BlackRock, Armistice Capital, and Vanguard Expand Neurological Therapeutics Exposure

Major institutional investors have concentrated capital within neurological disorder treatment companies throughout 2024 and early 2025, with BlackRock, Vanguard Group, and Armistice Capital establishing significant positions across diverse therapeutic categories. The sector has drawn institutional attention as companies advance treatments for ADHD, Parkinson's disease, hypertrophic cardiomyopathy, and epilepsy conditions.

Institutional allocations reflect confidence in specialized neurological therapeutics' commercial potential, benefiting from clearly identified patient populations, regulatory incentives for rare disease development, and constrained competitive landscapes. Recent quarterly filings demonstrate coordinated institutional activity across multiple neurological therapy companies with marketed products and progressing clinical programs.

Supernus Pharmaceuticals Demonstrates Commercial Momentum

Supernus Pharmaceuticals has attracted institutional investment from BlackRock, Vanguard Group, and Armistice Capital across its central nervous system portfolio. The neurological therapy company achieved full-year 2024 revenues of $661.8 million, reflecting 9% growth compared to 2023.

Armistice Capital trimmed its Supernus position by 260,000 shares during Q4 2024, though this 5.1% reduction maintained a meaningful stake. Institutional interest persists across passive index funds and active healthcare-focused investors targeting pharmaceutical sectors.

Qelbree, Supernus' non-stimulant ADHD treatment, generated 767,791 total prescriptions for full-year 2024, marking 25% growth compared to the prior year. Fourth-quarter 2024 net sales of Qelbree jumped 60% to $74.4 million, while full-year net sales reached $241.3 million, up 72% from 2023.

First-quarter 2025 performance sustained the trajectory with Qelbree net sales reaching $64.7 million, a 44% year-over-year increase, driven by 214,908 prescriptions—22% growth from Q1 2024. March 2025 established a monthly high with 75,277 prescriptions, while the prescriber base expanded to approximately 34,400 clinicians. Supernus maintained 2025 revenue guidance of $600–$630 million, supported by Qelbree's commercial progress and focused marketing initiatives.

Supernus achieved regulatory approval for ONAPGO (apomorphine hydrochloride) in February 2025, creating the first subcutaneous apomorphine infusion device for treating motor fluctuations in adults with advanced Parkinson's disease. The approval grants Supernus entry into the Parkinson's disease market, expanding beyond its existing neurological portfolio.

Cytokinetics Attracts Capital Ahead of Regulatory Decision

Cytokinetics has drawn institutional attention from Armistice Capital, T. Rowe Price, and AQR Capital Management as the company awaits FDA approval for aficamten, its hypertrophic cardiomyopathy treatment. Major institutional investors have preserved or expanded stakes despite regulatory uncertainties surrounding the drug's approval schedule.

FDA acceptance of Cytokinetics' New Drug Application for aficamten occurred in December 2024, initially establishing a September 26, 2025 target action date. The agency subsequently extended the review period to December 26, 2025, following a Risk Evaluation and Mitigation Strategy request, though no additional clinical data was required.

Aficamten has received Breakthrough Therapy Designation for symptomatic obstructive hypertrophic cardiomyopathy from both the FDA and China's National Medical Products Administration. The pivotal Phase 3 SEQUOIA-HCM trial demonstrated the drug's ability to improve exercise capacity in patients with obstructive HCM, showing a 1.8 ml/kg/min increase in peak oxygen uptake compared to baseline.

Institutional Investment Approaches Across Neurological Markets

Institutional interest spans beyond biotech specialists to include broader healthcare-focused investors, indicating confidence in commercial execution across multiple neurological conditions. Vanguard and BlackRock maintain positions through passive instruments, providing foundational institutional ownership typical of broad healthcare sector exposure.

Active investors such as Armistice Capital make conviction-based decisions around clinical catalysts and commercial execution, while index funds provide baseline ownership independent of company-specific developments. Neurological disorder treatments often require chronic administration, generating recurring revenue streams that appeal to institutional capital.

Demographic shifts, including aging populations and enhanced diagnostic capabilities, expand addressable patient populations over time while regulatory incentives support orphan drug development for rare neurological conditions. Market dynamics favor companies with novel mechanisms of action and differentiated clinical profiles, though development risks from clinical failures remain considerable.

Sector Outlook Supports Continued Institutional Engagement

Institutional participation across companies like Supernus Pharmaceuticals and Cytokinetics reflects measured exposure to neurological therapy development alongside other institutional participants in the sector. Recent clinical results, regulatory approvals, and commercial execution provide evaluation criteria for ongoing investment decisions across the institutional investor base.

Concentration of institutional capital in neurological disorder companies demonstrates confidence in the sector's capacity to deliver clinical value and commercial returns. Regulatory catalysts, marketed products, and advancing clinical programs continue attracting institutional attention as companies execute neurological therapy development initiatives throughout upcoming quarters.