Madrigal Pharmaceuticals, Inc. Common Stock Canaccord Genuity's 46th Annual Growth Conference
Review the key takeaways and the transcript of this earnings call.
- Madrigal Pharmaceuticals reported excellent commercial growth for Rezdiffra since its launch in Q1 2024, with Q2 revenue of $364 million, a 71% year-over-year increase.
- The company has over 49,000 active patients on Rezdiffra as of Q2 2026 and is on a $1.3 billion trailing 12-month revenue run rate, positioning the drug as a potential megablocker.
- Madrigal's pipeline expanded from one drug to ten assets in just over a year, including a GLP-1 small molecule agonist (2086), a DGAT2 inhibitor (Vagistat), an siRNA targeting PNPLA3, and additional undisclosed RNA therapies.
- The company highlighted the broad efficacy of Rezdiffra across all patient subtypes and its favorable safety and tolerability profile, maintaining leadership despite new competitors like Wegovy.
- Madrigal emphasized the cardiometabolic benefits of Rezdiffra, including reductions in LDL-C, Lp(a), and triglycerides, which may reduce cardiovascular risk in NASH patients.
- Two ongoing phase 3 studies include the Maestro NASH 54-month long-term data expected in 2028 and an event-driven outcomes study in F4 patients, both potentially leading to full approvals and label expansions.
- The company launched Rezdiffra in Europe, including Germany and the UK, but expects negligible sales in 2026 due to reimbursement challenges related to the US MFN strategy.
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Transcript
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Hi, good afternoon, everyone. My name is Edward Nash, senior biotech analyst here at Canaccord Genuity. It is my pleasure to have with us today the management team for Madrigal Pharmaceuticals. Joining us from the company, we have Mardi C. Dier, the Chief Financial Officer, Carole Huntsman, Chief Commercial Officer, and we also have David Soergel, who is the Chief Medical Officer. Thank you all for joining us today.
Thank you. Thank you. At least in the biotech world, usually I would say Madrigal doesn't need any introductions because they were the company to get the first drug approved for a very large indication and out there known as MASH.
You've had a really impressive second quarter, and with continued strong growth. Although the company does not provide specific revenue guidance, could you maybe talk to us a little bit about the commercial growth of Rezdiffra since its launch in April of 2024, and how Madrigal positions Rezdiffra from a perspective of the long-term expectations?
Yeah. Great. Thanks, Ed, and thanks for having us. We really appreciate being here. I'll take a stab at answering that question. At Madrigal, we've had excellent commercial growth since our launch in the first quarter of 2024, and we're focused very much on our two top priorities, which is building value for Rezdiffra, getting Rezdiffra to as many patients as we can, and building our pipeline so we can maintain our leadership position in MASH. If we talk about the quarter specifically, we announced on 2Q at the end of July, and we had excellent top-line growth. We announced $364 million in revenue, which was 71% increase year over year, looking at the same quarter a year ago. If you look at our trailing 12 months in revenue, we're on a run rate of approximately $1.3 billion. That's only after nine quarters of launch.
This is putting us on a trajectory of a mega blockbuster, which is exactly what we think Rezdiffra is. We do give KPIs every quarter, and we look at our patient adds and how many patients that we have on Rezdiffra. Nine quarters in, and we look at this as active patients at the end of each quarter. At the end of Q2 2026, we had over 49,000 patients on Rezdiffra. We're very excited about achieving a significant threshold. We crossed the 50,000 patient mark in the early July time point. At any launch, specialty or otherwise, that's a significant milestone. We really think that the growth of the company will continue, and we talked a little bit about what we expect for third and fourth quarter.
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