Greetings, and welcome to the Collegium Pharmaceutical First Quarter 2026 earnings conference call. I'll now turn the call over to Ian Karp, Head of Investor Relations at Collegium. Thank you. You may now begin.
Great. Thanks so much. Welcome to Collegium Pharmaceutical's First Quarter 2026 earnings conference call. I'm joined today by Vikram Karnani, our President and Chief Executive Officer; Colleen Tupper, our Chief Financial Officer; and Scott Dreyer, our Chief Commercial Officer. Before we begin today's call, we wanna remind participants that none of the information presented today is intended to be promotional and that any forward-looking statements made today are made pursuant to the safe harbors provision of the Private Securities Litigation Reform Act of 1995. You are cautioned that such forward-looking statements involve risks and uncertainties as detailed in the company's periodic reports filed with the Securities and Exchange Commission. Our future results may differ materially from our current expectations discussed today. Our earnings press release and this call will include discussion of certain non-GAAP information.
You can find our earnings press release, including relevant non-GAAP reconciliations, on our corporate website. With that, I'll now turn the call over to our President and CEO, Vikram Karnani.
Thank you, Ian. Good morning, everyone, and thank you for joining our 1st quarter 2026 earnings call. At Collegium, we are building a leading diversified biopharmaceutical company committed to improving the lives of people living with serious medical conditions. In the 1st quarter, we made meaningful progress on our 2026 strategic priorities and took an important step forward with the proposed acquisition of AZSTARYS, a differentiated commercial ADHD treatment for people 6 years and older. The addition of AZSTARYS accelerates our growth trajectory by strengthening our position in ADHD, complementing Jornay PM, and extending revenues into the late 2030s. This strategic acquisition reinforces our longstanding commitment to improving patient care while delivering long-term shareholder value. In the 1st quarter, we also made meaningful progress on our other 2026 strategic priorities, driving additional growth for Jornay and continuing to enhance the durability of our pain portfolio.
For Jornay, we delivered continued strong growth across prescriptions, prescribers, and market share. Prescriber adoption reached another all-time high this quarter, reflecting the positive impact of our sales and marketing investments. We also delivered another so-solid quarter for our pain portfolio, with total pain portfolio net revenues growing 4% year-over-year, driven by growth from both BELBUCA and XTAMPZA ER. Steady cash flow generation from our pain portfolio continues to provide a strong financial foundation that supports our disciplined approach to capital deployment and business development. We are off to a strong start in 2026 and remain well-positioned to continue executing against our strategy and deliver long-term value for our shareholders. In the first quarter, we demonstrated strong execution across our entire portfolio. Jornay prescriptions grew by 14% year-over-year and generated $38.9 million in net revenue, up 36% year-over-year.
Our pain portfolio generated $154.6 million in net revenue, up 4% year-over-year, reinforcing our confidence in its continued durability. We achieved both top and bottom line growth, with total net product revenues up 9% and adjusted EBITDA up 9% year-over-year. In addition, we generated more than $57.1 million in cash from operations and ended the quarter with over $421.8 million in cash, up $35 million from the end of 2025. With a clear focus towards the future, we also successfully executed a key element of our capital deployment strategy, announcing the proposed acquisition of AZSTARYS in March. As mentioned, this acquisition will add a differentiated and highly complementary medicine to our existing portfolio, strengthening our position in ADHD.
We believe AZSTARYS has significant future growth potential, and we plan to leverage our established commercial infrastructure and expertise to maximize its performance. The acquisition is expected to strengthen our ADHD portfolio, broaden our revenue base, support margin expansion, and extend the longevity of our portfolio with patent protection through December 2037. The required waiting period under the Hart-Scott-Rodino Act has now expired, and we remain on track to close in the second quarter of this year. Turning now to other recent corporate updates. In the first quarter, our partner, Hikma Pharmaceuticals, launched authorized generic versions of both Nucynta and Nucynta ER. Our authorized generic agreement with Hikma supports our strategy to maximize the life cycle of our pain portfolio while maintaining patient access. This agreement provides us with a significant profit share, positioning us to compete effectively with potential third-party generics.
In March, we launched our Embrace Your Sparkle campaign with Paris Hilton, who was treated with Jornay to help manage her ADHD symptoms. This campaign aims to encourage broader understanding and open dialogues about ADHD. Together, we are reframing common stereotypes and highlighting experiences that are often part of living with ADHD, including the importance of talking to a doctor and finding an individualized treatment plan. In February, we announced a new partnership with Boston Legacy FC, a member of the National Women's Soccer League. Aligned with our commitment to healthier people, stronger communities, we are sponsoring a sensory room that will be available at every home game this season to help create an inclusive experience for all fans.
In partnership with the organization known as Children and Adults with Attention-Deficit/Hyperactivity Disorder, also known as CHADD, we are designing this room to support comfort and regulation for fans who may need a break from the visual and auditory stimulation of a match day experience, helping ensure a positive and inclusive guest experience. More recently, in April, we announced updates to our board of directors. Dr. John Fallon will retire from our board at our annual meeting of shareholders on May 14th. We thank Dr. Fallon for his years of service to our company, board, and shareholders. In addition, Michael Donovan has been nominated to join our board, and his nomination will be presented for shareholder approval at the 2026 annual meeting. Mr. Donovan most recently served as an audit partner at Ernst & Young, where he has held several leadership roles.
He brings financial expertise gained from over 36 years of extensive business, accounting, and financial experience serving public and private companies in the life sciences industry. Finally, we remain dedicated to our commitment to leading with science. In the first quarter, we presented real-world data highlighting our ADHD and responsible pain medicines at the American Professional Society of ADHD and Related Disorders and PainConnect. These are important meetings for scientific exchange, and it was encouraging to see our medicines highlighted. As we look ahead to the rest of the year, we remain focused on three key priorities. First, we will continue to drive growth for Jornay. In 2026, we expect to deliver $190 million-$200 million in revenue, an increase of 31% at the midpoint of our guidance range.
As Scott Dreyer will touch on later, we are seeing the positive impact of the sales and marketing investments we made in 2025 to raise awareness of Jornay and drive growth. Second, we will continue to maximize the durability of our pain portfolio. Our pain medicines generate significant revenues and cash flows that will continue to support our future aspirations. Third, we remain committed to executing our capital deployment strategy, which balances business development, debt repayment, and opportunistic share repurchases. In the near term, we are focused on closing and then seamlessly integrating AZSTARYS into our product portfolio, further accelerating our growth trajectory and increasing our impact within the broader ADHD community. We are confident that we can achieve our strategic priorities and remain well-positioned for growth as we work to help improve the lives of patients and create long-term value for our shareholders.
With that, I will turn it over to Scott to discuss commercial highlights.
Thanks, Vikram, and good morning, everyone. Our lead growth driver, Jornay PM, is off to a strong start to the year, building on the positive momentum we generated in 2025. In the first quarter of 2026, we grew prescriptions, prescribers, and market share year-over-year. Jornay is a highly differentiated medicine and the only ADHD stimulant with once-daily evening dosing that provides symptom control upon awakening, through the afternoon, and into the evening. Many patients, including pediatrics, adolescents, and adults, report challenges starting their day, which is an area of key differentiation for Jornay, as it's already starting to work when patients wake up in the morning. In addition to efficacy upon awakening, symptom control throughout the day is important for most patients because it can eliminate the need for an additional booster at school or work, and Jornay delivers efficacy that lasts throughout the day.
HCP perceptions of Jornay are very positive and have gotten even better following enhanced commercial efforts. Based on new market research conducted in the first quarter of 2026, HCPs continue to give Jornay a high favorability rating and rank Jornay as the number one branded ADHD medicine in terms of product differentiation, with a score significantly higher than all other medicines in the same category. In addition, 70% of surveyed HCPs indicate a strong intent to increase prescribing, which was the highest among all other branded ADHD medicines. As we've previously highlighted, since acquiring Jornay, we've made targeted investments strategically designed to increase awareness, specifically by increasing the size of our ADHD sales force and launching new digital marketing programs. We're highly encouraged by the latest market research, which shows that HCP awareness of Jornay has significantly improved since last year.
Unaided recall among targeted HCPs increased to 67%, up from 52%, approaching the awareness levels of established brands like Vyvanse and CONCERTA. Patient and caregiver requests for Jornay also increased, and market research shows that when a patient or caregiver specifically asks to try Jornay, more than 70% of HCPs will honor that request. We were particularly pleased to see that Collegium was ranked number 1 in reputation among pharmaceutical companies specializing in ADHD. Healthcare providers rated Collegium sales representatives favorably, particularly in comparison to our competitors, and our messages around efficacy were seen as impactful and easily recalled. These results indicate that we're focused on the right messages and that our sales force is highly effective in delivering them. Jornay continues to be the fastest-growing stimulant for the treatment of ADHD.
In the first quarter of 2026, over 206,000 prescriptions were written, up 14% year-over-year. Importantly, we saw growth across both patient segments of the business, pediatrics and adults. In the first quarter of 2026, the pediatric and adolescent segment, representing about 80% of total prescriptions, grew 12% year-over-year. The adult segment, representing about 20% of total prescriptions, grew 23% year-over-year. Jornay's broad prescriber base also hit an all-time high of approximately 30,000 in the first quarter, up 17% year-over-year. We continue to see growth in new prescribers along with increases in depth of prescribing among our targeted physicians. Jornay's market share of the long-acting branded methylphenidate market grew to 26% this past quarter, up 5.8 percentage points year-over-year.
In addition to increasing awareness among HCPs, caregivers, and patients, 2026 growth opportunities include initiatives to increase depth of prescribing, improve patient persistency, and deepen penetration in the adult market. Our research indicates that adult patients place greater importance on the need for morning efficacy than HCPs. We believe closing this perception gap between adult patients and their providers will help drive future prescription growth. Turning now to the proposed acquisition of AZSTARYS, which represents a highly complementary and differentiated addition to our ADHD portfolio. Despite several different treatment options available today, many patients struggle to find the right individual treatment solution. Market research indicates that on average, ADHD patients try about 3 different ADHD medicines before finding the right treatment. One benefit of adding AZSTARYS to our ADHD portfolio is that it's complementary to Jornay, and it meets the needs of a different patient type.
For patients who need efficacy upon awakening in the morning and throughout the day without the need for a booster medicine in the afternoon, Jornay represents a unique treatment option. AZSTARYS is the first and only ADHD treatment with both fast and long-acting medicines in one capsule, providing patients with rapid efficacy about 30 minutes after they take it that lasts later into the evening. This is important because it offers flexibility for patients. For example, patients who may not have a consistent schedule and need rapid efficacy after they take their prescription, in addition to duration of effect, may be particularly drawn to AZSTARYS. Based on this different profile compared to Jornay, AZSTARYS usage is a bit more weighted towards adults than Jornay, with about 1/3 of prescriptions in adults and roughly 2/3 in children and adolescents. HCP perceptions of AZSTARYS are also very positive.
In the same new market research I noted earlier, healthcare professionals rated AZSTARYS high in terms of product differentiation and brand favorability. Approximately 54% of HCPs indicated a strong intent to increase prescribing of AZSTARYS. Like Jornay, we know that if a patient or caregiver specifically asks to try AZSTARYS, 70% of HCPs will honor that request. We're encouraged by these results. It shows that perceptions of AZSTARYS are strong. We're receiving highly positive feedback from prominent KOLs regarding the potential addition of AZSTARYS to the Collegium portfolio. Particularly regarding the opportunity to bring two best-in-class products together, two methylphenidate treatments that address distinct patient needs. KOLs also view this as an opportunity and an important signal for Collegium's long-term commitment to advancing care in ADHD. Like Jornay, we see opportunities to raise awareness among HCPs, patients, and caregivers by leveraging our commercial expertise and infrastructure.
In summary, AZSTARYS is highly complementary to Jornay, and both brands offer differentiated treatment options for different patient types in the stimulant segment of the market. The stimulant segment is large. In 2025, about 98 million stimulant prescriptions were written, and AZSTARYS and Jornay each generated over 760,000 prescriptions. Given the differentiation of each brand and the size of the stimulant segment, we believe there's significant opportunity to increase market share moving forward. Importantly, the combination of both Jornay and AZSTARYS into a single commercial organization will better serve the growing ADHD patient community and increase our standing among healthcare professionals. For the remainder of the year, we'll focus on driving accelerated growth for Jornay and seamlessly integrating AZSTARYS into our ADHD portfolio following the acquisition close.
We continue to launch new marketing efforts aimed at raising awareness of Jornay among healthcare providers, patients, and caregivers. Earlier this year, we launched our Embrace Your Sparkle campaign with Paris Hilton to help encourage a broader understanding and open dialogue about ADHD. We remain committed to maintaining broad patient access for Jornay. As we announced earlier this year, we secured new formulary access under a major commercial health plan, which went into effect on May first, increasing Jornay's coverage for an estimated 4.5 million covered lives. Driven by these strategic investments and continued commercial execution, we're confident we can deliver significant prescription growth and achieve our Jornay net revenue guidance.
Lastly, as we approach the expected close of the AZSTARYS acquisition, we're focused on rapidly integrating this medicine into our portfolio and leveraging our commercial infrastructure and capabilities to drive additional growth of the brand while generating meaningful operational efficiencies. We look forward to keeping you updated on our continued progress. Turning now to our pain portfolio. Collegium's the leader in responsible pain management with a unique and differentiated portfolio of medicines. BELBUCA, XTAMPZA ER, and Nucynta ER collectively represent about half of the branded ER market. Our pain portfolio is highly differentiated with strong brand fundamentals. BELBUCA remains the only long-acting opioid medicine that uses buprenorphine buccal film technology. In market research, it was ranked as the number 1 brand ER opioid in terms of differentiation and favorability.
Similarly, XTAMPZA, the only extended-release oxycodone medicine that uses our proprietary best-in-class abuse-deterrent technology, DETERx, was ranked as the number 1 ER oxycodone medicine in terms of differentiation and favorability. In the first quarter, we delivered consistent performance in our pain portfolio, which continues to fuel the financial foundation of our business. We grew revenues for both XTAMPZA and BELBUCA year-over-year in line with our expectations. Revenues from the Nucynta franchise, including revenues associated with our authorized generics, were stable, which was also in line with our expectations. As expected, prescriptions for all products were pressured by typical first quarter dynamics, where deductibles reset and out-of-pocket costs increased for patients. Overall, performance across the pain portfolio was positive, reinforcing our belief that the life cycle of these medicines may prove to be longer and more robust than is currently appreciated in the market.
We remain committed to maximizing the revenue for our overall pain portfolio while maintaining broad payer coverage. In closing, our commercial team started the year strong, delivering solid performance across both ADHD and pain. For the rest of the year, we'll concentrate on driving further growth for Jornay, maximizing the value of the pain portfolio, and seamlessly integrating AZSTARYS. I'll now hand the call over to Colleen to discuss financial highlights.
Thanks, Scott. Good morning, everyone. We are encouraged by our 1st quarter results, which reflect significant Jornay PM growth, consistent pain portfolio performance, and robust cash generation. Total net product revenues were $193.5 million in the quarter, up 9% year-over-year. Jornay net revenue was $38.9 million in the quarter, up 36% year-over-year. It is important to note that Jornay's year-over-year comparison is impacted by approximately $4 million of destocking that occurred in Q1 of 2025. This created a lower prior year comparator. BELBUCA net revenue was $52.6 million in the quarter, up 2% year-over-year. XTAMPZA ER net revenue was $50.8 million in the quarter, up 7% year-over-year. Total Nucynta franchise net revenue was $47 million in the quarter, flat year-over-year.
This includes $2.7 million in revenue from the profit share on the authorized generic versions of Nucynta and Nucynta ER distributed by Hikma. GAAP operating expenses were $86.4 million in the quarter, up 14% year-over-year. Non-GAAP adjusted operating expenses were $69.3 million in the quarter, up 11% year-over-year. The increase in operating expenses includes the targeted investments we made to drive Jornay growth, including the expansion of our sales force and new marketing campaigns. As a reminder, 2026 results will include the full year impact of these investments. GAAP net income was $14.5 million in the quarter, up 500% year-over-year. Non-GAAP adjusted EBITDA was $103.9 million in the quarter, up 9% year-over-year.
GAAP earnings per share was $0.45 basic and $0.40 diluted in the quarter, compared to $0.08 basic and $0.07 diluted in the prior year quarter. Non-GAAP adjusted earnings per share was $1.76 in the quarter, compared to $1.49 in the prior year quarter. Please see our press release issued earlier today for a reconciliation of GAAP to non-GAAP results. We generated operating cash flows of $57.1 million in the first quarter, and as of March 31, 2026, we had $421.8 million in cash equivalents, and marketable securities, up $35.1 million from the end of 2025. Our strong financial position enabled us to continue to execute our capital deployment strategy and enter into an agreement to acquire AZSTARYS.
As previously announced, we plan to acquire AZSTARYS for $650 million in cash. Corium shareholders may also be eligible for up to $135 million in potential additional payments contingent on future commercial and manufacturing milestones. We plan to fund the acquisition through a combination of $350 million in cash on hand, a testament to the strength of our underlying business, and $300 million from our delayed draw term loan. We estimate that our net debt to adjusted EBITDA will be approximately 2x following the close of the transaction, and our future cash flows from operations will support continued rapid delevering.
Importantly, we expect the deal to be immediately accretive to adjusted EBITDA and estimate that AZSTARYS will generate over $50 million in pro forma net revenues in the second half of 2026. We also expect to generate more than $50 million of cost synergies within 12 months following deal close based on our ability to leverage our existing ADHD commercial infrastructure. The addition of AZSTARYS is also expected to meaningfully extend our revenues through 2037, as AZSTARYS is protected by 6 Orange Book patents, most of which don't expire until December 2037. We are on track to close the acquisition in the second quarter of this year.
We are reaffirming our current 2026 financial guidance, which reflects our existing business, not including the impact of the proposed acquisition of AZSTARYS. We expect total product revenues in the range of $805 million-$825 million. This represents a 4% increase year-over-year, driven by Jornay growth and durable revenues from our pain portfolio. We expect Jornay revenue to be in the range of $190 million-$200 million, a 31% increase year-over-year. We expect Jornay gross to net to remain stable in 2026 in the mid 60% range. As a reminder, gross to nets tend to fluctuate on a quarterly basis, and we expect gross to nets to be highest in the first quarter and higher in the first half of the year compared to the second half due to typical seasonal dynamics.
We expect adjusted EBITDA in the range of $455 million-$475 million, up 1% year-over-year. We plan to provide updated 2026 financial guidance for the combined business, including AZSTARYS, after the acquisition closes. Our capital deployment strategy is focused on creating long-term value for our shareholders by executing on business development, paying down debt, and opportunistically returning capital to shareholders. Our proposed acquisition of AZSTARYS is a result of our thoughtful and disciplined business development approach. We have a long track record of successful business development and a proven ability to rapidly integrate commercial products and accelerate their growth. After closing the AZSTARYS acquisition, we estimate that our net debt to adjusted EBITDA will be approximately 2x, and we remain committed to rapidly de-levering consistent with our capital deployment strategy.
Finally, we continue to consider opportunistic share repurchases as an important tool to return value to shareholders. Since 2021, we have returned $222 million in value to shareholders and currently have $150 million remaining in the share repurchase program that has been authorized by our board through December 31st, 2026. I will now turn the call back to Vikram.
Thank you, Colleen. 2026 is off to an exciting start. We are focused on our strategic priorities of driving significant growth for Jornay PM, maximizing the durability of our pain portfolio, and executing on our capital deployment strategy, including closing and rapidly integrating AZSTARYS into our portfolio. The addition of AZSTARYS strengthens our ADHD portfolio, accelerates our growth trajectory, and increases our top and bottom-line potential. This represents an important strategic step forward as we build a leading diversified biopharmaceutical company, create long-term value for our shareholders, and deliver meaningfully differentiated medicines for patients. We are grateful to the patients who rely on our medicines, the healthcare professionals who care for them, and our employees whose execution continues to drive our progress. I will now open up the call for questions. Operator?
Thank you. We'll now be conducting a question-and-answer session. To ask a question at this time, you may press star one from your telephone keypad, and a confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to withdraw your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment please for our first question. Our first question today comes from the line of Brandon Folkes with H.C. Wainwright & Co. Please proceed with your questions.
Hi. Thanks for taking my questions, and congrats on a very good quarter. Maybe just two from me. Can you talk about once you bring AZSTARYS into the portfolio, you know, how do you balance the focus on going deeper with both brands and the current 30,000 prescribers you called out on Jornay? Are you looking to grow the breadth of prescribers once you bring in AZSTARYS? Can you just update us on this, your thinking in terms of positioning the two brands in the rep's bag and in terms of prioritizing, you know, a rep's call in front of a physician? You know, how do you balance those two products? Is it different per physician? Just help us think through that. Thank you.
Thanks, Brandon Folkes. Maybe I'll kick us off, and then I'll invite Scott Dreyer to offer some more color. It's important to remember that AZSTARYS and Jornay are highly complementary to each other. As a reminder, the reason for that is because they appeal to different patient types, right? I think in our prepared remarks, we mentioned that if a patient needs efficacy upon awakening in the morning, physicians think about Jornay as the appropriate medicine for them. If you are a patient that has less structure to your schedule, for example, and are more in need for rapid onset of action and, you know, that impact lasting throughout the day, AZSTARYS may be more appropriate for you.
At the core of our commercial strategy and our positioning is that important differentiation between those two medicines and the patient types. Maybe Scott can elaborate a little bit further on the go-to-market balance between.
Yeah.
Having those 2 products in the same bag.
I think in terms of the positioning and the balance, one thing that's important to reinforce is there's also obviously a high overlap of physicians. I mentioned the 30,000 prescribers for Jornay. AZSTARYS in the first quarter had almost 26,000 prescribers, and they're high overlap. It's the same targets that we're going to. You asked if we're here to grow both. The answer is yes. We're looking to grow with products, and the positioning is very clear. The positioning is focused on the differentiated patient type that Vikram mentioned. At the physician level, we'll determine prioritization of order, but the biggest thing to take away is we will grow both products with a focus on those clear patient types. The other thing I'll just reinforce is.
The physician perceptions of both drugs are so strong. In my commentary, I mentioned Jornay is number one on product differentiation and favorability, high future intent to prescribe. AZSTARYS is ranked just a little bit below that, also very high on product favorability, differentiation, future intent to prescribe. You put all that together, and it just puts us in a place to leverage the breadth of this portfolio and grow both brands going forward.
Great. Thank you very much. Congrats again on a good quarter.
Thanks, Brandon.
The next question is from the line of Les Zalewski with Truist.
Hey, this is Jeevan on for Les. Thanks for taking our questions. yeah. I was wondering if you could just describe how your success with Jornay PM reads through to a similar trajectory for AZSTARYS. Also, you know, how should we think about your longer term strategy in ADHD versus maybe expanding into adjacent CNS or psychiatric call points?
Yeah. Thanks, Jeevan. Maybe Scott Dreyer, take the first one and I can pick up the second one on future adjacencies.
Yeah, no, it's a great question. Look, the first thing I want to reinforce is, when you look at AZSTARYS, Corium did a really good job launching the product, right? They got momentum going. They grew the brand. I mentioned prescribers, but with limited resources. When I look at the overlaps of what we've done with Jornay, part of this acquisition is the fact that we can effectively leverage our expertise, leverage the learnings, what we've done from both a physician and a consumer standpoint, and our financial wherewithal to invest in AZSTARYS from here to grow. That's the focal point of kind of what we'll do as we'll bring both brands together.
Yep. I'll take the question on adjacencies. Look, as we've said before, our business development approach remains focused on acquiring commercial or commercial-ready medicines that are primarily in the areas where we already have made significant commercial investment. To the extent that that is actionable and to the extent that there are differentiated medicines at the right profile, that would be an area of focus. However, we are also aware of the fact that we are open to exploring other adjacent areas, both within CNS but also outside of it. The bar is higher from a business development standpoint there. We wanna make sure that we are acquiring assets that can be grown through efficient sales and marketing approach.
Part of that is leveraging what we have or those areas that may not need significant investments in sales and marketing. We've talked previously about an example of that being rare disease. Our strategy remains unchanged in terms of how we are looking for further growth through further business development. Next question, please.
The next question is from the line of Dennis Ding with Jefferies. Please proceed with your questions.
Hi, this is Anthea on for Dennis. Thank you for taking our questions, and congrats on the quarter. Two questions from us. We'll see early data from an orexin agonist in ADHD in second half. I'm just curious how you're framing readouts from that class of drugs and if you expect any impact to Jornay or AZSTARYS. Secondly, how should we think about the impact of the Nucynta AG and IR generic over the next several quarters? I think IQVIA is showing 75% and 50% share of the branded still in ER and IR. Is that aligned with what you were expecting and what's contemplated into the guidance, and do you expect that to stabilize? Thank you.
Thank you. I think, if your first question, if I understood you correctly, was around the early data that you're seeing from a different class of medicines, I think there's a lot that still needs to be proven out. We look at the data, we're following the data, but until we have more information, until these drugs are further along in their development programs, I don't think we would want to speculate or comment. What we believe we have in the near future is our two potentially very differentiated medicines in AZSTARYS and Jornay PM. We look forward to continuing to drive growth for both products, as Scott said, within the ADHD community. With that investment, that makes us one of the most committed organizations that is serving the ADHD community.
Colleen, you wanna take the Nucynta question?
Yeah, absolutely. Good morning, Anthea. On the Nucynta front, what I would say is our 2026 revenue guidance remains unchanged. The total revenue, net revenue guidance of $805 million-$825 million contemplates the impact of the various generic dynamics. Thus far, we don't see anything that changes our expectations.
Great. Thank you.
Our next question is from the line of Serge Belanger with Needham & Company.
Hi. Good morning. Thanks for taking the questions. First one regarding the ADHD portfolio. Can you remind us about access, whether both Jornay and AZSTARYS will have comparable access once both products are under your control? Secondly, regarding the pain portfolio, had a pretty nice performance over 1Q. I know that the scripts were down pretty significantly for a couple products.
Year-over-year, just curious what drove the performance here. I know you took a price increase, but were there other factors that led to the better performance than expected? Thanks.
Yeah. I think on the ADHD portfolio, I think it's important to understand both Jornay as well as AZSTARYS are in a very good position from an overall payer coverage standpoint, so access is available to patients. I think for us, from a forward-looking standpoint, we've always been committed to making sure that we provide or we support broader coverage, broader access and support patients via a and reduce their or keep, you know, try to help them control their out-of-pocket expenses with a good copay assistance program. That will be approach going forward. On the pain products, the specifics on the financials, maybe Colleen take that question, please.
Absolutely. Good morning, Serge. For both Xtampza and Belbuca, as expected, Q1 dynamics were at play on the volume front. The year-over-year growth is driven by profitability improvements in line with our payer strategy, combination of the price increases and a little bit of gross to net benefit as well.
Thank you. The next question is from the line of David Amsellem with Piper Sandler. Please receive your questions.
Thanks. A couple from me. First, on the sales force for ADHD, can you just remind us what portion of ADHD prescribers or ADHD volumes your current sales organization covers? Then over time, what do you aspire to in terms of coverage of both prescribers and volumes in terms of your commercial infrastructure for ADHD? That's number one. Then number two is, as you look at Jornay, and maybe to a lesser extent AZSTARYS, heavily weighted towards pediatric use. I guess over time, what's your view on the mix between pedes and adults and where that could evolve to for both products, particularly Jornay, since it's been so heavily skewed towards the pediatric setting? Thanks.
Yeah. Thanks, David. Scott, maybe you wanna take both and if there's any other commentary on that as well.
Yeah, sure. First, starting off with Salesforce, if you look at how we're currently structured, I think the main thing I wanna reinforce is we size to effectively cover the market, right? There's no piecemeal approach to our sizing. If you look right now, it's a pretty concentrated business. About 20,000 physicians cover a third of all TRXs in the country, right? We go to about 25,000. That gives us about 60% coverage of the branded market, and that's exactly as optimal as we can do without going to white space and being inefficient. We're sized right. Now, as we bring in AZSTARYS, we're doing the work to figure out exactly any tweaks we'd make on the footprint.
The main thing I want you to know is we will optimally size to cover the market, and that's what we do now. Second, when it comes to Jornay, what was the second question?
The second question was about the mix of adult and pedes.
Mix of adult and pedes. The first thing, if you look, they're both methylphenidate products, right, David Amsellem? That market is about 70%, 30% pedes. AZSTARYS leans a little bit more to adult. We think mostly driven by the profile of the drug and the fact that you take it and get 30-minute efficacy quick. It's a little more flexible dosing for flexible schedules. That pushes it a little more adult. For Jornay in the 80/20 that we're at now, we do expect to continue to penetrate more into the adult market, which would drive a little bit of a mix difference. The primary driver of that is what I mentioned, is this insight we have that there's a bit of a disconnect, that adult patients, about 50% say they actually need efficacy immediately upon awakening, right? What Jornay provides.
You wake up, the drug's already working, and yet HCPs don't view that need as highly. We'll be leaning into that and expect that our growth will continue there. Overall, we're growing volume very well in both segments right now. Right, 14% in the first quarter. That was 12% year-over-year pediatric growth. That was 23% adult growth. We're growing now, but we expect the mix to continue to shift.
Thank you.
Thanks, David.
Thank you. At this time, this will conclude our question and answer session. I'll hand the floor back to Vikram for closing remarks.
Thank you. Thanks to everyone for joining our call and hope you have a wonderful day and weekend.
Thank you. This will conclude today's conference. You may disconnect your lines at this time. We thank you for your participation and have a wonderful day.