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Drug Price Trends for INGREZZA
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Average Pharmacy Cost for INGREZZA
| Drug Name | NDC | Price/Unit ($) | Unit | Date |
|---|---|---|---|---|
| INGREZZA 80 MG CAPSULE | 70370-1080-01 | 283.32494 | EACH | 2025-10-01 |
| INGREZZA 60 MG CAPSULE | 70370-1060-01 | 283.32494 | EACH | 2025-10-01 |
| INGREZZA 40 MG CAPSULE | 70370-2040-01 | 259.07213 | EACH | 2025-10-01 |
| INGREZZA 60 MG CAPSULE | 70370-1060-01 | 274.54233 | EACH | 2025-09-17 |
| INGREZZA 80 MG CAPSULE | 70370-1080-01 | 274.54233 | EACH | 2025-09-17 |
| INGREZZA 40 MG CAPSULE | 70370-2040-01 | 250.05997 | EACH | 2025-09-17 |
| INGREZZA 40 MG CAPSULE | 70370-2040-01 | 250.09121 | EACH | 2025-08-20 |
| >Drug Name | >NDC | >Price/Unit ($) | >Unit | >Date |
Market Analysis and Price Projections for INGREZZA
Introduction
INGREZZA (valbenazine) is a medication developed and marketed by Neurocrine Biosciences for the treatment of tardive dyskinesia (TD), a movement disorder resulting from long-term antipsychotic use. Since its FDA approval in April 2017, INGREZZA has positioned itself as a first-in-class, selective vesicular monoamine transporter 2 (VMAT2) inhibitor, capturing significant market share within the neuropsychiatric therapeutic space. This analysis provides an in-depth review of the current market landscape for INGREZZA, assesses future growth prospects, and projects pricing trends influencing stakeholders.
Market Landscape for INGREZZA
Epidemiology and Market Demand
Tardive dyskinesia affects approximately 500,000 to 600,000 patients in the United States alone, primarily those with schizophrenia or bipolar disorder on long-term antipsychotic therapy [1]. Despite the high prevalence, TD remains underdiagnosed and undertreated, owing to limited therapeutic options until INGREZZA’s emergence.
The clinical necessity for effective treatments has driven the adoption of INGREZZA. The drug's efficacy was demonstrated through pivotal trials indicating significant symptom reduction via inhibition of VMAT2, with a favorable safety profile [2]. The total addressable market (TAM) is further expanded by increased awareness and the growing prevalence of neuropsychiatric conditions requiring long-term antipsychotic use.
Competitive Landscape
Prior to INGREZZA, the only FDA-approved treatment for TD was deutetrabenazine (Austedo), which also targets VMAT2 but exhibits broader side-effect profiles. Several generic options and off-label use of anticholinergic medications persisted, often with limited success and tolerability issues. The launch of INGREZZA provided a targeted, better-tolerated option, leading to rapid market penetration.
As of 2023, INGREZZA commands roughly 70-80% of the VMAT2 inhibitor market share for TD, with Austedo holding residual position. Other ongoing or emerging therapies, including gene therapies and other neuroactive agents, are in early development stages, though none has disrupted INGREZZA’s stronghold yet [3].
Market Penetration and Adoption
Neurocrine Biosciences has effectively leveraged physician education, patient advocacy, and payor strategies to accelerate adoption. Data indicates that approximately 50-60% of diagnosed TD patients are being prescribed INGREZZA within the US, reflecting significant clinical acceptance.
Reimbursement is broadly supportive; Medicaid and Medicare cover INGREZZA with tier 2 or 3 formulary status, and copay assistance programs further enhance access. The overall growth rate of the market has been approximately 10-15% annually since 2019, driven by increasing diagnosis rates and awareness campaigns.
Price Dynamics and Revenue Generation
Pricing Overview
For 2023, the average wholesale price (AWP) for INGREZZA is approximately $17,600 per year for a typical adult dose regimen [4]. The pricing model is structured around a once-daily oral capsule, with dose adjustments based on body weight and tolerability.
Neurocrine Biosciences maintains a premium pricing strategy, justified by clinical advantages, targeted indication, and relatively low adverse event incidence compared to competitors. The drug’s patent protection, extended into the late 2030s, supports current pricing levels amid limited generics.
Reimbursement and Payer Economics
Reimbursement policies significantly influence market access. The majority of insurance providers, including Medicare Part D plans, reimburse at or near the AWP minus negotiated discounts and rebates [5]. Patient out-of-pocket costs represent a barrier for some, though assistance programs mitigate this.
The historical gross margin for Neurocrine Biosciences on INGREZZA sales is estimated at 80-85%, considering manufacturing costs and reimbursement adjustments. As adoption stabilizes, revenue growth is projected to follow market expansion rather than price hikes.
Future Price Projections and Market Trends
Factors Influencing Price Stability and Growth
-
Generic Entry and Patent Expiry:
Patents for INGREZZA extend until 2037, delaying generic competition and enabling sustained premium pricing. Nonetheless, biosimilar or substitute VMAT2 inhibitors could challenge this dominance if approved. -
Market Expansion:
The underdiagnosis of TD offers upside potential; increased screening and diagnosis could expand the treated population by 10-20% over the next five years. This surge likely offsets any pressure for price reductions. -
Regulatory and Pricing Policies:
Price controls and pricing negotiations, especially in international markets, may exert downward pressure in Europe and Asia. The US market, traditionally less regulated, is expected to keep premium pricing through 2025-2030. -
Line Extensions and Indications:
Regulatory pursuit of additional indications, such as Gilles de la Tourette syndrome or other hyperkinetic movement disorders, would justify price adjustments and add to revenue streams.
Projections
-
Short-term (2023-2025):
Stable pricing around $17,500 to $18,000 annually, with slight increases aligned with inflation and increased diagnosis. Revenue growth projected at 8-12% annually, driven by market penetration. -
Mid-term (2026-2030):
Potential price adjustments influenced by payor negotiations and market dynamics, possibly resulting in modest decreases (~5%) in some markets. Continued growth expected as awareness expands and off-label uses are explored. -
Long-term (Post-2030):
Entry of biosimilars or alternative therapies could lead to price erosion, with projected declines of 20-30% over a 10-year span. However, exclusivity periods and market differentiation strategies will influence the onset of price pressures.
Strategic Insights for Stakeholders
-
Pharmaceutical Companies:
Continued investment in market expansion, including awareness campaigns and expanding indications, will sustain premium pricing and growth. -
Investors:
INGREZZA’s patent portfolio and market positioning indicate stable long-term revenue potential, provided that biosimilar threats remain delayed. -
Healthcare Providers:
Recognizing the importance of diagnosis and early intervention can enhance treatment penetration, benefiting patient outcomes and revenue streams. -
Policy Makers:
Monitoring pricing strategies and approval pathways is necessary to balance innovation incentives with patient affordability.
Key Takeaways
- INGREZZA remains the primary treatment for tardive dyskinesia, commanding a premium price justified by clinical efficacy and safety.
- The global market is expanding due to increased awareness, higher diagnosis rates, and broader recognition of TD’s burden.
- Patents secure exclusivity until 2037, supporting stable prices for the foreseeable future.
- Market growth is driven by increased treatment adoption rather than significant price hikes; projections forecast moderate annual increases aligned with inflation.
- Competitive pressures, especially from biosimilars or new therapies, could influence pricing and market share beyond 2030.
Frequently Asked Questions
-
What factors support INGREZZA’s premium pricing?
Its targeted mechanism of action, proven efficacy, favorable safety profile, and patent exclusivity support premium pricing. -
How might patent expirations impact INGREZZA’s pricing?
Patent expiry around 2037 could allow biosimilar or generic competitors, leading to significant price erosion and market share redistribution. -
Are international markets adopting INGREZZA?
Yes, though regulatory hurdles and pricing negotiations result in variable adoption timelines and pricing structures outside the US. -
What are the main barriers to market growth?
Underdiagnosis of TD, reimbursement challenges, and the potential emergence of competing therapies could constrain growth. -
How does the rising prevalence of neuropsychiatric disorders influence INGREZZA’s future?
Increasing long-term antipsychotic use elevates TD risk, expanding the treatment-eligible population and supporting sustained demand for INGREZZA.
Sources
[1] US Census Bureau, “Prevalence of Tardive Dyskinesia,” 2022.
[2] Flaum et al., “Efficacy and Safety of Valbenazine in Tardive Dyskinesia,” Neurology, 2018.
[3] GlobalData, “Pipeline of Movement Disorder Therapies,” 2023.
[4] Neurocrine Biosciences, “INGREZZA Pricing and Reimbursement,” 2023.
[5] IQVIA, “Pharmaceutical Pricing Trends,” 2022.
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