How Much of Neurocrine Is Still INGREZZA, and How Armistice Capital’s Other Neuroscience Holdings Compare

In the first quarter of 2025, INGREZZA accounted for more than nine-tenths of Neurocrine Biosciences’ revenue, based on the company’s reported growth rates. By the second quarter of 2026, its share had dropped to about 75%. The drug’s sales did not shrink. They grew 15% year over year to $716 million in the April-to-June period, according to the company’s July 30 release. Other products grew faster.

CRENESSITY, a treatment for a rare adrenal disorder, brought in $184 million in the quarter. VYKAT XR, acquired with Soleno Therapeutics in May, added $54 million in six weeks. Total revenue reached $959 million, up 39% from a year earlier, and INGREZZA’s portion fell to roughly three dollars of every four, based on the company’s reported figures.

The New York-based hedge fund Armistice Capital owns several neuroscience companies, Neurocrine among them, and each depends on its lead drug to a different degree. Armistice reported 535,838 Neurocrine shares worth $90.3 million as of June 30, InsiderSet’s tally of 13F filings shows. BlackRock’s 13,711,607 shares and RTW Investments’ 1,267,925 were both larger positions. In the same filing, Armistice held Supernus Pharmaceuticals, valued at $123 million, and Harmony Biosciences, valued at $57 million, StockZoa data show.

Neurocrine Builds Around Its Lead Drug

INGREZZA reached the market in 2017. Doctors prescribe it for tardive dyskinesia, which causes involuntary facial and body movements in some long-term antipsychotic users, and since a later approval for Huntington’s chorea. First-quarter sales were $656.9 million, up 20%, and second-quarter sales $716 million, up 15%, with record new patient starts. In July the company lifted its 2026 INGREZZA target by $125 million at the low end and $75 million at the high end, to a range of $2.825 billion to $2.875 billion. With $1.373 billion booked in the first half, that range implies second-half INGREZZA sales of about $1.45 billion to $1.5 billion.

“Neurocrine’s strong first-quarter performance reflects continued momentum across our commercial portfolio,” Chief Executive Kyle Gano said in May. Total first-quarter revenue was $814.5 million, up 42%, and GAAP net income was $197.9 million, or $1.91 a diluted share. Three months later, he said, “Our second quarter performance demonstrates the power of a strategy designed to compound over time.” On the August call, Gano described the tardive dyskinesia market as one that “continues to grow double digit year to year,” and Chief Commercial Officer Eric Benevich said, “INGREZZA outgrew the market.” Medicare coverage was broad, Gano said, with “about 70% of all Medicare lives covered.”

The growth in other products came quickly. CRENESSITY, which won FDA approval at the end of 2024 to treat classic congenital adrenal hyperplasia, generated $14.5 million in the first quarter of 2025, $153.3 million in the first quarter of 2026 and $184 million in the second quarter, a 247% increase over the year-earlier quarter. Roughly 15% of diagnosed patients, by the company’s estimate, had received a prescription by midyear, Chief Financial Officer Matt Abernethy said in his prepared remarks on the call. Benevich said the count of prescribing doctors had “nearly tripled compared to 1 year ago.” He added that “Most of the physicians that have tried CRENESSITY have only treated 1 patient so far,” and that more than nine in 10 patients were “paying $10 or less per month” on their own. Gano cited data showing “70 percent of patients, at the 2 year period were on a physiologic dose” of glucocorticoids, the steroid hormones that patients with the disorder have historically needed in high doses.

VYKAT XR treats hyperphagia, a persistent and extreme hunger, in patients age 4 and up who have Prader-Willi syndrome, an inherited condition. The FDA approved the drug on March 26, 2025. Neurocrine agreed in April to buy Soleno for $53 a share in cash, a $2.9 billion equity value, and closed the purchase May 18. “Today marks an important advancement in Neurocrine’s mission to deliver life-changing treatments,” Gano said at the closing. The drug’s pro forma sales for the full second quarter were $94 million. “VYKAT XR has the potential to become the third blockbuster in our portfolio,” Benevich said. Discontinuations rose after the deal closed. Abernethy said Neurocrine expected to be “through the bolus of the discontinuations here this quarter” and to return to sequential growth by the end of 2026. Gano said the discontinuation rate should settle “in the 25 to 30 percent range,” in line with other orphan drugs. Gano said VYKAT XR’s patent protection extends to “the mid-2040s.”

Had Soleno been part of Neurocrine for the whole quarter, revenue would have reached $998 million on a pro forma basis, and INGREZZA’s share would have been closer to 72%.

The diversification cost cash. Neurocrine had about $2.65 billion in cash, cash equivalents and marketable securities at March 31 and about $482 million at June 30, after paying for Soleno. An undrawn $1 billion revolving credit line remained available, and the company carried “no debt,” Abernethy said. Deal-related costs should total roughly $150 million, he said. GAAP earnings for April through June came to $144 million ($1.39 a share), against $108 million a year before. Excluding certain items, Neurocrine earned $297 million ($2.85 a share), up from $166 million ($1.65).

INGREZZA’s pricing also has a set end point. Gano told analysts that Medicare price negotiations for the drug are expected to begin in 2027 and that a negotiated price would apply “to INGREZZA in 2029.” Abernethy said future “EPS variability is really going to be based upon, as you said, the impact of the IRA implementation in 2029.” Austedo, Teva’s competing drug for the same conditions, receives its Medicare negotiated price of $4,093 for a 30-day supply on Jan. 1, 2027, Manatt Health’s review of the CMS data shows, about 38% below Austedo’s 2024 list price of $6,623. The next list, released in January 2026 for prices starting in 2028, does not include INGREZZA, according to the Academy of Managed Care Pharmacy’s copy. Teva’s U.S. Austedo sales grew 33% to $676 million in the quarter, and the company now projects $2.45 billion to $2.6 billion for the year, Nasdaq’s recap of Teva’s call shows. More than 60% of new Austedo patients started on the once-daily XR version.

Harmony Depends on One Molecule

Harmony Biosciences sits at the other end of the range. WAKIX, its treatment for narcolepsy, is the only product named in its revenue, which reached a record $261.3 million in the second quarter, up 30% from $200.5 million a year earlier, the company reported Aug. 4. The estimated number of patients on the drug rose by 450 during the quarter to 8,950.

“Our record second-quarter revenue reflects sustained demand for WAKIX,” Chief Executive Jeffrey M. Dayno said.

Harmony earned $75.4 million, or $1.28 a diluted share, in the quarter, up from 68 cents a year earlier, and held $962.5 million in cash, cash equivalents and investments at June 30, about twice Neurocrine’s cash balance after the Soleno purchase. It reiterated its 2026 forecast for WAKIX revenue of $1 billion to $1.04 billion.

Much of Harmony’s pipeline extends the same molecule. Pitolisant is the active ingredient in WAKIX, and the FDA accepted Harmony’s application for a gastro-resistant version, pitolisant GR, in July, with a target decision date of April 1, 2027, and a planned launch in the first half of that year. A high-dose formulation, pitolisant HD, has Phase 3 results due in 2027 in narcolepsy and idiopathic hypersomnia. WAKIX itself is in a Phase 3 trial in Prader-Willi syndrome, the same disease VYKAT XR treats, with results expected in mid-2027.

Harmony has two programs built on other compounds. EPX-100 is in Phase 3 trials for two rare epilepsies, Lennox-Gastaut syndrome and Dravet syndrome, with results expected in the first half of 2027. BP-205, an orexin-2 agonist, is in Phase 1, with multiple-dose data expected in the fourth quarter of 2026, Phase 1b data in early 2027 and Phase 2 studies planned for mid-2027. Harmony expects FDA decision dates in 2028 for pitolisant HD, for WAKIX in Prader-Willi syndrome and for EPX-100.

Where the Holders Stand

Neurocrine’s register is led by index managers. BlackRock’s stake was valued at $2.31 billion on June 30, InsiderSet data show. Vanguard’s three filing entities together reported about 10.2 million shares: 4,974,083 at Vanguard Portfolio Management, 4,545,339 at Vanguard Capital Management and 647,763 at Vanguard Fiduciary Trust. State Street’s 4,385,598 shares carried a reported value of $739.1 million. RTW Investments’ 1,267,925 shares were valued at $213.7 million.

Armistice’s neuroscience holdings moved in different directions during the second quarter. The fund raised its Supernus stake by 39%, to about 2.6 million shares, StockZoa data show. It held about 25% fewer Neurocrine shares than at the end of March and about 3% fewer Harmony shares, which numbered roughly 1.6 million. It also held Alto Neuroscience, valued at $23 million after a 5% reduction in shares.

Supernus, at about 1.5% of the portfolio, was among Armistice’s five largest reported positions on June 30, according to 13f.info. The others were index put options on the SPDR S&P 500 ETF Trust and iShares Russell 2000 ETF, a Madrigal Pharmaceuticals stake and Cytokinetics call options. Neurocrine made up about 1.1% of the fund’s reported portfolio and Harmony about 0.7%. Armistice reported $8.17 billion across 333 holdings.

Supernus Spreads Its Revenue

Supernus has a broader product mix. Its total second-quarter revenue rose 32% to $219.1 million from $165.5 million, according to its Aug. 3 release. Qelbree, a nonstimulant ADHD drug, was the largest product at $89.2 million, up 15%, or about 41% of revenue. GOCOVRI, for Parkinson’s disease, added $37.6 million, up 2%.

Total net product sales were $165.7 million, up 5%. Supernus also collects half of Biogen’s U.S. net revenue from ZURZUVAE, a postpartum depression drug, after acquiring Sage Therapeutics in July 2025. That collaboration revenue came to $35.4 million. ONAPGO, a Parkinson’s infusion treatment, generated $13.5 million, up from $1.6 million. Combined revenue from Qelbree, GOCOVRI, ZURZUVAE and ONAPGO rose 52% to $175.7 million.

Older products declined. Trokendi XR and Oxtellar XR each fell 25%, and APOKYN fell 51%. Supernus recorded a $54.9 million non-cash impairment on APOKYN, which produced a net loss of $58.4 million, or $1.01 a share, compared with net earnings of $22.5 million a year earlier. Adjusted operating earnings were $31.2 million. Royalty, licensing and other revenue rose to $18 million from $7.5 million. Supernus held about $372.1 million in cash, cash equivalents and current marketable securities at June 30. The company raised its 2026 revenue forecast to $860 million to $890 million and its adjusted operating earnings forecast to $150 million to $180 million, and it expects ONAPGO sales of $55 million to $70 million for the year.

“Our first-half 2026 results reflect the continued strength and sustained momentum of our growth products,” Chief Executive Jack Khattar said.

The same day, Supernus announced an all-stock merger of equals with Indivior Pharmaceuticals. Supernus described the combined business as a diversified central nervous system biopharmaceutical company. The deal requires shareholder and regulatory approval.

Three Pipelines, Most Dates in 2027

Neurocrine’s next large readouts arrive in 2027: Phase 3 results for direclidine in schizophrenia and osavampator in major depressive disorder. Both are named in the company’s second-quarter release as 2027 events, the same calendar year in which INGREZZA’s Medicare talks are expected to start.

Earlier-stage work moved in August. Regulators cleared a new trial on Aug. 26, when the FDA accepted Neurocrine’s investigational new drug application for a Phase 2 test of NBI-1117567 in Alzheimer’s cognition, Nxera Pharma said. Nxera, which found the compound with its NxWave structure-based design platform, received $10 million for the milestone. Taken by mouth, the compound activates muscarinic receptors, favoring the M1 subtype while also acting on M4. Nxera links M1 to cognition and M4 to psychosis.

Two other compounds from the 2021 partnership reached Phase 2 before it. The licensing terms allow Nxera to collect as much as $2.6 billion in R&D funding and milestone payments, along with royalties. Nxera retained Japanese rights to M1 agonists, with Neurocrine holding co-development and profit-sharing options there, and it plans to recognize the $10 million in its fiscal third quarter. “Alzheimer’s cognition remains an area of significant unmet medical need globally,” Nxera President and Chief Executive Christopher Cargill said.

The Alzheimer’s field is busy. Jeffrey L. Cummings’ annual review of the Alzheimer’s drug pipeline found 158 agents in 192 trials in 2026, versus 138 agents and 182 trials in 2025, the Alzheimer’s Association reported. Symptomatic drugs meant to improve cognition, the group NBI-1117567 would join, were 18% of the total. Disease-targeting drugs were 73% and neuropsychiatric symptom treatments 10%. Phase 2 accounted for 84 drugs in 89 trials. “Alzheimer’s is no longer an untreatable disease,” Cummings said.

Other muscarinic drugs in Alzheimer’s are aimed at psychosis rather than cognition. Bristol Myers Squibb is running three ADEPT studies of Cobenfy, its schizophrenia drug, in psychosis tied to Alzheimer’s, with data now expected to begin arriving in early 2027 after slower enrollment, FiercePharma reported. As recently as April, Bristol Myers had expected all three studies to report in 2026. Cobenfy’s second-quarter sales were $63 million.

Harmony’s calendar is similar. Its pitolisant GR decision date falls on April 1, 2027, and its pitolisant HD, Prader-Willi and EPX-100 readouts are all due in 2027.

Spending on those programs differs by company. Neurocrine now plans $1.275 billion to $1.325 billion of GAAP R&D spending this year and $1.575 billion to $1.6 billion of GAAP SG&A, both above its earlier ranges. Abernethy said a potential osavampator launch “would require a step up in overall investment.” Supernus guided to combined research, development, selling and administrative expense of $630 million to $660 million.

Neurocrine’s Medical Leadership

Neurocrine changed chief medical officers in late September. Sanjay Keswani stepped down by mutual agreement, with Eiry W. Roberts resuming the post immediately, according to a Sept. 29 RTTNews report that gave no further reason.

Roberts first held the post from 2018 to 2025, then stayed on as an adviser. Her earlier tenure covered the work that widened INGREZZA’s labeled uses and the crinecerfont trials behind CRENESSITY. She came to Neurocrine after 26 years at Eli Lilly, where her roles included vice president of R&D.

Roberts takes the role again ahead of the clinical readouts Neurocrine has scheduled for 2027. The third-quarter report is scheduled for Monday, Nov. 2, after the market close, with the release at 4 p.m. Eastern and management’s call 30 minutes later, BioPharmaWatch said.

The three companies reported more than $1.4 billion in combined second-quarter revenue, with different revenue mixes. At Harmony, WAKIX remains the only product named in revenue. At Neurocrine, INGREZZA’s share of revenue fell to about three-quarters in the second quarter as CRENESSITY and VYKAT XR grew. At Supernus, the largest product accounts for about two-fifths of revenue, and a merger with Indivior is pending. The funds’ Sept. 30 holdings are due in the next 13F round in mid-November.