Madrigal Pharmaceuticals Reports First-Quarter 2026 Financial Results and Provides Corporate Updates
Rhea-AI Summary
Madrigal Pharmaceuticals (Nasdaq: MDGL) reported 1Q26 Rezdiffra net sales of $311.3M, up 127% year-over-year, and >42,250 patients on therapy as of March 31, 2026. Cash and marketable securities totaled $817.9M. The company licensed ARO-PNPLA3 and added six preclinical siRNA programs; MGL-2086 Phase 1 is on track to start in 2Q26. First-quarter operating expenses were $404.1M with a net loss of $94.4M, which included $54.3M of one-time business development expenses. Intellectual property protection for Rezdiffra is expected into 2045.
AI-generated analysis. Not financial advice.
Positive
- Net sales $311.3M in 1Q26, +127% YoY
- >42,250 patients on Rezdiffra as of Mar 31, 2026
- $817.9M cash and marketable securities at Mar 31, 2026
- Acquired global rights to clinical-stage ARO-PNPLA3
- Added six preclinical siRNA programs for MASH
Negative
- Operating expenses of $404.1M in 1Q26
- Net loss of $94.4M (1Q26), or $3.25 per share
- $54.3M one-time upfront BD expense included in results
- Cash declined from $988.6M at Dec 31, 2025 to $817.9M
News Market Reaction – MDGL
On the day this news was published, MDGL gained 7.42%, reflecting a notable positive market reaction. Argus tracked a peak move of +3.1% during that session. Our momentum scanner triggered 6 alerts that day, indicating moderate trading interest and price volatility. This price movement added approximately $887M to the company's valuation, bringing the market cap to $12.84B at that time.
Data tracked by StockTitan Argus on the day of publication.
Key Figures
Market Reality Check
Peers on Argus
MDGL is down 3.12% with above-average volume, while key biotech peers show mixed, mostly modest moves (e.g., MRNA -2.02%, HALO +0.80%, VRNA and BPMC nearly flat). Momentum scans flag only JAZZ up 3.65%, suggesting MDGL’s reaction is company-specific rather than a sector-wide move.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Feb 19 | Q4/FY 2025 earnings | Positive | -11.1% | Reported strong 2025 Rezdiffra sales and cash of $988.6M with global expansion steps. |
| Nov 04 | Q3 2025 earnings | Positive | +7.8% | Q3 2025 net sales of $287.3M, >29,500 patients and new patent protection to 2045. |
| Aug 05 | Q2 2025 earnings | Positive | +8.6% | Q2 2025 Rezdiffra sales of $212.8M plus extended patents and new credit facility. |
| May 01 | Q1 2025 earnings | Positive | -1.9% | Q1 2025 net sales of $137.3M and >17,000 patients with strong trial data. |
| Feb 26 | Q4/FY 2024 earnings | Positive | +15.0% | First commercial year for Rezdiffra with $180.1M sales and key Phase 3 data. |
Earnings releases often highlight strong Rezdiffra growth, but price reactions have been mixed, with both sharp gains and notable selloffs on generally positive updates.
Over the past year, Madrigal’s earnings releases have tracked the rapid commercial ramp of Rezdiffra and strengthening finances. Events on Feb 26, 2025, Aug 5, 2025 and Nov 4, 2025 all emphasized strong sales growth, expanding patient counts and cash balances, with mostly positive price reactions. The Feb 19, 2026 and May 1, 2025 reports also described robust fundamentals but saw negative next‑day moves, showing that strong metrics have not always translated into immediate share price gains.
Historical Comparison
In the past five earnings-related releases, MDGL’s average next-day move was about ±3.69%. Today’s -3.12% reaction sits within that historical range but leans to the weaker side versus typically positive responses.
Earnings updates from 2024–2026 chart Rezdiffra’s rise from initial launch to blockbuster-level sales, alongside growing cash reserves, expanded patents into 2045, European rollout and a broadening MASH-focused pipeline.
Market Pulse Summary
The stock moved +7.4% in the session following this news. A strong positive reaction aligns with Madrigal’s demonstrated ability to convert MASH demand into rapid revenue growth, as seen with Q1 2026 Rezdiffra net sales of $311.3M and more than 42,250 patients on therapy. Historical earnings moves averaged about ±3.69%, with several prior reports triggering sizable gains. However, high short interest around 18.47% and elevated operating expenses of $404.1M could contribute to volatility and limit the durability of sharp upside moves.
Key Terms
sirna medical
pnpla3 medical
glp-1 medical
mri-pdff medical
lp(a) medical
ldl-c medical
AI-generated analysis. Not financial advice.
- First-quarter 2026 Rezdiffra® (resmetirom) net sales of
$311.3 million , representing year-over-year growth of127% - As of March 31, 2026, more than 42,250 patients on Rezdiffra, up 2.5x from 1Q25, reflecting continued strong physician adoption and high patient demand
- Advances pipeline with global licensing agreement for a clinical-stage siRNA asset targeting a mutation in the PNPLA3 gene, a genetically validated driver of MASH
- MGL-2086 (oral GLP-1) Phase 1 trial on track to initiate in 2Q26; ervogastat/resmetirom drug-drug interaction study on track to initiate in 4Q26
- Reports cash, cash equivalents, restricted cash and marketable securities of
$817.9 million as of March 31, 2026 - Company to host conference call today, May 6, 2026, at 8 a.m. EDT
CONSHOHOCKEN, Pa., May 06, 2026 (GLOBE NEWSWIRE) -- Madrigal Pharmaceuticals, Inc. (Nasdaq: MDGL), a biopharmaceutical company focused on delivering novel therapeutics for metabolic dysfunction-associated steatohepatitis (MASH), today reports first-quarter 2026 financial results and provides corporate updates.
Bill Sibold, Chief Executive Officer of Madrigal, stated: “2026 is off to a terrific start. Rezdiffra has achieved blockbuster status on a trailing-12-month net sales basis, reflecting broad physician adoption and high patient demand. The market dynamics continue to be very favorable for 2026 and for long-term growth due to a high unmet need in a rapidly growing market that has expanded nearly 50 percent to approximately 460,000 patients in the span of only two years. We’re continuing to steadily add patients, reinforcing our confidence in our robust growth expectations for Rezdiffra in 2026.”
Sibold continued: “We also strengthened our pipeline with a clinical stage siRNA asset targeting a mutation in the PNPLA3 gene that predisposes a significant portion of people with MASH to advanced liver fibrosis, including progression to cirrhosis. This new asset advances our strategy to develop next-generation combination therapies across the spectrum of disease. With our strong cash position and intellectual property protection for Rezdiffra expected into 2045, we are well-positioned to maintain our leadership in MASH, supported by the differentiated clinical profile of Rezdiffra as the only approved liver-directed therapy for this disease, our growing commercial success and an expanding, industry-leading MASH pipeline.”
First Quarter 2026 and Recent Corporate Updates
- Madrigal adds clinical-stage siRNA asset targeting PNPLA3 mutation
- On May 5, Madrigal announced a licensing agreement with Arrowhead Pharmaceuticals, Inc. for global rights to ARO-PNPLA3, a clinical stage GalNAc-conjugated small interfering RNA (siRNA) asset designed to reduce expression of PNPLA3, a genetically validated driver of MASH.
- ARO-PNPLA3 targets MASH patients who are homozygous for a mutation in the PNPLA3 gene, which is highly prevalent among Hispanic patients and represents approximately
30% of patients with moderate to advanced fibrosis (consistent with stages F2 and F3). - Data from a Phase 1 trial of ARO-PNPLA3 demonstrated up to a
46% reduction in liver fat (as measured by MRI-PDFF) at 12 weeks following a single dose at the highest dose level tested in PNPLA3 I148M homozygous patients.
- Expanded pipeline with global rights to six pre-clinical siRNA programs
- In February 2026, Madrigal expanded its MASH pipeline with six innovative siRNA programs, providing the potential for a genetically targeted approach, combined with the broad efficacy of Rezdiffra, to create the next generation of MASH therapies.
- Preclinical development is underway.
- Strong scientific presence at the upcoming EASL Congress
- Madrigal will present 8 abstracts at the European Association for the Study of Liver (EASL) Congress, taking place May 27-30, 2026, in Barcelona, Spain.
- Accepted abstracts include a poster featuring a secondary analysis from Madrigal’s MAESTRO-NASH/NAFLD1 trials showing that Rezdiffra reduced Lp(a) and LDL-C in patients with MASH, supporting its potential to reduce cardiovascular risk independent of baseline statin use, as well as two posters sharing real-world efficacy data for patients on Rezdiffra for up to one year.
First-Quarter 2026 Financial Results
- Total Revenues: First-quarter 2026 net revenues were
$311.3 million , an increase of127% compared to$137.3 million in the comparable prior year period. - Operating Expenses: First-quarter 2026 operating expenses were
$404.1 million , inclusive of$34.0 million in non-cash stock-based compensation expense, compared to operating expenses of$216.6 million , inclusive of$20.9 million in non-cash stock-based compensation expense for the prior year period. First-quarter operating expenses also included one-time, upfront business development expenses of$54.3 million for strategic pipeline expansion.- Cost of Sales: First-quarter 2026 cost of sales was
$26.8 million compared to$4.5 million in the comparable prior year period. This was inclusive of non-cash stock-based compensation expense. - R&D Expenses: First-quarter 2026 R&D expenses were
$108.7 million compared to$44.2 million in the comparable prior year period, both inclusive of non-cash stock-based compensation expense. The increase in R&D expenses was primarily due to one-time, upfront business development expenses of$54.3 million . - SG&A Expenses: First-quarter 2026 SG&A expenses were
$268.5 million compared to$167.9 million in the comparable prior year period, both inclusive of non-cash stock-based compensation expense. The increase was primarily due to continued investment in commercial activities for Rezdiffra, including headcount for the endocrinology field force expansion that began in the fourth quarter of 2025, as well as marketing efforts, including a direct -to-consumer (DTC) campaign.
- Cost of Sales: First-quarter 2026 cost of sales was
- Net Loss: First-quarter 2026 net loss was
$94.4 million or$3.25 per share (basic and diluted) compared to a net loss of$73.2 million or$2.61 per share (basic and diluted) in the comparable prior year period. Net loss in 2026 was inclusive of one-time, upfront business development expenses of$54.3 million , or$1.87 per share.
- Cash, Cash Equivalents, Restricted Cash and Marketable Securities: As of Mar. 31, 2026, Madrigal had cash, cash equivalents, restricted cash, and marketable securities of
$817.9 million , compared to$988.6 million as of Dec. 31, 2025.
Conference Call and Webcast
At 8 a.m. EDT today, May 6, Madrigal will host a webcast to review its financial and operating results and provide a general business update. To access the webcast, please visit the investor relations section of the Madrigal website or click here to register. An archived webcast will be available on the Madrigal website following the event.
About MASH
Metabolic dysfunction-associated steatohepatitis (MASH) is a serious liver disease that can progress to cirrhosis, liver failure, liver cancer, the need for liver transplantation, and premature mortality. MASH is the leading cause of liver transplantation in women and the second leading cause of all liver transplantation in the U.S. It is the fastest-growing indication for liver transplantation in Europe.
Once patients progress to MASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis), the risk of adverse liver outcomes increases dramatically: these patients have a 10 to 17 times higher risk of liver-related mortality as compared to patients without fibrosis. Patients with MASH who progress to cirrhosis face a 42 times higher risk of liver-related mortality, underscoring the need to treat MASH before complications of cirrhosis develop. MASH is also an independent driver of cardiovascular disease, the leading cause of mortality for patients.
As disease awareness improves and disease prevalence increases, the number of diagnosed patients with F2 to F4c MASH is growing.
About Madrigal
Madrigal Pharmaceuticals, Inc. (Nasdaq: MDGL) is a biopharmaceutical company focused on delivering novel therapeutics for metabolic dysfunction-associated steatohepatitis (MASH), a liver disease with high unmet medical need. Madrigal’s medication, Rezdiffra (resmetirom), is a once-daily, oral, liver-directed THR-β agonist designed to target key underlying causes of MASH. Rezdiffra was the first medication approved by both the FDA and European Commission for the treatment of MASH with moderate to advanced fibrosis (F2 to F3). An ongoing Phase 3 outcomes trial is evaluating Rezdiffra for the treatment of compensated MASH cirrhosis (F4c). For more information, visit www.madrigalpharma.com.
Forward Looking Statements
This press release includes “forward-looking statements” made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, as amended, including statements related to the expected growth of Rezdiffra sales in 2026, expectations regarding patent protection for Rezdiffra, Madrigal’s clinical development plans and timelines for its pipeline, Madrigal’s leadership position in the MASH sector, the potential size of the MASH market, the potential benefit of Rezdiffra in patients with compensated MASH cirrhosis and the potential benefit of siRNAs in the treatment of MASH. Forward-looking statements are subject to a number of risks and uncertainties including, but not limited to: the assumptions underlying the forward-looking statements; our ability to successfully commercialize Rezdiffra in the U.S. and Europe; risks related to obtaining and maintaining regulatory approvals, including, but not limited to, potential regulatory delays or rejections; our history of operating losses and the possibility that we may never achieve or maintain profitability; risks associated with meeting the objectives of our clinical trials, including, but not limited to our ability to achieve enrollment objectives concerning patient numbers (including an adequate safety database), outcomes objectives and/or timing objectives for our trials; any delays or failures in enrollment, and the occurrence of adverse safety events; risks related to the effects of Rezdiffra’s (resmetirom’s) mechanism of action or of any other product candidate; market demand for and acceptance of Rezdiffra; our ability to service indebtedness and otherwise comply with debt covenants; outcomes or trends from competitors; future topline data timing or results; our ability to prevent and/or mitigate cyber-attacks; our ability to protect our intellectual property rights; the uncertainties inherent in clinical testing; uncertainties concerning analyses or assessments outside of a controlled clinical trial; and changes in laws and regulations applicable to our business and our ability to comply with such laws and regulations. Undue reliance should not be placed on forward-looking statements, which speak only as of the date they are made. Madrigal undertakes no obligation to update any forward-looking statements to reflect new information, events, or circumstances after the date they are made, or to reflect the occurrence of unanticipated events. Please refer to Madrigal’s submissions filed with the U.S. Securities and Exchange Commission (SEC) for more detailed information regarding these risks and uncertainties and other factors that may cause actual results to differ materially from those expressed or implied. Madrigal specifically discusses these risks and uncertainties in greater detail in the sections appearing in Part 1A of its Annual Report on Form 10-K for the year ended December 31, 2025, and as updated from time to time by Madrigal’s other filings with the SEC.
Madrigal may use its website to comply with its disclosure obligations under Regulation FD. Therefore, investors should monitor Madrigal’s website in addition to following its press releases, filings with the SEC, public conference calls, and webcasts.
Madrigal Pharmaceuticals, Rezdiffra™ and associated logos are trademarks of Madrigal Pharmaceuticals, Inc.
Investor Contact
Tina Ventura, IR@madrigalpharma.com
Media Contact
Christopher Frates, media@madrigalpharma.com
(tables follow)
| Madrigal Pharmaceuticals, Inc. | |||||||
| Condensed Consolidated Statement of Operations | |||||||
| (in thousands, except share and per share amounts) | |||||||
| (unaudited) | |||||||
| Three Months Ended | |||||||
| March 31, | |||||||
| 2026 | 2025 | ||||||
| Revenues: | |||||||
| Product revenue, net | $ | 311,337 | $ | 137,250 | |||
| Operating expenses: | |||||||
| Cost of sales | 26,847 | 4,513 | |||||
| Research and development | 108,692 | 44,172 | |||||
| Selling, general and administrative | 268,521 | 167,876 | |||||
| Total operating expenses1 | 404,060 | 216,561 | |||||
| Loss from operations | (92,723 | ) | (79,311 | ) | |||
| Interest income | 8,243 | 9,370 | |||||
| Interest expense | (7,819 | ) | (3,297 | ) | |||
| Other expense, net | (2,092 | ) | - | ||||
| Net loss | $ | (94,391 | ) | $ | (73,238 | ) | |
| Basic and diluted net loss per common, Series A | |||||||
| preferred, and Series B preferred share | $ | (3.25 | ) | $ | (2.61 | ) | |
| Basic and diluted weighted average number of shares outstanding2 | 29,032,422 | 28,085,234 | |||||
| (1) Amounts include non-cash stock-based compensation expense as follows: | |||||||
| Cost of sales | $ | 96 | $ | - | |||
| Research and development | $ | 7,865 | $ | 5,215 | |||
| Selling, general and administration | $ | 26,057 | $ | 15,716 | |||
| Total stock-based compensation | 34,018 | 20,931 | |||||
| (2) Basic and diluted weighted average number of shares outstanding are inclusive of common stock (22,959,235), previously issued prefunded warrants (3,605,790), previously issued Series A and Series B convertible preferred shares outstanding (2,369,797) and earned PSUs (97,600). | |||||||
| Madrigal Pharmaceuticals, Inc. | |||||||
| Condensed Consolidated Balance Sheets | |||||||
| (in thousands) | |||||||
| (unaudited) | |||||||
| March 31, | December 31, | ||||||
| 2026 | 2025 | ||||||
| Cash, cash equivalents, restricted cash and marketable securities | $ | 817,926 | $ | 988,649 | |||
| Trade receivables, net | 187,356 | 134,476 | |||||
| Other current assets | 177,025 | 122,645 | |||||
| Other non-current assets | 45,020 | 13,819 | |||||
| Total assets | $ | 1,227,327 | $ | 1,259,589 | |||
| Liabilities and Equity | |||||||
| Current liabilities | $ | 338,259 | $ | 310,288 | |||
| Long-term liabilities | 345,614 | 346,612 | |||||
| Stockholders’ equity | 543,454 | 602,689 | |||||
| Total liabilities and stockholders’ equity | $ | 1,227,327 | $ | 1,259,589 | |||
