Madrigal Pharmaceuticals, Inc. (MDGL)

Key figures

The last twelve months reported, with the latest price and balance sheet.

Revenue, last twelve months

$1.3B

Revenue growth

149.0%

Net income, last twelve months

-$325.1M

Earnings per share

-$12.89

Operating margin

-25.1%

Net margin

-25.3%

Return on equity

-62.1%

Market value

$10.0B

Cash

$292.7M

Debt

$340.8M

Debt to equity

0.65

Shares outstanding

23.1M

Financial statements

Revenue, profit and cash flow by fiscal year, each year linked to its annual report.

By quarter

What the company said with its results

From the second-quarter 2026 results, filed 30 July 2026.

• Revenue rose 71% on U.S. demand. Net revenues were $364.3 million, against $212.8 million a year earlier. The company attributed the rise to increased U.S. Rezdiffra demand. First-quarter net revenues were $311.3 million, per the prior release.
• Net loss was $57.9 million. Net loss was $57.9 million, or $1.99 per share, against $42.3 million, or $1.50 per share, a year earlier. First-quarter net loss was $94.4 million, per the prior release.
• Patients passed 50,000 in July. Management said the company surpassed 50,000 active patients on Rezdiffra earlier in July. The prior release reported more than 42,250 patients as of March 31, 2026.
• Cost of sales rose with royalties. Cost of sales was $40.0 million, against $9.1 million a year earlier. Management cited higher royalties payable to Roche on increased Rezdiffra net sales and a write-down of certain work-in-process inventory.
• R&D rose on upfront deal expense. R&D expenses increased mainly on one-time, upfront business development expenses of $25.0 million, which the company said equaled $0.86 per share of net loss.
• SG&A rose on commercial spending. SG&A was $289.4 million, against $196.9 million a year earlier. Increases reflected endocrinology field force headcount added from the fourth quarter of 2025 and a direct-to-consumer campaign.
• Operating expenses reached $420.6 million. Total operating expenses were $420.6 million, including $35.4 million of non-cash stock-based compensation, against $260.0 million a year earlier, which included $25.2 million.
• Patent protection into 2042 and 2045. Two patents cover Rezdiffra's FDA-approved label and one covers F4c. The company expects protection into 2045 for one label patent and into 2042 for the other two.
• Higher-risk share fell in F4c. In MAESTRO-NAFLD-1 OLE F4c results, the share of patients classified as higher risk for clinically significant portal hypertension fell from 75% at baseline to 54.5% at Year 2, per the ANTICIPATE-NASH model.
• Nearly half show liver stiffness gains. Real-world data over a mean follow-up of about nine months showed nearly 50% of patients on Rezdiffra reached at least a 25% improvement in liver stiffness, a key treatment response measure.
• Lipid reductions regardless of statin use. A secondary analysis of Phase 3 trials found Rezdiffra improved key histologic MASH endpoints and reduced LDL and Lp(a), regardless of baseline statin use.
• MGL-2086 Phase 1 dosing began. First healthy volunteers were dosed in a single ascending dose trial of MGL-2086, an oral GLP-1 described as an orforglipron derivative, to assess safety and dose response. Dosing began in June 2026.
• Combination with Rezdiffra in MASH. Management said combining Rezdiffra with MGL-2086 offers potential for a best-in-disease MASH treatment delivered as a once-daily, well-tolerated pill.
• Weight loss may boost antifibrotic effect. MAESTRO-NASH data showed that modest weight loss of at least 5% may enhance Rezdiffra's antifibrotic efficacy, which management gave as the rationale for combination therapy development.

Company events

The newest 8-K filings of 189 held.

Every filing

The newest filings with the SEC of 408 held.

Insider trades

Form 4 trades by officers, directors and 10% owners, last 12 months.

Planned insider sales

Form 144 notices, filed when the sell order goes to the broker.

Large holders

Schedule 13D and 13G filings by holders of more than 5% of the voting shares.

Trades by members of the House

From each member's periodic transaction report.

Short interest

Shares sold short and not yet bought back, on each FINRA settlement date.

Funds that hold it

From each fund's latest Form 13F.

457 funds held it at 30 Jun 2026: 210 added and 131 trimmed in the quarter. The largest:

Peers

Companies in the same industry.

• Eli Lilly & Co. (LLY): revenue $79.7B, market value $1.21T
• Johnson & Johnson (JNJ): revenue $99.3B, market value $652.9B
• AbbVie Inc. (ABBV): revenue $64.4B, market value $506.1B
• Merck & Co., Inc. (MRK): revenue $66.6B, market value $348.1B
• Novartis AG (NVS): revenue $54.5B, market value $297.8B
• AstraZeneca PLC (AZN): revenue $58.7B, market value $263.1B
• Abbott Laboratories (ABT): revenue $46.6B, market value $177.7B
• Novo Nordisk A/S (NVO): revenue $46.8B, market value $171.0B
• Pfizer Inc. (PFE): revenue $63.7B, market value $168.0B
• Vertex Pharmaceuticals Inc. (VRTX): revenue $12.6B, market value $134.2B

What the company does

Madrigal Pharmaceuticals is a biopharmaceutical company focused on therapeutics for metabolic dysfunction-associated steatohepatitis ("MASH"), a liver disease that can lead to cirrhosis, liver failure, liver cancer, need for liver transplantation and premature mortality. Its only approved product is Rezdiffra (resmetirom), a once-daily, oral, liver-directed thyroid hormone receptor beta ("THR-β") agonist. The FDA approved Rezdiffra in March 2024, it became commercially available in the United States in April 2024, and the company launched it in Germany in September 2025. Madrigal had 915 full-time employees as of 31 December 2025. It was incorporated in Delaware in March 2000.

What it sells

Rezdiffra is approved, together with diet and exercise, for adults with noncirrhotic MASH with moderate to advanced liver fibrosis (F2 to F3). The FDA granted accelerated approval. The European Commission granted a conditional marketing authorization in August 2025, valid in all 27 member states of the European Union and in Iceland, Liechtenstein and Norway. The company reports Rezdiffra as the first medication approved by both the FDA and the European Commission for this use.

The company's product revenue comes from sales of Rezdiffra, recorded net of prompt pay discounts, returns, chargebacks, rebates and co-payment assistance. In the United States, Rezdiffra is distributed through a network of specialty pharmacy providers.

Who it sells to

It estimates that 315,000 diagnosed patients with F2 to F3 MASH are under specialist care in the United States, and about 370,000 across Europe. In its first six quarters of launch in the United States, the sales force focused on hepatologists and gastroenterologists. From the fourth quarter of 2025 the field team also targets select endocrinologists. The company also works with payers on access and supports care pathways in physician offices. It says it expects to launch in other European countries one by one, depending on reimbursement procedures and regulatory approval. It may use third-party distributors in smaller European countries and other regions.

Trials and pipeline

Rezdiffra was approved on the basis of the Phase 3 MAESTRO-NASH trial, in which 955 patients formed the primary efficacy analysis group. As a post-marketing commitment, the outcomes portion of that trial continues, and the company says it expects data in 2028. Separately, the Phase 3 MAESTRO-NASH OUTCOMES trial enrolled 845 patients with compensated MASH cirrhosis (F4c). They were randomized 3:1 to 80 mg resmetirom or placebo, and the company says it expects results in 2027.

- MGL-2086, an oral GLP-1 receptor agonist, from CSPC Pharmaceutical Group Limited. - Ervogastat, a Phase 2 oral DGAT-2 inhibitor, from Pfizer. - Six preclinical siRNA programs, from Ribocure.

Resmetirom itself is licensed from Hoffmann-La Roche, which receives tiered single-digit royalties on net sales of Rezdiffra.

How it is made and protected

Madrigal owns no manufacturing facilities and says it has no plans to build any. Evonik Corporation supplies resmetirom, the active ingredient, under an agreement with an initial term to 31 December 2029. UPM Pharmaceuticals, Inc. is the primary supplier of Rezdiffra tablets for the United States, with an initial term to April 2032. Corden Pharma GmbH, based in Germany, is the primary tablet supplier for Europe and a secondary supplier for the United States.

As of 31 December 2025, the company owned or co-owned nine United States issued patents and 107 foreign issued patents, along with 24 United States and 97 foreign pending applications. Six United States patents are listed in the FDA Orange Book. The latest of these expires on 4 February 2045 and covers the weight-threshold dosing regimen in the approved label.

Competition

The company names semaglutide from Novo Nordisk A/S as approved by the FDA for MASH and pending in the European Union. It reports more than 140 drugs in development for MASH, including 51 in Phase 2 trials. Other companies running Phase 3 trials include Novo, Inventiva S.A., Roche, Eli Lilly and Boehringer Ingelheim International GmbH. Madrigal says some competitors have greater financial, technical and personnel resources. The company lists efficacy, safety profile, method of administration, pricing, reimbursement and promotional activity as the key factors for an approved product.

Its people

Of the 915 full-time employees, 258 work in research, development and medical affairs, 526 in commercial activities and 131 in general and administrative functions. None are covered by collective bargaining agreements. The company also retains consultants as needed.

*From Madrigal Pharmaceuticals's annual report on Form 10-K for the year ended 31 December 2025. [The filing](https://www.sec.gov/Archives/edgar/data/1157601/000162828026009514/mdgl-20251231.htm)*

From the company's 10-K.