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Madrigal Pharmaceuticals Inc (MDGL)
NASDAQ:MDGL
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Madrigal Pharmaceuticals (MDGL) AI Stock Analysis

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MDGL

Madrigal Pharmaceuticals

(NASDAQ:MDGL)

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Neutral 47 (OpenAI - 5.2)
Rating:47Neutral
Price Target:
$500.00
▼(-8.17% Downside)
Action:Reiterated
Date:08/17/26
MDGL’s score is held down primarily by continued losses and ongoing cash burn despite rapid revenue growth and very strong gross margins. Technicals add a near-term headwind with the stock trading below key moving averages and a negative MACD. The latest earnings call improves the outlook due to strong commercial momentum and reiterated growth guidance, but near-term profitability pressure and sizable gross-to-net discounts limit the score.
Positive Factors
Rapid Rezdiffra commercialization and patient adoption
Rezdiffra is demonstrating strong commercial traction, with rapid sales and patient growth. More than 10,000 prescribers and first-line payer access support durable expansion as diagnosis improves and treatment adoption broadens.
Negative Factors
Persistent losses and negative cash flow
Revenue growth has not yet translated into profitability or self-funded operations. Continued losses and cash burn may require Madrigal to use its balance sheet or raise capital, limiting flexibility until commercial scale absorbs operating costs.
Read all positive and negative factors
Positive Factors
Negative Factors
Rapid Rezdiffra commercialization and patient adoption
Rezdiffra is demonstrating strong commercial traction, with rapid sales and patient growth. More than 10,000 prescribers and first-line payer access support durable expansion as diagnosis improves and treatment adoption broadens.
Read all positive factors

Madrigal Pharmaceuticals (MDGL) vs. SPDR S&P 500 ETF (SPY)

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 sales of its prescription drug Rezdiffra in the United States. Revenue is generated when wholesalers, specialty distributors, or pharmacies purchase product (net of estimated rebates, chargebacks, returns, di...

Madrigal Pharmaceuticals Earnings Call Summary

Earnings Call Date:May 06, 2026
(Q1-2026)
|
% Change Since: |
Next Earnings Date:Oct 29, 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
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
Strong commercialization ramp (revenue up to ~$1.28B TTM 2026) and exceptionally high gross margins (~93–97%) are major positives, but profitability and cash generation remain the key constraints. The company is still meaningfully loss-making (TTM net loss ~$325M) with negative operating cash flow (~-$198M) and negative free cash flow (~-$206M). Balance sheet is viable with positive equity (~$524M), though rising leverage (debt-to-equity ~0.64) reduces flexibility if cash burn persists.
Income Statement
46
Neutral
Balance Sheet
50
Neutral
Cash Flow
38
Negative
BreakdownTTMDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue1.28B958.40M180.13M0.000.000.00
Gross Profit1.17B902.25M173.90M0.000.000.00
EBITDA-298.76M-264.47M-450.13M-360.39M-290.92M-241.44M
Net Income-325.10M-288.28M-465.89M-373.63M-295.35M-241.85M
Balance Sheet
Total Assets1.24B1.26B1.04B640.55M362.57M273.33M
Cash, Cash Equivalents and Short-Term Investments838.75M983.56M926.25M634.13M358.77M270.35M
Total Debt347.75M354.36M119.57M117.19M49.89M797.00K
Total Liabilities720.92M656.90M287.86M235.21M165.18M77.22M
Stockholders Equity523.72M602.69M754.38M405.33M197.39M196.11M
Cash Flow
Free Cash Flow-206.28M-190.02M-457.03M-325.71M-225.07M-184.13M
Operating Cash Flow-197.72M-189.55M-455.57M-324.23M-224.86M-183.92M
Investing Cash Flow46.97M32.32M-274.39M-502.52M206.69M-5.05M
Financing Cash Flow251.04M255.98M735.06M595.12M313.45M171.24M

Madrigal Pharmaceuticals Technical Analysis

Technical Analysis Sentiment
Negative
Last Price544.51
Price Trends
50DMA
518.23
Negative
100DMA
516.52
Negative
200DMA
511.28
Negative
Market Momentum
MACD
-3.31
Positive
RSI
45.87
Neutral
STOCH
59.58
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 544.51 is above the 20-day moving average (MA) of 521.56, above the 50-day MA of 518.23, and above the 200-day MA of 511.28, indicating a bearish trend. The MACD of -3.31 indicates Positive momentum. The RSI at 45.87 is Neutral, neither overbought nor oversold. The STOCH value of 59.58 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative 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

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
78
Outperform
$12.70B15.5742.49%9.23%53.08%
68
Neutral
$15.50B26.23190.44%128.41%
64
Neutral
$26.15B-95.26-6.12%-67.58%45.61%
59
Neutral
$15.61B-22.3131.67%202.39%12.83%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
50
Neutral
$9.51B-16.54-110.84%-7.49%-98.12%
47
Neutral
$11.73B-39.38-56.65%149.04%-0.28%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
MDGL
Madrigal Pharmaceuticals
507.56
116.13
29.67%
EXEL
Exelixis
51.24
13.48
35.70%
IONS
Ionis Pharmaceuticals
57.24
13.81
31.80%
ASND
Ascendis Pharma
248.50
54.42
28.04%
BBIO
BridgeBio Pharma
79.86
30.84
62.91%
ROIV
Roivant Sciences
36.20
24.39
206.52%

Madrigal Pharmaceuticals Corporate Events

Business Operations and StrategyExecutive/Board Changes
Madrigal Pharmaceuticals Adds Renowned Leader to Board
Positive
Aug 12, 2026
On August 11, 2026, Madrigal Pharmaceuticals expanded its Board of Directors from eight to nine members and elected John C. Reed, M.D., Ph.D., as a Class II director, with his term running until the 2027 annual meeting of stockholders. Reed, curre...
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...
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.Date of analysis: Aug 17, 2026