Alkermes plc (ALKS) Earnings

Management highlights

- CEO Richard Pops discussed the excellent first quarter financial performance, completion of Avidel acquisition to be a leader in sleep medicine, entry of Eli Lilly into the therapeutic space as external validation, and updates on Elixirexin development including enrollment in Brilliance Phase 3 program in narcolepsy. - Chief Commercial Officer Todd Nichols reviewed commercial performance, including strong start to the year, progress in integrating Avidel commercial team, and details on Vivitrol, Aristata, Levolvi, and Lumerize sales and guidance. - Chief Financial Officer Joshua Reed reviewed financial results, including total revenues, adjustments to 2026 financial expectations due to purchase price accounting for Avidel acquisition, and outlook for net sales in Q2 and other financial metrics. - Chief Operating Officer Blair Jackson provided update on expanding development work in orexin portfolio, including new molecules ALX7290 and ALX4510 for ADHD and fatigue respectively, and details on their clinical studies.

Guidance

- Expect Q2 net sales from proprietary portfolio, including full quarter of Lumerize revenues, in range of $385 - $405 million. - 2026 GAAP net loss expected to be in range of $70 - $90 million and EBITDA in range of positive $105 - $135 million. - Vivitrol 2026 net sales guidance $460 - $480 million, Aristata $365 - $385 million, Levolvi $380 - $400 million, Lumerize $350 - $370 million (Alkermes to record $315 - $335 million since mid-February acquisition close).

Segment performance

During the first quarter, total revenues were $392.9 million. Proprietary product portfolio net sales were $338.1 million. Manufacturing royalty revenues were $54.8 million. Cost of goods sold were $61.6 million. For Vivitrol, net sales in the quarter were $112.4 million, with 2026 guidance of $460 - $480 million. Aristata product family net sales were $93.8 million, with 2026 guidance of $365 - $385 million. Levolvi net sales grew 32% year-over-year to $92.4 million, with 2026 guidance of $380 - $400 million. Lumerize generated approximately $72 million of net revenue in the full quarter, with 2026 guidance of $350 - $370 million (Alkermes to record $315 - $335 million since mid-February close of acquisition).

Analyst Q&A

• Q: On orexin programs beyond sleep-wake, in ADHD, talk about thought process regarding development as monotherapy vs adjunctive therapy and endpoints for fatigue program.

  A: Blair Jackson discussed preclinical data showing orexin agonists perform as well or better than stimulants as monotherapy in ADHD, and for fatigue, using PROMIS fatigue scale and other disease-specific scales. -

• Q: On timelines for indications beyond narcolepsy and potential asset sale.

  A: Rich Pops and Blair Jackson discussed ongoing clinical work in ADHD and fatigue, and stated it's premature to talk about potential sale process. -

• Q: On phase two ADHD study, types of patients to enroll and translatability of primary endpoint.

  A: Blair Jackson discussed enrolling broad base of patients, using ACERS as primary endpoint, and relative effect size across patient population. -

• Q: On Lumerize guidance and net price pressure.

  A: Todd Nichols stated no impact on Lumerize from multi-source generics for XyREM so far, and full year guide incorporates range of gross to net scenarios. -

• Q: On Vibrance 3 data, dose cohorts and split dosing.

  A: Rich Pops stated will have top line results from entire study including split dose arm, and specifics on split dose strategy kept close to vest. -

• Q: On Lumerize net patient starts and valyloxibate development.

  A: Todd Nichols discussed 3,600 patients on therapy with 28% year-over-year growth, and Blair Jackson discussed plan to develop valyloxibate with multiple formulations in clinic. -

• Q: On competitive landscape for orexin agonist and key endpoints in Vibrance Phase 3 trial.

  A: Rich Pops discussed Alkermes having only program with range of doses credentialed in large phase two studies, and differentiating features including range of doses for NT1 and NT2. -

• Q: On 7290 and ADHD, efficacy and tolerability, and Vibrance 3 enrollment.

  A: Blair Jackson discussed potential for strong efficacy and mitigated AE profile, and Rich Pops discussed importance of quality of enrollment in Phase 3 study. -

• Q: On Lumerize in combination with OX2R agonist and Vibrance 2 data.

  A: Rich Pops discussed harnessing energy into clinical program over time, and Rich Pops discussed additional data on Vibrance 2 study including time course data on ESS score. -

• Q: On NT2 patient segmentation and orexin agonists in other indications, and Lumerize IH study placebo arm and Vivitrol revenue trajectory.

  A: Akash Tiwari discussed dosing flexibility, Rich Pops discussed Lumerize IH study design with randomized withdrawal and blinded basis, and Todd Nichols discussed Vivitrol revenue trajectory and preparedness for Teva generic entry. -

• Q: On patient mix change and ADHD differentiation.

  A: Todd Nichols discussed not forecasting additional favorable patient mix for remainder of year, and Blair Jackson discussed differentiation in ADHD on efficacy and tolerability. -

• Q: On Vibrance 3 IH study split dose and LumRise IH opportunity.

  A: Rich Pops discussed hypothesis for split dose in IH and laboratory measure use, and Todd Nichols discussed Lumerize IH opportunity with market expansion and switch patient potential.