Neurocrine Biosciences (NBIX) Q2 FY26 earnings call: guidance and Q&A

What is the visibility on INGREZZA pricing dynamics for next year, especially with AUSTEDO MFP, and how much additional cost might be incurred to maintain access?

Management stated that 70% of Medicare lives are covered in 2026 with consistent pricing expected. They anticipate ample opportunity for strong access in 2027 and 2028 for MFP-adjacent products. It's too early to quantify additional costs for maintaining access next year.

“I think where we are right now is we do see a process and the path moving forward is not just us but others that there'll be a place for MFP adjacent products for Medicare beneficiaries.”

asked by Paul Matteis · answered by Kyle Gano

Was CRENESITY's strong Q2 revenue growth (20% QoQ) due to one-time issues, or is this pace sustainable for the back half of the year?

The strong Q2 performance for CRENESITY was an extension of a steady and consistent pattern of new patient adds and adoption across all target segments. No one-time issues were cited, suggesting continued strong momentum.

“I think characterizing Q2 is really an extension of what we've seen earlier in the launch, a very steady and consistent pattern of new patient adds.”

asked by Philip Nadeau · answered by Eric Benevich

Given VYKAT XR's flat sequential sales, what specific actions are being taken to accelerate its launch trajectory now that it's under Neurocrine's control?

Q2 results were aligned with expectations. The focus is on fundamentals: finding patients, educating providers on selection, titration, and achieving good outcomes. Neurocrine will leverage its commercial, medical, and patient support capabilities to drive sequential growth exiting 2026.

“But ultimately, I think the fundamentals are what matters, continuing to find patients to introduce VYKAT XR to the providers that care for them, primarily in endocrinology and then provide good education and guidance around how to select appropriate patients, how to help them through the titration process and to achieve good outcomes.”

asked by Tazeen Ahmad · answered by Eric Benevich

How are new patient boluses affecting dropout rates for VYKAT XR, and when will new starts and dropout rates reach an equilibrium?

New patient starts have been steady. Discontinuations from the initial launch bolus are being pulled through, but the ultimate rate is expected to settle into the 25%-30% range typical for orphan medicines. Sequential growth is expected as the company exits 2026.

“In terms of discontinuations, obviously, with a bolus of patients at the launch, we do see some of those discontinuations being pulled through as time has gone along, but we expect to see the ultimate rate settling into what we would see with other orphan medicines in the 25% to 30% range.”

asked by Brian Skorney · answered by Kyle Gano

What is the clinical plan and timeline for next-gen CRENESITY assets, especially given a recent acquisition of a potential future competitor in CAH?

The next-gen asset, NBIP-01435 (a protein-based therapeutic peptide), showed great Phase I data and will start a Phase II study shortly. CRENESITY has set a high bar with strong efficacy, safety, multiple formulations, and years of clinical data, making it difficult for competitors and internal programs to surpass.

“So we have great Phase I data that's come out of the program thus far, and we look forward to starting a Phase II study shortly and bringing that to patients as quickly as we can.”

asked by Cory Kasimov · answered by Kyle Gano

How does Neurocrine plan to smooth top and bottom-line growth through the 2029 INGREZZA IRA implementation year, considering pipeline scenarios?

The company expects continued top-line revenue growth through the end of the decade due to the evolution of its commercial portfolio. On the expense side, Phase III trials will be sunsetting, shifting the pipeline to earlier stages. Episodic investments for potential launches (like osavampator) may cause earnings variability, but the North Star is long-term revenue growth.

“I think overarching, what we see in the evolution of our commercial portfolio are medicines that are growing over that time frame as well. So we think we'll end up being in a good position there to see continued top line revenue growth through the end of this decade and beyond.”

asked by Joshua Schimmer · answered by Kyle Gano

Given the pipeline includes candidates in large markets with larger competitors, what is the long-term operating margin target, and how will Neurocrine compete?

Neurocrine is not providing long-term operating margin guidance but notes its non-GAAP operating income is over 30%. The strategy is to build a portfolio of first- and best-in-class medicines across neurology, psychiatry, endocrinology, and immunology, leveraging unique molecules and mechanisms. This diversifies risk and allows for playing in larger disease states with objective endpoints.

“From a strategic perspective, what we're doing is setting up the pipeline to have a portfolio of not only first but best-in-class medicines across neurology, psychiatry and endocrinology as well as immunology.”

asked by Sumant Kulkarni · answered by Kyle Gano