Key Highlights

  • Diluted EPS of USD 1.83 compared with the USD 0.86 consensus loss estimate and a USD 4.01 loss last year.
  • Net product Revenue rose 50% to USD 431.3 million, topping the consensus estimate of USD 404.17 million.
  • Research and development expense fell 59% to USD 71.8 million, while selling, general and administrative expense rose 27%.
  • Cash, restricted cash and marketable securities totaled USD 961.8 million, down from USD 988.6 million at year end 2025.

Madrigal Pharmaceuticals, Inc. (NASDAQ:MDGL) reported third quarter 2026 diluted EPS of USD 1.83 on Net Income of USD 55.4 million, a swing from a net loss of USD 114.2 million, or USD 4.01 per share, a year earlier. The consensus estimate had called for a loss of USD 0.86 per share. Net product revenue from Rezdiffra reached USD 431.3 million, up 50% from USD 287.3 million and above a consensus estimate of USD 404.17 million. The company attributed the increase to higher Demand for Rezdiffra in the United States.

Operating Leverage as One Time Costs Roll Off

Income from operations was USD 56.0 million against a loss of USD 114.0 million. Research and Development expense fell USD 102.2 million to USD 71.8 million because the prior year quarter carried USD 117.3 million of one time upfront Business development costs, partly offset by higher clinical development costs and a USD 7.3 million rise in compensation. Selling, general and administrative expense rose USD 56.6 million to USD 265.7 million, with professional fees and other external spending up USD 21.1 million on direct to consumer Marketing and compensation up USD 29.7 million for the endocrinology field force expanded from the fourth quarter of 2025. Cost of sales more than doubled to USD 37.8 million on higher royalties payable to Roche. Over nine months, net product revenue was USD 1,106.9 million versus USD 637.3 million, and the net loss narrowed to USD 96.9 million from USD 229.7 million.

Trial Timelines and Financing Terms

Rezdiffra is approved by the FDA and holds conditional marketing authorization from the European Commission, and it launched in Germany in September 2025. The company said data from the MAESTRO-NASH OUTCOMES trial in compensated MASH cirrhosis are scheduled for late 2027, and outcomes data from MAESTRO-NASH for 2028. It plans to start the Phase 3 MAESTRO-CSPH trial, which would enroll more than 2,000 patients, in the first half of 2027, pending regulatory discussions, with results in the early 2030s. Debt rests on a senior secured Credit Facility of up to USD 500.0 million entered in July 2025, which carries a Liquidity covenant. Management said it may need additional Capital over the long term, and USD 300.0 million remains available under its at-the-market sales agreement.

Cash, Cash Flow and Interest Against Prior Marks

Cash, restricted cash and marketable securities of USD 961.8 million compare with USD 988.6 million at December 31, 2025. Net cash used in Operating Activities was USD 23.6 million over nine months against USD 56.1 million a year earlier, while net cash from financing fell to USD 15.4 million from USD 247.0 million. The accumulated Deficit stood at about USD 2,187.4 million. Interest expense was USD 8.1 million against USD 7.5 million, and interest income USD 8.2 million against USD 10.3 million. Third quarter net income of USD 55.4 million compares with the USD 96.9 million nine month net loss, and no shares were sold under the at-the-market agreement in 2026.