Collegium Pharmaceutical (NASDAQ:COLL) outlined its 2026 outlook and discussed its planned acquisition of the ADHD treatment AZSTARYS during a fireside chat at Needham & Company’s 25th Annual Healthcare Conference. President and CEO Vikram Karnani and Chief Financial Officer Colleen Tupper spoke with Needham healthcare analyst Serge Belanger about growth drivers across the company’s ADHD and pain portfolios, expected seasonality, and the company’s capital deployment priorities.
2026 guidance excludes AZSTARYS impact
Karnani said the company’s 2026 guidance reflects the existing business and “does not yet reflect the expected impact of the AZSTARYS acquisition.” Collegium guided to total revenues of $805 million to $825 million, representing 4% year-over-year growth. The company also guided to adjusted EBITDA of $455 million to $475 million, representing 1% year-over-year growth.
Karnani also pointed to potential upside factors, including the possibility Jornay PM outperforms expectations as it did in 2025, less impact from the Nucynta authorized generic than forecasted, and “expected immediate accretion” from AZSTARYS once the deal closes and guidance is updated.
AZSTARYS: complementary to Jornay PM and longer exclusivity
Discussing the acquisition, Karnani described AZSTARYS as “the first and the only ADHD treatment with both fast and long-acting medicines in one capsule,” combining an immediate-release component for rapid onset with an extended-release profile for duration through the day. He positioned the product as differentiated from, and complementary to, Jornay PM, which he said is commonly prescribed for patients who need efficacy upon awakening.
Karnani said the deal expands Collegium’s position in ADHD, improves revenue diversification, and is expected to be immediately accretive to adjusted EBITDA, with “even greater contribution in 2027.” He also emphasized intellectual property protection and durability, noting the product is supported by six Orange Book-listed patents, most expiring in December 2037, and said there have been “no generic filers to date.”
Transaction terms and commercial considerations
Tupper outlined the transaction structure, stating Collegium is acquiring AZSTARYS, related intellectual property, and global rights from Corium, a private company, for $650 million upfront. She said the asset is “unencumbered by any royalties” following a recent royalty settlement. She added that potential milestone payments could total up to $135 million, tied to future commercial, manufacturing, and regulatory milestones, including manufacturing process improvements.
Belanger asked whether AZSTARYS could cannibalize Jornay PM. Karnani said he did not expect significant cannibalization, citing different delivery profiles and patient types, and reiterated confidence in continued Jornay PM growth supported by a sales force expansion from 125 to 180 representatives and increased non-personal promotion timed around the back-to-school season.
On payer coverage, Karnani said AZSTARYS “has pretty broad coverage to begin with,” and that Collegium would evaluate opportunities to improve economics while balancing access and profitability through gross-to-net management. Tupper added that the company believes it is acquiring AZSTARYS at “a bit of an inflated gross to net” and would look to optimize it, though she said she would not expect “significant change.”
Karnani said Corium’s ADHD sales force is approximately 100 reps, compared with Collegium’s 180. He said the company is evaluating the appropriate resource base to support growth for both products and would provide more detail after closing.
Because Corium is privately held, Karnani said net revenue details are not publicly disclosed. However, he said AZSTARYS generated over 760,000 prescriptions in 2025, and Collegium expects the product to generate more than $50 million in net revenues in the second half of 2026, with additional growth in 2027 and beyond. He also said AZSTARYS was launched in 2021 and experienced significant growth in 2022 through 2024.
ADHD market size and Jornay PM growth levers
Karnani described the ADHD market as “quite big,” citing over 110 million prescriptions written in 2025, with most prescriptions being generics. He said stimulants represent about 90% of the market, and both Jornay PM and AZSTARYS primarily source prescriptions from generic stimulants, which he said leaves “ample room for growth for both medicines.”
On Jornay PM, Karnani attributed 2025 prescription growth to increased promotion from the sales force expansion and marketing efforts. He said the company saw growth not only in prescriptions from existing prescribers but also a “significant growth in number of new writers,” which he said supports confidence in continued growth. He also said non-personal promotion efforts reach healthcare professionals via web and social media, extending beyond the company’s roughly 21,000 sales-force targets to an additional 50,000 healthcare professionals.
Karnani said the company has not provided peak sales guidance for Jornay PM, citing the need for more time to assess the full impact of the expanded sales force and marketing initiatives.
Pain portfolio: stable outlook with Nucynta generic dynamics
Tupper said Xtampza revenue grew about 4% year-over-year in fiscal 2025 and that the company expects flat to low single-digit revenue growth in 2026 driven primarily by price and gross-to-net improvements rather than volume. She noted that in January 2026, Xtampza secured new exclusive access for about 2 million commercial lives. She also said full-year Xtampza gross-to-nets ended fiscal 2025 in the low 40% range, down from the low 70% several years earlier, and are expected to remain stable in 2026.
On exclusivity, Tupper said there has been one generic filer for Xtampza and that Collegium settled with that filer (Teva) for September 2033. Regarding a potential generic OxyContin product, she said the company has not seen activity in the marketplace and continues to monitor.
For BELBUCA, Tupper said revenue grew about 5% in 2025 and that 2026 guidance reflects flat to low single-digit growth driven by a combination of volume and gross-to-net improvements.
Discussing Nucynta, Tupper said the company’s 2026 guidance implies about a 2% reduction overall in the pain portfolio, fully reflecting Nucynta generic dynamics. She said an external generic entrant for Nucynta IR launched in the first quarter of 2026 and that Collegium’s authorized generic partner Hikma launched shortly after; she added the external entrant appears to have limited product access and low volumes so far. She also said a Nucynta ER authorized generic launched late in the first quarter and that Hikma is currently the only product in that marketplace. Tupper said the company expects external generics could arrive later, with Teva potentially in July 2027 and Rhodes in 2028.
Tupper also highlighted seasonal pressures in the first quarter across both ADHD and pain products, including deductible resets that can reduce demand due to “sticker shock” and increase copay assistance expense, which affects gross-to-net dynamics.
On leverage and financing, Tupper said Collegium ended 2025 at about one turn net debt-to-EBITDA and recently put in place a new syndicated credit facility that includes a $580 million term loan, a $300 million delayed draw, and a $100 million revolver. She said the company plans to use the delayed draw along with balance-sheet cash to fund the AZSTARYS upfront payment and expects leverage to be about two turns at closing.
Looking ahead, Karnani said Collegium’s priorities remain centered on growing Jornay PM (and AZSTARYS post-close), maximizing the pain portfolio, and deploying capital to create shareholder value. He said the company remains focused near term on “commercial or commercial-ready assets” given its lack of R&D infrastructure, while remaining open to future share repurchases or debt paydown depending on opportunities.
About Collegium Pharmaceutical (NASDAQ:COLL)
Collegium Pharmaceutical, Inc is a specialty pharmaceutical company focused on the development, manufacture and commercialization of products for pain management and opioid dependence. The company’s core expertise lies in its DETERx microsphere technology, a platform designed to provide extended-release delivery of active pharmaceutical ingredients while deterring manipulation for unintended routes of abuse.
The company’s principal marketed products include Xtampza® ER (extended-release oxycodone), which received approval from the U.S.
