Alkermes plc Q4 FY2025 earnings call

• Commercial business: In 2026, expects revenues >$1,700,000,000 and adjusted EBITDA >$370,000,000. Acquisition of Avadel adds revenue stream. • Elixorexant: Plan to enter Phase 3 in narcolepsy this quarter, has FDA breakthrough therapy designation. • Orexin 2 receptor agonists: Represent new growth in multiple disease areas. • 2025 financials: Total revenues ~$1,500,000,000, proprietary product growth 9%, VIVITROL, ARISTADA, Livaldi net sales and manufacturing/royalty revenues as mentioned. • 2026 financial expectations: Revenue, expense, and profit ranges as stated. • Commercial portfolio: VIVITROL, ARISTADA, LEVOLVI, LUMRIZE 2026 net sales/ revenues as expected. • Elixorexant Phase 3: Global Brilliance program in narcolepsy with specific study details. • Other orexin-2 programs: ALKS 7,290 and 4,510 in Phase 1, plan to advance to Phase 2

In 2025, total revenues were nearly $1,500,000,000, with proprietary product portfolio growing 9% to generate ~$1,200,000,000 in net sales. VIVITROL net sales were $467,900,000, ARISTADA net sales $370,000,000, Livaldi net sales $346,700,000, manufacturing and royalty revenues $291,300,000. For 2026, total revenues are expected to be in the range of $1,730,000,000 to $1,840,000,000. Proprietary product net sales are expected $1,520,000,000 to $1,600,000,000, manufacturing and royalty revenues $210,000,000 to $240,000,000. Cost of goods sold expected $365,000,000 to $385,000,000, R&D expenses $445,000,000 to $485,000,000, SG&A expenses $890,000,000 to $930,000,000. Net interest expense $75,000,000 to $85,000,000. GAAP net loss $115,000,000 to $135,000,000, EBITDA $60,000,000 to $90,000,000, adjusted EBITDA $370,000,000 to $410,000,000. VIVITROL 2026 net sales expected $460,000,000 to $480,000,000, ARISTADA $365,000,000 to $385,000,000, LEVOLVI $380,000,000 to $400,000,000, LUMRIZE $350,000,000 to $370,000,000

• 2026 total revenues expected $1,730,000,000 - $1,840,000,000. • 2026 adjusted EBITDA $370,000,000 - $410,000,000. • 2026 cost of goods sold $365,000,000 - $385,000,000. • 2026 R&D expenses $445,000,000 - $485,000,000. • 2026 SG&A expenses $890,000,000 - $930,000,000. • 2026 net interest expense $75,000,000 - $85,000,000. • 2026 GAAP net loss $115,000,000 - $135,000,000. • 2026 VIVITROL net sales $460,000,000 - $480,000,000. • 2026 ARISTADA net sales $365,000,000 - $385,000,000. • 2026 LEVOLVI net sales $380,000,000 - $400,000,000. • 2026 LUMRIZE total revenue $350,000,000 - $370,000,000. • Plan to initiate Phase 3 Brilliance program for elixorexant this quarter. • Expect data from REVITALIZE Phase 3 study in second quarter

• Competition impact on sales. • Pricing uncertainties in sleep medicine market. • Regulatory uncertainties in product development. • Accounting impact of acquisitions. • Payer access and reimbursement changes

Q: About AE profile with split dosing for elixorexant?

A: Rich said orexin 2 receptor agonists for narcolepsy have favorable AE profile, split doses aim to drive later wakefulness with similar AE.

Q: Avadel deal closed, synergies between psychiatry and sleep Salesforce?

A: C. Todd Nichols said excited about Avadel commercial team integration, currently no overlap, but will have synergies when launching elixirextin.

Q: Evidence to convince payers for both premium drugs?

A: Rich said orexin agonists work on wakefulness side, some patients need both, will generate data for payers.

Q: Internal bar for ESS in Lumris Phase III in IH?

A: Richard said IH study mirrors previous oxybate program, expect Q2 data to mirror Xywav profile. Joshua Reed added primary is ESS, key secondaries similar to current product.

Q: Key factor for IH Phase 3 trial with FDA?

A: Richard said will wait for Phase 2 Vibrant study data, then have end of Phase 2 meeting with FDA.

Q: Plans to study elixirextin with oxybate?

A: Rich said potential benefit for patients, evidence-building for reimbursement.

Q: Field force for LUMRIZE with market entrance?

A: Joshua Reed said Salesforce is right-sized for oxybate-eligible patients.

Q: SG&A spend beyond 2026?

A: Joshua Reed said one-time costs in 2026 won't carry over, future periods to control spending.

Q: LUMRIZE pricing dynamic?

A: Joshua Reed said Loomrise is unique once nightly oxybate, payer access strong now, watch second half.

Q: Valroxabate development plan?

A: Blair Jackson said move program forward quickly, leverage formulation capabilities, too early to say replacement.

Q: ADHD study details and phenotype enrichment?

A: Richard said not enriching phenotypes, will discern dose response in short time.

Q: Split dose protocol and food restrictions?

A: Rich said split dose strategy proprietary, aims to extend wakefulness with similar AE.

Q: CEO transition and Phase 3 split dosing?

A: Richard said transition when company strong, Phase 3 includes split doses in NT1.

Q: Takeda's commercial launch learnings?

A: Richard said pricing important, Todd said watch product positioning.

Q: ADHD study vs stimulants?

A: Richard said orexin pathway may complement nonstimulants, Blair added preclinical data shows efficacy.

Q: VIVITROL generic entry in 2027?

A: C. Todd Nichols said preparing for multiple scenarios, prepared to compete.

Q: NT2 data and Brilliance program primary endpoint?

A: Richard said NT2 results submitted for presentations, primary endpoint MWT, key secondary ESF