Last updated: February 14, 2026
Overview
NDC 33342-0173 corresponds to Ingrezza (valbenazine), developed by Neurocrine Biosciences. It is indicated for treating tardive dyskinesia, a movement disorder caused by long-term antipsychotic use.
Market Landscape
Prevalence and Demand:
- Tardive dyskinesia affects approximately 500,000 patients in the US, with an estimated growth rate of 2–3% annually (source: [1]).
- Ingrezza is the first FDA-approved selective VMAT2 inhibitor for this indication, holding a significant market share since approval in 2017.
Market Penetration:
- As of 2022, Ingrezza's global sales surpass $1.3 billion.
- In the US, it maintains high prescription volume, primarily through specialized neurology and psychiatry providers.
Competitors:
- Other VMAT2 inhibitors, such as deutetrabenazine (Austedo) and tetrabenazine, pose some competition.
- However, Ingrezza's favorable side effect profile and indication specificity give it a market advantage.
Regulatory and Reimbursement Factors:
- Reimbursement is supported by Medicare and private insurers.
- Price negotiations and formulary placements influence net revenue.
Pricing and Cost Analysis
Current Pricing:
- Average wholesale price (AWP) per capsule ranges from $30 to $45, depending on dosage.
- Typical monthly treatment costs range from $5,000 to $6,000 for a standard dose.
Pricing Trends:
- Prices have remained relatively stable since market entry.
- Price increases over the past five years have averaged 2–3% annually, driven by inflation and manufacturing costs.
Comparison to Competitors:
| Drug |
Average Monthly Cost |
Indication |
Year Approved |
| Ingrezza (Valbenazine) |
$5,200 |
Tardive dyskinesia |
2017 |
| Austedo (Deutetrabenazine) |
$4,800 |
Tardive dyskinesia, chorea |
2017 |
| Tetrabenazine |
$4,500 |
Chorea, movement disorders |
2008 |
Market Projections
Growth Assumptions:
- The tardive dyskinesia market is expected to grow at 3% annually over the next five years, driven by increased diagnosis and treatment awareness.
- Patent exclusivity until 2032 limits generic competition.
Revenue Forecasts:
- When accounting for current market share, patent protection, and demand trends, Ingrezza's global sales could reach approximately $2.5 billion by 2027.
- US market revenue could comprise roughly 70% of this figure, assuming no significant price erosion or new entrants.
Pricing Strategy Outlook:
- Price stability is expected for the next 2-3 years.
- Potential discounts or formulary shifts may influence net prices, especially as healthcare providers aim to reduce costs.
Risks and Opportunities
- Introduction of biosimilars or generics after patent expiry could reduce prices.
- Expansion into new indications (e.g., other movement disorders) could trigger additional sales.
- Changes in payer policies may alter access and reimbursement.
Key Takeaways
- NDC 33342-0173 (Ingrezza) remains a dominant player in an expanding market.
- Product pricing has been stable, with modest annual increases, maintaining high treatment costs.
- Market growth depends on increased diagnosis, clinician adoption, and absence of significant generic entry before 2032.
- Competition from other VMAT2 inhibitors is present but does not currently threaten Ingrezza's market position.
- Potential for revenue growth exists, driven by market expansion and approval of new indications.
FAQs
Q1: How does Ingrezza's pricing compare to similar drugs?
Ingrezza's average monthly cost ($5,200) is slightly higher than Austedo and tetrabenazine but reflects its stronger safety profile and approval status for tardive dyskinesia.
Q2: What is the patent status for Ingrezza?
Patent protections extend until 2032, limiting biosimilar or generic competition until then.
Q3: Are there upcoming regulatory or reimbursement changes affecting pricing?
Post-2023, potential shifts include price negotiations through Medicare Part D formulary reviews, which could influence net prices but not the list price.
Q4: What factors could influence a decline in Ingrezza sales?
Introduction of generics, reductions in diagnosis rates, or shifts in treatment guidelines favoring alternative therapies.
Q5: How does the market size for tardive dyskinesia influence Ingrezza's revenue potential?
Despite the relatively small patient pool, high treatment costs and market growth expectations position Ingrezza for sustained, substantial sales.
References
[1] National Institute of Mental Health. Tardive Dyskinesia. 2021.
