INGReZZA's Growing Value in Tardive Dyskinesia: Market Differentiation and Unmet Needs Drive Neurocrine's Strategic Position

Neurocrine Biosciences' INGREZZA® (valbenazine) has emerged as a cornerstone in the treatment of tardive dyskinesia (TD), a neurological disorder characterized by involuntary, repetitive movements. As the first and only FDA-approved therapy for TD, INGREZZA has carved out a unique position in a market plagued by unmet medical needs. Despite intensifying competition from Teva's Austedo, Neurocrine's strategic innovations and clinical differentiation position INGREZZA to maintain its dominance in the coming years.

Clinical Differentiation and Unmet Needs

INGREZZA's market leadership is underpinned by its robust clinical profile. A post-hoc analysis of the Phase 4 KINECT-PRO™ study revealed that 57.8% of patients achieved symptomatic remission after 24 weeks of treatment, with the highest remission rate (62.5%) observed at the 80 mg dosageNeurocrine Biosciences Presents New Post-Hoc Analysis: …^[3]. These improvements translated into meaningful quality-of-life gains, as evidenced by significant enhancements in patient-reported outcomes such as the Tardive Dyskinesia Impact Scale (TDIS™) and the EuroQoL Visual Analog Scale (EQ-VAS)Neurocrine Biosciences Presents New Post-Hoc Analysis: …^[3].

The drug's sprinkle formulation further distinguishes it from competitors, offering a critical advantage for patients with swallowing difficulties—a population often excluded from traditional capsule-based therapiesNBIX: INGREZZA, Pipeline Developments, and Market Analysis^[1]. This formulation not only improves adherence but also addresses a key unmet need in TD management, where treatment discontinuation due to tolerability issues remains a persistent challenge.

Competitive Landscape and Strategic Response

Teva's extended-release Austedo, approved in 2023, has intensified competition in the TD marketWith Teva competition heating up, Neurocrine's tame Ingrezza …^[2]. However, INGREZZA has maintained a stronger sales position, generating $2.3 billion in 2024 compared to Austedo's $1.6 billionNBIX: INGREZZA, Pipeline Developments, and Market Analysis^[1]. Neurocrine's leadership attributes this resilience to INGREZZA's clinically differentiated profile and proactive market strategies.

To counter competitive pressures, Neurocrine has expanded its sales force and launched direct-to-consumer advertising campaigns, aiming to enhance patient and physician awarenessWith Teva competition heating up, Neurocrine's tame Ingrezza …^[2]. These efforts are expected to drive growth in the second half of 2025, particularly as the company leverages its 13 years of remaining market exclusivity for INGREZZAWith Teva competition heating up, Neurocrine's tame Ingrezza …^[2].

Pipeline Innovations and Future Potential

Neurocrine is further solidifying its leadership through pipeline advancements. NBI-1140675, a second-generation VMAT2 inhibitor in Phase 1 trials, could offer improved tolerability or dosing convenience, addressing another unmet need in TD treatmentNBIX: INGREZZA, Pipeline Developments, and Market Analysis^[1]. Additionally, INGREZZA's recent approval for Huntington's disease chorea—a second indication—positions it as a versatile therapeutic option, broadening its market reachNBIX: INGREZZA, Pipeline Developments, and Market Analysis^[1].

The company's diversification into congenital adrenal hyperplasia with Crenessity also signals a strategic pivot to reduce reliance on a single product, potentially creating a second blockbusterWith Teva competition heating up, Neurocrine's tame Ingrezza …^[2].

Conclusion: A Strong Investment Case

INGREZZA's combination of clinical efficacy, formulation innovation, and strategic market positioning makes it a compelling asset in Neurocrine's portfolio. While competitive pressures persist, the drug's ability to address unmet needs—such as patient adherence, long-term management, and expanded indications—ensures its relevance in an evolving TD landscape. With a robust pipeline and proactive commercial strategies, Neurocrine is well-positioned to sustain INGREZZA's growth trajectory and deliver long-term value to investors.