Collegium Pharmaceutical (NASDAQ:COLL) reported record third-quarter 2026 revenue as growth in its attention-deficit/hyperactivity disorder portfolio helped offset declining sales of pain medicines. The company reaffirmed its full-year outlook, though quarterly earnings fell from a year earlier.
Total net product revenue rose 3% year over year to $216.3 million. JORNAY PM generated $51.9 million, up 24%, while AZSTARYS contributed $26.5 million in its first full quarter under Collegium’s ownership. Together, the two ADHD medicines accounted for more than 36% of revenue, compared with 19% for the ADHD business a year earlier, President and CEO Vikram Karnani said.
Net income fell to $21.8 million, or $0.60 per diluted share, from $31.5 million, or $0.84 per diluted share, a year earlier. Adjusted earnings per share declined to $1.96 from $2.25, and adjusted EBITDA fell 9% to $121.6 million.
ADHD prescriptions grow
Karnani attributed the ADHD portfolio’s performance in part to promotional activity, an expanded sales force and the back-to-school season. JORNAY PM prescriptions increased 16% year over year, while nearly 33,000 health care providers prescribed the medicine during the quarter, up 19%.
Prescriptions for children and adolescents, who represent about 80% of JORNAY PM’s business, rose 13%. Adult prescriptions increased 27%. Karnani said new-to-brand prescriptions rose 22% in September and that the momentum continued into October.
AZSTARYS prescriptions grew nearly 2% year over year after declining nearly 2% in 2025. Collegium acquired the medicine in May and had its sales representatives trained to promote both ADHD products by July. The company has approximately 190 representatives targeting about 27,000 health care providers.
Karnani said he expects AZSTARYS prescription growth to accelerate in 2027 as expanded physician outreach and new patient and caregiver marketing efforts take effect. He declined to provide a specific prescription-growth rate or revenue target.
CFO Colleen Tupper said AZSTARYS gross-to-net deductions were 73.4% in the third quarter, compared with 74.1% in the second quarter. She attributed the slight improvement mainly to timing and said the company was evaluating opportunities to improve the figure but was not providing a target.
Pain portfolio faces pressure
Collegium’s pain portfolio generated approximately $138 million in third-quarter revenue. BELBUCA sales were $57.7 million, down 1% year over year; XTAMPZA ER sales fell 9% to $45.8 million; and NUCYNTA franchise sales declined 44% to $30.8 million, including $4.2 million from profit sharing on authorized generic versions.
Karnani attributed the NUCYNTA decline largely to generic competition and said XTAMPZA faced continued payer pressure. He added that XTAMPZA prescriptions increased about 3% from the second quarter and that a large payer covering approximately 15 million lives would move the medicine to an exclusive formulary position on Jan. 1, 2027.
Asked about potential generic competition for BELBUCA, Tupper said Collegium had not seen specific signs that Teva planned to launch a generic after the Jan. 23, 2027, settlement date. She said the company was monitoring for Food and Drug Administration approval, published pricing and indications from wholesalers and distributors. Collegium continues to invest in BELBUCA and would act quickly if a generic launch occurs, she said.
Outlook and capital allocation
Collegium reaffirmed its 2026 forecast for total product revenue of $825 million to $855 million, representing 8% growth at the midpoint. The outlook includes $190 million to $200 million from JORNAY PM and $65 million to $75 million in partial-year AZSTARYS revenue. Adjusted EBITDA is projected at $445 million to $470 million.
Third-quarter operating cash flow was $86.5 million, and the company ended September with $144.8 million in cash, cash equivalents and marketable securities. Tupper said net debt was approximately two times adjusted EBITDA.
Collegium expects to complete a $50 million accelerated share repurchase before year-end and has $100 million remaining under its broader repurchase authorization. Karnani said the company continues to weigh acquisitions, debt repayment and shareholder returns when allocating capital.
About Collegium Pharmaceutical (NASDAQ:COLL)
Collegium Pharmaceutical, Inc is a specialty pharmaceutical company focused on developing and commercializing medicines for pain management and central nervous system disorders. The company primarily serves the U.S. market and emphasizes products designed to address significant patient and healthcare-provider needs.
Its pain portfolio includes Xtampza ER, an extended-release oxycodone formulation designed with abuse-deterrent properties, as well as Nucynta and Nucynta ER, which contain tapentadol and are used to treat acute and chronic pain.
