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Madrigal Pharmaceuticals
(NASDAQ:MDGL)
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Rating:49Neutral
Price Target:
$499.00
▼(-6.21% Downside)
Action:Reiterated
Date:06/18/26
The score is held back primarily by ongoing losses and negative free cash flow despite strong revenue growth and high gross margins. Earnings-call momentum in sales and patient growth provides support, but guidance still points to continued 2026 unprofitability and margin pressure from gross-to-net discounts and higher operating spend. Technicals are broadly neutral and valuation is constrained by the negative P/E and lack of dividend yield.
Positive Factors
Blockbuster revenue growth
Sustained blockbuster sales and rapid patient adoption establish durable commercial scale, providing predictable product revenue to fund operations and pipeline investment. Large recurring prescription base reduces execution risk for U.S. commercialization and supports leverage of fixed infrastructure over time.
Negative Factors
Negative operating and free cash flow
Persistent negative operating and free cash flow means the business still relies on financing or asset sales to sustain growth and fund trials. Even with improving trends, continuing cash burn constrains flexibility for sustained commercial investment or optionality for additional M&A without dilutive funding.
Read all positive and negative factors
Positive Factors
Negative Factors
Blockbuster revenue growth
Sustained blockbuster sales and rapid patient adoption establish durable commercial scale, providing predictable product revenue to fund operations and pipeline investment. Large recurring prescription base reduces execution risk for U.S. commercialization and supports leverage of fixed infrastructure over time.
Read all positive factors
Madrigal Pharmaceuticals (MDGL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$12.18B
Dividend YieldN/A
Average Volume (3M)291.06K
Price to Earnings (P/E)―
Beta (1Y)0.26
Revenue Growth256.82%
EPS Growth29.06%
CountryUS
Employees528
SectorHealthcare
Sector Strength45
IndustryBiotechnology
Share Statistics
EPS (TTM)-12.80
Shares Outstanding23,055,658
10 Day Avg. Volume287,409
30 Day Avg. Volume291,058
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 Cap0.96
Enterprise Value/Revenue10.28
Enterprise Value/Gross Profit11.04
Enterprise Value/Ebitda-41.41
Forecast
1Y Price Target
$676.73Price Target Upside27.20% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering9
EPS Forecast (FY)-6.98
Revenue Forecast (FY)$1.49B
Madrigal Pharmaceuticals Business Overview & Revenue Model
Company Description
Madrigal Pharmaceuticals, Inc. is a biopharmaceutical company in the clinical development phase, concentrating its efforts on discovering and commercializing innovative treatments for cardiovascular, metabolic, and liver disorders. Its most advanc...
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:May 06, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 11, 2026
Earnings Call Sentiment Positive
The call conveyed a strongly positive commercial and scientific momentum: Rezdiffra has achieved blockbuster status with rapid patient growth, a materially expanding addressable market, and an increasingly diverse pipeline (including a promising siRNA asset). These positives are balanced by elevated operating expenses, one‑time business development costs, a material gross‑to‑net discount, and near‑term non‑profitability with cash modestly reduced by strategic uses. Management emphasized durable long‑term opportunity, upcoming outcomes milestones (2027–2028), and disciplined, data‑driven pipeline advancement.Positive Updates
Blockbuster Net Sales and Strong Quarterly Revenue
Trailing 12-month net sales for Rezdiffra exceeded $1.1 billion. First quarter 2026 net sales were $311.3 million, representing year-over-year growth of 127%.
Negative Updates
Net Loss and Near‑Term Profitability Pressure
Net loss for Q1 2026 was $94.4 million versus $73.2 million a year ago (≈+29%), inclusive of $54.3 million of one‑time upfront business development expenses. Management does not expect full‑year profitability in 2026 and expects Q2 to be unprofitable due to the PNPLA3 acquisition; profitability is targeted for later periods.
Read all updates
Q1-2026 Updates
Positive
Negative
Blockbuster Net Sales and Strong Quarterly Revenue
Trailing 12-month net sales for Rezdiffra exceeded $1.1 billion. First quarter 2026 net sales were $311.3 million, representing year-over-year growth of 127%.
Read all positive updates
Company Guidance
The company reiterated growth and financial guidance for 2026: Q1 net sales were $311.3M (+127% YoY) and trailing 12‑month net sales exceed $1.1B, with >42,250 active patients on therapy at quarter end (2.5x YoY) and the U.S. addressable F2/F3 market having grown ~50% from 315,000 (end‑2023) to 460,000 (end‑2025) while diagnosis is just over 10% and Rezdiffra penetration is just under 10%; management expects to steadily add patients through 2026, F4C represents ~245,000 specialists’ patients and the event‑driven outcomes readout is expected in 2027 (F2/F3 histology readout in 2028); financials include Q1 cost of sales $26.8M, R&D $108.7M (including $54.3M one‑time BD expense), SG&A $268.5M, $34M noncash stock‑based comp, and a Q1 net loss of $94.4M; they expect gross‑to‑net in the mid‑ to‑high‑30s% for the rest of 2026, full‑year R&D roughly flat with 2025, higher full‑year SG&A (with a Q2 spike tied to DTC/timing), a Q2 recording of the $25M ARO‑PNPLA3 upfront, ending Q1 cash of $817.9M, and do not expect profitability in 2026 (though they say profitability is “inevitable” thereafter).Madrigal Pharmaceuticals Financial Statement Overview
Summary
Income Statement
44
Neutral
Balance Sheet
55
Neutral
Cash Flow
34
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 1.13B | 958.40M | 180.13M | 0.00 | 0.00 | 0.00 |
| Gross Profit | 1.05B | 902.25M | 173.90M | 0.00 | 0.00 | 0.00 |
| EBITDA | -281.09M | -264.47M | -450.13M | -360.39M | -290.92M | -241.44M |
| Net Income | -309.44M | -288.28M | -465.89M | -373.63M | -295.35M | -241.85M |
Balance Sheet | ||||||
| Total Assets | 1.23B | 1.26B | 1.04B | 640.55M | 362.57M | 273.33M |
| Cash, Cash Equivalents and Short-Term Investments | 817.93M | 983.56M | 926.25M | 634.13M | 358.77M | 270.35M |
| Total Debt | 347.31M | 354.36M | 119.57M | 117.19M | 49.89M | 797.00K |
| Total Liabilities | 683.87M | 656.90M | 287.86M | 235.21M | 165.18M | 77.22M |
| Stockholders Equity | 543.45M | 602.69M | 754.38M | 405.33M | 197.39M | 196.11M |
Cash Flow | ||||||
| Free Cash Flow | -272.41M | -190.02M | -457.03M | -325.71M | -225.07M | -184.13M |
| Operating Cash Flow | -268.10M | -189.55M | -455.57M | -324.23M | -224.86M | -183.92M |
| Investing Cash Flow | 60.63M | 32.32M | -274.39M | -502.52M | 206.69M | -5.05M |
| Financing Cash Flow | 249.67M | 255.98M | 735.06M | 595.12M | 313.45M | 171.24M |
Madrigal Pharmaceuticals Technical Analysis
Positive
532.02
Price Trends
508.68
Positive
492.13
Positive
497.09
Positive
Market Momentum
6.50
Negative
57.96
Neutral
64.53
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 532.02 is above the 20-day moving average (MA) of 501.31, above the 50-day MA of 508.68, and above the 200-day MA of 497.09, indicating a bullish trend. The MACD of 6.50 indicates Negative momentum. The RSI at 57.96 is Neutral, neither overbought nor oversold. The STOCH value of 64.53 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 |
|---|---|---|---|---|---|---|---|
85 Outperform | $14.04B | 17.90 | 40.21% | ― | 3.33% | 38.64% | |
68 Neutral | $25.27B | -78.07 | -6.85% | ― | -89.16% | -84.69% | |
64 Neutral | $15.12B | -20.58 | 36.00% | ― | 355.17% | -6.09% | |
61 Neutral | $17.12B | 29.33 | -5641.90% | ― | 155.14% | ― | |
57 Neutral | $13.52B | -41.11 | -58.57% | ― | 47.40% | 32.85% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
49 Neutral | $12.18B | -41.26 | -50.15% | ― | 256.82% | 29.06% |
* Healthcare Sector Average
MDGL
Madrigal Pharmaceuticals
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Madrigal Pharmaceuticals Corporate Events
Business Operations and StrategyExecutive/Board ChangesShareholder Meetings
Madrigal Shareholders Approve 2026 Equity Compensation Plans
Positive
Jun 17, 2026
At its June 17, 2026 annual meeting, Madrigal Pharmaceuticals’ shareholders approved a new 2026 Stock Plan and a 2026 Employee Stock Purchase Plan, reinforcing the company’s equity-based compensation framework and broadening employee o...
Executive/Board ChangesShareholder Meetings
Madrigal Pharmaceuticals Reclassifies Board Ahead of 2026 Meeting
Neutral
Apr 28, 2026
On April 22, 2026, Madrigal Pharmaceuticals’ board of directors reclassified its three director classes to more evenly distribute membership ahead of the June 17, 2026 annual stockholders meeting, moving directors Julian C. Baker and Daniel ...
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.