Acadia Eyes Blockbuster Growth with $1.7B Goal and Alzheimer's Bet

SAN DIEGO, CA – January 13, 2026 – Acadia Pharmaceuticals has laid out an ambitious roadmap for the coming years, projecting significant revenue growth from its commercial drugs while advancing a pipeline that holds multi-billion-dollar potential, most notably a high-stakes candidate for Alzheimer's disease psychosis. During a presentation at the 44th Annual J.P. Morgan Healthcare Conference, CEO Catherine Owen Adams declared 2026 a "pivotal year" for the company, outlining a strategy aimed at securing its position as a leader in therapies for neurological and rare diseases.

The San Diego-based firm is forecasting approximately $1.7 billion in global net sales by 2028, a figure built on the continued strength of its two approved products, NUPLAZID for Parkinson’s disease psychosis and DAYBUE for Rett syndrome. This confident projection is coupled with major anticipated clinical milestones, setting the stage for a transformative period for the company and the patients it serves.

“With approximately $1.7 billion in global projected net sales by 2028, our commercial engine anchored by NUPLAZID and DAYBUE, continues to gain momentum,” said Adams. “Acadia is well-positioned to capture significant value across both our commercial portfolio and pipeline.”

Bolstering a Billion-Dollar Commercial Engine

Acadia's financial confidence is rooted in the solid performance and strategic expansion of its current portfolio. The company projects its flagship drug, NUPLAZID (pimavanserin), will contribute approximately $1 billion to its 2028 sales goal. As the first and only FDA-approved treatment for the hallucinations and delusions associated with Parkinson’s disease psychosis, NUPLAZID has already been used by 97,000 patients. The company estimates it holds about a 25% share of the market, which it plans to grow by expanding its sales force by 30% in early 2026 to deepen its reach among newly diagnosed patients. A favorable court ruling in 2025 that extended the drug’s key patent protection to 2038 has further solidified its long-term revenue potential, a development that was well-received by analysts.

Meanwhile, DAYBUE (trofinetide), the first and only approved treatment for the rare neurodevelopmental disorder Rett syndrome, is projected to generate around $700 million in sales by 2028. The drug has seen strong market adoption, with reports indicating increasing prescription rates from community-based physicians. Further strengthening its franchise, Acadia announced the upcoming launch of DAYBUE STIX, a new dye- and preservative-free powder formulation. Approved by the FDA in December 2025, this more flexible option is designed to improve the treatment experience for patients and their caregivers. It will see a limited rollout in the first quarter of 2026, followed by a broader launch in the second quarter.

The Next Frontier: A Bet on Alzheimer's Psychosis

Beyond its commercial success, Acadia is making a significant wager on its late-stage pipeline, with the experimental drug remlifanserin at its center. This candidate is being evaluated for Alzheimer’s disease psychosis (ADP), a debilitating condition that currently has no approved treatments. The company announced that top-line results from its Phase 2 RADIANT study are expected between August and October 2026, creating a major potential catalyst for the firm's valuation.

The market opportunity is immense. Acadia estimates that remlifanserin could represent approximately $4 billion of the pipeline's total $11 billion unadjusted full peak sales opportunity, an estimate that also includes its potential use in Lewy body dementia psychosis. While the company acknowledges the inherent risks of drug development, the sheer size of the unmet need in ADP has captured the attention of the market. Some analysts have already modeled risk-adjusted peak sales of over $1.4 billion for remlifanserin, citing its potential for once-daily dosing and a cleaner safety profile compared to off-label antipsychotics often used in this vulnerable patient population.

The development of remlifanserin, a new 5-HT2A receptor agonist, builds on the same scientific mechanism as NUPLAZID, demonstrating a focused strategy on a pathway thought to be critical in neuropsychiatric disorders. A successful readout later this year could not only pave the way for a breakthrough therapy but also dramatically reshape Acadia's future.

Expanding Global Reach and Patient-Centric Innovation

Acadia's strategy extends well beyond the U.S. market, with a concerted effort to make its therapies available to patients globally. The company recently secured approval for DAYBUE in Israel for Rett syndrome patients two years of age and older. This follows the establishment of managed access programs in several European nations, including Germany, Italy, and France, providing the drug to patients ahead of formal marketing authorization.

A critical next step will be the opinion from the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP), which is expected in the first quarter of 2026. A positive opinion would clear the path for approval across the European Union. Furthermore, the company is advancing a Phase 3 study of trofinetide in Japan, with top-line results anticipated between October 2026 and March 2027. These parallel efforts underscore a commitment to addressing the global need for a Rett syndrome treatment.

The focus on patient needs is also evident in product-level innovations like DAYBUE STIX. By creating a formulation that is easier to administer and free of common additives, Acadia is directly addressing feedback from the Rett syndrome community, where treatment administration can be a significant daily challenge for caregivers. This patient-centric approach is designed to improve adherence and quality of life, strengthening the drug's position in the market.

A Diversified R&D Strategy for Sustained Growth

While remlifanserin represents the pipeline's crown jewel, Acadia is cultivating a broader research and development engine to ensure long-term growth. The company announced plans to initiate five new Phase 2 or Phase 3 studies and deliver four late-stage clinical trial readouts by the end of 2027. This activity spans eight disclosed programs, signaling a robust and diversified approach to tackling unmet needs in neurology.

The company has already expanded the investigation of remlifanserin into a second indication, Lewy body dementia psychosis, with a Phase 2 study initiated in late 2025. This move suggests confidence in the drug's mechanism and a strategy to maximize its therapeutic potential across related neurodegenerative conditions. By balancing the aggressive commercialization of its approved products with strategic investments in a multi-asset pipeline, Acadia is positioning itself not just for near-term financial success, but for sustained scientific innovation and market leadership in the challenging field of brain health.