Neurocrine Biosciences (NASDAQ:NBIX) executives used a conference discussion to frame 2026 as a year of execution ahead of what they described as a “data-rich” 2027 across multiple mid- and late-stage clinical programs. CEO Kyle Gano and head of investor relations Todd Tushla also reviewed recent commercial performance for the company’s marketed products, including Ingrezza and CRENESSITY, and addressed investor questions around pricing dynamics and the Inflation Reduction Act (IRA).
2026 positioned as execution year ahead of 2027 readouts
Gano said the company entered 2026 with “enterprise-wide momentum,” following what he characterized as an expanding and increasingly diversified portfolio. He emphasized that the company’s focus in 2026 is on performance and execution to support delivery of phase II and phase III data in 2027, which he described as the beginning of “many years to come” of anticipated data flow.
Ingrezza: 2025 growth, 2026 guidance, and pricing discussion
Gano said Ingrezza, now in its eighth year of commercialization, produced $2.51 billion in 2025 revenue, up about 9% year over year, with “double-digit volume growth” and record new prescriptions (NRX) across multiple quarters. He noted a headwind in 2025 related to gross-to-net and net price per script tied to contracts taken on during the year, but said the company expects a “clean year” in 2026 from a contracting and access perspective.
For 2026, management reiterated Ingrezza revenue guidance of $2.7 billion to $2.8 billion. In discussing price expectations, Gano described a 4%–5% year-over-year price decline on a full-year blended basis, relative to exiting 2025, due to expanded access and the contractual dynamics put in place in 2025. He and Tushla also pointed to a larger year-over-year net price per script decline in the first quarter (about 10% on a Q1-to-Q1 basis) that they said would “recover a bit into Q2,” with pricing expected to be “on even ground in the second half of the year.”
Operationally, Gano said Neurocrine plans to leverage improved access secured in 2025 and a sales force expansion expected to be “live in Q2.” He said the company aims to go deeper with existing prescribers and reach new prescribers, including those on the antipsychotic side that the company had not been calling on previously. He also referenced a direct-to-consumer campaign planned for later in 2026. Gano noted that roughly 10% of an estimated 800,000 patients are currently on a VMAT2 inhibitor, which he cited as an indicator of remaining growth opportunity, and said Ingrezza intellectual property extends to 2038.
IRA and Medicare price considerations: 2026–2029 framework
Asked about uncertainty around future Ingrezza pricing, Gano laid out what he called three periods under the IRA: 2026 (before either Neurocrine or competitor Teva implements a Medicare maximum fair price, or MFP), 2027–2028 (when Teva’s MFP is implemented), and 2029 (when Neurocrine’s MFP is implemented).
He said 2026 is “relatively normal” for Neurocrine and cited strong access, adding that about 70% of tardive dyskinesia (TD) and Huntington’s disease (HD) patients are under existing contracts with plans. Regarding Teva’s MFP for Austedo, Gano said the outcome “landed in a pretty good spot,” within Neurocrine’s internal expectations, describing it as a 38% discount to Teva’s 2024 wholesale acquisition cost (WAC). He said the company believes it can “manage through that and can still see really good growth for the brand.”
Gano also said Neurocrine is negotiating with Medicare plans for 2027 and expects to provide an update later in 2026 on where those discussions land.
CRENESSITY: first-year results and launch dynamics
Turning to CRENESSITY, Gano said 2025 was the product’s first year of commercial sales and generated $300 million in revenue. He said the company reached about 10% of the congenital adrenal hyperplasia (CAH) market in the first year, emphasizing both the milestone and the remaining opportunity. He cited multiple launch metrics, including that 80% of dispensed prescriptions were reimbursed and that the company observed strong persistence during the year. He also said CRENESSITY has intellectual property extending into the early 2040s.
Tushla addressed investor sensitivity around “start forms” (new patient starts), calling nonlinear trajectories typical for orphan launches. He said new patient start forms in 2025 exceeded internal expectations each quarter and described weekly adds as consistently double-digit throughout the year, though variable by quarter. He said that, combined with persistence and reimbursement, investors should focus on the trend in net revenue over time.
Gano also noted seasonal dynamics that can affect quarterly interpretation, including Ingrezza reauthorizations in the first quarter and what he described as a commercial plan “pay down” effect for CRENESSITY in Q1 that can create gross-to-net noise that works through during the quarter.
Pipeline: multiple 2027 readouts and next-generation programs
Gano highlighted an “industry-leading neuropsychiatry portfolio,” stating that osavampator and direclidine are expected to deliver phase III data in 2027, with direclidine data extending into early 2028. He also referenced several phase II programs anticipated to read out in a similar timeframe, including NBI-570 (an M1/M4 dual agonist in schizophrenia) and next-generation VMAT2 efforts.
On osavampator, management discussed prior phase II results and outlined the phase III program design, noting three placebo-controlled trials and one randomized withdrawal study, with readouts expected in the second half of 2027. Gano said the earlier phase II trial was exploratory and not planned as pivotal.
For next-generation VMAT2, Gano said the company is pursuing potency, once-daily dosing, and low total daily dose, with the longer-term goal of supporting a long-acting injectable option to improve compliance. He said NBI-890 has entered a phase II trial in TD and is expected to have data in the second half of 2027, and also referenced NBI-675 as another program.
Gano also pointed to additional pipeline areas he believed investors may be overlooking, including a next-generation CAH program, NBIP-1435, described as a long-acting injectable CRF1 antagonist currently in phase I, with plans to move into phase II/III later in 2026. He further noted CRF2-related work in metabolic disease, including polycystic ovary syndrome (PCOS), with data expected “in the next year.”
About Neurocrine Biosciences (NASDAQ:NBIX)
Neurocrine Biosciences (NASDAQ: NBIX) is a biopharmaceutical company based in San Diego, California, focused on developing treatments for neurological, endocrine and neuropsychiatric disorders. Since its founding in 1992, the company has pursued a research‐driven strategy aimed at addressing unmet medical needs in movement disorders, reproductive health and central nervous system conditions. Neurocrine’s operations encompass drug discovery, clinical development and commercialization activities.
The company’s lead marketed product, Ingrezza™ (valbenazine), is indicated for the treatment of tardive dyskinesia, a movement disorder associated with long-term antipsychotic use.
