You're right, Long, about the enhanced sales force for the DRP launch. That will surely add to expenses, but there will also be an offset to some degree when the two depression trials, trofinetide trial, and negative symptoms/schz trial conclude, not to mention some of the post-marketing studies. And as you know, all those costs pale in comparison to the sales Acadia will see just from DRP alone.
Branded competition to Nuplazid in PDP is at least 4-5 years away (IRLAB Therapeutics is working on something); in DRP it's probably 4-5 years away too (KRTX is at work on a phase 1b in Alzheimer's psychosis).
I might have to do more homework, but I just don't see AXSM as much of a threat to the Nuplazid franchise. The benefits Nuplazid offers to MDD sufferers should make it an attractive option for prescribing physicians: e.g., sustained anti-depressant effect; no weight gain or extra pyramidal symptoms seen in other drugs; improvement in sexual dysfunction; less sleepiness during the day, etc. And then there's the excellent tolerability profile.
AXSM is ending its agitation trial early, citing concerns about Covid-19 (
see link). I wonder if Acadia will do the same for the first of its phase 3 MDD trials.