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Madrigal’s Earnings Call: Rezdiffra’s Success and Future Plans

Madrigal ((MDGL)) has held its Q1 earnings call. Read on for the main highlights of the call.

Madrigal Pharmaceuticals’ recent earnings call painted a picture of both triumph and challenge. The company celebrated the successful launch and impressive growth of its product, Rezdiffra, while also acknowledging the hurdles posed by increased operational expenses and uncertainties in its European market strategy.

Successful US Launch of Rezdiffra

Madrigal Pharmaceuticals has achieved a significant milestone with the US launch of Rezdiffra. The product has secured over 80% commercial payer coverage and treated more than 17,000 patients, generating $317 million in net sales within its first year. This success underscores the strong demand and effective market penetration of Rezdiffra.

Strong Q1 2025 Financial Performance

The company reported robust financial results for the first quarter of 2025, with net sales reaching $137 million. This figure represents a 33% increase from the previous quarter, despite typical Q1 challenges, highlighting the product’s strong market performance.

Significant Growth in Patient Adoption

Rezdiffra’s patient adoption has seen remarkable growth, with the number of patients increasing from 11,800 at the end of Q4 2024 to over 17,000 by the end of Q1 2025. This growth reflects the product’s efficacy and acceptance among patients and healthcare providers.

High Physician Penetration Rate

The engagement of healthcare providers with Rezdiffra is evident, with 70% of the top 6,000 target prescribers having prescribed the medication. This high penetration rate indicates strong support from the medical community.

Compelling Two-Year F4c Data

Madrigal shared promising two-year data for Rezdiffra, showing a mean reduction of 6.7 kilopascals in liver stiffness among patients. This data suggests that many patients are moving into a lower risk category for liver disease progression.

Upcoming Regulatory Decision in Europe

Madrigal is on track for a mid-year regulatory decision in Europe, with plans to launch Rezdiffra in Germany in the latter half of the year. This expansion is a critical step in the company’s growth strategy.

Strong Financial Position

The company ended Q1 2025 with a robust financial position, holding $848.1 million in cash, cash equivalents, restricted cash, and marketable securities. This financial strength supports ongoing US launch efforts and the anticipated European expansion.

Increased SG&A Expenses

Madrigal reported increased SG&A expenses for Q1 2025, totaling $167.9 million, up from $80.8 million in Q1 2024. This rise is attributed to heightened commercial launch activities and an increase in headcount.

Expected Increase in Gross to Net Discount

The company anticipates an increase in the gross to net discount throughout 2025 as payer contracting begins. This expectation is part of the evolving financial landscape for Rezdiffra.

Uncertainty in European Launch Strategy

Despite the positive outlook, Madrigal faces uncertainties regarding its European launch strategy, particularly concerning pricing and the acceptance of non-invasive testing. These challenges will need to be addressed to ensure successful market entry.

Forward-Looking Guidance

Looking ahead, Madrigal Pharmaceuticals remains optimistic about Rezdiffra’s continued success. With a strong financial foundation and a growing patient base, the company is well-positioned to support its US launch efforts and expand into the European market. The upcoming regulatory decision in Europe is a pivotal moment for the company’s international strategy.

In conclusion, Madrigal Pharmaceuticals’ earnings call reflects a company on the rise, buoyed by the successful launch of Rezdiffra and strong financial performance. While challenges remain, particularly in the European market, the company’s strategic focus and robust financial health position it well for future growth.

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