Madrigal Pharmaceuticals Stock Earnings Reports

Madrigal reported a strong Q3 2025 driven by its launch of Rezdiffra (resmetirom). Net sales were $287.3M (up 35% QoQ), the product is annualizing at >$1B in only its sixth quarter of launch, and >29,500 patients are on therapy with >10,000 prescribers. Management emphasized large remaining opportunity (they target ~315,000 diagnosed moderate–advanced fibrosis patients and estimate >90% remain untreated). Key commercial developments: a new U.S. patent for Rezdiffra was listed in the Orange Book extending protection into 2045; payer contracting for 2026 is progressing with expectations of broad first-line access and no step edits for many plans; gross‑to‑net is expected to step to the midpoint of the 20–30% range in Q4 2025 and move to the high‑30% range starting Q1 2026. International expansion began with a launch in Germany (country-by-country approach). Pipeline and clinical strategy: the Phase III MAESTRO‑NASH outcomes trial in compensated cirrhosis (F4c) is ongoing with an outcomes readout expected in 2027 and the F2/F3 MAESTRO‑NASH readout expected in 2028; management presented encouraging 2‑year open‑label F4c data and plans a Phase I for their acquired oral GLP-1 (MGL‑2086) in H1 2026 to develop an oral fixed‑dose combination with resmetirom. Financials: R&D spiked to $174M (Q3) primarily due to a one-time $117M expense for the global license of MGL‑2086; SG&A rose to $209.1M driven by launch investments; cash and marketable securities totaled ~$1.1B (includes $350M initial term loan). Management reiterated focus on continued patient additions, durable market access, building a combination-capable pipeline, and steady net sales growth in 2026 and beyond.