Slides
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Third Quarter 2026 Earnings Call November 4, 2026
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Call Agenda Al Kildani Senior Vice President, IR and Corporate Communications Welcome Catherine Owen Adams Chief Executive Officer CEO Opening Remarks Tom Garner Executive Vice President, Chief Commercial Officer Commercial Update Sanjeev Pathak, M.D. Senior Vice President, Head of Clinical Development R&D Update Mark Schneyer Executive Vice President, Chief Financial Officer Financial Update Catherine Owen Adams Chief Executive Officer Closing Remarks All Q&A Session 2
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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, including sales growth for DAYBUE, uptake of DAYBUE STIX, and potential for enhanced stockholder value; (ii) expectations for NUPLAZID’s commercial reach; (iii) the continued development of remlifanserin in Alzheimer's disease psychosis (ADP) and Lewy body dementia psychosis, as well as our other product candidates; (iv) the safety profile of remlifanserin; (v) the interpretation of topline results from our Phase 2 RADIANT study, including post-hoc and enriched subgroup analyses; (vi) the approval and commercial launch of DAYBU (trofinetide) in the EU and our plans for continued expansion in the EU; (vii) plans for, including timing, development and progress of commercialization, clinical or regulatory milestones for our products, and our product candidates; (viii) benefits to be derived from and efficacy of our products, including the potential advantages of our products; (ix) estimates regarding the prevalence of the diseases targeted by our products and product candidates; (x) potential markets for any of our commercial products; (xi) our expectations to advance out clinical programs and their potential to become meaningful growth opportunities, including our belief that the results from the Phase 2 RADIANT will enable the Phase 3 study of remlifanserin in ADP; (xii) our plans to pursue distribution partnerships for trofinetide in Rett syndrome; and (xiii) our estimates regarding our future financial performance, cash position, profitability, expenses, or capital requirements, including our 2026 financial guidance and potential peak sales in Alzheimer’s disease psychosis and Lewy body dementia. 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; 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 quarterly report on Form 10-Q for the quarter ended September 30, 2026, anticipated to be filed today, as well as our subsequent filings with the Securities and Exchange Commission from time to time. 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. Non-GAAP Financial Measures: In addition to the financial results and financial guidance that are provided in accordance with accounting principles generally accepted in the United States (GAAP), this presentation also contains the following non-GAAP (also referred to herein as adjusted) financial measures: non-GAAP adjusted revenues for NUPLAZID for the third quarter of 2025 and non-GAAP adjusted total revenues for the third quarter of 2025. When preparing the non-GAAP financial results, the Company excludes adjustments made to reflect the change in estimate in its NUPLAZID Inflation Reduction Act rebate accruals covering the third quarter of 2025, which management considers to be unusual and a non-recurring item. These non-GAAP financial measures are provided as a complement to results provided in accordance with GAAP. Our management uses this non-GAAP measure to better analyze the Company’s financial results, compare period-to-period and year-to-year changes and evaluate performance, and believes these non-GAAP financial measures are useful to investors and other users of the Company’s financial statements to help facilitate period-to-period comparisons. These non-GAAP financial measures are not meant to be considered in isolation or as a substitute for comparable GAAP measures; should be read in conjunction with the Company’s condensed consolidated financial statements prepared in accordance with GAAP; have no standardized meaning prescribed by GAAP; and are not prepared under any comprehensive set of accounting rules or principles in the reconciliation table included herein. Accordingly, the non-GAAP measures presented here are also unlikely to be comparable with non-GAAP disclosures released by other companies. In addition, from time to time in the future, there may be other items that the Company may exclude for purposes of its non-GAAP financial measures; and the Company may in the future cease to exclude items that it has historically excluded for purposes of its non-GAAP financial measures. Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are presented in the tables at the end of this presentation. 3
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Opening Remarks CHIEF EXECUTIVE OFFICER Catherine Owen Adams 4
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Third Quarter Highlights DAYBUE (trofinetide) is only approved in the United States (for the treatment of Rett syndrome in adults and pediatric patients two years of age and older), Canada, Israel and EU (for the treatment of neurobehavioral symptoms of Rett syndrome in adults and pediatric patients aged five years and older). NUPLAZID (pimavanserin) is only approved in the U.S. by the FDA for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. *Based on Non-GAAP adjusted net sales. See the Non-GAAP to GAAP reconciliations at the end of this presentation. 5 Q3 sales $140M, +39% YoY driven primarily by US STIX momentum Granted new patent allowance extending US LOE by nearly 5 years to 2041 Raising guidance range for FY 2026 now expect $505M to $520M Announced Phase 3 enabling data for remlifanserin in ADP Data from ILLUMERA Phase 2 study of remlifanserin in LBDP expected in Q4 2027 Data from NORLIGHT Phase 2 study of ACP-211 in MDD now expected in 2H 2027 Q3 sales $202M, +12%* YoY Growth driven primarily by volume Narrowing guidance range for FY 2026 to now expect $760M to $775M R&D
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Commercial Update CHIEF COMMERCIAL OFFICER Tom Garner 6
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DAYBUEUpdates 7 $140M Q3 Net Sales* • Record, volume-driven growth with DAYBUE STIX expanding the opportunity through new patient starts and patient restarts • Launched commercially in Europe (Germany) • New U.S. patent protection through March 2041 extends the long-term growth runway +13% +39% YoY Growth 50 75 100 125 150 DAYBUE Net Sales 3Q25 3Q26 $101M $140M +39% *As used herein, references to DAYBUE net product sales includes global net product sales of all commercially available forms of trofinetide, including DAYBUE, DAYBUE STIX and future net sales of DAYBU.
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DAYBUE Growth Drivers Support Long-Term Opportunity 8 Received European Commission approval Launched commercially in Germany with patients already receiving treatment Additional country market reimbursement dossiers to be submitted this year European ExpansionSTIX Adoption Building Momentum Continued new patient uptake and restarts provide two distinct opportunities to drive sustained growth >50% of all U.S. DAYBUE patients are currently receiving STIX
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NUPLAZIDUpdates 9 $202M Q3 Net Sales +12% YoY Growth* *Based on Non-GAAP adjusted net sales. See the Non-GAAP to GAAP reconciliations at the end of this presentation. 100 125 150 175 200 NUPLAZID Net Sales 3Q25 3Q26 $180M* $202M +12%* • NBRx trends support continued volume-driven growth • Sales force expansion increasing HCP engagement, with meaningful potential upside as productivity matures • DTC investment expanding PDP awareness and supporting patient and caregiver engagement
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10 R&D Update SENIOR VICE PRESIDENT | HEAD OF CLINICAL DEVELOPMENT Sanjeev Pathak, M.D.
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Neurological and Rare Diseases Products and Pipeline Product candidates and 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. More information regarding our acquired or licensed product candidates (ACP-211, ACP-711, ACP-271, ACP-2591 and Stoke ASO) available in Acadia's public filings. Rare diseases DAYBUE® Franchise Rett Syndrome Analog of GPE ACP-2591 Rett Syndrome, Fragile X Syndrome cGP analog ACP-271 Huntington’s Disease GPR88 agonist STOKE ASO SYNGAP1 Antisense oligonucleotide (ASO) PROGRAM INDICATION MOLECULE DESCRIPTION DISCOVERY IND ENABLING PHASE 1 PHASE 2 PHASE 3 LAUNCHED Neurological diseases NUPLAZID® Parkinson's Disease Psychosis 5HT2A inverse agonist and antagonist Remlifanserin (ACP-204) Alzheimer's Disease Psychosis (ADP) New 5HT2A inverse agonist Remlifanserin (ACP-204) Lewy Body Dementia w/ Psychosis (LBDP) New 5HT2A inverse agonist ACP-211 Major Depressive Disorder Deuterated R-norketamine ACP-711 Essential Tremor Selective GABAA-α3 modulator ACP-271 Tardive Dyskinesia GPR88 agonist 11
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Data support the continued development of remlifanserin in ADP with the two Phase 3 trials currently underway Selection of 60 mg dose RADIANT: Phase 2 Remlifanserin ADP Data Achieve Goals of Enabling Phase 3 Dose Selection and Design Optimization Narrowly missed primary endpoint (SAPS H+D) for remlifanserin 60 mg Significance (nominal) on key secondary endpoint of CGI-S Favorable safety and tolerability profile No new safety signals Phase 3 EnablingSafety & TolerabilityEfficacy 12
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Remlifanserin Efficacy Across Psychosis Scales 13 -5 -4 -3 -2 -1 0 1 2 Endpoint Dose N¹ Difference vs placebo (95% CI) at Week 6 p-value Effect Size SAPS H+D Total Score 60 mg 107/109 -2.2 (-4.5, 0.1) 0.0603 0.26 CGI-S ADP 60 mg 107/109 -0.4 (-0.7, -0.1) 0.0077 0.37 NPI/NPI-NH Psychosis Score 60 mg 99/108 -1.5 (-2.8, -0.1) 0.0385 0.29 CGI-I ADP 60 mg 107/109 -0.3 (-0.6, -0.1) 0.0208 — Favors remlifanserin Favors placebo SAPS H+D Total Score is primary endpoint. CGI-S ADP is key secondary endpoint. NPI/NPI-NH Psychosis Score and CGI-I ADP are other secondary endpoints. SAPS H+D Total Score, CGI-S ADP and NPI/NPI-NH Psychosis Score: MMRM. CGI-I ADP: Week 6 mean score difference (LOCF), CMH p-value. Endpoint-specific units are not directly comparable. P-values are nominal. ¹N = placebo/Remlifanserin. CGI-I / CGI-S ADP = Clinical Global Impression of Improvement / Severity for Alzheimer’s Disease Psychosis; CI = confidence interval; CMH = Cochran–Mantel–Haenszel; LOCF = last observation carried forward; mFAS = modified full analysis set; MMRM = mixed model for repeated measures; NPI = Neuropsychiatric Inventory; SAPS H+D = Scale for the Assessment of Positive Symptoms, Hallucinations and Delusions domains. -1.0 -0.8 -0.6 -0.4 -0.2 0.0 0.2 Favors remlifanserin Favors placebo
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Phase 2 Study Safety Profile Supports Continued Phase 3 Development • No signal of QT prolongation vs placebo • Low rates of serious adverse events and discontinuations due to adverse events • No AE was seen in more than 5% of patients receiving 60 mg remlifanserin • Only somnolence (3.2%) and nausea (2.4%) were seen in more than 2% of patients on 60 mg remlifanserin and were numerically higher than placebo • Data to date suggest no negative impact on motor symptoms or cognition Placebo (N=115) n (%) Remlifanserin 30 mg (N=120) n (%) Remlifanserin 60 mg (N=125) n (%) Any TEAE 48 (41.7) 46 (38.3) 46 (36.8) Any TEAE Leading to Discontinuation from Study Drug 3 (2.6) 1 (0.8) 3 (2.4) Any TEAE with an Outcome of Death 2 (1.7) 0 0 14Safety analysis set Includes all patients receiving at least 1 dose of investigational product
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15 Key Changes to Ongoing Phase3 RADIANT Program Phase 3 program in ADP: enrollment continuing, with protocols updated based on Phase 2 learnings Dose 60 mg Focus of Phase 3 Key changes intended to improve the ability to detect a treatment effect Modifications to the pre-specified statistical plan No changes to inclusion criteria Refined site selection Based on site performance in Phase 2 Expanded use of central raters Particularly at sites with rating challenges or limited availability of qualified local raters Dropped 30 mg arm Remlifanserin is investigational and not approved by any regulatory authority.
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16 Two Phase 2 Readouts Expected in 2027 in Areas of Significant Unmet Need Remlifanserin Lewy body dementia psychosis Q4 2027 ILLUMERA Phase 2 results • Novel, highly selective 5-HT2A inverse agonist, mechanism validated by pimavanserin • RADIANT Phase 2 in ADP: no observed motor adverse effects or negative impact on cognition, AE rates similar to placebo • Received FDA Fast Track Designation ACP-211 Major depressive disorder 2H 2027 NORLIGHT Phase 2 results • Oral, deuterated R-norketamine • Phase 1 data: Suggests no sedation, limited dissociation, no blood-pressure liability; data to be presented at 2027 meetings Remlifanserin and ACP-211 are investigational and not approved by any regulatory authority. Milestones are anticipated and forward-looking. ADP: Alzheimer’s disease psychosis; PMDA: Pharmaceuticals and Medical Devices Agency.
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17 Financial Update CHIEF FINANCIAL OFFICER Mark Schneyer
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Millions, Except EPS 3Q26 3Q25 YoY Change TOTAL Revenue $342.3 $280.9* 22%* DAYBUE $140.1 $101.1 39% NUPLAZID $202.2 $179.8* 12%* R&D $76.3 $87.8 (-13%) SG&A $159.2 $133.4 19% EPS (diluted) $0.31 $0.42 - Cash and Investments Balance $976.4 18 Q3 2026 Financial Highlights * Represents Non-GAAP adjusted figures. See the Non-GAAP to GAAP reconciliations at the end of this presentation.
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Updated Guidance* Prior Guidance* NUPLAZID Net Sales $760 to $775 Million $760 to $790 Million NUPLAZID Gross-to-Net 22% to 23% 22% to 24% DAYBUE Net Sales1 $505 to $520 Million $480 to $510 Million DAYBUE Gross-to-Net 23% to 24% 23% to 25% Total Revenue $1.265 to $1.295 Billion $1.24 to $1.30 Billion R&D Expense $325 to $340 Million $355 to $380 Million SG&A Expense $665 to $685 Million $660 to $700 Million 19 FY 2026 Financial Guidance *All numbers for FY26 are GAAP 1Includes contributions from named patient supply programs outside the U.S.
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Concluding Remarks CHIEF EXECUTIVE OFFICER Catherine Owen Adams 20
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Acadia is Positionedfor the Next Phaseof Growth 21 PROVEN EXECUTION Commercial momentum across both brands • Excellent third quarter for DAYBUE® and NUPLAZID® • Continued momentum expected through year-end TRANSFORMATIONAL OPPORTUNITY Remlifanserin: advancing with conviction • RADIANT in ADP: efficacy signal observed at 60 mg; insights to potentially optimize Phase 3 • Additional ADP data to be presented at CTAD 2026 CATALYST OUTLOOK Multiple value-driving milestones • Remlifanserin ILLUMERA Phase 2 in LBDP Q4 2027 • ACP-211 NORLIGHT Phase 2 in major depressive disorder 2H 2027 Remlifanserin and ACP-211 are investigational and not approved by any regulatory authority. Milestones are anticipated and forward-looking.
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Q&A Session 22
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Appendix 23
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Non-GAAP Reconciliation 3Q25 3Q26 GAAP NUPLAZID Net Product Sales $177.5 $202.2 Change in estimate recorded in period $4.9 — Allocation of 2025 Amount (2.6) — Non-GAAP Adjusted NUPLAZID Net Product Sales $179.8 $202.2 DAYBUE Net Product Sales $101.1 $140.1 Non-GAAP Adjusted Total Revenue $280.9 $342.3 24
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25 Tiered Royalty Rates (annual net sales)1 ≤$150M 17% >$150M, but ≤$300M 20% >$300M 23% Sales Milestones2 Net Sales ≥$120M $15M Net Sales ≥$240M $30M Net Sales ≥$400M $50M Net Sales ≥$600M $75M Tiered Royalty Rates (annual net sales)1 ≤$250M 10% >$250M, but ≤$500M 12% >$500M, but ≤$750M 14% >$750M 15% Remaining Sales Milestones2 Net Sales ≥$500M $50M Net Sales ≥$750M $100M Net Sales ≥$1B $150M Terms of Agreement with Neuren for DAYBUE/DAYBU (trofinetide) in North America and Europe North America Europe3 1 Royalty rates payable on the portion of annual net sales that fall within the applicable range 2 Based on net sales in one calendar year 3 All of the European Union member states as of July 13, 2023 plus the United Kingdom, Iceland, Norway, Switzerland and Liechtenstein • First Commercial Sale Milestone: $35M