Neurocrine Biosciences, Inc. (NBIX) Earnings

Management highlights

- Over the past several years, the company has a vision to be a leading biopharmaceutical company by growing and diversifying revenue base and advancing pipeline. First quarter performance shows meaningful progress. Ingresa, in its ninth year since launch, continues to grow double-digit. Chronicity is annualizing over $600M per year. Pipeline progress includes plan for six new Phase I and four new Phase II programs this year. Key data readouts expected in 2027 for Osteo-Vapidora Major Depressive Disorder, Direct Lidine and Schizophrenia, and MBI-P2118 in obesity. - Commercial teams did outstanding quarter, delivered over $800M total revenue with over 40% Y/Y growth. Ingresa's strong performance driven by double-digit volume growth and record new patient additions. Chronicity launch progresses well with steady new patient starts, high persistency and compliance rates, favorable reimbursement. - Clinical pipeline highlights: presented new two-year chronicity data from Phase III Catalyst Adult Study at AACE 2026, showing sustained glucocorticoid dose reductions and positive impacts on various health aspects. Presented first real-world head-to-head claims data comparing Ingresa to deuterated tetrabenazine at Academy of Managed Care Pharmacy 2026 annual meeting, showing greater treatment persistence with Ingresa. Initiated three phase two studies and plan to initiate four additional phase 1 studies in 2026

Guidance

- Reaffirmed 2026 Ingresa guidance of $2.7 to $2.8 billion. - Anticipated closing of acquisition of Celeno Therapeutics remains on track to close in second quarter. - Plan to provide additional financial details on Q2 earnings call regarding the acquisition. - Multiple key data readouts expected over next 18 months, including Osevanpator, DirectLadeen, and CRF2 obesity program

Segment performance

First quarter net product sales exceeded $800 million, 44% year-over-year growth. Ingresa first quarter 2026 sales were $657 million, up 20% year-over-year, driven by double-digit volume growth and record new patient additions. Adjusting for one less order week in Q1 2025, growth was ~11%. Chronicity first quarter 2026 sales were $153 million, driven by strong persistency and consistent new patient enrollment, annualizing at over $600 million per year. Ingresa revenue contribution: first quarter sales $657M, Chronicity $153M, together over $800M total revenue with over 40% Y/Y growth

Analyst Q&A

• Q: Congrats on strong quarter, ask about chronicity growth, progress, physician activation efforts, where scripts come from.

  A: Overall ahead of expected, new patient starts steady, consistent with Q4, strong persistency and compliance, favorable reimbursement, most physicians have only treated one patient so far, substantial opportunity ahead.

• Q: For Ingresa and Kernessity, confirm no material inventory build or one-offs, speak to seasonality dynamic this quarter and cadence.

  A: No material inventory, clean quarter, team managed seasonality well, expect somewhat similar to historical, set up for nice growth year rest of 2026.

• Q: On chronicity, elaborate on new patient start forms, expected cadence.

  A: Kyle mentioned moving away from specific numbers, focusing on top line net sales, saw good steady new patient starts from Q4 to Q1, extended to persistency and compliance, broad accumulation of patients over time.

• Q: Ask about pipeline, accrual of neuropsych assets, timing of top-line readouts.

  A: Sanjay said Ossipapitor phase three studies should read out next year, first phase three for Direct Ladeen schizophrenia next year, second phase three the following year.

• Q: Talk about reauthorization processes for chronicity, reimbursement trends.

  A: CH population primarily commercially insured and secondarily Medicaid, low Medicare exposure, so no surge in reauthorizations like Ingresa, reauthorization approvals high.

• Q: Follow up on chronicity, physicians having written once, where patients coming from, saturation.

  A: Not saturated, still early in launch, three segments of prescribers, about 15% of patients under care of centers of excellence, distribution proportional, flow of patients through practices is a contributor to steady new patient ads, Salesforce expansion will increase prescribing depth and prescriber base.

• Q: Ask about seasonality for chronicity.

  A: On gross to net front, couple points of improvement off Q1, still early in launch cycle, hard to tag normal seasonality, flow of patients consistent quarter in, quarter out due to constrained prescriber universe, no massive seasonality like Ingresa.

• Q: Ask about upcoming ENDO meeting, physician outreach initiatives, data updates for Chronicity.

  A: Looking forward to ENDO in June to engage with endocrinology community, had momentum at recent pediatric endo meeting, two-year open label data on Chronicity showing impact of decreased glucocorticoid doses, androgen levels, better weight control, insulin resistance, decreased virilization, decreased bone age advancement, with 35,000 patient-week exposures.

• Q: Ask about Friedreich's ataxia gene therapy program, phase one study design, initial data in 2027.

  A: Kyle said planning to start FAA program shortly, will share patient-level data towards end of 2027, consider as Phase 1B trial.

• Q: Ask about GGG agonist, therapeutic window, Phase 1 development.

  A: Still early days, CRFR2 agonist for obesity readout next year, GGG program targeting first in human this year, will look iteratively at clinical data for both programs.

• Q: Ask about Ingresa payer coverage, implications of XR losing preferred coverage.

  A: Coverage similar to end of 2025, about 70% of TD and HD Medicare beneficiary lives covered for Ingresa, wouldn't expect wide changes in reimbursement.

• Q: Follow up on 24-month data for chronicity, prevalence of insulin resistance and obesity in pediatric and adult CEH patients, main reasons for discontinuing.

  A: Weight gain, insulin resistance, cardiometabolic issues common in pediatric CH population, strong persistence and compliance in real-world setting, around 95% completed trials and rolled over, over 80% completed two years in open label data.

• Q: Ask about chronicity, new patient starts vs persistent patients, positioning of schizophrenia and MDD drugs.

  A: Didn't give specific number of new patient starts, rate of new patient ads in Q1 steady, consistent with Q4, schizophrenia and MDD drugs are added on to antidepressants not achieving good response, potentially occupying niche in marketplace.

• Q: Ask about chronicity trends evolving this year, NBIP2118 phase one data needs.

  A: Still early in commercial ramp, steady new patient ads in Q1, Salesforce expansion will build depth and add new prescribers, expect to reach and activate patients not under endocrinologist care, data on NBIP2118 in second half of 2027.

• Q: Ask about 1435 program, relative potency vs chronicity at CRF1 receptor, differentiation needed.

  A: Excited about 1435 program, injectable peptide, preclinically good durable efficacy, can compare biomarker readouts with chronicity, chronicity is foundational therapy, 1435 offers alternative route of administration and potential differentiation.

• Q: Ask about TD screening in long-term care setting and impact on Ingresa market share.

  A: Consensus recommendations on TD screening help advance gains, raised awareness, teams leveraging TD Awareness Week to raise energy around screening in all care settings.

• Q: Ask about thoughts on developing CRF antagonists in cognition and working memory-related indications, pipeline partnering.

  A: Interesting concept, CRF may be linked to cognition in CH patients, right now pipeline more weighted to psychiatry, not slated for partnering yet, but will consider as programs progress.

• Q: Ask Matt about tax rate modeling.

  A: Expect non-GAAP effective tax rate to be between 22% and 24% this year and within low 20s going forward.

• Q: Ask about diurnal sale rationale, additional clinical or real-world evidence needed for broader buy-in of chronicity in male and adult patients.

  A: Diurnal sale was felt better suited in another organization, for broader buy-in of chronicity in male and adult patients, for adult males, compliance may be lower, need to address different treatment rationales based on gender and stage of life.

• Q: Ask about persistence and compliance rates for chronicity, expectations in 2026.

  A: Compliance and persistency very consistent regardless of when patients started, due to great tolerability and single pharmacy distributor Panther.

• Q: Ask about Cronosophon and CAA patients under four, opportunity, regulatory and commercial timeline.

  A: There's unmet need for younger patients, study on patients under four is ongoing, assuming data in next couple of years to potentially expand label.

• Q: Ask about Ingresa seasonality pattern for remaining quarters, market dynamics after IRA negotiation.

  A: Expect 2026 similar to prior years with seasonal payer disruption in Q1, team managed seasonality well, expanded field sales team effective in early Q2, expect tangible lift from expanded team later in year.

• Q: Follow up on persistence and compliance rates for chronicity, reasons for discontinuations.

  A: Very low rate of discontinuations, not due to insurance issues as out-of-pocket costs are low, mostly due to moving or lost to follow-up