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What are the key sales KPIs for the Biotech Therapeutics industry in 2027?

By Kory White · Updated Nov 2026 · 9 min read
Illustration of a glowing double helix sweeping up the left side toward a rising set of colorful sales bars with a white trend line and scattered dots on the right
Direct answer

The sales KPIs that matter most for a commercial-stage biotech therapeutics company are net product revenue and its growth, patients on therapy (with new starts), prescriptions, the quality and mix of revenue, commercial spend (SG&A) against sales, and results against guidance. These companies mostly sell a few products, so one metric rarely tells the story, and several of the best-known sales metrics are not published. This page uses only figures read in third-quarter 2026 company releases. Madrigal reported Rezdiffra net sales of $431.3 million and more than 55,850 patients on therapy, argenx reported $1.7 billion of VYVGART product net sales, up 54%, and Insmed reported BRINSUPRI revenues of $400.1 million. Akebia shows why to read patients and revenue together: its patients grew while its revenue fell on an inventory reduction at its largest customer.

No release read here publishes a gross-to-net discount, a sales-cycle length, a customer acquisition cost or a persistence rate, so none is given. Companies define patients and prescriptions differently, so compare each KPI over time within one company. This is business content about sales metrics, not medical information, and not financial advice.

Net product revenue and its growth

Net product revenue is sales of the drug after the discounts and rebates a company records. It is the headline KPI, and the growth rate (year over year, and quarter over quarter for a launch) is what investors and boards watch first. Report it by product, not only as a total.

Pick the comparison that fits the stage. For a mature product the year-over-year rate is the cleanest. For a launch, the quarter-over-quarter rate shows momentum, as with Insmed's 29% growth for BRINSUPRI over the second quarter, and Denali's second full quarter at $17.8 million.

Patients on therapy

For a chronic-use product, the number of patients currently on therapy is the volume KPI that sits underneath revenue. It is usually reported as a point-in-time count at quarter end, and the definition matters: Madrigal's is a count of patients on Rezdiffra at the end of the period.

Read the count against the addressable pool. Madrigal says the U.S. F2-F3 MASH market grew to more than 530,000 addressable patients through June 30, 2026 and is on track for more than 30% growth by year-end 2026. A patient count with no denominator tells you little about share or runway, so track both.

Not every company publishes a patient count. argenx's release read for this page gives product net sales but no patient figure, so none is quoted for it.

Prescriptions and new patient starts

Prescriptions are the demand signal closest to the prescriber. Total prescriptions show the size of the active base, and new-to-brand prescriptions (new patient starts) show how fast the base is growing.

Prescriber count is the third piece. Akebia reports it alongside patients, which lets a sales leader see whether growth comes from more prescribers or deeper use by existing ones. Madrigal's release does not give a prescriber count, only a qualitative statement about prescriber adoption.

Why revenue and patients can move apart

The most useful lesson in this quarter's releases is that net revenue can fall while the patient base grows. Akebia's Vafseo net product revenues were $14.8 million in Q3 2026 against $14.3 million a year earlier, and its release says revenues were lower than Q2 2026 primarily because of an inventory reduction at its largest customer, even as active patients rose about 8.1%.

That is channel inventory, not demand, and it is why a revenue KPI should always sit beside a patient or prescription KPI. If you only watch one, a customer's stocking decisions can look like a demand problem, or the reverse. Where a company discloses its own explanation, quote it with the period.

Revenue quality: product sales versus license, royalty and milestones

Not every revenue dollar repeats. License fees, milestones and royalties can be large in one quarter and absent in the next, so a healthy sales scorecard separates recurring product sales from the rest.

Viridian is the clearest example: total revenues were lower year over year even though product sales began, because the prior-year quarter held a $70,000 thousand license payment. Axsome's SUNOSI line shows a related trap: the reported product revenue figure includes a milestone, so product sales alone were $38.5 million.

Revenue concentration and mix

Biotech companies often depend on one or two products. Track the share each product and each geography contributes, because a single label expansion or supply change moves the whole company.

Lumpiness is part of the picture for one-time treatments. Sarepta says it expects ELEVIDYS net product revenue in the fourth quarter to trend in line with the third quarter, subject to normal variability associated with a one-time gene therapy. A recurring-use product and a one-time product need different forecasting rhythms.

Commercial spend: SG&A against sales

Selling, general and administrative expense is the closest public proxy for the cost of selling. It also holds general overhead, so treat it as a ratio to watch over time, not a pure sales cost. Companies often explain the movement, which is where the useful detail is.

The pattern is that spend rises before and during a launch. Divide SG&A by net sales yourself using each company's own filing, and compare a launch company only with other launch companies, since a company in its first quarter and one in its ninth year are at different points on the curve.

Gross margin and what is not published

Early launch quarters can distort gross margin. Denali reported cost of goods sold of $0.2 million on $17.8 million of AVLAYAH revenue, and explains that because manufacturing costs incurred before FDA approval were expensed as research and development, cost of goods sold in the initial commercialization period reflects a lower average per-unit cost as previously expensed inventory is sold. Do not treat that early margin as permanent.

No release read for this page publishes a gross-to-net discount, a sales-cycle length, a customer acquisition cost, a rep productivity figure or a persistence rate. These are real sales KPIs, but they are tracked internally, so no number is given here. Measure them on your own data.

Market access and reimbursement milestones

For specialty drugs, coverage and reimbursement set how fast demand turns into revenue. Two companies disclose access events as part of their sales story. Viridian says CMS assigned Lumvoa a permanent J-code, J3242, effective January 1, 2027. Akebia ties its near-term revenue to its TDAPA expiration approaching and says it believes access will expand beyond TDAPA-only patients to nearly all clinically eligible patients in 2027, which is a company belief, not a result.

A practical way to track this is a dated list of access events (codes, coverage decisions, payment programs) next to the revenue and patient lines, so a change in either can be tied to the access change that preceded it.

Results against guidance

Guidance turns a quarter into a signal. Raising a range says management sees demand ahead of plan; a quarter below it says the opposite.

For a launch product, a guided quarterly number like Denali's is the clearest target against which to measure the next release.

A scorecard to start with

Read together, the releases point to a short monthly or quarterly scorecard. This structure is my judgment, built on the KPIs the companies themselves report.

Questions people ask

What are the most important sales KPIs for a biotech therapeutics company?

Net product revenue and growth, patients on therapy and new starts, prescriptions, the mix of product versus license or milestone revenue, SG&A against sales, and results against guidance. Companies publish the first few well and the rest unevenly.

What is a patients-on-therapy KPI?

It is the count of patients actively using a company's product at a point in time, such as quarter end. Madrigal reported more than 55,850 on Rezdiffra at September 30, 2026 and Akebia about 11,500 active on Vafseo. Definitions differ by company, so quote each one's own.

Why can revenue fall when patients grow?

Because revenue also reflects customer inventory and pricing. Akebia reported Vafseo net product revenues of $14.8 million in Q3 2026, lower than Q2 2026 mainly on an inventory reduction at its largest customer, while active patients rose about 8.1%.

How much do biotech companies spend on selling?

Use SG&A as a proxy. In Q3 2026 Madrigal reported SG&A of $265.7 million, Axsome $203.1 million and Insmed $253.0 million, alongside net revenue of $431.3 million, $259.7 million and $524.4 million. SG&A includes overhead, so it is not a pure sales cost.

Do biotech companies publish gross-to-net, sales cycle or customer acquisition cost?

Not in the releases read for this page. These are tracked internally, so measure them on your own data rather than looking for an industry benchmark.

Are these figures comparable across companies?

Not strictly. Products, launch stages and definitions differ, so compare each KPI over time within one company, and treat cross-company numbers as context. All figures here are in U.S. dollars as reported.

Sources

Figures were read from the linked company releases on November 7, 2026. They are company-reported for the periods stated, in U.S. dollars. Where no figure was published, the page says so instead of estimating. Illustration: original artwork created for answrsnow. This page is about sales metrics, not medical information, and is not financial advice.

Top photo: Illustration: original artwork created for answrsnow

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