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Jefferies London Healthcare Conference Catherine Owen Adams Chief Executive Officer NOVEMBER 18, 2025
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Forward-Looking Statements This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements other than statements of historical fact and can be identified by terms such as “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “projects,” “predicts,” “outlook,” “potential,” "milestone," "guidance" and similar expressions (including the negative thereof) intended to identify forward-looking statements. Forward-looking statements contained in this presentation, include, but are not limited to, statements about: (i) our business strategy, objectives and opportunities; (ii) plans for, including timing, development and progress of commercialization or regulatory timelines for our products, including NUPLAZID and DAYBUE, and our product candidates; (iii) benefits to be derived from and efficacy of our products, including the potential advantages of our products,; (iv) the timing and conduct or our clinical trials; (v) estimates regarding the prevalence of the diseases targeted by our products and product candidates; (vi) potential markets for any of our commercial products; and (vii) our estimates regarding our future financial performance, product sales, cash position, profitability, expenses, or capital requirements. Forward-looking statements are subject to known and unknown risks, uncertainties, assumptions and other factors that may cause our actual results, performance or achievements to differ materially and adversely from those anticipated or implied by our forward-looking statements. Such risks, uncertainties and other factors include, but are not limited to: our dependency on the continued successful commercialization of our products and our ability to maintain or increase sales of our products; the costs of our commercialization plans and development programs, and the financial impact or revenues from any commercialization we undertake; our ability to obtain necessary regulatory approvals for our product candidates and, if and when approved, market acceptance of our products; our dependence on third-party collaborators, clinical research organizations, manufacturers, suppliers and distributors; the impact of competitive products and therapies; our ability to generate or obtain the necessary capital to fund our operations; our ability to grow, equip and train our specialized sales forces; our ability to manage the growth and complexity of our organization; our ability to maintain, protect and enhance our intellectual property; our ability to meet our financial guidance; and our ability to continue to stay in compliance with applicable laws and regulations. Given the risks and uncertainties, you should not place undue reliance on these forward-looking statements. For a discussion of these and other risks, uncertainties and other factors that may cause our actual results, performance or achievements to differ, please refer to our annual report on Form 10-K for the year ended December 31, 2024 as well as our subsequent filings with the Securities and Exchange Commission from time to time, including our quarterly reports on Form 10-Q. The forward-looking statements contained herein are made as of the date hereof, and we undertake no obligation to update them after this date, except as required by law. 2
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Building Long Term Growth in Neurological & Rare Diseases CORE COMMERCIAL FRANCHISE LATE-STAGE PIPELINE EARLY-STAGE PIPELINE BUSINESS DEVELOPMENT EXPANSION AREAS Alzheimer's Disease Psychosis ACP-204 (new 5-HT2A) Lewy Body Dementia Psychosis ACP-204 (new 5-HT2A) Major Depressive Disorder ACP-211 (NMDA receptor antagonist) Essential Tremor ACP-711 (selective GABAA-α3 modulator) Tardive Dyskinesia ACP-271 (GPR88 agonist) Rett/Fragile X ACP-2591 (cGP analogue) Huntington's Disease ACP-271 (GPR88 agonist) SYNGAP1 Stoke ASO (antisense oligonucleotide) Endocrine Metabolic Nephrology Cardiovascular Immunology NEUROLOGICALRARE POWERED BY: Precision medicine | Data innovation | Globalization | Patient empowerment 3
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4 Additional Potential for Pipeline-Driven Growth for New Products 1. Previously provided 2025 financial guidance (May 6, 2025). 2. Based on internal Acadia estimates for current products as of November 2025. 3. Internal Acadia estimate for risk adjusted peak sales potential of pipeline molecules as of November 2025. 4. Internal Acadia estimate for full potential peak sales for pipeline molecules as of November 2025, assuming all are successfully approved and commercialized. Note: Peak sales used for calculations do not all occur within the same fiscal year. Potential Peak Sales of Current Products 2025 Guidance Risk-adjusted Peak Sales Potential Full Peak Sales Potential $1.5-$2 Billion2 >$1 Billion1 $11 Billion4 $2.5 Billion3 Current Commercial Outlook Building from a position of strength with NUPLAZID and DAYBUE Incremental Pipeline Potential Addressing high unmet needs with little competition
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Recent 8 Disclosed and multiple undisclosed programs Phase 2 or Phase 3 study readouts anticipated by the end of 2027 REFLECTS BREADTH OF PIPELINE AND STRENGTH OF R&D STRATEGY 5 4 Additional Phase 2 or Phase 3 study starts expected by the end of 2026 Building Momentum Across Our Pipeline Anticipated Phase 2 Initiation of ACP-204 in Lewy Body Dementia Psychosis Phase 3 Initiation of trofinetide in Japan 4Q25 Phase 2 initiation of ACP-211 in Major Depressive Disorder 1Q26 Initiate first-in-human study of ACP-271 in healthy volunteers EU CHMP opinion on trofinetide Mid-2026 Top-line results from Phase 2 study of ACP-204 in Alzheimer's Disease Psychosis 5
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Neurological 6
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Overview of Parkinson's-Related Hallucinations and Delusions ~1M patients with Parkinson’s Disease (PD) in U.S. Around 50% may develop hallucinations and/or delusions at some point during course of their disease 1 SYMPTOMS Seeing, hearing or experiencing things that others don’t Believing things that are not true Low awareness Market research indicated that at the start of 2024 less than 10% of caregivers and patients were aware that hallucinations and delusions are associated with PD 2 ~130,000 PD patients are treated with an atypical antipsychotic annually 3 1. Elin B Forsaa, et al. A 12-year population-based study of psychosis in Parkinson disease Arch. Neurol.. 2010; Aug;67(8):996-1001 2. Source: Acadia confidential market research; 3. Acadia estimate as of June 2024 based on claims data 7
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~93K ~25% 2038 NUPLAZID for the Treatment of Parkinson’s- Related Hallucinations and Delusions NUPLAZID is the first and only FDA-approved drug for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. Patients treated Share of 130,000 patients on atypical antipsychotics Capsule formulation patent expiry after composition of matter patent expiry to October 2030 3Q Update: Based on Acadia internal estimates. 8
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NUPLAZID Q3 Update Referrals +21% YoY growth Commercial momentum Strong HCP and patient engagement driving awareness and NUPLAZID demand Executional focus on driving referral demand with rapid conversion into new prescriptions New prescriptions +23% YoY growth 2026 strategic investments 30% increase in customer- facing roles starting in 1Q26 Strategic focus on recently diagnosed patients and newly activated physicians for broader reach $177.5M Net sales +12% YoY growth 9 $159.2M $162.9M $159.7M $168.5M $177.5M 150 155 160 165 170 175 180 NUPLAZID Net Sales 3Q24 4Q24 1Q25 2Q25 3Q25
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Rare Disease 10
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1. Acadia market research, Neul JL et al, Annal Neurol. 2010;68;944-50 and https://www.rettsyndrome.org/about-rett-syndrome/ what-is-rett-syndrome/. 2. Based on Acadia Pharmaceuticals analysis of claims data as of 2024 claims data. 3. Based on Acadia internal estimates. 11 Overview of Rett Syndrome Typically caused by mutations in the MECP2 gene disrupting the function of MECP2 protein crucial for brain development and function Debilitating Symptoms of Rett Syndrome1 ~5,500–5,800 diagnosed patients in U.S.2 with a prevalent population of ~6,000 - 9,000 ~9,000–12,000 prevalent population in EU3 SYMPTOMS Fine and gross motor impairment Loss of verbal and nonverbal communication Hand stereotypes Loss of independence and require 24/7 support GI symptoms including severe constipation Seizures 11
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+2000 Patients treated >50% Persistency at 12 months The first and only FDA approved drug for the treatment of Rett syndrome in adults and pediatric patients 2 years of age and older. DAYBUE for the Treatment of Rett Syndrome SEEKING APPROVAL IN EU - CHMP OPINION ANTICIPATED Q1 2026 >300 Patients in the LOTUS real-world observational study Based on Acadia internal estimates. 12
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DAYBUE Q3 Update Market penetration U.S. overall: ~40% Community setting: ~27% Q3 field force execution Highest QoQ referral growth since launch 74% of new prescriptions from community physicians Named patient supply programs available across multiple regions EU Israel Middle East Latin America $101.1M Record net sales quarter 1,006 Patients treated globally 13 $69.9M $91.2M $101.1M 50 60 70 80 90 100 110 DAYBUE Net Sales 3Q23 3Q24 3Q25
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Pipeline 14
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Neurological and Rare Diseases Pipeline PROGRAM INDICATION MOLECULE DESCRIPTION DISCOVERY IND ENABLING PHASE 1 PHASE 2 PHASE 3 LAUNCHED Neurological diseases NUPLAZID® 1 Parkinson's Disease Psychosis 5HT2A inverse agonist and antagonist ACP-204 3 Alzheimer's Disease Psychosis New 5HT2A inverse agonist ACP-204 3 Lewy Body Dementia w/ Psychosis New 5HT2A inverse agonist ACP-711 3, 4 Essential Tremor Selective GABAA-α3 modulator Est. 4Q25 ACP-211 3 Major Depressive Disorder Deuterated R-norketamine ACP-271 3 Tardive Dyskinesia GPR88 agonist Est. 1Q26 1. NUPLAZID (pimavanserin) is only approved in the U.S. by the FDA for the treatment of hallucinations and delusions associated with Parkinson’s disea se psychosis. 2. Acadia has an exclusive license to develop and commercialize trofinetide worldwide from Neuren Pharmaceuticals. DAYBUE (trofinetide) is only approved in the U.S. by the FDA and in Canada by Health Canada for the treatment of Rett syndrome in adults and pediatric patients two years of age and older. 3. Investigational agents, for which the safety and efficacy of these agents have not been established. There is no guarantee these investigational agents will be filed with or approved by any regulatory agency. 4. Acadia entered into an exclusive worldwide license agreement with Saniona for the development and commercialization of ACP -711. 5. Acadia entered into a collaboration with Stoke Therapeutics to discover, develop and commercialize novel RNA -based medicines for the potential treatment of severe and rare genetic neurodevelopmental diseases; ASO = Antisense oligonucleotide. 6. ACP-271 study is in health volunteers. Rare diseases DAYBUE® 2 Rett Syndrome Analogue of GPE ACP-2591 3 Rett Syndrome; Fragile X Syndrome cGP analogue ACP-271 3 Huntington’s Disease GPR88 agonist Est. 1Q26 STOKE ASO 3, 5 SYNGAP1 Antisense oligonucleotide (ASO) 15
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ACP-204 Program Designed to Build Upon Lessons From Pimavanserin ACP-204 Pimavanserin Speed time of onset Enable dose-ranging to higher exposures Design study to robustly evaluate disease under study Minimize or eliminate QT prolongation Acadia Pharmaceuticals Inc. Data on file. 16
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1. Cummings J. et al. Criteria for Psychosis in Major and Mild Neurocognitive Disorders: International Psychogeriatric Associations (IPA) Consensus Clinical and Research Definition. Am J of Geriatric Psychiatry. 2020; 28 (12); 1256-1269 2. Based on Acadia internal estimates. Overview of Alzheimer’s Disease Psychosis (ADP) Approximately 30% of patients with Alzheimer’s disease experience psychosis commonly consisting of hallucinations and delusions1. There are no approved treatments for hallucinations and delusions associated with Alzheimer’s disease psychosis. Affecting 800,000 to 850,000 Alzheimer’s patients in U.S. currently treated with antipsychotics, antidepressants or mood stabilizers2. 17
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Global, placebo-controlled, double-blind Phase 2 enrolling ADP = Alzheimer’s Disease Psychosis; QD = Once Daily; SAPS-H+D = Scale for Assessment of Positive Symptoms - Hallucinations + Delusions. NCT06159673 ACP-204: RADIANT Phase 2 / Phase 3 Trial in Alzheimer's Disease Psychosis PHASE 2 N=318, double-blind, randomized 1:1:1 TWO PHASE 3 STUDIES of similar size Placebo ACP-204 (60 mg QD) ACP-204 (30 mg QD) Top-Line Results Expected Mid-2026 PRIMARY ENDPOINT SAPS-H+D total score change from baseline to Week 6 Placebo ACP-204 (60 mg QD) ACP-204 (30 mg QD) 6-WEEKS 6-WEEKS 52-WEEK DURATION OPEN-LABEL STUDY 18
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LBD is a progressive brain disorder that affects thinking, movement, mood, and behavior Associated with abnormal deposits of alpha-synuclein in the brain1. No therapies approved for LBD with psychosis and some traditional antipsychotics that are commonly used in other diseases can be harmful. >1 million people in the U.S may be living with LBD; 50% -75% of people with LBD experience psychosis (LBDP) 2 Approximately 200,000 patients living with LBD are being treated with antipsychotics3 1. Simuni T, Chahine LM, Poston K, et al. A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research. Lancet Neurol. 2024 Feb;23(2):178-190. doi: 10.1016/S1474-4422(23)00405-2. PMID: 38267190. 2. Cummings et al 2018. 3. Based on IQVIA data and Acadia internal estimates. Overview of Lewy Body Dementia (LBD) 19
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Parkinson’s Disease Dementia Lewy Body Dementia with Psychosis Dementia with Lewy Bodies Recently Initiated Phase 2 Study in Lewy Body Dementia with Psychosis in Q3 2025 Phase 2 program will enroll both Parkinson’s Disease Dementia and Dementia with Lewy Bodies patients with psychosis Relapse data from pimavanserin withdrawal study suggest potential utility of targeting 5HT2A in these patients % of patients experiencing relapse: 5.3% (1 of 19) patients receiving pimavanserin 55.0% (11 of 20) receiving placebo Alpha-synuclein and other biomarkers will be evaluated to characterize patient population 20
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52-WEE PRIMARY ENDPOINT SAPS-LBDP at 6 Weeks KEY SECONDARY ENDPOINT CGI-S-LBDP EXPLORATORY BIOMARKER Skin biopsy for neuronal α-synuclein disease SAFETY FOLLOW UP Global, placebo-controlled, double-blind Phase 2 enrolling ACP-204: Phase 2 Randomized, Placebo-Controlled Trial in Lewy Body Dementia with Psychosis RANDOMIZATION OF PATIENTS STRATIFIED BY DIAGNOSIS DOUBLE-BLIND TREATMENT PERIOD ACP-204 (60 mg QD) n=60 Parkinsons Disease Dementia–Psychosis (50% cap) Dementia Lewy Body– Psychosis CGI-I = Clinical Global Impressions – Improvement; CGI-S = Clinical Global Impressions – Severity; DLB-P = Dementia with Lewy Bodies-Psychosis; LBDP = Lewy Body Dementia with Psychosis; PDD-P = Parkinson’s Disease Dementia - Psychosis; QD = Once Daily; SAPS = Scale for Assessment of Positive Symptoms. Acadia Pharmaceuticals Inc. Data on file. NCT07029581 ACP-204 (30 mg QD) n=60 Placebo n=60 6-WEEKS 4-WEEKS 52-WEEK DURATION OPEN-LABEL STUDY6-WEEKS 21
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Major Depressive Disorder is a common and serious medical illness that is marked by persistent sadness and loss of interest, often leading to emotional and physical problems 1-2 ACP-211: Major Depressive Disorder Unmet Need Current approved treatments for Major Depressive Disorder can be limited by extent and onset of efficacy, or show quick anti-depressant impact but require extensive in-office medical monitoring because of sedation and dissociation 3 Rationale for Development ACP-211 designed as an oral therapy with potential for ketamine-like efficacy, targeting minimal required in-office monitoring 1. Olanow CW, et al. In: Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill; 2015. 2. Ghanekar S, Zesiewicz T. Practical Neurology. 2023; September/October:20. https://practicalneurology.com/articles/2023-sept-oct/treatment-of-essential-tremor. 3. Louis ED, et al. Eur J Neurol. 2010;17:882-884 22
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Pervasive Disease Burden and Unmet Need in Major Depressive Disorder (MDD) ~21M Adults with MDD1 ~9M medically treated in the US2 ~3M Patients with treatment-resistant depression (TRD) in the US2 Economic burden in the US (2020 values)4 2 ~$326B Highest cause of disability (all diseases) *3 1. https://www.nimh.nih.gov/health/statistics/major-depression 2. Zhdanava M, et al. J Clin Psychiatry 2021; 82(2):20m13699. 3. JAMA 2013; 310:591 4. Greenberg PE, et al. Pharmacoeconomics. 2021 Jun;39(6):653-665. *Ranked by years lived with disability in 2010 ND 23
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21- UP TO 42 DAYS 4-WEEKS MADRS = Montgomery-Åsberg Depression Rating Scale; MDD = Major Depressive Disorder; TPP = Target Product Profile Acadia Pharmaceuticals Inc. Data on file. MDD Patients with inadequate response to Anti-depressant treatment N =153 randomized 1:1:1 PRIMARY ENDPOINT Δ MADRS Total at week 4 DOUBLE-BLIND TREATMENT PERIOD SCREENING PERIOD Placebo ACP-211 low dose ACP-211 high dose Phase 2 projected study start Q4 2025 ACP-211: Phase 2, 4-week, randomized, double-blind, placebo-controlled, multi-center study 24
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Essential Tremor is a movement disorder with high-frequency postural and/or kinetic tremor, mainly affecting the upper limbs 1 ACP-711: Essential Tremor Unmet Need Current treatments for essential tremor are not always effective and can have significant side effects2,3 No new pharmacological therapies have been approved in >50 years Rationale for Development ACP-711 is a selective GABAA-α3 modulator targeting cerebellar GABA system dysfunction Phase 1 data to date support potential absence of cognitive or sedative effects, negative impact on sleep 1. Olanow CW, et al. In: Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill; 2015. 2. Ghanekar S, Zesiewicz T. Practical Neurology. 2023; September/October:20. https://practicalneurology.com/articles/2023-sept-oct/treatment-of-essential-tremor. 3. Louis ED, et al. Eur J Neurol. 2010;17:882-884 25
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Pervasive Disease Burden and Unmet Need in Essential Tremor (ET) ~7M Or 2.2% of the US population is estimated to have ET1 Up to 10X ~1M people More prevalent than Parkinson’s disease2 Who were diagnosed with ET in the US sought treatment 3* FROM 2015 TO 2019 1. Louis ED, Ottman R. Tremor Other Hyperkinet Mov (N Y). 2014;4:259. 2. https://tremor.org.uk/essential-tremor. 3. Vetterick C, et al. Adv Ther. 2022 Dec;39(12):5546-5567. *In a retrospective, observational study of a large US insurance claims database 26
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Phase 1 Elderly cohort underway Phase 2 Projected study start Q4 2026 ADP = Alzheimer’s Disease Psychosis; QD = Once Daily; SAPS-H+D = Scale for Assessment of Positive Symptoms - Hallucinations + Delusions. NCT06159673 ENDPOINTS INCLUDE Δ TETRAS-PS Score at week 4 Δ TETRAS-ADL Score at week 4 Δ CGI-I at week 4 SCREENING PERIOD N=150 randomized 1:1:1 Essential Tremor Patients Placebo ACP-711 low dose ACP-711 high dose DOUBLE-BLIND TREATMENT PERIOD ACP-711: Next Steps in Clinical Development DAY -28 TO 0 4-WEEKS 27
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ACP-271: GPR88 Program Provides Unique Opportunities in Treatment of Multiple Neurological Disorders GPR88 ACP-271 Graphical representation; not indicative of actual binding site ACP-271 is an investigational agent, for which the safety and efficacy have not been established or approved by the FDA Orally dosed potential first-in-class GP88 agonist that may modulate the balance of D1 and D2 signaling without affecting dopamine levels. Target indications in both Tardive Dyskinesia and Huntington’s Disease Anticipate initiating first-in-human study in healthy volunteers during Q1 2026 28
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ACP-711 Phase 2 in Essential Tremor ACP-271 Phase 1 in Healthy Volunteers ACP-101 ACP-211 in Major Depressive Disorder Phase 2 in LBDP 2025-2026 Completed and Anticipated Milestones Q1 Q3 Q4Q2 ACP-204 (ADP/LBDP) 2025 Q1 Q3 Q4Q2 TOP-LINE RESULTS & SUBSEQUENT CLOSE OUT FIRST PATIENT IN FIRST PATIENT IN FIRST PATIENT IN FIRST PATIENT IN 2026 Anticipated CHMP Opinion Name patient supply available in select countries Phase 3 in Japan Filed MAA with EMA FIRST PATIENT IN Phase 2 in ADP TOP-LINE RESULTS Annual Sales > $1B Other Pipeline Programs 29 Corporate
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Q&A 30