Madrigal Pharmaceuticals (MDGL) Q2 2026 earnings summary

Executive summary

• Rezdiffra net sales reached $364.3 million in Q2 2026, up 71% year-over-year, with over 49,000 active patients at quarter-end and surpassing 50,000 in July, reflecting strong launch execution and market demand.

• Trailing 12-month net sales for Rezdiffra approached $1.3 billion, driven by robust U.S. growth and negligible European contribution due to reimbursement challenges.

• The company is advancing a leading MASH pipeline with over 10 programs, including four clinical-stage assets, new licenses for GLP-1 and other targets, and multiple combination strategies.

• Expanded intellectual property with three new patents for Rezdiffra, including F2-F3 and F4C indications, extending protection into the 2040s.

• Ongoing Phase 3 and Phase 1 trials aim to expand Rezdiffra's indications and support full regulatory approvals.

Financial highlights

• Q2 2026 net sales: $364.3 million, up 71% year-over-year; six-month revenue up 93% to $675.6 million.

• Net loss for Q2 2026 was $57.9 million ($1.99 per share), compared to $42.3 million ($1.50 per share) in Q2 2025, including a $25 million one-time business development expense.

• Operating expenses rose to $420.6 million from $260.0 million year-over-year, including $35.4 million in non-cash stock-based compensation.

• Cost of sales: $40 million, up from $9.1 million year-over-year, driven by increased royalties and inventory write-down.

• Cash, cash equivalents, and marketable securities at $838.9 million at Q2 end.

Outlook and guidance

• Expectation for continued robust sales and steady patient growth through 2026, with comfort around consensus quarterly growth rates.

• Full-year 2026 R&D expenses projected to be similar to 2025, inclusive of one-time payments.

• SG&A expenses expected to increase in 2026 due to annualization of sales force and ongoing commercial support.

• Management expects continued losses until Rezdiffra and pipeline assets generate sufficient revenue.

• Full FDA and EMA approvals for Rezdiffra depend on ongoing outcomes trials, with key data expected in 2027–2028.