Crinetics Soars as New Acromegaly Drug Smashes Sales Forecasts
Oral drug PALSONIFY generates over $5 million in its first quarter, more than doubling analyst estimates and signaling a major shift in treatment for the rare disease.
Crinetics Pharmaceuticals (CRNX) has made a dramatic entrance into the commercial market, with its newly launched acromegaly drug, PALSONIFY™ (paltusotine), crushing initial sales forecasts and signaling a potential paradigm shift in treatment for the rare endocrine disorder. The company’s stock has rallied to near 52-week highs following the announcement, reflecting investor optimism about the drug's blockbuster potential.
In a presentation at the 44th Annual J.P. Morgan Healthcare Conference, Crinetics announced preliminary fourth-quarter net product revenue for PALSONIFY of over $5.0 million. This figure, from the drug’s first quarter on the market, dramatically exceeded analysts' consensus estimates, which were pegged closer to $3 million. The company reported it had received over 200 patient enrollment forms from more than 125 unique prescribers by the end of December, indicating rapid adoption by physicians.
Shares of Crinetics reacted positively to the news last week, and while seeing a slight pullback in Tuesday trading to $54.31, they remain near a 52-week high of $57.99. The strong launch has pushed the San Diego-based company’s market capitalization above the $5 billion mark, cementing its transition from a clinical-stage developer to a commercial biopharmaceutical powerhouse.
The success of PALSONIFY lies in its convenience and efficacy. Approved by the FDA in September 2025, it is the first once-daily oral therapy for acromegaly, a condition caused by excess growth hormone that leads to enlarged body tissues and other complications. Previously, the standard of care often involved burdensome and frequently painful injections of somatostatin receptor ligands. As a small molecule tablet, PALSONIFY offers a significant improvement in quality of life, a factor that analysts believe will drive a high rate of patient conversion.
"This is an impressive initial dynamic," wrote analysts at Baird, who reiterated an "Outperform" rating on the stock following the announcement. The firm noted that the launch "effectively doubled the sell-side consensus estimate" and subsequently raised its own full-year 2026 revenue forecast for Crinetics from $57 million to $84 million. Baird further projected that if the company maintains its current pace of acquiring approximately 150 new patient start forms per quarter, annual sales could approach $100 million.
Wall Street sentiment is overwhelmingly bullish, with 14 of 16 analysts covering the stock holding a "Buy" or "Strong Buy" rating. The consensus 12-month price target sits at $82.43, suggesting more than 50% upside from current levels. This optimism is fueled not only by the strong sales but also by the drug's pricing. The wholesale acquisition cost (WAC) of approximately $290,000 per year was higher than many had anticipated, further bolstering revenue projections.
According to a company filing with the SEC, the results represent an "early strong success" for the launch. Founder and CEO Scott Struthers has called it a "breakout year" for the company, a sentiment echoed by analysts who see the drug as a foundational asset.
The strong uptake suggests PALSONIFY is poised to capture significant market share from legacy injectable treatments. Analysts at Oppenheimer previously stated the drug is positioned to "become standard-of-care over time," citing the shortcomings of existing therapies. The clinical data has been robust, showing PALSONIFY can reliably control key biomarkers of the disease while also reducing patient-reported symptoms like headache, joint pain, and fatigue.
With a successful commercial launch underway for PALSONIFY and a promising pipeline that includes the investigational drug atumelnant for other endocrine-related conditions, Crinetics is entering a new phase of growth. The company's ability to exceed early expectations has provided a strong validation of its strategy, transforming the treatment landscape for patients with acromegaly and establishing a solid commercial foundation for its future.