Commercial Launch Momentum
Strong early commercial traction for ZUNVEYL: 4,941 bottles dispensed in Q4 2025 (including 1,859 bottles in December, the strongest month since launch). Lauren reported 62% quarter-over-quarter growth in bottles dispensed, and management views adoption as accelerating and compounding.
Expanding Prescriber and Facility Adoption
Prescribing doctors increased 50% versus Q3 2025 and cumulative homes with prescriptions rose 69% in Q4. The sales team reached nearly 2,000 nursing homes in the quarter, with launch-to-date reach of roughly 3,856–4,000 unique facilities.
High Repeat Usage Signals Durable Adoption
Repeat behavior is strong: 729 homes placed orders in Q4 and approximately 82% (over 600) were repeat orders. Of the 865 prescribers who wrote orders in Q4, about 69% (roughly 600) were repeat writers—an early indicator of embedded use in facility treatment protocols.
Revenue Build from Launch
Reported revenues from launch through year-end 2025 totaled $10.2 million. Q4 2025 total revenue was $2.8 million, including $2.5 million in net product sales from ZUNVEYL; full-year net product sales were $6.8 million.
Payer Progress — National PBM Contracts
Executed a second national PBM contract during Q4 2025, bringing the company to agreements with 2 of the 4 major PBMs relevant to long-term care. Management expects downstream plan-level pull-through to begin showing early traction in Q2 2026 and broader implementation in Q3 2026.
Strong Tolerability and Clinical Visibility
ZUNVEYL reporting shows few adverse events: GI adverse events remain in the low single digits with only two spontaneous GI AE reports at quarter end—far below internal expectations for reporting volume. Physicians are increasingly comfortable titrating to the 10 mg therapeutic dose.
Clinical & Real-World Evidence Program
Company initiated/announced three real-world studies to strengthen payer and provider evidence: BEACON (initiated Feb 2026; topline expected Q4 2026), CONVERGE (initiates Apr 2026; topline expected Q3 2026), and RESOLVE (initiates Q2 2026, outpatient). Medical team presented 15 abstracts/posters in 2025.
Balance Sheet and Funding
As of December 31, 2025, Alpha Cognition had approximately $66 million in unrestricted cash and cash equivalents (including ~$38 million net proceeds from an October 2025 equity offering). The company is debt-free and states this runway supports operations well into 2027 and a path to operational profitability in 2027.
Commercial Infrastructure Expansion
Sales force expansion is largely complete (nearly 98% filled earlier; additional hires in March 2026 to complete expansion). The company also increased reimbursement resources and completed national speaker training for 48 KOLs to accelerate peer-to-peer education.
Progress on Formulation and International Opportunities
R&D progress includes a planned comparative PK study for the sublingual formulation in Q2 2026 and a pathway toward clinical entry (target: early 2027 pending FDA Type C meeting). Partner in Asia (CMS Pharma) is progressing regulatory work with an expectation of two strategic product approvals in 2026 (timing uncertain).