Axsome Therapeutics (AXSM) FY Conference Summary Company Overview - **Company**: Axsome Therapeutics - **Focus**: Development of innovative medicines for central nervous system (CNS) disorders, addressing significant unmet needs in psychiatry and neurology [2][3] Industry Context - **CNS Disorders**: Over 150 million people in the U.S. are affected by serious CNS conditions, which have been historically underserved by the biopharma industry [2][3] - **Key Conditions**: Major depressive disorder (MDD), Alzheimer's disease agitation, smoking cessation, ADHD, binge eating disorder, obstructive sleep apnea, migraine, narcolepsy, fibromyalgia, and shift work disorder [3][4] Core Strategies - **Five Pillars of Innovation**: 1. **Novel Mechanisms of Action**: Focus on distinct treatment outcomes in areas with multiple existing products [4] 2. **Multi-Mechanistic Modes of Treatment**: Examples include Ovelity and Cymbravo [5] 3. **Clinical Trial Innovation**: Designing trials to effectively detect signals from active molecules [5] 4. **Molecular Drug Delivery**: Innovative delivery methods for CNS-active molecules [6] 5. **Diversified Pipeline**: A singular neuroscience pipeline with three commercial products and multiple late-stage programs [6][7] Financial Highlights - **Potential Peak Sales**: Total potential peak sales across the pipeline estimated at $16.5 billion, with approved products like Avelity, Synoscience, and Bravo projected to reach $2 billion to $4.5 billion [8] - **Cash Position**: $300 million in cash resources as of the end of Q1, sufficient to reach cash flow positivity [39][40] Product Updates - **Ovelity**: Rapid growth with an annualized run rate of $400 million; over 50% of prescriptions are first-line treatments [11][14] - **Sunosi**: Steady growth with an annualized run rate of $100 million, focusing on potential label expansion [17] - **Simbravo**: Newly approved for acute migraine treatment, launching imminently [12][18] Clinical Trials and Regulatory Updates - **Cymbravo**: Approved earlier in the year, with positive Phase III clinical trial readouts [9] - **AXS-five**: NDA submission for Alzheimer's disease agitation on track for Q3; high unmet need with 7 million adults affected [21][22] - **Salriamfetol**: Exploring additional indications including ADHD and major depressive disorder, with ongoing trials [25][28] - **AXS-twelve**: NDA submission planned for narcolepsy in the second half of the year [33] - **AXS-fourteen**: Focused on fibromyalgia, with plans for a new 12-week fixed-dose trial following FDA feedback [35][36] Intellectual Property - **Patent Portfolio**: Broad coverage for pipeline programs, with settlements reached with multiple first filers [38] Conclusion - **Leadership and Future Outlook**: Strong leadership team and board, with a focus on providing updates throughout the year [40]

Financial Data and Key Metrics Changes - Total product revenues for Q1 2025 were $121.5 million, representing a year-over-year growth of 62% compared to $75 million in Q1 2024 [16][17] - Net loss for Q1 2025 was $59.4 million or $1.22 per share, an improvement from a net loss of $68.4 million or $1.44 per share in Q1 2024 [20] - Cash and cash equivalents at the end of Q1 2025 were $300.9 million, down from $315.4 million at year-end [20] Business Line Data and Key Metrics Changes - Avelity net product sales were $96.2 million for Q1 2025, representing 80% year-over-year growth from $53.4 million in Q1 2024 [17] - Sunosi net product revenues were $25.2 million for Q1 2025, a 17% year-over-year increase from $21.6 million in Q1 2024 [17][18] - Avelity led the market in TRx growth in Q1 with approximately 167,000 prescriptions, reflecting 76% year-over-year growth [21] Market Data and Key Metrics Changes - Avelity coverage remained stable in Q1 with 78% of all lives covered across channels and 63% in the commercial segment [22] - Sunosi total prescriptions were over 46,000, representing a 12% growth versus Q1 2024 [23] - Payer coverage for Sunosi was stable with 83% of lives covered across channels [25] Company Strategy and Development Direction - The company aims to advance three novel NDA stage product candidates: AXS-fourteen for fibromyalgia, AXS-five for Alzheimer's disease agitation, and AXS-twelve for narcolepsy [6][10] - The company is focused on executing multiple Phase III clinical programs to broaden the potential of current products and candidates [6] - The company anticipates a strong launch for Cymbravo, with positive feedback from healthcare providers regarding its clinical profile [25] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to navigate trade policy developments, stating that any potential impact would be immaterial [13] - The company expects 2025 to be a catalyst-rich year with potentially five marketed products across six indications by 2026 [15] - Management remains optimistic about achieving cash flow positivity based on the current operating plan [20][96] Other Important Information - The company has submitted an NDA for AXS-fourteen and anticipates a decision in Q2 2025 [7] - AXS-five has been granted breakthrough therapy designation by the FDA, with an sNDA submission planned for Q3 2025 [9] - The company is closely monitoring the competitive landscape, particularly regarding new entrants in the narcolepsy treatment space [35] Q&A Session Summary Question: Recent interactions with the FDA regarding developmental agents - Management indicated that dialogue with the FDA remains status quo and no changes have been noted regarding review teams or agency responsiveness [30] Question: DTC advertising plans for Avelity - A national campaign is expected to launch later this year, with a focus on engaging patients [34] Question: Coverage expectations for Avelity - Management aims to increase the number of covered lives and reduce utilization management barriers [68] Question: Expected cadence of coverage for Cymbravo - Management is focused on securing access quickly, acknowledging the competitive market [48] Question: Sales potential for AXS-fourteen in fibromyalgia - Management is enthusiastic about the market opportunity, with approximately 17 million people diagnosed in the U.S. [63] Question: Profitability outlook for 2025 - Management remains confident in achieving cash flow positivity but has not provided specific guidance on timing for profitability [96]