Axsome Therapeutics, Inc. (AXSM) Earnings & Analysis

Latest quarter

Axsome reported Q2 FY2026 revenue of $218.4 million, below the $224.5 million consensus. Its adjusted loss of −$0.99 per share, as the consensus counts it, matched the estimate. Revenue rose 45.5% from $150.0 million a year earlier.

The filing attributed higher product sales primarily to increased unit volumes for Auvelity and Sunosi. Auvelity U.S. net sales rose to $180.3 million from $119.6 million, while Sunosi net sales increased to $33.8 million from $28.9 million. Symbravo U.S. net sales were $2.3 million, compared with $0.4 million a year earlier, when the product began commercial sales.

Axsome’s gross margin rose to 93.8% from 91.0%, while its operating margin was −22.7%, compared with −24.5% a year earlier. The filing said selling, general and administrative expenses rose to $208.1 million from $130.3 million, driven partly by commercial activity and personnel costs. Net loss increased to $51.3 million from $48.0 million. Free cash flow was −$33.4 million, compared with −$32.4 million a year earlier.

Adjusted EPS is the figure the consensus estimates, not the GAAP EPS above.

What management said on the call

CEO Herriot Tabuteau said Axsome launched Auvelity for Alzheimer’s disease agitation during the quarter and completed its sales-force expansion. Chief Commercial Officer Ari Maizel said overall Auvelity prescriptions reached approximately 266,000 in Q2, while new-to-brand prescriptions rose 26% from Q1.

Asked about the sources of growth, Maizel said the Q2 increase in new prescribers and new-to-brand prescriptions largely came from the expanded sales force and predominantly from the major depressive disorder indication. He said primary care was the predominant growth driver in the quarter and that Axsome expected more specialists to adopt the treatment as the Alzheimer’s agitation launch progressed.

Analysts also asked about sampling. Maizel said free samples let clinicians give patients titration doses before a first prescription, but Axsome did not share sampling as a proportion of overall demand. He noted that “samples are not prescriptions” and therefore do not appear in the prescription data he discussed.

For Symbravo, Maizel said underlying demand grew 30% versus Q1 and that the sales force was expanding to approximately 150 representatives. CFO Nick Pizzie said Symbravo net sales decreased $1.8 million from Q1, primarily reflecting a prior-period adjustment and greater patient-service program use. He said its gross-to-net discount moved into the high 80% range, while discounts for Auvelity and Sunosi were each approximately 50% in Q2. Pizzie expected the Symbravo discount to return to prior levels for the rest of the year and the other two discounts to improve throughout the year.

Asked about inventory, Pizzie said “there was no stocking at the end of the quarter” and that inventory remained roughly at two weeks. He said research and development spending would continue to rise as ADHD trials had begun. Tabuteau said the FDA accepted Axsome’s application for AXS-12 for cataplexy in narcolepsy, with a target action date of May 1, 2027, and that Axsome anticipated fourth-quarter results from its binge eating disorder trial.

Guidance

On the Q1 call, CFO Nick Pizzie said selling, general and administrative expenses would likely increase in Q2 and level out shortly thereafter. In its Q2 filing, Axsome said it anticipated those expenses would marginally increase through the end of 2026 as commercial activities continued.