Collegium Pharmaceutical reported record quarterly revenue of $216.3 million on November 5, up 3.3% from a year earlier, and said its ADHD medicines now supply more than 36% of it. Both figures are accurate. Neither describes whether the business is growing.
The 3.3% compares a company that owns Azstarys, the ADHD drug it bought in May, with a year-earlier company that did not. The acquisition note in Collegium’s quarterly report also presents revenue as if it had owned Azstarys since January 2025, by adding the seller’s historical Azstarys sales to its own. On that unaudited pro forma basis, third-quarter revenue was $216.3 million against $234.9 million a year earlier, a decline of 7.9%.
The acquisition moved the mix faster than it moved growth.
The ADHD share rose 16.3 percentage points in a year, from 20.0% of revenue to 36.2%. About 9 of those points came from adding a product that already existed. Without Azstarys, Jornay PM, Collegium’s other ADHD drug, would have been 27.3% of revenue. The rise of about 7 points to that level splits roughly evenly between Jornay PM’s own growth and a smaller pain business beneath it (Behavioral Wire’s arithmetic).
Where the $18.6 million went
Like for like, revenue fell $18.6 million. Three lines account for all of it (Behavioral Wire’s arithmetic from the product revenue table and the pro forma disclosure in the third-quarter 10-Q):
- Jornay PM: up $10.1 million, to $51.9 million.
- Azstarys: up about $0.9 million, to $26.5 million. The year-earlier figure, about $25.6 million, is implied by the pro forma disclosure and reflects the seller’s own revenue recognition.
- Pain portfolio: down $29.6 million, to $138.0 million.
On that comparable basis, ADHD growth replaced a little over a third of what pain lost.
Full-year guidance points the same way. Collegium reaffirmed adjusted EBITDA of $445 million to $470 million, which management described as essentially flat against 2025, with Azstarys included from its May closing. Higher sales and marketing spending and the pain decline both sit inside that figure, so flat guidance does not isolate what Azstarys earns. It does show that full-year adjusted EBITDA, with Azstarys included, is not expected to grow.
| Revenue ($M) | Q3 2025 | Q1 2026 | Q2 2026 | Q3 2026 |
|---|---|---|---|---|
| Jornay PM | 41.8 | 38.9 | 46.1 | 51.9 |
| Azstarys | n/a | n/a | 12.9 | 26.5 |
| Pain portfolio | 167.6 | 154.6 | 140.9 | 138.0 |
| Total | 209.4 | 193.5 | 199.9 | 216.3 |
| ADHD share | 20.0% | 20.1% | 29.5% | 36.2% |
Source: Collegium 10-Qs. Azstarys revenue begins at the May 12, 2026 closing; the second quarter includes about seven weeks. Pain portfolio includes Belbuca, Xtampza ER, the Nucynta products and their authorized generics, and Symproic.
ADHD sales are seasonal. Management said back-to-school demand lifts the third quarter and carries into the fourth, and Jornay PM’s revenue fell back in the first quarter of each of the past two years, from $45.9 million to $38.9 million this year and from $29.3 million to $28.5 million a year earlier (fourth-quarter figures are Behavioral Wire’s subtraction of nine months from the full year). The bridge above compares the same quarter a year apart, so the pattern does not distort it.
The comparable trend has turned. In the second quarter, the same pro forma disclosure showed $219.1 million against $214.0 million a year earlier, up 2.4%. For the first nine months, pro forma revenue is $653.6 million against $645.7 million, up 1.2%. The third quarter is where pain erosion overtook ADHD growth.
Jornay PM is doing the growth work
Jornay PM, an evening-dosed methylphenidate acquired with Ironshore Therapeutics in 2024, grew revenue 24% on prescription growth of 16%. The 10-Q attributes the increase to higher volume, a higher gross price and lower deductions for co-pay programs and returns, partly offset by higher rebates. Management said on the call that its share of the branded long-acting methylphenidate market reached about 30%.
Azstarys has not yet shown comparable growth. Its prescriptions rose nearly 2% after a decline in 2025, which management said likely reflected limited promotion under its previous owner. Its net revenue on the pro forma comparison rose 3.7%. Neither the 10-Q nor the call separates price from volume for Azstarys. Because the year-earlier figure was booked by the seller, the gap between prescription and revenue growth cannot be attributed to pricing.
The chief financial officer said Azstarys gave up 73.4% of its gross sales to rebates, discounts and other deductions in the third quarter, against 74.1% in the second. She said there was room to improve that, but declined to give a target. She also said she did not expect the rapid improvement Jornay PM saw after its acquisition, which came largely from falling product returns. Management expects Azstarys prescription growth to accelerate into 2027 and gave no figure.
One full quarter of ownership is not a verdict on Azstarys. It does mean the acquisition has so far bought revenue rather than growth, and that the growth thesis currently rests on a product Collegium already owned.
Pain erosion is both current and approaching
Nucynta, an opioid whose immediate-release form met a third-party generic in February 2026, accounts for $24.0 million of the $29.6 million pain decline. Branded Nucynta revenue fell $28.2 million, and Collegium’s share of authorized-generic sales by its partner Hikma added back $4.2 million. Xtampza ER fell $4.7 million on lower volume and higher rebates, which management attributed to payer pressure across branded long-acting opioids. Belbuca was nearly flat, down $0.5 million, and Symproic fell $0.4 million.
That is the current erosion. The forward risk sits with Belbuca, the largest pain product at $57.7 million in the third quarter. Under a 2018 settlement, Teva holds a license that permits it to begin selling a generic version on January 23, 2027, or earlier in certain circumstances (terms disclosed by BioDelivery Sciences, the Belbuca owner Collegium later acquired; the chief financial officer cited the same date on the call).
A license is not a launch: Teva would still need FDA approval of its generic application. The chief financial officer said Belbuca faces only limited near-term generic risk and that the company had seen no sign of an approval, published generic pricing or wholesaler contracting. Based on past generic launches, she expects some or all of those signals at least a month before a launch. Separate patent challenges remain in litigation: Alvogen’s, over a newer product, and Ascent’s, each under a statutory 30-month stay on FDA approval, with Alvogen’s trial set for April 2027. A 2022 judgment already bars Alvogen’s original application until December 2032.
One offset is due in January. Management said a large payer covering about 15 million lives will give Xtampza ER exclusive formulary status from January 1, 2027.
Nucynta is shrinking. Its economics changed in October.
Collegium had paid Grünenthal, the drug’s originator, royalties under a license that set rates of up to 14% of Nucynta net sales. On October 15 it paid Grünenthal $17.0 million to settle their disputes, including a patent suit over the authorized generic of Nucynta ER. The settlement:
- ended the license and every remaining royalty obligation;
- assigned Collegium the two Orange Book patents covering Nucynta ER;
- led to the suit’s dismissal with prejudice on October 16.
Collegium’s filings put the royalty rate at up to 14% of net sales, depending on patent expirations and generic entry, and do not say what rate applied in 2026, so the saving is not stated. No royalty has accrued on Nucynta sales since September 16. The revenue decline is therefore likely to overstate the fall in what the product contributes, by an amount the public record does not state. Of the $17.0 million, $11.0 million was expensed in the third quarter.
What the profit line shows
Operating income fell to $28.7 million from $62.1 million. About $26 million of the $33.4 million decline came from three items the company treats as acquisition-related or one-off:
- $9.7 million of acquired Azstarys inventory recorded at a stepped-up fair value;
- the $11.0 million settlement charge;
- about $5.2 million of higher acquisition-related costs.
Salaries and marketing rose a further $17.4 million, which the company attributes mainly to supporting Jornay PM and Azstarys. Higher revenue and a $2.9 million gain from revaluing the Azstarys milestone liability partly offset the increase. Adjusted EBITDA, which excludes amortization, the inventory step-up, settlements, acquisition costs, the milestone-liability gain and stock compensation, fell 9% to $121.6 million.
The balance sheet carries the acquisition
Collegium paid about $655.6 million in cash at the May closing, including $42.0 million placed in escrow. It funded the payment with $355.6 million of its own cash and a $300.0 million delayed-draw term loan. Up to $135 million more is payable if Azstarys reaches milestones the company describes as commercial and manufacturing; the filed purchase agreement redacts their terms. The company valued that obligation at $35.6 million at September 30.
At that date, term-loan principal stood at $854.5 million, and $241.5 million of convertible notes fall due in February 2029. Cash and equivalents were $144.8 million. Management put net debt at about two times adjusted EBITDA.
The convertibles carry a deadline beyond their own. The term loan matures in December 2030, but its maturity moves to November 18, 2028 if both conditions hold on that date:
- more than $50 million of the convertibles is outstanding; and
- liquidity, as the credit agreement defines it (cash, cash equivalents, marketable securities and undrawn revolver amounts), is below $350 million less any permanent prepayments or repurchases of the convertibles.
Cash plus the undrawn $100 million revolving facility came to about $245 million at September 30 (Behavioral Wire’s arithmetic), a snapshot more than two years before the test date.
In August, Collegium paid $50 million under an accelerated share repurchase, in the same quarter it repaid $11.0 million of scheduled term-loan principal. $100 million remains under a repurchase authorization that runs through December 31, 2026. Asked on the call what would lead it to favor debt reduction over buybacks, the chief executive said the company weighs acquisitions, debt repayment and returns to shareholders each time it has cash to deploy. He gave no ranking among them.
Operating cash flow was $86.5 million in the quarter. The chief executive also restated the model on the call: buy differentiated products, integrate them and grow them. With Azstarys, the first two steps are done; the third has only begun.
The question the 36% does not answer
The pain portfolio still supplies 64% of revenue and lost $29.6 million against a year earlier. On a comparable basis, the two ADHD drugs together added $11.0 million. Closing that revenue gap requires Jornay PM to keep compounding and Azstarys to grow revenue well beyond the 3.7% of its first full quarter. It also requires the pain base to hold up through Teva’s January licensed entry date and the Alvogen and Ascent challenges. The end of Nucynta’s royalty should soften the loss in profit, by an amount the company has not disclosed, and Collegium reports revenue, not profit, by product, so replacing pain’s revenue is not the same as replacing its profit.
Collegium has bought itself an ADHD business large enough to matter. It has not yet shown that the business can replace the revenue pain is losing.