Collegium Pharmaceutical Leans Into Growth After Earnings

Collegium Pharmaceutical Inc. ((COLL)) has held its Q1 earnings call. Read on for the main highlights of the call.

Collegium Pharmaceutical’s latest earnings call struck an upbeat tone as management balanced solid execution with frank discussion of risks. Executives highlighted robust growth in ADHD drug JORNAY PM, resilient pain franchises, strong cash generation and an accretive AZSTARYS acquisition, while acknowledging higher operating costs, generic pressure on Nucynta and a temporary rise in leverage.

Strong Top-Line Growth

Collegium reported total net product revenues of $193.5 million in the first quarter of 2026, up 9% year over year. The company’s pain portfolio contributed $154.6 million, growing 4% and underscoring the durability of its core franchises despite seasonal and competitive headwinds.

JORNAY PM: Rapid Prescription and Revenue Momentum

JORNAY PM remained the growth engine, with more than 206,000 prescriptions in the quarter, up 14% from a year earlier, and net revenue of $38.9 million, up 36%. Prescribers climbed to about 30,000 and market share in long-acting branded methylphenidate reached 26%, with management targeting 2026 JORNAY revenue of $190 million to $200 million.

Durable Pain Portfolio Performance

Belbuca delivered net revenue of $52.6 million, up 2% year over year, while Xtampza ER posted $50.8 million, rising 7%. The Nucynta franchise generated $47.0 million, essentially flat as authorized generic profit-share offset pressure on branded volume, reflecting resilience but also intensifying generic dynamics.

Profitability and Cash Generation

Non-GAAP adjusted EBITDA reached $103.9 million, a 9% year-over-year increase that matched top-line growth, while GAAP net income jumped to $14.5 million. Operating cash flow came in at $57.1 million and cash, equivalents and marketable securities climbed to $421.8 million, enhancing financial flexibility ahead of the AZSTARYS deal.

Strategic Acquisition of AZSTARYS

The company is advancing a $650 million cash acquisition of AZSTARYS, plus up to $135 million in contingent milestones, with closing expected in the second quarter. Management projects AZSTARYS will be immediately accretive to adjusted EBITDA, add more than $50 million in pro forma net revenue in the second half of 2026 and provide over $50 million in cost synergies within 12 months.

Commercial Execution and Market Research

Collegium underscored strong commercial execution, noting unaided recall of JORNAY among health care providers rose to 67% from 52% year over year. Surveys showed 70% of clinicians plan to increase JORNAY prescribing and AZSTARYS also tested well, while patient and caregiver requests were cited as a powerful driver of ADHD prescribing decisions.

Capital Allocation Flexibility

To fund AZSTARYS, Collegium plans to deploy $350 million of cash on hand and draw a $300 million term loan, aiming for post-close net debt to adjusted EBITDA of about 2x. The company also highlighted $150 million of remaining share repurchase authorization, having already returned $222 million to shareholders since 2021.

Reaffirmed 2026 Guidance

For 2026, excluding AZSTARYS, management reaffirmed expectations for total product revenue of $805 million to $825 million, about 4% growth year over year. Adjusted EBITDA is guided to $455 million to $475 million, implying roughly 1% growth, with JORNAY revenue of $190 million to $200 million and gross-to-net metrics expected to remain stable in the mid-60% range.

Brand and Community Initiatives

The company is leaning into brand-building with campaigns such as “Embrace Your Sparkle,” featuring public figures and partnerships aimed at boosting ADHD awareness. Management said these initiatives, alongside collaborations with advocacy groups and sports organizations, are designed to deepen engagement with patients and caregivers.

Higher Operating Expenses from Commercial Investments

Operating expenses rose as Collegium expanded its ADHD sales force and launched new marketing campaigns, pushing GAAP operating costs to $86.4 million, up 14% year over year. Non-GAAP adjusted operating expenses increased 11% to $69.3 million, and management cautioned that these investments will remain a full-year headwind in 2026.

Generic and Authorized Generic Dynamics for Nucynta

Hikma’s launch of authorized generic versions of Nucynta and Nucynta ER introduced new complexity, with Collegium collecting $2.7 million of profit-share in the quarter. Even so, the Nucynta franchise posted flat revenue, and management flagged generic competition as an ongoing risk to branded pricing and volume, albeit one already embedded in guidance.

Seasonal Prescription Pressure and Script Declines

Executives noted that first-quarter prescription volumes across pain products fell year over year as patients faced deductible resets and higher out-of-pocket costs. Revenue still improved thanks to price increases and favorable gross-to-net trends, but management warned that seasonal patterns can distort quarterly comparisons.

Increased Leverage from Acquisition Financing

The planned $300 million delayed-draw term loan will push leverage modestly higher, with net debt to adjusted EBITDA expected around 2x after AZSTARYS closes. Management emphasized that robust cash generation should support rapid deleveraging, though investors will be watching closely how quickly the balance sheet is brought back down.

Modest Near-Term Adjusted EBITDA Growth Outlook

Despite solid revenue momentum, the company’s 2026 adjusted EBITDA guidance implies only about 1% growth year over year, excluding AZSTARYS. That outlook reflects deliberate reinvestment in commercial infrastructure and ADHD marketing, limiting near-term margin expansion but aimed at sustaining longer-term growth.

Comparability and Gross-to-Net Volatility

Management reminded investors that JORNAY’s 36% revenue growth was flattered by about $4 million of destocking in the prior-year quarter, and that gross-to-net dynamics are seasonally higher in the first half. These factors could introduce volatility into quarterly results even if full-year trends remain intact.

Forward-Looking Guidance and Outlook

Looking ahead, Collegium is steering toward mid-single-digit revenue growth and modest EBITDA expansion while layering in AZSTARYS as a new ADHD pillar. The company expects stable gross-to-net for JORNAY, continued durability in pain products and immediate accretion from AZSTARYS, with combined-company guidance to follow once the acquisition closes.

Collegium’s earnings call painted a picture of a specialty pharma company leaning into growth while managing tangible risks. Investors are being asked to accept higher operating spend and a temporary leverage bump in exchange for accelerating ADHD momentum, a broader portfolio and extended patent life, with management confident its strategy will translate into sustained cash flow and shareholder returns.