Neurocrine's Ingrezza Sales Keep Growing: Can the Momentum Last?

Neurocrine Biosciences NBIX has had an encouraging start so far in 2026, with strong revenue growth, supported by continued momentum in its commercial portfolio. The top-line benefits primarily from Ingrezza, the company's blockbuster VMAT2 inhibitor, which remains Neurocrine’s primary revenue driver and a key pillar of its growth story.

Ingrezza sales rose 17% year over year to $1.4 billion in the first half of 2026, supported by record new prescriptions and double-digit total volume growth. The strong performance prompted management to raise its Ingrezza sales guidance for full-year 2026 to $2.83-$2.88 billion from $2.7-$2.8 billion. The midpoint implies approximately 13% year-over-year growth, indicating that Neurocrine expects the drug's commercial momentum to remain solid through the remainder of the year.

Ingrezza is approved for two indications — tardive dyskinesia (TD) and chorea associated with Huntington's disease (HD). However, TD represents the larger commercial opportunity for Ingrezza. Neurocrine estimates that roughly 800,000 people in the United States are affected by the disease, yet only about half are diagnosed and approximately 10% receive a VMAT2 inhibitor, highlighting the significant room for broader treatment adoption. Continued diagnosis and treatment penetration could therefore support Ingrezza's sales growth even as the drug's existing patient base expands.

In comparison, chorea affects the vast majority of the roughly 40,000 Americans living with HD. Although the addressable population is considerably smaller than that for TD, the indication provides an additional source of demand and strengthens Ingrezza's position across the movement-disorder market.

Pricing Exposure Could Become a Concern for NBIX Over Time

While Ingrezza continues to benefit from strong volume growth, pricing remains an important consideration for its future sales trajectory. In 2025, pricing concessions related to broader formulary access partially offset volume gains. Although management expects 2026 net pricing to remain broadly consistent with last year's levels, pricing pressure is expected to rise in the longer term.

A key factor could be the pricing of Teva Pharmaceuticals' TEVA Austedo and Austedo XR, which compete with Ingrezza across both approved indications. TEVA’s therapies are set to enter the Medicare Drug Price Negotiation Program in 2027, with negotiated prices below pre-negotiation levels. This could make Austedo/Austedo XR more price-competitive among Medicare patients and potentially put additional pressure on Ingrezza's pricing and formulary positioning. Neurocrine has said it remains confident in maintaining broad access for Ingrezza, although greater pricing competition could become a concern over time.

At the same time, Austedo is gaining momentum in the market. Teva reported second-quarter 2026 Austedo sales of $696 million, up 40% year over year, underscoring the drug's growing competitive position. Like NBIX, TEVA also raised its 2026 outlook for Austedo to $2.45-$2.60 billion from $2.40-$2.55 billion.

While Austedo remains the most direct competitive threat, the pipeline is also evolving beyond VMAT2 inhibitors. Acadia Pharmaceuticals ACAD recently started clinical development on ACP-271, a GPR88 agonist for TD. Though this candidate is still in early-stage development, its different mechanism could represent a longer-term competitive consideration for Ingrezza.

NBIX’s Price Performance, Valuation & Estimates

Shares of Neurocrine Biosciences have outperformed the industry year to date, as seen in the chart below.

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The company is currently trading at a premium to the industry. Based on the price-to-sales (P/S) ratio, the stock trades at 3.69 times forward 12-month sales, above the industry average of 2.02 times.

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Estimate revisions for Neurocrine Biosciences’ 2026 and 2027 EPS have been mixed over the past 30 days.

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Neurocrine currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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