Alpha Cognition (NASDAQ:ACOG) reported third-quarter 2026 net product revenue of approximately $7.8 million, up 30% from the preceding quarter, as prescriptions and prescriber adoption increased for its Alzheimer’s treatment ZUNVEYL.
Management reiterated its goal of reaching operating profitability in 2027, citing revenue growth alongside relatively stable spending. The company also said it does not expect new formulary coverage wins through the remainder of 2026, though it hopes to make progress early next year.
Revenue Growth Outpaces Spending
Third-quarter ZUNVEYL revenue rose from approximately $6 million in the second quarter and $2.3 million a year earlier, Interim Chief Financial Officer Henry Du said. Gross product margin was approximately 94%, consistent with the previous quarter.
Operating expenses increased to $13.7 million from $12.9 million in the second quarter and $5.6 million a year earlier. The company reported a $6.4 million operating loss, which Du said improved from the prior quarter as revenue grew faster than expenses.
Net loss narrowed to $7.6 million, or $0.35 per share, from $8.2 million, or $0.38 per share, in the second quarter. Du said approximately $1.2 million in nonoperating items, primarily a noncash charge tied to the fair value of warrant liabilities, accounted for the difference between the operating and net losses.
Alpha Cognition ended September with $37.8 million in cash and cash equivalents, down from $41.4 million at the end of June. The third-quarter cash decline included approximately $1.4 million in proceeds from warrant and stock option exercises. Du said the company remained debt-free.
Management reiterated its full-year 2026 operating expense forecast of $50 million to $54 million. Alpha Cognition is not providing revenue guidance and expects to issue 2027 expense guidance late in the fourth quarter or at the beginning of 2027, Du said.
Prescriber and Facility Adoption Expand
Chief Operating Officer Lauren D’Angelo said more than 11,000 ZUNVEYL prescriptions were filled in the third quarter, an increase of approximately 40% from the preceding quarter. Chief Executive Officer Michael McFadden cited an approximately 31% quarter-over-quarter increase in filled prescriptions during his remarks. Management did not explain the difference between the two figures.
D’Angelo said net revenue per prescription remained stable at approximately $650 per bottle, with growth driven by volume rather than price. More than 30,000 prescriptions have been filled across six quarters of commercialization, according to McFadden.
The number of healthcare professionals prescribing ZUNVEYL during the quarter grew 23% sequentially to 1,654, while cumulative prescribers since launch reached 2,438. D’Angelo said that exceeded the company’s original full-year target of approximately 2,000 and put it on track to surpass its revised goal of 2,500.
Approximately 78% of prescribers wrote repeat prescriptions, and the average rose to about seven prescriptions per writer from six in the second quarter. The number of nursing homes with a ZUNVEYL prescription increased 29% sequentially to 1,400, with approximately 80% placing repeat orders during the quarter.
D’Angelo said the existing commercial organization is appropriately sized for now. The company sees an opportunity to increase prescribing among current writers before expanding into additional prescribers or beyond long-term care, she said.
Payer Access Remains a Focus
Approximately 95% of prescriptions are approved when Alpha Cognition’s reimbursement team supports the prior authorization process, D’Angelo said. She added that approximately 70% of long-term care lives have access to ZUNVEYL with a $0 copay.
However, payer coverage has remained unchanged from prior quarters. D’Angelo said Alpha Cognition does not expect a formulary win in the remaining months of 2026 but hopes to see traction early in 2027. Broader coverage could provide additional growth, she said.
The company expects gross-to-net adjustments to remain consistent through the fourth quarter and does not plan a price increase during that period. D’Angelo said no decision had been made on pricing for early 2027.
Studies and Development Programs Advance
McFadden highlighted initial results from CONVERGE, a retrospective real-world evidence program using long-term care data. Among residents new to acetylcholinesterase inhibitor therapy or switching from a competing drug, approximately 80% of ZUNVEYL residents reached a therapeutic dose within 180 days, he said. He described the result as statistically superior to other drugs in the class.
On average, ZUNVEYL residents discontinued two medication classes, while residents on generic acetylcholinesterase inhibitors added two more classes than they discontinued, McFadden said. The company expects further dataset updates in January and March and plans to begin publishing CONVERGE data in the first half of 2027.
The RESOLVE interventional study had enrolled more than 57 patients and is expected to finish in the second half of 2027. McFadden said its primary focus is tolerability, with neuropsychiatric behavior assessed as a secondary measure.
A pharmacokinetic study of the company’s sublingual program concluded in early October with inconclusive data. McFadden said results were inconsistent with previous datasets and could reflect an analysis issue or an issue related to the species used in the study. The company plans another study beginning in early January.
Alpha Cognition is also awaiting regulatory responses on applications in three Asian countries, including China, McFadden said. The company previously said it anticipated approvals in two countries in the near term.
About Alpha Cognition (NASDAQ:ACOG)
Alpha Cognition Inc. is a biopharmaceutical company focused on developing and commercializing treatments for neurodegenerative diseases and cognitive disorders. The company’s work is centered on therapies intended to address the medical needs of patients with Alzheimer’s disease and other conditions affecting cognition. Its lead commercial product is ZUNOVO (galantamine hydrobromide) extended-release capsules, an orally administered treatment approved by the U.S. Food and Drug Administration for mild-to-moderate dementia of the Alzheimer’s type.
