MADRIGAL PHARMACEUTICALS (MDGL) Company Report

Madrigal Pharmaceuticals reported $287.3 million in sales for its last quarter, achieving a billion-dollar run rate for Rezdiffra, with over 10,000 prescribers and over 29,500 patients on drug, six quarters into its launch.
For 2026, the company has secured first-line access and no step-throughs with payers for Rezdiffra, with gross-to-net discounts expected to step up to the high 30 percentile.
Madrigal anticipates high single-digit growth in net revenues from Q3 to Q4 2025, with net revenues flat to down in Q1 2026 due to typical Q1 effects and gross-to-net impact, but expects robust sales growth for 2026 overall.
The company is expanding its focus to endocrinologists and has advanced its pipeline, including an oral GLP-1 asset entering Phase 1 in H1 2026 and an Orange Book listed patent for Rezdiffra extending to 2045.
Madrigal Pharmaceuticals does not plan to provide 2026 guidance.

1 day ago

Transcript

Madrigal Pharmaceuticals Discusses Rezdiffra Launch Performance and 2026 Outlook

MDGL

Revenue Acceleration/Inflection

Guidance Update

New Projects/Investments

Madrigal Pharmaceuticals announced that Rezdiffra achieved a billion-dollar run rate, with $287.3 million in sales in the last quarter, over 10,000 prescribers, and nearly 29,500 patients on drug, six quarters into its launch.
The company has secured 2026 payer contracting for Rezdiffra, ensuring first-line access and improved utilization management criteria, with the gross-to-net discount projected to be in the high 30 percentile for 2026.
Madrigal is expanding its commercial focus to include endocrinologists, targeting approximately 2,000 high-priority prescribers starting in Q4, to address patients with MASH despite GLP-1 use.
While robust sales growth is anticipated for 2026, net revenues for Q1 2026 are expected to be flat to down due to typical Q1 effects and the full impact of commercial contracting.
Intellectual property for Rezdiffra has been secured with an Orange Book listed patent until 2045, providing a long-term foundation for the company's leadership in MASH treatment.

1 day ago

Transcript

Madrigal Pharmaceuticals Provides Business Update and 2026 Outlook

MDGL

Guidance Update

Product Launch

New Projects/Investments

Madrigal Pharmaceuticals reported $287.3 million in sales in its last quarter, achieving a billion-dollar run rate after six quarters since launch, with over 10,000 prescribers and 29,500 patients on drug.
For 2026, the company has secured payer contracting ensuring first-line access for Rezdiffra, which is expected to increase the gross-to-net discount to the high 30 percentile from the low end of 20%-30% in 2025.
Madrigal anticipates a high single-digit growth rate quarter-over-quarter for Q4 2025, with Q1 2026 net revenues projected to be flat to down due to seasonal effects and the gross-to-net step-up, but expects robust sales growth for the full year 2026.
A new dedicated effort to target 2,000 high-priority endocrinologists began in Q4, contributing to an expected increase in OpEx for 2026 alongside pipeline development.
The company emphasizes Rezdiffra's long-term potential with a patent until 2045 and is actively pursuing business development, including an oral GLP-1 asset, to solidify its leadership in the MASH space.

1 day ago

Transcript

Madrigal Pharmaceuticals Discusses Rezdiffra Launch, Gross-to-Net, and Future Strategy

MDGL

Product Launch

Guidance Update

New Projects/Investments

Rezdiffra's launch has achieved an annualized run rate of over $1 billion after six quarters, with over 10,000 prescribers, though market penetration remains less than 10% of the 315,000 target population.
Gross-to-net discounts for Rezdiffra are projected to increase from the mid-20s% at the end of 2025 to the high 30s% in 2026 due to new commercial contracting, which is considered typical for a specialty product in its third year.
Madrigal anticipates a decision in 2026 regarding the assignment of a five-year Patent Term Extension (PTE) to either the Form I Polymorph or the composition of matter patent for Rezdiffra.
The company's near-term focus for 2026 is on driving Rezdiffra sales, expanding its label for the F4C indication, and developing its pipeline, rather than achieving profitability.

2 days ago

Transcript

Madrigal Discusses Rezdiffra Performance and 2026 Outlook

MDGL

Product Launch

Guidance Update

New Projects/Investments

Madrigal's Rezdiffra has completed its sixth quarter of launch, achieving an annualized run rate of over $1 billion and reaching over 10,000 prescribers.
Market penetration for Rezdiffra is currently less than 10% of the 315,000 diagnosed MASH patient population, with plans to expand the sales force to target endocrinologists starting in Q4.
Gross-to-net discounts are projected to increase from the mid-20s% at year-end to the high 30s% starting January 1st, 2026, as the company transitions to commercial contracting.
Madrigal secured a 2045 patent for Rezdiffra, with a decision on extending other key patents expected in 2026.
The company's primary focus for 2026 is on driving sales, expanding the F4C indication, and pipeline development, rather than achieving near-term profitability.

2 days ago

Transcript

Madrigal Pharmaceuticals Discusses Rezdiffra Launch, Gross-to-Net, and IP Strategy

MDGL

Product Launch

Guidance Update

New Projects/Investments

Madrigal Pharmaceuticals' Rezdiffra has achieved an annualized run rate of over $1 billion after its sixth quarter of launch, with over 10,000 prescribers and less than 10% penetration into its target population. The company is expanding its sales force to target endocrinologists, with an expected impact in 2026.
The gross-to-net discount is projected to increase significantly from the mid-20s% in Q4 to the high 30s% starting January 2026, due to new commercial contracting, which is considered typical for a specialty product in its third year of launch.
Madrigal has secured a dosing patent extending to 2045 for Rezdiffra, and a decision on assigning a five-year Patent Term Extension (PTE) to other patents is expected in 2026. This dosing patent is considered strong as generics would need to adopt the label's weight-threshold dosing, which would violate the patent.
Profitability is not the primary focus for 2026, as the company prioritizes driving Rezdiffra sales, expanding its F4C indication, and building its pipeline.

2 days ago

Transcript

Madrigal Discusses Rezdiffra Launch, Market Penetration, and Future Outlook

MDGL

Product Launch

Guidance Update

Revenue Acceleration/Inflection

Madrigal's CEO, Bill Sibold, highlighted the successful launch of Rezdiffra for MASH, describing it as an "outstanding launch" and emphasizing the company's focus on the next phase of market penetration.
The company is targeting 315,000 diagnosed F2, F3 MASH patients in the U.S., with current penetration around 10%.
CFO Mardi Dier stated that Gross to Net for Rezdiffra is expected to be in the high 30s throughout 2026, driven by commercial and Medicare contracting.
Madrigal expressed increased confidence in its MAESTRO OUTCOMES (F4c) study, with results anticipated in 2027, based on positive open-label experience showing significant decreases in liver stiffness measurements and other biomarkers.

Nov 20, 2025, 8:30 AM

Transcript

Madrigal Provides Update on Rezdiffra Launch, Financial Outlook, and Pipeline

MDGL

Product Launch

Guidance Update

New Projects/Investments

Madrigal's CEO, Bill Sibold, characterized the Rezdiffra launch as "outstanding" for addressing the high unmet need in MASH, with intellectual property secured until 2045. The initial target patient population in the U.S. is 315,000 diagnosed patients, with current penetration around 10%. Consensus peak sales for Rezdiffra are estimated between $5 billion and $10 billion.
Madrigal anticipates the Gross Unit impact to be in the high 30s throughout 2026, starting January 1, 2026, following commercial payer contracting that began in Q4 2025. The business mix is approximately 50-55% commercial payers, 30-35% Medicare, and the remainder Medicaid and government.
The company reported over 29,500 net patients on Rezdiffra as of the last quarter. While typical well-tolerated orals show 60-70% persistence after a year, real-world data for Rezdiffra has indicated closer to 90% persistency at 12 months in some reports. Madrigal expects to be "steadily adding patients" long-term.
Madrigal is expanding its pipeline, including an oral GLP-1 for a fixed-dose combination with Rezdiffra, to maintain long-term leadership in MASH. The F4C Maestro Outcomes study is projected to deliver in 2027, with increased confidence based on open-label experience showing positive effects in a more severe patient population.

Nov 20, 2025, 8:30 AM

Transcript

Madrigal Provides Update on Rezdiffra Launch, Pipeline, and Financial Outlook

MDGL

Product Launch

New Projects/Investments

Guidance Update

Madrigal's Rezdiffra, a treatment for MASH, has IP protection until 2045 and is currently treating less than 10% of its initially identified US patient population of 315,000 patients.
The company is developing an oral GLP-1 to potentially create a fixed-dose combination with Rezdiffra, aiming to extend its leadership in the MASH market.
Madrigal anticipates its Gross Unit impact to be in the high 30s throughout 2026, driven by new commercial and Medicare contracts effective January 1, 2026.
The Maestro Outcomes (F4C) study for Rezdiffra is expected to deliver results in 2027, with increased confidence based on positive open-label data in a more severe patient population.

Nov 20, 2025, 8:30 AM

Transcript

Madrigal Pharmaceuticals Presents Positive Two-Year Data for Rezdiffra in MASH Cirrhosis

MDGL

Madrigal Pharmaceuticals announced positive two-year data from the Phase 3 MAESTRO-NAFLD-1 trial for Rezdiffra in patients with compensated MASH cirrhosis (F4c).
Rezdiffra treatment significantly improved liver stiffness, fibrosis biomarkers, and markers of clinically significant portal hypertension risk in this advanced patient population.
The treatment also improved disease-specific quality of life measures, and analysis underscored the need for sustained therapy to prevent disease progression, as treatment interruption led to a temporary attenuation of beneficial effects.
Rezdiffra was well-tolerated, with safety data consistent with previous studies.

Nov 10, 2025, 1:00 PM

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