Madrigal Pharmaceuticals Inc (MDGL)
NASDAQ:MDGL
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Madrigal Pharmaceuticals
(NASDAQ:MDGL)
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Rating:55Neutral
Price Target:
$533.00
▲(2.58% Upside)
Action:ReiteratedDate:02/20/26
The score is driven primarily by strong financial momentum (sharp revenue scaling, very high gross margins, and minimal leverage) but held back by continued net losses and negative free cash flow. Technical indicators are weak with the stock below key moving averages and negative MACD, while the earnings call was constructive on growth and market opportunity but highlighted near-term gross-to-net and expense pressures.
Positive Factors
Commercial launch & patient uptake
A near‑$1B first full year and accelerating quarterly patient adds reflect durable product‑market fit among specialists. Sustained adoption of Rezdiffra and growing patient counts underpin multi‑quarter revenue scalability, supporting reinvestment in access, persistence programs, and commercial expansion over 2–6 months.
Negative Factors
Negative cash flow and net losses
Despite strong revenue scale, the company remains cash flow negative with meaningful net losses. Continued negative FCF constrains financial flexibility if commercialization or persistence weakens, increasing dependence on the existing cash stockpile and requiring discipline in spending or potential external financing decisions within the next few quarters.
Read all positive and negative factors
Positive Factors
Negative Factors
Commercial launch & patient uptake
A near‑$1B first full year and accelerating quarterly patient adds reflect durable product‑market fit among specialists. Sustained adoption of Rezdiffra and growing patient counts underpin multi‑quarter revenue scalability, supporting reinvestment in access, persistence programs, and commercial expansion over 2–6 months.
Read all positive factors
Madrigal Pharmaceuticals (MDGL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$11.92B
Dividend YieldN/A
Average Volume (3M)350.38K
Price to Earnings (P/E)―
Beta (1Y)0.32
Revenue Growth864.21%
EPS Growth48.12%
CountryUS
Employees528
SectorHealthcare
Sector Strength45
IndustryBiotechnology
Share Statistics
EPS (TTM)-2.57
Shares Outstanding22,939,968
10 Day Avg. Volume338,993
30 Day Avg. Volume350,379
Financial Highlights & Ratios
PEG Ratio1.10
Price to Book (P/B)21.68
Price to Sales (P/S)13.63
P/FCF Ratio-68.75
Enterprise Value/Market Cap1.01
Enterprise Value/Revenue12.60
Enterprise Value/Gross Profit13.38
Enterprise Value/Ebitda-45.66
Forecast
1Y Price Target
$704.88Price Target Upside35.66% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering9
EPS Forecast (FY)-4.51
Revenue Forecast (FY)$1.48B
Madrigal Pharmaceuticals Business Overview & Revenue Model
Company Description
Madrigal Pharmaceuticals, Inc., a clinical-stage biopharmaceutical company, focuses on the development and commercialization of therapeutic candidates for the treatment of cardiovascular, metabolic, and liver diseases. Its lead product candidate i...
How the Company Makes Money
Madrigal makes money primarily through net product sales of Rezdiffra in the United States. Revenue is generated by selling Rezdiffra into the pharmaceutical distribution channel (e.g., wholesalers/specialty distributors) and ultimately to patient...
Madrigal Pharmaceuticals Earnings Call Summary
Earnings Call Date:Feb 19, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:May 12, 2026
Earnings Call Sentiment Positive
The call communicated a strong, high-performing commercial launch (nearly $1B first-year sales), accelerating patient uptake, a sizable and fast-growing U.S. addressable market, a cash-strong balance sheet, and rapid pipeline expansion anchored to Rezdiffra (patent protection to 2045). Key near-term headwinds include expected gross-to-net deterioration into the high 30% range in 2026 (reducing net revenue), Q1 seasonality and contracting timing effects, higher R&D/SG&A from business-development and launch investments, and limited near-term international revenue. Management portrayed confidence in continued robust growth, disciplined R&D/combination strategy, and an adaptive approach to payer partnerships and persistence initiatives.Positive Updates
Exceptional Launch Sales
Fourth quarter 2025 net sales of $321,100,000 (more than triple Q4 2024) and full year 2025 net sales of $958,400,000 — a nearly $1.0B first full year on market, characterized by strong demand and market build-out.
Negative Updates
Gross-to-Net Pressure and Net Revenue Compression
Full-year 2025 gross-to-net impact finished at the low end of the previously guided 20%–30% range, but company expects gross-to-net to move into the high 30% range in 2026 due to payer contracting — a material headwind to net sales realization.
Read all updates
Q4-2025 Updates
Positive
Negative
Exceptional Launch Sales
Fourth quarter 2025 net sales of $321,100,000 (more than triple Q4 2024) and full year 2025 net sales of $958,400,000 — a nearly $1.0B first full year on market, characterized by strong demand and market build-out.
Read all positive updates
Company Guidance
Management guided to continued robust growth in 2026 off a strong 2025 launch (Q4 net sales $321.1M, FY2025 net sales $958.4M; Q4 >36,250 patients on Rezdiffra vs >29,500 at end‑Q3), highlighted a large addressable F2–F3 specialist population (315,000 representative patients, up nearly 50% since 2023) and an F4C opportunity of ~245,000 patients that could roughly double the commercial opportunity; Rezdiffra has patent protection into 2045, the company ended 2025 with $988.6M cash, R&D spend was $116.3M in Q4 and $388.5M for FY2025 (2026 R&D expected roughly flat), and FY2025 gross‑to‑net landed at the low end of the 20–30% range with 2026 gross‑to‑net expected in the high‑30s (Q1 typically a mid‑ to high‑single‑digit net sales step down due to reverifications plus the zero‑to‑contracting impact); pipeline metrics include >10 programs (oral GLP‑1 Phase 1 expected in Q2, a late‑stage DGAT2 Evogastat with MIRNA PDFF responses of 72% ≥30% and 61% ≥50% at 150 mg, and six preclinical siRNAs), MAESTRO outcomes remain on track for 2027 data with expected placebo event accrual of ~5–10% annually, and real‑world persistence runs ~60–70% at one year (with some sites up to ~90%).Madrigal Pharmaceuticals Financial Statement Overview
Summary
Income Statement
42
Neutral
Balance Sheet
74
Positive
Cash Flow
45
Neutral
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 958.40M | 180.13M | 0.00 | 0.00 | 0.00 |
| Gross Profit | 902.25M | 173.90M | 0.00 | 0.00 | 0.00 |
| EBITDA | -264.47M | -450.13M | -360.39M | -290.92M | -241.44M |
| Net Income | -288.28M | -465.89M | -373.63M | -295.35M | -241.85M |
Balance Sheet | |||||
| Total Assets | 1.26B | 1.04B | 640.55M | 362.57M | 273.33M |
| Cash, Cash Equivalents and Short-Term Investments | 983.56M | 926.25M | 634.13M | 358.77M | 270.35M |
| Total Debt | 354.36M | 119.57M | 117.19M | 49.89M | 797.00K |
| Total Liabilities | 656.90M | 287.86M | 235.21M | 165.18M | 77.22M |
| Stockholders Equity | 602.69M | 754.38M | 405.33M | 197.39M | 196.11M |
Cash Flow | |||||
| Free Cash Flow | -190.02M | -457.03M | -325.71M | -225.07M | -184.13M |
| Operating Cash Flow | -189.55M | -455.57M | -324.23M | -224.86M | -183.92M |
| Investing Cash Flow | 32.32M | -274.39M | -502.52M | 206.69M | -5.05M |
| Financing Cash Flow | 255.98M | 735.06M | 595.12M | 313.45M | 171.24M |
Madrigal Pharmaceuticals Technical Analysis
Positive
519.61
Price Trends
469.47
Positive
511.67
Positive
452.88
Positive
Market Momentum
19.06
Negative
60.27
Neutral
48.58
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For MDGL, the sentiment is Positive. The current price of 519.61 is above the 20-day moving average (MA) of 488.27, above the 50-day MA of 469.47, and above the 200-day MA of 452.88, indicating a bullish trend. The MACD of 19.06 indicates Negative momentum. The RSI at 60.27 is Neutral, neither overbought nor oversold. The STOCH value of 48.58 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for MDGL.
Madrigal Pharmaceuticals Risk Analysis
Madrigal Pharmaceuticals disclosed 50 risk factors in its most recent earnings report. Madrigal Pharmaceuticals reported the most risks in the "Tech & Innovation" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Madrigal Pharmaceuticals Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
76 Outperform | $11.50B | 12.10 | 36.88% | ― | 9.93% | 54.33% | |
61 Neutral | $20.19B | -14.22 | -18.32% | ― | -83.82% | -109.22% | |
57 Neutral | $14.69B | -50.22 | 127.54% | ― | 103.32% | 47.55% | |
55 Neutral | $11.92B | -45.32 | -43.76% | ― | 864.21% | 48.12% | |
52 Neutral | $14.46B | -20.69 | 39.18% | ― | 62.46% | -73.59% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
50 Neutral | $12.42B | -33.22 | -68.82% | ― | 20.39% | 34.00% |
* Healthcare Sector Average
MDGL
Madrigal Pharmaceuticals
519.61
197.29
61.21%
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Madrigal Pharmaceuticals Corporate Events
Business Operations and Strategy
Madrigal Gains Expanded Patent Control Over Rezdiffra With Roche
Positive
Jan 30, 2026
On January 29, 2026, Madrigal Pharmaceuticals and Roche amended their long-standing research, development, and commercialization agreement, giving Madrigal full and exclusive control over all patent term adjustments and extensions related to Rezdi...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.