAY PM net revenue of $190 to $200 million; AZSTARYS net revenue of $65 to $75 million; and adjusted EBITDA of $445 to $470 million. The company did not reconcile adjusted EBITDA guidance to GAAP, citing the unreasonable-efforts exception.

The release contains no year-to-date figures, so we cannot derive what the fourth quarter must deliver. The release also names no regulatory or pipeline catalysts. Scientific activity was limited to seven JORNAY PM and AZSTARYS abstracts at the AACAP and NEI meetings. Commercial initiatives included the Start Talking ADHD resource hub and a partnership with Boston Legacy FC.

What to watch next

Three questions stand out. First, whether AZSTARYS prescription growth of nearly 2% holds and builds toward the $65 to $75 million guided range. Second, how quickly pain declines, especially Nucynta, outpace ADHD gains, and how that affects the adjusted EBITDA margin. Third, how the company deploys capital beyond the ASR, given its stated focus on business development and debt reduction.

Management will take questions at investor conferences in Q4: Stifel on November 11, Truist on November 12, Jefferies London on November 17 and Piper Sandler on December 1.