Where Will Neurocrine Biosciences Be in 5 Years?

Neurocrine Biosciences (NASDAQ: NBIX) generated $959 million in revenue in Q2 2026, representing an increase of 39% year over year. Its flagship drug, Ingrezza, continues to deliver double-digit percentage sales growth, while two newer treatments help the company expand beyond its original neurological disease franchise. Neurocrine is also approaching several important clinical milestones, including late-stage trial results for experimental treatments targeting depression and schizophrenia.

By 2031, I expect Neurocrine to be a substantially larger pharmaceutical company, potentially generating more than $6 billion in annual revenue. Whether its stock follows that growth, however, will depend on the success of its newer drugs and how much investors are willing to pay for its earnings.

Ingrezza remains the foundation

If you're unfamiliar, Ingrezza treats tardive dyskinesia, a neurological condition that causes involuntary movements, often associated with long-term use of certain psychiatric medications. It's also approved to treat chorea (involuntary muscle movements) associated with Huntington's disease.

In Q2, Ingrezza sales reached $716 million, up 15% from $624 million a year earlier. Management subsequently raised its full-year 2026 Ingrezza sales forecast to between $2.825 billion and $2.875 billion. And there's still room for more growth.

Neurocrine estimates that about 800,000 Americans have tardive dyskinesia. Many patients remain undiagnosed or untreated, providing an opportunity to expand prescriptions without requiring another Food and Drug Administration (FDA) approval.

To be sure, Ingrezza does face competition from Teva Pharmaceuticals' (NYSE: TEVA) Austedo, which also treats tardive dyskinesia and Huntington's-related chorea. Future pricing pressure, changes in insurance reimbursement, and eventual generic competition could limit growth. Still, I expect Ingrezza to remain Neurocrine's largest product by 2031, although the company's dependence on it should decline significantly.

Two newer drugs are becoming major revenue contributors

Neurocrine's second-largest product is Crenessity, approved in December 2024 to treat classic congenital adrenal hyperplasia (CAH). This is a rare inherited disorder that interferes with the body's ability to produce certain hormones. Patients often require long-term steroid treatment, which can cause serious complications.

Q2 sales reached $184 million, compared with $53 million a year earlier. That's an increase of 247%. Annualizing the latest quarter produces a revenue run rate of $736 million, although actual full-year sales will depend on continued prescription growth and reimbursement. Neurocrine estimates at least 20,000 Americans have CAH, giving the company a relatively small but commercially meaningful patient population.

Image source: Getty Images.

The company acquired Soleno Therapeutics for about $2.9 billion in May, adding Vykat XR to its portfolio. Vykat XR treats hyperphagia, or persistent, excessive hunger, in patients with Prader-Willi syndrome, a rare genetic disorder.

The drug generated $54 million in sales between the May 18 acquisition closing and June 30. Including sales recorded before the acquisition, the drug generated about $94 million during the full second quarter, equivalent to an annualized revenue run rate of $376 million.

Combined, Crenessity and Vykat XR are already generating more than $1 billion in annualized revenue. Continued adoption could make both significant contributors by 2031.

The pipeline could produce additional blockbusters

Neurocrine has several experimental treatments approaching important clinical milestones. There's Osavampator, which is being evaluated in Phase 3 trials for major depressive disorder, while direclidine is undergoing Phase 3 testing for schizophrenia. Both programs are expected to produce trial results in 2027.

These are considerably larger markets than those targeted by Crenessity and Vykat XR. However, psychiatric drug development carries substantial clinical risk. Both treatments must show meaningful benefits and an acceptable safety profile before Neurocrine can even seek regulatory approval. The company is also developing additional neurological treatments, including experimental drugs targeting Alzheimer's disease and epilepsy.

What could Neurocrine look like in 2031?

Neurocrine's Q2 revenue of $959 million represents an annualized run rate of about $3.84 billion. If annual revenue grows at a compounded rate of 10% from that baseline during the next five years, it would reach about $6.18 billion. A 12% growth rate would produce roughly $6.76 billion.

Those are achievable scenarios if Ingrezza continues growing, Crenessity and Vykat XR expand their patient populations, and at least one late-stage pipeline candidate reaches commercialization.

Neurocrine reported Q2 net income of about $144 million, showing it already has a profitable commercial business to support further research and acquisitions. The biggest risks are really clinical trial failures, rising development expenses, and pricing pressure on Ingrezza.

I expect Neurocrine to generate $6 billion to $7 billion in annual revenue by 2031, with a broader portfolio and less dependence on any single drug. That would represent substantial growth from today's business. But be sure to pay particular attention to the company's 2027 clinical readouts, which could determine whether Neurocrine becomes a much larger neuroscience franchise or remains primarily a three-product pharmaceutical company.

Jeff Siegel has no position in any of the stocks mentioned. The Motley Fool recommends Neurocrine Biosciences. The Motley Fool has a disclosure policy.