AXSM

We rate Axsome Therapeutics, Inc. (AXSM) as a Hold with a composite score of 55.2/100 at a current price of $168.40. The stock presents a mixed quantitative picture — neither compelling enough to warrant new accumulation nor weak enough to justify selling for existing holders. Our factors are split, and the overall profile suggests patience is warranted.

The rating is primarily driven by strength in stability (80th percentile) and momentum (72th percentile), which together account for the majority of the composite score. Offsetting weakness in investment (23th percentile) and quality (45th percentile) tempers our overall conviction. We assign a No Moat rating (29/100), High uncertainty, and Poor capital allocation.

Key items to watch: balance sheet deleveraging progress; sustainability of the current growth rate; the path to profitability. Any material change in these dynamics could warrant a reassessment of our rating. The moat trend is stable, which suggests the competitive landscape is stable for now.

Axsome Therapeutics, Inc. holds a top-quartile position (#0 of 50) within the Manufacturing sector, based on our composite quantitative scoring across quality, value, momentum, and stability factors. The composite score of 55.2/100 places it at rank #1246 in our full 7,333-stock universe. At $6.1B in market capitalization, Axsome Therapeutics, Inc. is a mid-cap player in the Manufacturing space, which limits certain scale advantages but may allow for more agile strategic execution.

The near-term outlook is constructive, with revenue growing at 96% and momentum in the 72th percentile confirming positive market sentiment and institutional accumulation. The combination of strong top-line growth and favorable price dynamics suggests the company is executing well on its growth strategy. Investment factor at the 23th percentile indicates reinvestment patterns that investors should monitor for sustainability.

The margin cascade tells an important story: gross margins of 93% (+50.5pp vs sector) narrow to operating margins of -40% (-40.8pp vs sector) and net margins of -42.5%, yielding a gross-to-net conversion rate of -46%. The significant margin erosion from gross to net suggests elevated operating expenses, high interest costs, or other structural drags that warrant monitoring.

At a current price of $168.40, Axsome Therapeutics, Inc. is trading near fair value based on current fundamentals. Our value factor score of 50/100 reflects a composite assessment across multiple valuation metrics including price-to-earnings, price-to-book, EV/EBITDA, and price-to-sales ratios relative to both sector peers and the broader market. Valuation metrics are mixed, with no strong signal of mispricing in either direction.

The stock currently trades at P/B of 125.6x, P/S of 16.9x. We evaluate these multiples in the context of both absolute levels and sector-relative positioning to form our valuation view.

We assign a High uncertainty rating to Axsome Therapeutics, Inc.. Key risk factors include significant leverage (808% debt-to-equity), current negative profitability (net margin -42.5%), low beta of 0.57 — while defensive, this may indicate limited upside participation in bull markets. The wide range of potential outcomes widens our fair value estimate and increases the possibility of permanent capital impairment. Investors considering this name should size positions accordingly and demand a meaningful margin of safety before initiating.

Specific risk factors that inform our assessment include: significant leverage (808% debt-to-equity); current negative profitability (net margin -42.5%); low beta of 0.57 — while defensive, this may indicate limited upside participation in bull markets; the combination of leverage (808% D/E) and thin margins (-42.5% net) amplifies downside risk. Each of these factors independently widens the distribution of potential outcomes, and in combination they create a risk profile that demands careful position sizing. The stability factor at the 80th percentile and quality factor at the 45th percentile provide a quantitative summary of the overall risk landscape.

Key risk mitigants include: healthy gross margins of 93% provide a buffer against cost pressures; above-average stability (80th percentile) suggests predictable business dynamics. These factors partially offset the identified risks and provide downside protection in adverse scenarios. On balance, the risk-reward profile warrants caution and disciplined position management.

We rate Axsome Therapeutics, Inc.'s capital allocation as Poor. Key concerns include low returns on equity (-297.3%), elevated leverage (808% D/E), negative profitability, weak asset returns (ROA -32.8%). Exemplary capital allocators generate ROE above 20% and maintain conservative leverage — Axsome Therapeutics, Inc. significantly underperforms these benchmarks, raising questions about management's ability to create shareholder value.

Investors should scrutinize management's reinvestment decisions and balance sheet trajectory before committing capital. Poor capital allocation often compounds over time: overlevered balance sheets limit strategic flexibility, while low returns on capital destroy shareholder value. We would need to see sustained improvement in profitability metrics and balance sheet discipline before considering an upgrade.

In summary, Axsome Therapeutics, Inc. receives a Hold rating with a composite score of 55.2/100 (rank #1246 of 7,333). Our quantitative framework assigns a No Moat (29/100, trend: stable), High uncertainty, and Poor capital allocation. The average factor score across quality, value, momentum, stability, and investment is 54/100.

Our analysis supports a neutral stance on Axsome Therapeutics, Inc.. While the quantitative profile is not weak enough to warrant selling, it lacks the multi-factor strength required for a buy recommendation. Existing holders should maintain positions and monitor for catalysts — either fundamental improvement or valuation compression — that would shift the risk-reward balance.