Financial Data and Key Metrics Changes - Total revenue for Q4 2025 increased 65% year-over-year to $196 million, and for the full year increased 66% to $639 million [4][11] - Net product sales of Auvelity for Q4 were $155.1 million, up 68% compared to the prior year, and total sales for Auvelity reached $507.1 million for the full year, representing a 74% year-over-year increase [12][15] - Net loss for Q4 was $28.6 million, or $0.56 per share, compared to a net loss of $74.9 million, or $1.54 per share for Q4 2024 [15] - Net loss for the full year of 2025 was $183.2 million, or $3.68 per share, compared to a net loss of $287.2 million, or $5.99 per share for 2024 [16] Business Line Data and Key Metrics Changes - Auvelity achieved sales of over $500 million in its third full year of launch, with significant growth contributing to overall revenue [4] - Sunosi generated net product revenue of $36.7 million for Q4, a 40% increase compared to Q4 2024, and $124.8 million for the full year, representing a 32% increase [12] - Symbravo generated $4.1 million in net sales for Q4 and $6.6 million for the full year, following its second full quarter of launch [12] Market Data and Key Metrics Changes - Auvelity prescriptions grew by 42% year-over-year, with over 225,000 prescriptions written in Q4 [18] - Payer coverage for Auvelity increased from 75% to 78%, bringing total coverage to 86% of all lives across channels [19] - Symbravo's overall payer coverage is approximately 52% at the start of the year, with 49% in commercial and 57% in government channels [21] Company Strategy and Development Direction - The company is advancing a broad CNS pipeline with 5 novel product candidates across 9 high-impact indications, including a planned phase 2/3 trial of AXS-05 in smoking cessation [5][6] - AXS-12's NDA submission for narcolepsy is expected imminently, with significant progress made following positive FDA pre-NDA meeting minutes [6] - The company plans to expand its sales force to approximately 600 representatives to support growth in MDD and potential Alzheimer's disease agitation [20] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to deliver upon vast opportunities for the growing portfolio of CNS medicines, supported by a scalable commercial platform [4][18] - The company anticipates continued momentum in its commercial business and expects to generate significant value through disciplined investment and performance across its CNS portfolios [104] Other Important Information - The company ended the year with $323 million in cash and cash equivalents, compared to $315 million at the end of 2024, indicating sufficient funds to support operations into cash flow positivity [17] - Gross and net discounts for Auvelity and Sunosi are expected to increase due to typical Q1 dynamics, with Symbravo's gross net discount remaining elevated during the launch phase [13] Q&A Session Summary Question: Implications of the new FDA publication on the one trial policy - Management is assessing the implications and will continue to vet clinical plans with the FDA, indicating potential for supportive evidence in ongoing studies [26][27] Question: Development plan for AXS-17 in epilepsy - The product has been studied in various indications, and the company is closely assessing different types of epilepsy for potential clinical success [31][33] Question: Auvelity payer coverage evolution post-ADA label addition - Existing coverage is expected to apply to the new indication, with efforts ongoing to ensure sufficient coverage and utilization management [35][36] Question: Initial launch cadence for Alzheimer's agitation - The company is preparing for a launch within a quarter post-approval, with metrics to be shared regarding script percentages from the ADA space [39][69] Question: Growth drivers for Sunosi - Growth is driven by both volume and improved access, with steady performance in both OSA and narcolepsy markets [44] Question: DTC campaign progress for Auvelity - The national TV campaign launched in late 2025 has generated positive impacts on new patient starts, with ongoing optimization of media spend [46][48] Question: Coverage expectations for Auvelity at steady state - The goal is to secure access for as many patients as possible, with steady progress in increasing covered lives anticipated [50][52] Question: AXS-12 opportunity in narcolepsy - AXS-12 offers compelling treatment options for patients, with strong data in cataplexy and potential benefits in excessive daytime sleepiness [72][74]