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Madrigal Pharmaceuticals, Inc.
NASDAQ: MDGL Healthcare Pharma 🔎 Screen
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$11.7B
Market Cap
2.2
P/E
PEG
-2,387.4%
ROCE
-42.5%
ROE
0.58
D/E
-31.3%
OPM
-11.3%
% from 52W High
75
α RS
🔍 MDGL is showing a high-conviction setup because it matches 3 of 39 tracked screener presets, Sector RRG has Technology in the Leading quadrant with the trail still rolling over, and RS Rating is 75. Net: Broad signal stack, not a recommendation. ? Conviction RRG RS Rating
Sources
Conviction 3/39 · Technology in Leading quadrant · RS Rating 75
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Currency-adjusted total returns for MDGL including FX impact
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📈 Price History
Ratio Health
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About

Madrigal Pharmaceuticals, Inc., a biopharmaceutical company, focuses on delivering novel therapeutics for metabolic dysfunction-associated steatohepatitis (MASH) in the United States. It offers Rezdiffra, a liver-directed thyroid hormone receptor beta agonist for treating MASH. The company was founded in 2016 and is headquartered in West Conshohocken, Pennsylvania.

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⭐ Superinvestors Holding MDGL
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Manager Shares Value % of Fund Period
Steve Cohen Point72 Asset Management 225.5K $118.0M 0.15% Mar 2026
Jim Simons Renaissance Technologies LLC 71.9K $37.6M 0.06% Mar 2026

SEC Form 13F data. 45-day lag from quarter end.

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📊 MIXED Madrigal's Rezdiffra hits $311M Q1 sales, 42,250 patients, $1.1B trailing run rate.
Revenue & Profitability
First quarter 2026 net sales were $311.3 million, up 127% year-over-year. Cost of sales was $26.8 million (royalties to Roche). Total operating expenses included $108.7 million in R&D (including $54.3 million in one-time business development costs) and $268.5 million in SG&A. Net loss for the quarter was $94.4 million, compared to $73.2 million in the prior year. Cash, equivalents, and marketable securities ended the quarter at $817.9 million. The company expects its gross-to-net discount to be in the mid-to-high thirties for the rest of 2026.
Outlook
Management views the MASH market as still in its infancy with a diagnosis rate just over 10% and Rezdiffra penetration under 10% of the 460,000 diagnosed F2/F3 patients. The addressable market has grown nearly 50% in two years, and increased industry investment is driving awareness and specialist involvement. Unmet need remains high, and management expects double-digit market expansion for years, with the F4-C outcomes trial potentially doubling the opportunity to approximately 245,000 additional patients.
Growth Drivers
Key growth levers include expanding the prescriber base (now over 10,000), increasing diagnosis rates, and driving deeper penetration in the growing addressable market. The endocrinology field force expansion (started Q4 2025) and potential F4-C outcomes trial readout in 2027 (covering well-compensated MASH cirrhosis) are expected to fuel further growth. Combination therapies with Rezdiffra (including GLP-1s and an siRNA for PNPLA3) represent longer-term growth drivers.
Balance Sheet & CapEx
Capital expenditure details were not discussed, but the company highlighted uses of cash for one-time business development payments (e.g., $25 million upfront for ARO-PNPLA3 to be recorded in Q2) and timing of API purchases for future Rezdiffra manufacturing. Full-year 2026 R&D expenses are expected to be roughly the same as 2025, inclusive of one-time BD payments. SG&A is expected to increase year-over-year, with higher Q2 SG&A due to timing of marketing and DTC expenses.
Margins
Cost of sales primarily reflects royalties owed to Roche. Gross-to-net discounts for Rezdiffra came in better than anticipated in Q1 and are expected to remain in the mid-to-high thirties for the rest of 2026. The company is preparing for profitability but does not expect to be profitable in 2026; profitability is considered inevitable beyond 2026, though certain quarters may tip positive depending on one-time spend. Operating expenses are increasing to support the launch and pipeline.
Key Risks
Q1 results reflected typical effects from benefit plan changes and insurance reverifications, which slowed patient adds. Gross-to-net discount variability remains a risk, though now better understood. The company relies on a single product (Rezdiffra) for all revenue. The F4-C outcomes trial is event-driven with a readout expected in 2027, and there is inherent uncertainty in event accrual. Pipeline programs are in early stages and may not succeed. The company is not yet profitable.
Generated by AI · Q1 2026 results · Not investment advice
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✓ 📞 Earnings Call Transcripts (5 quarters) submit a missing quarter
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📞 Earnings Call Transcripts (5)
Q2 2026 Q2 2026 2026-07-30
Rezdiffra delivered $364M in Q2 2026 net sales (up 71% YoY), surpassing 50,000 active patients and nearly $1.3B in trailing 12-month sales, with robust U.S. growth and negligible European contribution. The company advances a broad MASH pipeline and expects continued strong sales and patient growth in 2026.
Q1 2026 Q1 2026 2026-05-06
Rezdiffra delivered $311M in Q1 2026 net sales, up 127% year-over-year, with over 42,250 active patients and a rapidly expanding MASH market. The company is investing in a robust pipeline, including new siRNA assets, and expects continued strong growth, though profitability is not anticipated in 2026.
Q4 2025 Q4 2025 2026-02-19
Rezdiffra achieved nearly $1B in first-year net sales, establishing itself as the MASH standard of care amid a rapidly expanding US market. The company expects robust growth in 2026, driven by steady patient additions, pipeline expansion, and strong financials, despite higher gross to net impacts.
Q3 2025 Q3 2025 2025-11-04
Rezdiffra delivered $287.3M in Q3 2025 net sales, up 35% sequentially, with over 29,500 patients on therapy and more than 10,000 prescribers. Robust U.S. demand, expanding payer access, and a strong pipeline—including a new oral GLP-1—support continued growth into 2026.
Q2 2025 Q2 2025 2025-08-05
Q2 2025 net sales rose 55% to $212.8M, with Rezdiffra annualizing at $800M+ and strong prescriber adoption. New U.S. patent extends exclusivity to 2045, and international expansion is underway. Gross-to-net discounts are expected to remain within 20%-30% for 2025.
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Financial Model
Projections are built from each company's audited annual financials (Income Statement, Balance Sheet, Cash Flow) over the last 5 fiscal years. Forward assumptions — revenue growth %, EBITDA margin, D&A (USD millions), interest expense, tax rate, and capex — are AI-generated using historical context and refreshed twice a year: after the December results season and after the September/Q4 results season.

DCF Valuation
Fair Value = Σ(FCFt / (1+WACC)t) + Terminal Value. Terminal Value uses the Gordon Growth Model: FCF5 × (1+g) / (WACC−g). Default WACC: 10% (US risk-free ~4.5%, equity risk premium ~5.5%). Default terminal growth: 3% (long-run US nominal GDP proxy).

CAGR Tracker
Expected 5-year CAGR = (DCF Fair Value / Current Price)1/5 − 1. Assumes fair value is reached in exactly 5 years — a mechanical estimate only.

Data Sources & Limitations
Financial statements sourced from public filings. Prices updated daily. Forward assumptions are AI-generated. All monetary values in USD millions. Non-US ADR companies may have currency conversion inaccuracies. Models are point-in-time and do not update intra-quarter or account for M&A, macro shocks, or extraordinary items.

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