Madrigal Pharmaceuticals (MDGL) AI Stock Analysis

• Market Cap: $10.87B
• Dividend Yield: N/A
• Average Volume (3M): 285.92K
• Price to Earnings (P/E): ―
• Beta (1Y): 0.34
• Revenue Growth: 864.21%
• EPS Growth: 48.12%
• Country: US
• Employees: 528
• Sector: Healthcare
• Sector Strength: 45
• Industry: Biotechnology
• EPS (TTM): -5.08
• Shares Outstanding: 22,711,420
• 10 Day Avg. Volume: 327,152
• 30 Day Avg. Volume: 285,923
• PEG Ratio: -1.47
• Price to Book (P/B): 8.70
• Price to Sales (P/S): 36.44
• P/FCF Ratio: -14.36
• Enterprise Value/Market Cap: 0.97
• Enterprise Value/Revenue: 14.28
• Enterprise Value/Gross Profit: 14.99
• Enterprise Value/Ebitda: -39.15
• 1Y Price Target: $705.56
• Price Target Upside: 52.25% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 11
• EPS Forecast (FY): N/A
• Revenue Forecast (FY): N/A

• Rating: 52 Neutral
• Price Target: $500.00 ▲(7.89% Upside)

The score is held down primarily by ongoing losses and material cash burn despite strong revenue growth and very high gross margins. Technically, the stock shows weak momentum with price below key moving averages and a negative MACD. Offsetting these risks, the latest earnings call showed strong commercial traction for Rezdiffra and improving access outlook, supporting a mid-range overall score.

Positive Factors

Commercial Launch Traction

Rapid adoption demonstrates durable commercial execution: growing patient base and provider prescriptions underpin repeatable revenue scaling, reduce commercialization execution risk, and increase odds that launch investments convert into sustained market penetration over coming quarters.

Exceptional Gross Margins

Very high product-level margins indicate strong unit economics and pricing power for Rezdiffra, allowing revenue retention to fund SG&A and R&D spend. This margin buffer supports long-term profitability potential if commercial scale continues and gross-to-net pressures are managed.

Balance Sheet Liquidity & Manageable Leverage

Material cash reserves and low reported leverage provide runway to fund commercialization, Phase III studies, and the oral GLP-1 integration without immediate financing. This financial flexibility reduces dilution and execution risk during multi-quarter scale-up.

Negative Factors

Persistent Negative Cash Flow

Sustained negative operating and free cash flow means the business still consumes capital despite strong revenue growth; if revenue growth slows or gross-to-net worsens, the company may need to raise funds or cut investment, pressuring strategic options and returns.

Rising Operating Expenses

Sharp increases in R&D and SG&A to support pipeline expansion and commercialization materially widen the path to corporate breakeven. Even if partly one-time, higher baseline spend to support new programs and sales scale can depress margins for multiple quarters.

Payer Access & Competitive Pressure

Rising gross-to-net and unfinished payer contracts reduce realized revenue per script and increase reimbursement risk. Concurrent competitive entrants (GLP-1s) create structural pressure on market share and pricing, challenging durable revenue and margin assumptions.

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 is resmetirom, a liver-directed selective thyroid hormone receptor-ß agonist, which is in Phase III clinical trials for the treatment of non-alcoholic steatohepatitis. The company also develops MGL-3745, a backup compound to resmetirom. It has research, development, and commercialization agreement with Hoffmann-La Roche. Madrigal Pharmaceuticals, Inc. is headquartered in West Conshohocken, Pennsylvania.

How the Company Makes Money

Madrigal Pharmaceuticals primarily makes money through the development and commercialization of its proprietary drug candidates. The company aims to generate revenue by advancing its lead compound, resmetirom, through clinical trials and obtaining regulatory approval for commercialization. Once approved, Madrigal would earn revenue through product sales, potentially entering into licensing agreements or partnerships with larger pharmaceutical companies to expand market reach and distribution. The company's financial success is also supported by strategic collaborations and partnerships that may provide upfront payments, milestone payments, and royalties. Madrigal's revenue model is highly dependent on the successful clinical development and regulatory approval of its drug candidates.

Madrigal Pharmaceuticals Financial Statement Overview

Summary

Revenue is scaling quickly (TTM $740.6M, +43.7% YoY) with exceptionally high gross margin (~96%), but profitability and cash generation remain weak (EBIT margin ~-52%, net margin ~-54%, TTM FCF -$161.6M). Balance sheet leverage is manageable (debt-to-equity ~0.18), yet continued losses (ROE ~-38%) keep financial risk elevated.

Income Statement

TTM (Trailing-Twelve-Months) revenue rose to $740.6M with very strong year-over-year growth (+43.7%) and exceptionally high gross margin (~96%), indicating attractive product economics. However, the company remains meaningfully unprofitable with negative operating results (EBIT margin ~-52%) and a net loss of $289.1M (net margin ~-54%). Profitability has improved versus the 2024 annual loss, but earnings are still heavily pressured by operating expenses typical of a scaling biotech launch.

Balance Sheet

Leverage looks manageable with debt-to-equity at ~0.18 in TTM (Trailing-Twelve-Months), suggesting the balance sheet is not overly debt-funded. Equity has increased over time (from ~$197.4M in 2022 to ~$625.7M TTM), supporting financial flexibility. The key weakness is continued losses driving negative returns on shareholder capital (return on equity ~-38% TTM), which can erode balance sheet strength if losses persist.

Cash Flow

Cash burn remains significant: TTM (Trailing-Twelve-Months) operating cash flow was -$160.6M and free cash flow was -$161.6M. Cash outflows have improved materially versus 2024 annual levels (operating cash flow -$455.6M), but free cash flow still deteriorated year-over-year (growth -47.6%), highlighting ongoing investment and working-capital needs during commercialization. Free cash flow roughly tracks the net loss, indicating limited non-cash cushioning and continued reliance on external funding if the burn rate doesn’t moderate.

Breakdown	TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement
Total Revenue	740.64M	180.13M	0.00	0.00	0.00	0.00
Gross Profit	705.50M	173.90M	0.00	0.00	0.00	-471.00K
EBITDA	-270.14M	-450.13M	-360.39M	-290.92M	-241.44M	-201.77M
Net Income	-289.13M	-465.89M	-373.63M	-295.35M	-241.85M	-202.24M
Balance Sheet
Total Assets	1.36B	1.04B	640.55M	362.57M	273.33M	287.00M
Cash, Cash Equivalents and Short-Term Investments	1.11B	926.25M	634.13M	358.77M	270.35M	284.15M
Total Debt	346.40M	119.57M	117.19M	49.89M	797.00K	786.00K
Total Liabilities	736.73M	287.86M	235.21M	165.18M	77.22M	47.02M
Stockholders Equity	625.73M	754.38M	405.33M	197.39M	196.11M	239.97M
Cash Flow
Free Cash Flow	-161.63M	-457.03M	-325.71M	-225.07M	-184.13M	-157.90M
Operating Cash Flow	-160.58M	-455.57M	-324.23M	-224.86M	-183.92M	-157.56M
Investing Cash Flow	-43.21M	-274.39M	-502.52M	206.69M	-5.05M	159.78M
Financing Cash Flow	266.80M	735.06M	595.12M	313.45M	171.24M	5.09M

Madrigal Pharmaceuticals Technical Analysis

• Technical Analysis Sentiment: Negative
• Last Price: 463.42
• 50DMA: Negative
• 100DMA: Negative
• 200DMA: Positive
• MACD: Positive
• RSI: Positive
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For MDGL, the sentiment is Negative. The current price of 463.42 is below the 20-day moving average (MA) of 497.61, below the 50-day MA of 546.09, and above the 200-day MA of 414.46, indicating a neutral trend. The MACD of -18.88 indicates Positive momentum. The RSI at 28.87 is Positive, neither overbought nor oversold. The STOCH value of 27.73 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for MDGL.

Madrigal Pharmaceuticals Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
EXEL	78 Outperform	$11.43B	17.84	30.56%	―	9.93%	54.33%
ROIV	59 Neutral	$15.06B	-38.26	-14.73%	―	-83.82%	-109.22%
BBIO	58 Neutral	$14.49B	-15.22	―	―	62.46%	-73.59%
IONS	56 Neutral	$13.77B	-48.78	-39.99%	―	20.39%	34.00%
MDGL	52 Neutral	$10.87B	-35.63	-41.22%	―	864.21%	48.12%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
ASND	46 Neutral	$13.43B	-51.18	―	―	103.32%	47.55%

Madrigal Pharmaceuticals Corporate Events

Madrigal Gains Expanded Patent Control Over Rezdiffra With Roche

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 Rezdiffra, including those on patents owned by Roche or jointly held. In return, Madrigal agreed that royalties paid to Roche on net sales of Rezdiffra will remain at current levels and will not be reduced until certain existing or potential patent term extensions expire, a move that strengthens Madrigal’s strategic control over a key asset while maintaining Roche’s royalty economics for a longer period, with implications for both companies’ revenue visibility and IP positioning around Rezdiffra.

The most recent analyst rating on (MDGL) stock is a Buy with a $587.00 price target. To see the full list of analyst forecasts on Madrigal Pharmaceuticals stock, see the MDGL Stock Forecast page.