Madrigal Posts First Profitable Quarter as Rezdiffra Sales Jump 50.1% to $431.3 Million
Madrigal Pharmaceuticals posted its first profitable quarter as third-quarter sales of its liver drug Rezdiffra jumped 50.1% to $431.3 million, pushing year-to-date sales past $1 billion.
Net income was $55.4 million, or $1.83 per diluted share, compared with a net loss of $114.2 million, or $4.01 per share, a year earlier, according to the earnings release Madrigal filed with an 8-K on Tuesday. Revenue rose from $287.3 million, driven by U.S. demand for Rezdiffra, the company said.
Rezdiffra, approved to treat MASH with moderate to advanced liver fibrosis, reached year-to-date net sales of $1.1 billion. More than 55,850 patients were on the drug as of Sept. 30.
"Rezdiffra surpassed $1 billion in year-to-date net sales, achieving blockbuster status less than three years after launch, and we are still early in a rapidly growing market," CEO Bill Sibold said in the release.
Costs fall as sales scale
Operating expenses declined 6.5% to $375.3 million from $401.2 million. Research and development spending dropped to $71.8 million from $174.0 million, mainly because the year-earlier quarter included a one-time $117.3 million upfront business development expense.
Selling, general and administrative expenses rose 27.1% to $265.7 million as Madrigal kept investing in Rezdiffra's commercial rollout, including an expanded endocrinology field force and a direct-to-consumer campaign. Cost of sales more than doubled to $37.8 million on higher royalties payable to Roche.
Next target: cirrhosis
Madrigal said the addressable U.S. market for F2-F3 MASH grew to more than 530,000 patients through June 30, 2026.
The company plans a second Phase 3 outcomes trial, MAESTRO-CSPH, in patients with well-compensated MASH cirrhosis, known as F4c. It is expected to enroll more than 2,000 patients and begin in the first half of 2027, subject to regulatory discussions. Data from its ongoing MAESTRO-NASH OUTCOMES trial are expected in late 2027.
"Our objective in F4c is clear: be first and best," Sibold said.
Balance sheet
Cash, cash equivalents, restricted cash and marketable securities totaled $961.8 million at Sept. 30, compared with $988.6 million at the end of 2025. Madrigal also said it appointed John C. Reed, a Johnson & Johnson research and development executive, to its board in August.
By the numbers
- Rezdiffra net sales: $431.3 million, up 50.1%
- Net income: $55.4 million, versus a $114.2 million loss
- Diluted EPS: $1.83
- Year-to-date Rezdiffra sales: $1.1 billion
- Patients on Rezdiffra: more than 55,850
- Cash and marketable securities: $961.8 million
Sources
- Madrigal Pharmaceuticals Form 8-K with third-quarter 2026 earnings release, filed Nov. 3, 2026 (accession 0001628280-26-069093)
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