MANAGEMENT'S DISCUSSION AND ANALYSIS OF THE FINANCIAL SITUATION

MANAGEMENT'S DISCUSSION AND ANALYSIS OF THE FINANCIAL SITUATION

AND OPERATING RESULTS - FOR THE THREE AND NINE - MONTH PERIODS ENDED DECEMBER 31, 2018 AND 2017

This management's discussion and analysis ("MD&A")

is presented in order to provide the reader with an overview of the financial results and changes to the financial position of

Acasti Pharma Inc. (referred to in this MD&A as "Acasti", "the Corporation"," we",

"us" and "our") as at December 31, 2018 and for the three and nine-month periods then ended.

This MD&A explains the material variations in the financial statements of operations, financial position and cash flows of

Acasti for the three and nine-month periods ended December 31, 2018 and 2017.

Market data and certain industry data and forecasts included in

this report were obtained from internal surveys, market research, publicly available information, reports of governmental agencies

and industry publications and surveys. We have relied upon industry publications as our primary sources for third-party industry

data and forecasts. Industry surveys, publications and forecasts generally state that the information they contain has been obtained

from sources believed to be reliable, but that the accuracy and completeness of that information is not guaranteed. We have not

independently verified any of the data from third-party sources or the underlying economic assumptions they made. Similarly, internal

surveys, industry forecasts and market research, which we believe to be reliable based upon our management's knowledge of

our industry, have not been independently verified. Our estimates involve risks and uncertainties, including assumptions that may

prove not to be accurate, and these estimates and certain industry data are subject to change based on various factors, including

those discussed under "Risk Factors" in this report. While we believe our internal business research is reliable and

the market definitions we use in this report are appropriate, neither our business research nor the definitions we use have been

verified by any independent source. This report may only be used for the purpose for which it has been published.

In this MD&A, financial information is for the three and nine-month

periods ended December 31, 2018 and 2017 and is based on the interim financial statements of the Corporation, which were prepared

in accordance with International Accounting Standard ("IAS") 34, Interim Financial Reporting, as issued by the International

Accounting Standards Board ("IASB"). The Corporation applied the same accounting policies in the preparation of these

condensed interim financial statements as those disclosed in note 3 of its most recent annual financial statements. In accordance

with its mandate, the Audit Committee of the Corporation's Board of Directors reviews the contents of the MD&A and recommends

its approval to the Board of Directors. The Board of Directors approved this MD&A on February 14, 2019. Disclosure contained

in this document is current to that date, unless otherwise noted. Note that there have been no significant changes to the "Use

of estimates and measurement uncertainty", "Critical Accounting Policies", and "Financial instruments"

in comparison to those disclosed in the Corporation's MD&A for the year ended March 31, 2018, filed with the securities

regulatory authorities on June 29, 2018. Readers should carefully review and consider the risks and uncertainties described in

the Corporation's filings with securities regulators, as well as in its Annual Report on Form 20-F filed with securities

regulatory authorities on June 29, 2018. The Corporation's financial results are published in Canadian dollars. All amounts

disclosed in this MD&A are in thousands of Canadian dollars, except share and per share amounts or unless otherwise indicated.

Additional information about the Corporation can be found on the

SEDAR website at www.sedar.com or on EDGAR at www.sec.gov/edgar.shtml under Acasti Pharma

The Class A shares of the Corporation ("Common Shares")

are listed for trading on the TSX Venture Exchange and on the NASDAQ Capital Market exchange under the ticker symbol "ACST".

We own or have rights to trademarks, service marks or trade names

that we use in connection with the operation of our business. In addition, our name, logo and website names and addresses are our

service marks or trademarks. CaPre and Onemia are our registered trademarks. The other trademarks, trade names and service

marks appearing in this MD&A are the property of their respective owners. Solely for convenience, the trademarks, service marks,

tradenames and copyrights referred to in this MD&A are listed without the , and TM symbols, but we will assert,

to the fullest extent under applicable law, our rights or the rights of the applicable licensors to these trademarks, service marks

This MD&A contains information that may be forward-looking information

within the meaning of Canadian securities laws and forward-looking statements within the meaning of U.S. federal securities laws,

both of which we refer to in this MD&A as forward-looking information. Forward-looking information can be identified by the

use of terms such as "may", "will", "should", "expect", "plan", "anticipate",

"believe", "intend", "estimate", "predict", "potential", "continue"

or other similar expressions concerning matters that are not statements about the present or historical facts. Forward-looking

information in this MD&A includes, among other things, information or statements about:

Although the forward-looking information in this MD&A is based

upon what we believe are reasonable assumptions, you should not place undue reliance on that forward-looking information since

actual results may vary materially from it. Important assumptions made by us when making forward-looking statements include, among

In addition, the forward-looking information in this MD&A is

subject to a number of known and unknown risks, uncertainties and other factors, including those described in this MD&A under

the heading "Risk Factors", many of which are beyond our control, that could cause our actual results and developments

to differ materially from those that are disclosed in or implied by the forward-looking information, including, among others:

All of the forward-looking information in this MD&A is qualified

by this cautionary statement. There can be no guarantee that the results or developments that we anticipate will be realized or,

even if substantially realized, that they will have the consequences or effects on our business, financial condition or results

of operations that we anticipate. As a result, you should not place undue reliance on the forward-looking information. Except as

required by applicable law, we do not undertake to update or amend any forward-looking information, whether as a result of new

information, future events or otherwise. All forward-looking information is made as of the date of this MD&A.

Caution Regarding Non-IFRS Financial Measures

The Corporation uses multiple financial measures for the review

of its operating performance. These measures are generally IFRS financial measures, but one adjusted financial measure, Non-IFRS

operating loss, is also used to assess its operating performance. This non-IFRS financial measure is directly derived from the

Corporation's financial statements and is presented in a consistent manner. The Corporation uses this measure, in addition

to the IFRS financial measures, for the purposes of evaluating its historical and prospective financial performance, as well as

its performance relative to competitors and to plan and forecast future periods as well as to make operational and strategic decisions.

The Corporation believes that providing this Non-IFRS information to investors, in addition to IFRS measures, allows them to see

the Corporation's results through the eyes of management, and to better understand its historical and future financial performance.

Earnings and other measures adjusted to a basis other than IFRS

do not have standardized meanings and are unlikely to be comparable to similar measures used by other companies. Accordingly, they

should not be considered in isolation. The Corporation uses Non-IFRS operating loss to measure its performance from one period

to the next without the variation caused by certain adjustments that could potentially distort the analysis of trends in its operating

performance, and because the Corporation believes it provides meaningful information on the Corporation's financial condition

and operating results. Acasti's method for calculating Non-IFRS operating loss may differ from that used by other corporations.

Acasti calculates its Non-IFRS operating loss measurement by adding

to net loss finance expenses that includes change in fair value of derivative warrant liabilities, depreciation and amortization,

impairment loss, change in fair value of derivative warrant liabilities, and stock-based compensation and by subtracting finance

income and deferred tax recovery. Items that do not impact core operating performance of the Corporation are excluded from the

calculation as they may vary significantly from one period to another. Finance income/expenses include foreign exchange gain (loss).

Acasti also excludes the effects of certain non-monetary transactions recorded, such as stock-based compensation, from its Non-IFRS

operating loss calculation. Excluding this item does not imply it is necessarily non-recurring.

A reconciliation of net loss to Non-IFRS operating loss is presented

We are a biopharmaceutical innovator focused on the research, development

and commercialization of prescription drugs using omega-3, or OM3, fatty acids and phospholipids, or PLs, derived from krill oil.

OM3 fatty acids have extensive clinical evidence of safety and efficacy in lowering triglycerides, or TGs, in patients with hypertriglyceridemia,

or HTG. Our lead product candidate is CaPre, an OM3 phospholipid therapeutic, which we are developing initially for the treatment

of severe HTG, a condition characterized by very high or severe levels of TGs in the bloodstream ( 500 mg/dL). In accordance

with a study published in 2009 in the Archives of Internal Medicine by Ford et al., it is estimated that three to four million

people in the United States have severe HTG. In primary qualitative market research studies with Key Opinion Leaders (KOLs), High

Volume Prescribers (HVPs) and Pharmacy Benefit Managers commissioned by Acasti in August 2016 and November of 2017 by DP Analytics,

a division of Destum Partners, physicians interviewed indicated a significant unmet medical need exists for an effective, safe

and well-absorbing OM3 therapeutic that can also demonstrate a positive impact on the major blood lipids associated with cardiovascular

disease, or CVD, risk. We believe that CaPre will address this unmet medical need if our Phase 3 results reproduce what we observed

in our Phase 2 data. We initiated TRILOGY, our Phase 3 clinical program in North America during the second half of 2017 and started

clinical site activation as planned at the end of 2017. As of the date of this MD&A, patient enrollment and randomization is