Madrigal Pharmaceuticals, Inc. Common Stock 12th Annual Cantor Fitzgerald Global Healthcare Conference

Yeah. Well, first of all, thanks for having us, Prakhar. We are really happy to be here. Q2 was a great quarter for us. If you look at it from any of the metrics that we share, starting with $364 million in sales, that puts us in a very elite group. When you take out some of the already mega blockbusters that exist, there's very few companies that could put up a quarter like that, with some differences, and I will get to that in a second. We also announced that we had greater than 49,000 patients. That was the end of Q2, but we also said that we crossed the 50,000 mark in July, which is a big. It is a significant milestone when you cross 50,000.

Now, the other piece, which is really interesting, and this is getting a little bit more to the what's underappreciated, I think that there's still a lack of appreciation for the market dynamics that exist in MASH. That 50,000 and that 364 million, just to put in context, we are in a disease that's about 10% diagnosed today and 10% penetration. That's 1% of the opportunity. We are at the very beginning of what could be a big market, and the market growth dynamics are certainly exceptional. We reported at the end of 2023 that there was about 315,000 patients that were sitting in the practices that we were going to be calling on, our target prescribers, and that number grew to 460,000 at the end of 2025, almost 50% growth in two years.

What we're seeing through the first half of 2026 is very robust market growth that's continuing. We said that we expect double-digit market growth for the foreseeable future, and that's certainly the case. I think the market is treating us at times like it's a mature market where you are in a zero-sum game for market share, et cetera. Instead of looking and saying, "This is a lot like some specialty markets that evolved over 20 to 30 years, RA, psoriasis, IBD," and those have become $20, even $30 billion markets. We feel that that's what's going to happen with the MASH market. The difference, we're the leaders, we have a first-mover advantage, and because of the success of the product, we've now built a pipeline which really leads to longer-term growth and success as well.

I think that it's sometimes you look at something and say, "Is it too good to be true?" Well, this is not too good to be true.

Yeah. Well, look, a couple things. I think anytime you add a competitor or another launch to a market, it certainly helps with the growth of that market. We are seeing that. As I said, we are seeing a really robust growth continuing with MASH, with diagnosis, and Wegovy has helped that. What it has not done is it has not had any impact on the growth of Rezdiffra, and I think that really comes down to profiles. The Rezdiffra profile, you often hear me refer to it as kind of a holy grail profile, an effective, well-tolerated, safe, once-a-day pill. That has kind of been the gold standard, at least in my 35-year career experience so far, and that is what I think is driving a lot of the uptake of Rezdiffra. People are seeing that it has got a great profile, and even more importantly, the real-world evidence looks really good.

I think we look better than we did in clinical trials. That is the report that we got from physicians constantly are saying, "Patients are doing really well, even better than I would have expected." So all of that leads to this steadily adding comment that we have been making really for a number of quarters now that we have steadily added and expect to continue to steadily add patients, which is what we are going for here. You cannot fight certain dynamics of a new market. Rarely, and in fact, I do not think I have ever seen in my career where first product launches and every single patient just gets treated out of the gates. It takes time. Each physician, each prescriber has to go through their own checklist. They have to make sure they have got the resource to pull through a prescription.

They have got to make sure they know how to identify, how they source, how they create pathways. So it just takes some time. That is why we use benchmarking so frequently in our launch metrics, and on all the key metrics, we are at or near the top of those various metrics against other really successful specialty products.

Yeah. Look, as I said, some of that's just on a gradually you increase that diagnosis rate. Let me start with, that's why we were so specific and have been so specific about what the diagnosed population is that's at our target prescribers. Because that's ultimately what is the opportunity immediately in front of you. I'll get to the diagnosis in a second, but when you look at the 315 growing to 460 and growing well beyond that in itself represents an opportunity, which is a big specialty market if you were not to at all increase the diagnosis rate. So it's a way to give surety that, we have multiple paths to victory, so to speak. Now, when you think about diagnosis rates, it really depends. You look at the real high end, cystic fibrosis is over 75%.