Madrigal Revenue Jumps 50% to $431.3 Million as It Turns Profitable
Key Facts
Madrigal Pharmaceuticals reported revenue of $431.3 million in the third quarter of 2026, up 50% from $287.3 million in the same period a year earlier, attributing the growth to increased demand for Rezdiffra in the United States. The results came in the quarter in which the company recorded its first quarterly profit, moving from a net loss a year earlier to net income. Net income was $55.4 million, or $1.90 per basic share and $1.83 per diluted share. The company had recorded a net loss of $114.2 million, or $4.01 per basic and diluted share, in the third quarter of 2025. The figures put the drug's sales growth alongside a clear shift in the company's financial results.
Madrigal said net sales of Rezdiffra from the start of 2026 through the end of the third quarter totaled $1.1 billion, a level the company described as giving the drug "blockbuster drug" status. The company linked this performance to the treatment's expanding use in the U.S. market, where the number of patients taking it exceeded 55,850 as of September 30, 2026. It said the number had nearly doubled compared with the third quarter of 2025, as prescribing physicians continued to adopt the treatment and patient demand rose. These indicators reflect a broadening user base alongside higher annual revenue. They also show that sales growth was accompanied by an expansion in the number of patients receiving the treatment, rather than being limited to a financial comparison.
In estimates issued before the results announcement, analysts expected third-quarter revenue of $405.3 million and a loss of 83 cents per share, according to Investing.com. Actual revenue came in above that estimate, while the company reported diluted earnings per share of $1.83. A separate estimate from Google Finance put expected revenue at $405.12 million. Revenue in the second quarter of 2026 was $364.3 million, with an 11% quarter-on-quarter increase expected for the third quarter before the results were released. Reported revenue grew 50% year over year, compared with $287.3 million in the third quarter of 2025, according to the company statement.
The sales increase was accompanied by commercial investments and higher expenses. Selling and administrative expenses totaled $265.7 million in the third quarter of 2026, compared with $209.1 million in the same period a year earlier. The company attributed the increase to continued commercial investment in Rezdiffra, including expanding its team of endocrinology specialists and a direct-to-consumer marketing campaign. Cost of sales also rose to $37.8 million from $18.1 million a year earlier. Madrigal said higher royalties payable to Roche were the main driver of this increase, alongside growth in Rezdiffra's net sales in 2026. The expense items show that expanding commercial activity increased costs as revenue grew.
The company said the addressable U.S. market for patients with metabolic dysfunction-associated steatohepatitis, in fibrosis stages F2-F3, exceeded 530,000 patients as of June 30, 2026. It added that the market was on a path to grow by more than 30% by the end of 2026. The estimate comes as the base of patients taking Rezdiffra expands; the company said it had nearly doubled year over year by September 30. At the end of September, cash and cash equivalents, restricted cash and marketable securities totaled $961.8 million, compared with $988.6 million on December 31, 2025. The liquidity balance shows a decline from its level at the end of last year as the company continues commercial investment to support the treatment's wider adoption.
Madrigal shares, listed under the ticker MDGL, closed at $431.16 in the November 2, 2026 session, according to Google Finance data. The stock opened at $430.04 and traded between a low of $425.33 and a high of $436.74 during the session. The company had announced that third-quarter results would be released before the U.S. market opened on November 3, with management set to hold a live webcast to review the results and provide a business update at 8 a.m. Eastern time that day. The company also said in its results statement that the webcast would review financial and operating results and provide a general business update. Among the clinical milestones it cited, the company expects results from the MAESTRO-NASH OUTCOMES trial in 2027 and data from the ongoing MAESTRO-NASH trial in 2028.