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olivLaw · US equity research

Madrigal Pharmaceuticals, Inc. MDGL

Pharmaceutical Preparations · SIC 2834 · Vertical: Pharmaceutical Preparations (SIC 2834)

400.43USD+1.04% · 1 dayClose 04 Nov 2026

Madrigal Pharmaceuticals is a biopharmaceutical company focused on treating MASH, a serious liver disease, with its product Rezdiffra (resmetirom), the first therapy approved by the FDA for this indication. Net product sales reached 958.4 million USD in 2025, and the second quarter of 2026 brought 364.3 million USD, placing Rezdiffra at the center of market attention.

The AI analysis may be outdated: new filings came after its sources (see the «AI analysis» section).

At the close of 04 Nov 2026, Madrigal Pharmaceuticals, Inc. (MDGL) stock was 400.43 USD (+1.04% on the day), with market capitalisation 9.3 bn USD, beta 0.69, 52-week range 396.32–602.83 USD. Latest reported quarter (Q3 2026): revenue of 431.3 m USD (+50.1% YoY), net income of 55.4 m USD, diluted EPS 1.83 USD.

Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.

Market cap
9.3 bn USD
shares as of 29 Oct 2026
P/E (TTM)
unavailable
Diluted EPS TTM -14.90 · TTM to 30 Sept 2026
E/P (TTM)
-3.72%
TTM to 30 Sept 2026
Dividend yield
unavailable
Beta (2y)
0.69
Volatility (1y) 44%
52-week range
396.32602.83

Price history

Loading chart…

Technical reading

RSI (14)
24.0
oversold (≤ 30)
Bollinger (20, 2)
402.84 – 486.83
below the lower band · %B -0.03 · band width 18.9%
SMA 50 / 200
492.40 / 498.57
downtrend (price < SMA50 < SMA200)
MACD (12, 26, 9)
-22.68 / -19.86
MACD below signal

Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).

Performance

CompanyS&P 500vs S&P 500Vertical median
1 month−18.9%−2.0%−16.9 pp—
3 months−22.1%−2.2%−19.9 pp—
6 months−25.8%+4.3%−30.1 pp—
Year to date−31.2%+10.6%−41.8 pp—
1 year−9.9%+10.5%−20.4 pp+16.6%
3 years+172.6%+73.7%+98.9 pp+16.8%
5 years+330.4%+61.7%+268.7 pp—
Max drawdown (1y)
−34.3%
22 Dec 2025 → 03 Nov 2026
Max drawdown (5y)
−61.4%
28 Apr 2023 → 27 Oct 2023
Compound annual growth (5y)
+33.9%
S&P 500 +10.1%

Price returns, dividends excluded.

Quarterly results

Latest quarter: Q3 2026 · 30 Sept 2026

Revenue
431.3 m USD
+50.1% YoY
Net income
55.4 m USD
unavailable YoY
Diluted EPS
1.83
unavailable YoY
net / operating
12.9% / 13.0%

Quarterly margins

Quarterly statements · USD

Fiscal yearQ4 '24Q1 '25Q2 '25Q3 '25Q4 '25Q1 '26Q2 '26Q3 '26
Revenue103.3 m137.3 m212.8 m287.3 m321.1 m311.3 m364.3 m431.3 m
Cost of revenue—4.5 m——————
SG&A141.2 m167.9 m196.9 m209.1 m240.0 m268.5 m289.4 m265.7 m
Operating income-67.0 m-79.3 m-47.2 m-114.0 m-59.6 m-92.7 m-56.3 m56.0 m
Depreciation & amortisation363.0 k379.0 k377.0 k ≈358.0 k ≈392.0 k386.0 k381.0 k ≈391.0 k ≈
Interest expense3.5 m3.3 m3.3 m7.5 m8.3 m7.8 m7.9 m8.1 m
Net income-59.4 m-73.2 m-42.3 m-114.2 m-58.6 m-94.4 m-57.9 m55.4 m
Diluted EPS-2.71 ≈-2.61-1.50-4.01-11.49 ≈-3.25-1.991.83
Operating cash flow-104.5 m-88.9 m-47.1 m ≈79.9 m ≈-133.5 m-167.4 m23.3 m ≈120.6 m ≈
Capex195.0 k00 ≈857.0 k ≈-390.0 k3.8 m4.3 m ≈3.9 m ≈

≈ derived quarter (cumulative difference / share-days average)

E/P over time

E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.

Fiscal years

Fiscal year20182019202020212022202320242025
Revenue000000180.1 m958.4 m
Revenue YoYunavailableunavailableunavailableunavailableunavailableunavailableunavailable+432.1%
Net income-32.8 m-83.9 m-202.2 m-241.8 m-295.4 m-373.6 m-465.9 m-288.3 m
Net income YoYunavailableunavailableunavailableunavailableunavailableunavailableunavailableunavailable
Diluted EPSunavailableunavailable-13.09-14.63-17.23-19.99-21.90-12.85
Diluted EPS YoYunavailableunavailableunavailableunavailableunavailableunavailableunavailableunavailable
net %unavailableunavailableunavailableunavailableunavailableunavailable-258.6%-30.1%
Free cash flow-25.5 m-41.8 m-157.9 m-184.1 m-225.1 m-325.7 m-457.0 m-190.0 m

Reported results vs expectations

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Balance sheet & financial health

Fiscal year 2025 · 31 Dec 2025

Cash
198.7 m USD
Financial debt
339.9 m USD
Net debt
141.2 m USD
Equity
602.7 m USD
Total assets
1.3 bn USD
Debt / equity
0.56x
Current ratio
4.01x
ROE
-42.5%
ROA
-25.0%
FCF margin
-19.8%

Financial statements (source on every figure)

Revenue and net income (USD)

Margins

Income statement · USD

Revenue
2023
0
2024
180.1 m
2025
958.4 m

SEC (XBRL)· 19 Feb 2026verified

Cost of revenue
2023
0
2024
6.2 m
2025
—

SEC (XBRL)· 26 Feb 2025verified

Gross profit
2023
0 ≈
2024
173.9 m ≈
2025
—

SEC (XBRL)· 26 Feb 2025derived

SG&A
2023
108.1 m
2024
435.1 m
2025
813.8 m

SEC (XBRL)· 19 Feb 2026verified

Operating income
2023
-380.5 m
2024
-497.9 m
2025
-300.1 m

SEC (XBRL)· 19 Feb 2026verified

Depreciation & amortisation
2023
527.0 k
2024
1.1 m
2025
1.5 m

SEC (XBRL)· 19 Feb 2026verified

EBITDA
2023
-380.0 m ≈
2024
-496.8 m ≈
2025
-298.6 m ≈

SEC (XBRL)· 19 Feb 2026derived

Interest expense
2023
12.7 m
2024
14.7 m
2025
22.3 m

SEC (XBRL)· 19 Feb 2026verified

Income tax
2023
0
2024
0
2025
0

SEC (XBRL)· 19 Feb 2026verified

Net income
2023
-373.6 m
2024
-465.9 m
2025
-288.3 m

SEC (XBRL)· 19 Feb 2026verified

Diluted EPS
2023
-19.99
2024
-21.90
2025
-12.85

SEC (XBRL)· 19 Feb 2026verified

Weighted average diluted shares
2023
18.7 m
2024
21.3 m
2025
22.4 m

SEC (XBRL)· 19 Feb 2026verified

Balance sheet · USD

Cash
2023
99.9 m
2024
100.0 m
2025
198.7 m

SEC (XBRL)· 19 Feb 2026verified

Receivables
2023
0
2024
53.8 m
2025
134.5 m

SEC (XBRL)· 19 Feb 2026verified

Inventories
2023
0
2024
34.1 m
2025
74.8 m

SEC (XBRL)· 19 Feb 2026verified

Current assets
2023
637.3 m
2024
1.0 bn
2025
1.2 bn

SEC (XBRL)· 19 Feb 2026verified

Property, plant & equipment, net
2023
1.6 m
2024
2.2 m
2025
1.5 m

SEC (XBRL)· 19 Feb 2026verified

Intangibles (excl. goodwill)
2023
0
2024
4.7 m
2025
7.4 m

SEC (XBRL)· 19 Feb 2026verified

Total assets
2023
640.5 m
2024
1.0 bn
2025
1.3 bn

SEC (XBRL)· 19 Feb 2026verified

Accounts payable
2023
28.0 m
2024
43.6 m
2025
48.9 m

SEC (XBRL)· 19 Feb 2026verified

Long-term debt
2023
115.5 m
2024
117.6 m
2025
339.9 m

SEC (XBRL)· 19 Feb 2026verified

Current liabilities
2023
118.5 m
2024
169.3 m
2025
310.3 m

SEC (XBRL)· 19 Feb 2026verified

Total liabilities
2023
235.2 m
2024
287.9 m
2025
656.9 m

SEC (XBRL)· 19 Feb 2026verified

Equity
2023
405.3 m †
2024
754.4 m †
2025
602.7 m †

SEC (XBRL)· 19 Feb 2026verified

Cash flow · USD

Operating cash flow
2023
-324.2 m
2024
-455.6 m
2025
-189.6 m

SEC (XBRL)· 19 Feb 2026verified

Capex
2023
1.5 m
2024
1.5 m
2025
467.0 k

SEC (XBRL)· 19 Feb 2026verified

Free cash flow
2023
-325.7 m ≈
2024
-457.0 m ≈
2025
-190.0 m ≈

SEC (XBRL)· 19 Feb 2026derived

Investing cash flow
2023
-502.5 m
2024
-274.4 m
2025
32.3 m

SEC (XBRL)· 19 Feb 2026verified

Financing cash flow
2023
595.1 m
2024
735.1 m
2025
256.0 m

SEC (XBRL)· 19 Feb 2026verified

Computed indicators

Growth

Revenue growth (YoY)
432.1%
computed by olivLawFY 2025
Revenue CAGR 3Y
unavailable
the base of the ratio is not positive
Revenue CAGR 5Y
unavailable
the base of the ratio is not positive
EBIT growth (YoY)
unavailable
the base of the ratio is not positive
Net income growth (YoY)
unavailable
the base of the ratio is not positive
Net income CAGR 3Y
unavailable
the base of the ratio is not positive
Net income CAGR 5Y
unavailable
the base of the ratio is not positive
EPS growth (YoY)
unavailable
the base of the ratio is not positive
EPS CAGR 3Y
unavailable
the base of the ratio is not positive
EPS CAGR 5Y
unavailable
the base of the ratio is not positive
FCF growth (YoY)
unavailable
the base of the ratio is not positive

Profitability

Gross margin
unavailable
input data missing
EBITDA margin
-10.6%
computed by olivLawTTM to 30 Sept 2026
EBIT margin
-10.7%
computed by olivLawTTM to 30 Sept 2026
Net margin
-10.9%
computed by olivLawTTM to 30 Sept 2026
FCF margin
-11.8%
computed by olivLawTTM to 30 Sept 2026

Returns

ROE
-24.8%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
ROA
-11.1%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
ROIC
-22.8%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
ROCE
-15.6%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
Payout ratio (EPS)
unavailable
input data missing
Payout ratio (FCF)
unavailable
input data missing

Balance sheet

Net debt
-173.4 m USD
computed by olivLawbalance sheet at 30 Sept 2026
Net debt / EBITDA
unavailable
insufficient data
Debt / equity
0.5x
computed by olivLawbalance sheet at 30 Sept 2026
Interest coverage
-4.8x
computed by olivLawTTM to 30 Sept 2026

Liquidity

Current ratio
3.1x
computed by olivLawbalance sheet at 30 Sept 2026
Quick ratio
2.8x
computed by olivLawbalance sheet at 30 Sept 2026
Cash ratio
1.1x
computed by olivLawbalance sheet at 30 Sept 2026

Cash

Operating cash flow
-157.0 m USD
computed by olivLawTTM to 30 Sept 2026
Capital expenditure
11.6 m USD
computed by olivLawTTM to 30 Sept 2026
Free cash flow
-168.7 m USD
computed by olivLawTTM to 30 Sept 2026
FCF conversion
unavailable
insufficient data
Cash conversion
unavailable
insufficient data

Efficiency

Days sales outstanding
44 days
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
Days inventory outstanding
unavailable
input data missing
Days payables outstanding
unavailable
input data missing
Cash conversion cycle
unavailable
input data missing

Market and valuation

Market capitalisation
9.3 bn USD
computed by olivLawbalance sheet at 30 Sept 2026
Enterprise value
9.1 bn USD
computed by olivLawbalance sheet at 30 Sept 2026
Market cap / net income TTM
unavailable
insufficient data
P/E (TTM)
unavailable
insufficient data
Earnings yield
-3.7%
computed by olivLawTTM to 30 Sept 2026
P/B
14.8x
computed by olivLawbalance sheet at 30 Sept 2026
P/S
6.5x
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
EV/EBITDA
unavailable
insufficient data
EV/EBIT
unavailable
insufficient data
EV/Sales
6.4x
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
P/FCF
unavailable
the base of the ratio is not positive
FCF yield
-1.8%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
Dividend yield
unavailable
no dividend in the structured statements; a missing line is not a confirmed zero
Shareholder yield (distributions)
unavailable
input data missing

1 indicators that do not apply to the sector.

Valuation

olivLaw classification

Insufficient data
What is missing
  • indicators available: 5 of at least 6
  • score weight coverage: 35.4% of at least 60%
  • valuation methods computed: 0 of at least 1

A scoring methodology on indicators and valuation, not investment advice.

Closing price

400.43 USD

04 Nov 2026Source: olivLaw, closing series

Market cap: 9.3 bn USD

Key indicators

Market capitalisation
9.3 bn USD
computed by olivLawbalance sheet at 30 Sept 2026
P/E (TTM)
unavailable
insufficient data
P/B
14.8x
computed by olivLawbalance sheet at 30 Sept 2026
EV/EBITDA
unavailable
insufficient data
ROE
-24.8%
computed by olivLawTTM to 30 Sept 2026 · balance sheet at 30 Sept 2026
Net margin
-10.9%
computed by olivLawTTM to 30 Sept 2026
Revenue growth (YoY)
432.1%
computed by olivLawFY 2025
Dividend yield
unavailable
no dividend in the structured statements; a missing line is not a confirmed zero

Coverage and freshness

29/37 reporting lines present
Latest full fiscal year: 2025
Latest reported period: 30 Sept 2026
Latest balance sheet date: 30 Sept 2026
Share count (cover of the latest filing), as of: 29 Oct 2026
Source: SEC (XBRL)published 03 Nov 2026
verified 1484derived 80

Score by group

35% · Insufficient data

Estimated value range

unavailable — no valuation method could be computed

Valuation assumptions are editorial choices, not measured; beta is not measured.

Valuation methods

  • DCF (discounted cash flow)unavailable · the base of the ratio is not positive
  • Peers: EV/EBITDAunavailable · the base of the ratio is not positive
  • Peers: P/Eunavailable · the base of the ratio is not positive
  • Dividend discount (DDM)unavailable · the company pays no dividend: a dividend model needs an explicit initiation assumption

no valuation method could be computed

Multiple comparisons use the SIC vertical: Pharmaceutical Preparations (SIC 2834)

Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.

Assumptions (illustrative, editorial)

Risk-free rate
4.3%
Equity risk premium
5.0%
Beta (default)
1.00
Cost of equity
9.3%
Terminal growth
2.5%

Factor scorecard

Insufficient data

Minimum-evidence gate: indicators available: 5 of at least 6; score weight coverage: 35.4% of at least 60%; valuation methods computed: 0 of at least 1

FactorValueScoreWeight used
ROIC · Quality-22.8%31 (vs peers)29%
Net margin · Quality-10.9%44 (vs peers)18%
FCF conversion · Qualityunavailableunavailable—
Revenue CAGR 3Y · Growthunavailableunavailable—
EPS CAGR 3Y · Growthunavailableunavailable—
Net debt / EBITDA · Balance sheetunavailableunavailable—
Interest coverage · Balance sheet-4.8x0 (on a fixed band)18%
Current ratio · Balance sheet3.1x100 (on a fixed band)12%
P/E (TTM) · Valuationunavailableunavailable—
EV/EBITDA · Valuationunavailableunavailable—
FCF yield · Valuation-1.8%0 (on a fixed band)24%
Shareholder yield (distributions) · Returnsunavailableunavailable—
Payout ratio (FCF) · Returnsunavailableunavailable—

Factors without a value were dropped; the remaining weights were renormalised.

Score groups

  • Balance sheet40/100 · 2/3 factors with a value
  • Growth· partialunavailable · 0/2 factors with a value
  • Quality36/100 · 2/3 factors with a value
  • Returns· partialunavailable · 0/2 factors with a value
  • Valuation· partial0/100 · 1/3 factors with a value

A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.

Memo

MADRIGAL PHARMACEUTICALS, INC. (MDGL). Latest full fiscal year: 2025; data up to 2026-09-30.

Figures computed from the financial statements: revenue 958.4 m USD in 2025; YoY growth 432.1%; net margin -10.9%; ROE -24.8%.

Valuation cannot be computed from the available data.

Insufficient data for a verdict (indicators available: 5 of at least 6; score weight coverage: 35.4% of at least 60%; valuation methods computed: 0 of at least 1).

Text generated deterministically from the figures shown; no language model. Not investment advice.

What supports the thesis

  • Current ratio: 3.1x

What contradicts it

  • Interest coverage: -4.8x
  • FCF yield: -1.8%

Not assessed (insufficient data or a ratio without meaning): FCF conversion, Revenue CAGR 3Y, EPS CAGR 3Y, Net debt / EBITDA, P/E (TTM), EV/EBITDA, Shareholder yield (distributions), Payout ratio (FCF).

Versus the vertical median

Pharmaceutical Preparations (SIC 2834) · same industry (4-digit SIC) · compared with 39 companies

Multiples and returns vs the median

P/E
—
vertical median 32.4x
EV/EBITDA
—
vertical median 24.9x
P/S
6.5x
vertical median 7.1x
below median (−7.7%)
P/B
14.8x
vertical median 6.0x
above median (+145.8%)
ROE
-24.8%
vertical median -9.5%
below median
Net margin
-10.9%
vertical median 4.2%
below median (−360.0%)
EBIT margin
-10.7%
vertical median -4.2%
below median
Revenue YoY
432.1%
vertical median 5.9%
above median (+7,274.9%)
Net debt/EBITDA
—
vertical median -0.0x
Dividend yield
—
vertical median 2.2%

Price rebased to 100 (monthly, 5 years)

Companies in the vertical

Market capP/EROENet marginRevenue YoY1A / 3A
LLYEli Lilly And Company1,325.9 bn45.786.1%31.9%+44.7%+31% / +138%
JNJJohnson & Johnson640.8 bn40.420.0%16.2%+6.0%+29% / +72%
ONCBeone Medicines Ltd.524.7 bn817.514.7%10.7%+40.2%+4% / +90%
ABBVAbbVie Inc.505.5 bn49.2—15.7%+8.6%+26% / +101%
MRKMerck & Co., Inc.356.9 bn115.67.0%4.8%+1.3%+38% / +41%
ABTAbbott Laboratories190.6 bn30.612.4%13.9%+5.7%−15% / +5%
PFEPfizer Inc171.0 bn42.74.4%6.3%−1.6%+17% / −2%
VRTXVertex Pharmaceuticals Inc134.6 bn34.220.8%30.7%+8.9%+22% / +50%
BMYBristol-Myers Squibb Company126.1 bn13.744.1%18.5%−0.2%+25% / +25%
TEVATeva Pharmaceutical Industries Limited48.9 bn97.66.6%3.6%+4.3%+56% / +327%
ZTSZoetis Inc.34.3 bn13.764.4%27.5%+2.3%−35% / −53%
ROIVRoivant Sciences Ltd.26.0 bn—-6.2%-3,535.0%−71.6%+73% / +277%
UTHRUnited Therapeutics Corporation25.8 bn21.519.3%41.6%+10.6%+24% / +151%
RPRXRoyalty Pharma plc25.8 bn37.68.5%32.1%+5.1%+66% / +145%
INSMInsmed Inc22.9 bn—-72.5%-39.9%+66.7%−50% / +317%
VTRSViatris Inc.21.7 bn—-23.6%-23.9%−3.0%+77% / +106%
ALNYAlnylam Pharmaceuticals, Inc.21.4 bn8.1126.6%52.8%+65.2%−65% / −5%
TGTXTg Therapeutics, Inc.9.4 bn22.5100.3%55.2%+87.3%+85% / +381%
MDGLMadrigal Pharmaceuticals, Inc.9.3 bn—-24.8%-10.9%+432.1%−10% / +173%
BLRXBioLineRx Ltd4.9 bn—-12.8%-171.7%−95.9%−46% / −97%
BHCBausch Health Companies Inc.3.1 bn——-7.6%+6.7%+31% / +17%
ANABAnaptysbio, Inc.1.4 bn11.5—82.4%+157.0%+71% / +404%
KURAKura Oncology, Inc.677.0 m—-167.7%-384.3%+25.2%−37% / −21%
DMACDiaMedica Therapeutics Inc.580.8 m—-114.6%—unavailable+25% / +341%
PHATPhathom Pharmaceuticals, Inc.461.7 m——-30.2%+216.9%−64% / −19%

1- and 3-year price returns: for MDGL from daily closes (the same as the performance table), for the other companies from month-end closes.

olivLaw engine forecast

The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.

The engine has no published run for this company yet.

Valuation scenarios (editable assumptions)

Illustrative scenarios

Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.

Bear
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Base
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Bull
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Nothing is saved.

Estimated price (USD)

Estimated priceBearBaseBull
1 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
3 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
5 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
What moves the 3-year price the most

    AI analysis

    AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.

    Possibly outdated: the newest document it read is from 30 Jul 2026; since then the company filed 8-K (03 Nov 2026 · results), 10-Q (03 Nov 2026).

    In brief

    Madrigal Pharmaceuticals is a biopharmaceutical company focused on treating MASH, a serious liver disease, with its product Rezdiffra (resmetirom), the first therapy approved by the FDA for this indication. Net product sales reached 958.4 million USD in 2025, and the second quarter of 2026 brought 364.3 million USD, placing Rezdiffra at the center of market attention 13.

    SWOT

    Strengths

    • The company has an approved product, the first for MASH, with fast-growing sales and a patient base that has doubled in the past year 13. It also has an extensive patent position, with new patents granted in 2026 3.
    • Rezdiffra has an oral, once-daily profile considered well tolerated, which supports physician adoption 1.
    • The portfolio of external licenses, including for GLP-1 and siRNA molecules, offers long-term combination options 23.

    Weaknesses

    • The company depends almost entirely on a single product, which makes its performance vulnerable to any market or regulatory problem 1.
    • Net losses remain significant, and commercial and research spending in some quarters has grown faster than revenues 13.
    • The US accelerated approval and the EU conditional authorization depend on confirmatory studies, so reliance on those results is high 1.

    Opportunities

    • If the compensated cirrhosis studies are positive, eligibility for Rezdiffra could increase considerably 12.
    • Expansion across European countries, as reimbursement procedures are completed, could add new sales volumes 12.
    • Combinations with new molecules such as MGL-2086 could produce more effective therapies for patients 23.

    Threats

    • Payor pressure on prices and coverage, such as prior authorizations, could limit patient access 1.
    • The emergence of new MASH therapies could reduce Rezdiffra's market share, especially if they offer a more convenient profile 1.
    • A failure in confirmatory studies could lead to regulatory action, including withdrawal of the conditional approvals 1.

    Risks

    • Dependence on a single producthigh

      Rezdiffra accounts for nearly all revenue, so any commercial, safety or regulatory problem could seriously affect the whole company 1.

    • Conditional approvalshigh

      The accelerated FDA approval and the EU conditional marketing authorization depend on confirming clinical benefit; a negative result could lead to restrictions or withdrawal 12.

    • Reimbursement pressuremedium

      Insurers and government programs could limit coverage or reduce prices, which would affect net revenues 1.

    • Persistent operating lossesmedium

      Operating expenses rose in the second quarter of 2026 and the net loss was significant, which could require additional funding if revenue growth falls short 3.

    • Exposure to external licenseslow

      Upfront and milestone payments to external partners can raise unexpected costs and influence quarterly results 13.

    Investment thesis

    What would need to be true (bull case)

    • Rapid sales growth and a patient base that has doubled suggest physician adoption could continue if diagnosis in the market keeps expanding 3.
    • If outcome studies are positive, Rezdiffra could gain approval for compensated cirrhosis, opening a large patient population 12.
    • An extended patent portfolio running to 2045 and a combination pipeline offer a long protection period and growth options 13.

    What would break the thesis

    • Dependence on a single product makes the company's results highly sensitive to any market or regulatory problem 1.
    • If price pressure or reimbursement restrictions increase, revenues could slow faster than expected 1.
    • Net losses and high commercial spending could require additional funding if sales growth slows 3.

    What to watch

    • Results of the MAESTRO-NASH OUTCOMES trial in compensated cirrhosis2027
    • Trend in patient numbers and quarterly Rezdiffra net salesQ3 2026
    • Progress of the MGL-2086 Phase 1 trial and plans for combination studies2026
    • Expansion of the Rezdiffra launch to other European countries and reimbursement status2026

    Products, market & competition

    AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.

    Possibly outdated: the newest document it read is from 30 Jul 2026; since then the company filed 8-K (03 Nov 2026 · results), 10-Q (03 Nov 2026).

    The business

    Madrigal is a biopharmaceutical company focused on novel therapies for metabolic dysfunction-associated steatohepatitis (MASH), a serious liver disease that can lead to cirrhosis, liver failure, liver cancer and liver transplantation 1. Its approved product, Rezdiffra, is a once-daily oral, liver-directed THR-β agonist designed to target key underlying causes of MASH 1. Rezdiffra received FDA approval in March 2024, and in August 2025 the European Commission granted a conditional marketing authorization 1.

    Net sales of Rezdiffra were 958.4 million USD in 2025, and the company said quarterly sales were annualizing above one billion dollars at the end of 2025 1. As of June 30, 2026, more than 49,000 patients were on Rezdiffra, nearly double the level of the second quarter of 2025 3. The company is seeking to extend the label to compensated cirrhosis (F4c), with outcomes data from the MAESTRO-NASH OUTCOMES trial expected in 2027 12.

    Beyond Rezdiffra, Madrigal is building a pipeline that includes MGL-2086, an oral GLP-1 agonist in Phase 1, ervogastat, an oral DGAT2 inhibitor, an siRNA asset for PNPLA3 licensed in May 2026, and six siRNA programs licensed from Ribocure 123. The company reported accumulated losses of 2090.5 million USD as of December 31, 2025, so funding remains an important topic 1.

    Segments

    Rezdiffra (MASH, US and Europe)

    Rezdiffra is the company's only commercial product. Sales in 2025 were 958.4 million USD, and in the second quarter of 2026 they rose to 364.3 million USD 13. The German launch in September 2025 marked entry into the European market, with other countries to follow gradually 1.

    MASH pipeline

    The pipeline includes MGL-2086 (oral GLP-1 agonist), dosed in a Phase 1 trial starting June 2026, ervogastat (DGAT2 inhibitor), an siRNA asset for PNPLA3 and six siRNA programs 23. The stated aim is to combine these molecules with Rezdiffra 3.

    Market context

    The MASH market is large and under-treated, with about 315,000 patients with moderate to advanced fibrosis under specialist care in the US in 2023, a number that grew nearly 50% through 2025 to around 460,000 12. In Europe, about 370,000 patients with the same condition are diagnosed and under specialist care 12.

    The company argues that low diagnosis and treatment rates leave room for significant growth, and that MASH is the fastest-growing indication for liver transplantation in Europe 13. Growth, however, depends on physician awareness of the disease and patient access through insurance 1.

    Trends

    • Rising number of diagnosed patientstailwind

      The number of diagnosed patients under specialist care is growing as disease awareness improves, which could expand the market eligible for Rezdiffra 13.

    • Extension to compensated cirrhosistailwind

      If the MAESTRO-NASH OUTCOMES trial, expected in 2027, confirms benefit in F4c patients, eligibility could increase significantly, an opportunity the company views as potentially doubling its commercial scope 12.

    • Pricing and reimbursement pressureheadwind

      Third-party payors are trying to contain costs through prior authorizations, mandatory discounts and price negotiations, which could weigh on net revenues 1.

    • Rising commercial and R&D spendingmixed

      Selling, general and administrative and research expenses increased as the sales force expanded and a direct-to-consumer campaign ran, compressing the net result in the second quarter of 2026 3.

    Competitive position

    Rezdiffra was the first drug approved for MASH, giving it a pioneer position, but the company notes competition from existing off-label treatments and from therapies in development that could be approved in the future 1. Differentiation rests on its oral, once-daily profile and its generally good tolerability 1.

    Over the longer term, competition could come from molecules such as GLP-1 agonists, which Madrigal is also developing through MGL-2086, suggesting the MASH market will likely become more contested 23. The company suggests future treatments will include combinations and personalized regimens 1.

    • Existing off-label treatments

      Drugs already on the market used outside their approved MASH indication, an indirect competitor to Rezdiffra 1.

    • MASH therapies in development

      Candidates in development that could receive approval represent future competition in the MASH segment 1.

    • Oral GLP-1 agonists

      This drug class is relevant both as a potential competitor and as a possible combination partner, as with MGL-2086 23.

    • Arrowhead Pharmaceuticals

      The company licensed an siRNA asset for PNPLA3 to Madrigal, so it is currently more a partner than a competitor 2.

    News & filings

    In the press

    SEC filings

    Sources

    1. [1] Form 10-K, fiscal year ended 2025-12-31 · SEC / Madrigal Pharmaceuticals, Inc. · 19 Feb 2026
    2. [2] Form 10-Q, quarter ended 2026-06-30 · SEC / Madrigal Pharmaceuticals, Inc. · 30 Jul 2026
    3. [3] Form 8-K, results release (exhibit 99.1) · SEC / Madrigal Pharmaceuticals, Inc. · 30 Jul 2026

    Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.

    Madrigal Pharmaceuticals, Inc. (MDGL): stock, results, valuation and forecast · olivLaw