Answer

Updated guidance for Q1 2026 earnings report (Neurocrine Biosciences)

1) INGREZZA (VMAT2 inhibitor) — guidance reaffirmed

Management reaffirmed full-year 2026 INGREZZA guidance of $2.7 to $2.8 billion. ¹
The reaffirmation is explicitly tied to strong Q1 sales performance and the business’s momentum exiting Q1. ¹
Management also noted they will revisit guidance following the first half of the year. ¹

2) Crinesity (crinecerfont) — no formal numeric “guidance” change, but forward trajectory described

Management did not provide a specific 2026 sales range for Crinesity in these excerpts; however, they characterized the launch trajectory as strong and increasing. ¹
Crinesity Q1 sales were $153 million, and management emphasized gross-to-net pressure from commercial copay resets in Q1. ¹
Management expects that after Q1 payer seasonality/disruptions, execution and new patient starts should improve through the year; they also referenced sales force expansion effectiveness in early Q2. ²
They stated that they expect tangible lift later in the year with the expanded field sales team. ²

3) KRANESTENESITI / Kronesity disclosure policy (no longer sharing certain granular launch metrics)

For Kronesity (management’s orphan-medicine launch transparency approach), management said they are moving away from sharing specific numbers (e.g., cadence metrics) and focusing more on top-line net sales. ³

4) Soleno Therapeutics acquisition — timing only; no transaction financial guidance

The company said it is not providing financial guidance related to the transaction and will limit commentary during Q&A. ⁴
They stated the acquisition remains on track to close in the second quarter (assuming a Q2 close, they expect to provide additional financial details on the Q2 earnings call). ⁴

Q1 2026 sales performance (what happened in the quarter)

Overall company

Neurocrine reported more than $800 million in total revenue in Q1 2026, with over 40% year-over-year growth. ¹
The company stated that quarterly net product sales exceeded $800 million for the first time in its history, representing 44% year-over-year growth. ⁵
Management credited the result primarily to INGREZZA double-digit growth and the scale-up of the commercial portfolio. ⁵

INGREZZA (Q1 results)

Q1 2026 INGREZZA sales were $657 million, up 20% year-over-year. ¹
Management said that adjusting for one fewer order week in Q1 2025, growth was approximately 11%. ¹
They described INGREZZA as exiting Q1 with strength, supporting the reaffirmed full-year guidance. ¹
Additionally, management referenced record-like commercial execution: they noted that nine years post FDA approval and launch, they are still delivering record new patient starts, and estimated that ~90% of ~800,000 TD patients in the U.S. are not receiving first-line treatment with a VMAT2 inhibitor. ⁶

Crinesity (Q1 results)

Q1 2026 Crinesity sales were $153 million. ¹
Drivers cited: strong persistency and consistent new patient enrollment forms compared to Q4. ¹
Management also pointed to prescriber adoption and favorable reimbursement dynamics, but acknowledged slight gross-to-net pressure in Q1 due to commercial copay resets. ¹
They reiterated that Crinesity is on track toward blockbuster scale, stating sales now annualizing at over $600 million per year. ⁵⁷

Launch progress / commercial momentum indicators (context, not formal guidance)

Management said Crinesity is progressing with steady new patient starts, high persistency and compliance rates, and favorable reimbursement. ⁷
They reported real-world persistence/compliance examples: ~95% of patients completed and rolled over in adult and pediatric studies, and over 80% completed two years in an open-label dataset they referenced. ⁸
They also stated that, at a physician level, most physicians have only treated one patient thus far, implying further runway even if early adoption is strong. ⁹

Bottom line answer

Updated guidance: The only explicit numeric guidance change/update in these excerpts is that Neurocrine reaffirmed full-year 2026 INGREZZA guidance of $2.7–$2.8 billion and said it will revisit after the first half of 2026. ¹ For other elements (e.g., Soleno acquisition), management stated no transaction-related financial guidance and focused on expected Q2 closing and later disclosure timing. ⁴
Q1 sales performance: The company delivered > $800M total revenue (+40%+ YoY) and > $800M quarterly net product sales (+44% YoY), driven by INGREZZA ($657M, +20% YoY) and Crinesity ($153M), with modest Q1 gross-to-net headwinds from copay resets for Crinesity. ⁵¹

References

Fiserv, Inc. (FISV) earnings transcript 2026 - Q1

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Analyzing Fiserv's Strategic Use of AI and CapEx to Reach Revenue Goals in 2026

Sources used

Research question

Answer

Updated guidance for Q1 2026 earnings report (Neurocrine Biosciences)

1) INGREZZA (VMAT2 inhibitor) — guidance reaffirmed

2) Crinesity (crinecerfont) — no formal numeric “guidance” change, but forward trajectory described

3) KRANESTENESITI / Kronesity disclosure policy (no longer sharing certain granular launch metrics)

4) Soleno Therapeutics acquisition — timing only; no transaction financial guidance

Q1 2026 sales performance (what happened in the quarter)

Overall company

INGREZZA (Q1 results)

Crinesity (Q1 results)

Launch progress / commercial momentum indicators (context, not formal guidance)

Bottom line answer

References

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