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Dec 31, 2025
Madrigal Q4 2025 Earnings Report
Estimated Revenue:$313M
+238.8% YoY
Estimated EPS:-$0.5
+88.2% YoY
Key Takeaways
Madrigal Pharmaceuticals achieved a defining year in 2025, solidifying its leadership in the MASH market with nearly $1 billion in Rezdiffra sales in its first full year of launch. The company reported fourth-quarter net revenues of $321.1 million and full-year net revenues of $958.4 million, alongside strategic pipeline expansions and strong cash reserves.
Fourth-quarter 2025 Rezdiffra net sales reached $321.1 million, contributing to a full-year total of $958.4 million.
As of year-end 2025, over 36,250 patients were on Rezdiffra, demonstrating strong market penetration.
Madrigal expanded its MASH pipeline to over 10 programs, including new siRNA and DGAT-2 inhibitor licenses, aiming to define future MASH treatment.
The company reported robust cash, cash equivalents, restricted cash, and marketable securities totaling $988.6 million as of December 31, 2025.
Revenue by Segment
Forward Guidance
Madrigal Pharmaceuticals anticipates continued robust net sales growth for Rezdiffra in 2026, driven by broad first-line access and increasing disease awareness. The company also expects to advance its pipeline, including the initiation of IND-enabling activities for siRNA programs and a Phase 2 combination trial for ervogastat.
Positive Outlook
- Expected robust net sales growth for Rezdiffra in 2026.
- Anticipated broad first-line access for Rezdiffra.
- Increasing disease awareness for MASH and Rezdiffra.
- Initiation of IND-enabling activities for initial siRNA candidates in 2026.
- Plans to conduct a drug-to-drug interaction study with Rezdiffra and consult with the FDA on a Phase 2 combination trial for ervogastat this year.
Challenges Ahead
- Risks related to obtaining and maintaining regulatory approvals.
- Potential regulatory delays or rejections.
- Uncertainties regarding the timing and results of future topline data.
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