Madrigal Pharmaceuticals Reports Strong Q1 Earnings Amid Market Challenges
Written by Emily J. Thompson, Senior Investment Analyst
Updated: Apr 23 2026
0mins
Source: Newsfilter
Madrigal Pharmaceuticals' stock fell 3.20% and hit a 20-day low amid a generally positive market, with the Nasdaq-100 and S&P 500 both showing gains.
The company reported a Q1 GAAP EPS of -$3.25, beating expectations by $0.79, alongside revenues of $311.3 million, a 126.7% year-over-year increase. This strong performance reflects robust market demand for Rezdiffra, despite ongoing challenges in penetration and diagnosis rates. Additionally, the number of active patients on Rezdiffra has grown significantly, exceeding 42,250, indicating a positive trend in market expansion.
Despite the strong earnings report, there remains a divergence in market sentiment regarding the company's future performance, which may lead to cautious investor behavior.
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Analyst Views on MDGL
Wall Street analysts forecast MDGL stock price to rise
12 Analyst Rating
10 Buy
2 Hold
0 Sell
Strong Buy
Current: 513.590
Low
527.00
Averages
636.22
High
900.00
Current: 513.590
Low
527.00
Averages
636.22
High
900.00
About MDGL
Madrigal Pharmaceuticals, Inc. is a biopharmaceutical company. The Company is focused on delivering novel therapeutics for metabolic dysfunction-associated steatohepatitis (MASH), a liver disease with high unmet medical need. The Company’s medication, Rezdiffra (resmetirom), is a once-daily, oral, liver-directed THR-b agonist designed to target key underlying causes of MASH. Rezdiffra is the medication approved by the United States Food and Drug Administration (FDA) for the treatment of MASH with moderate to advanced fibrosis (consistent with stages F2 to F3). Rezdiffra is a prescribed medicine used along with diet and exercise to treat adults with nonalcoholic steatohepatitis (NASH) with moderate to advanced liver scarring (fibrosis), but not with cirrhosis of the liver. An ongoing Phase III outcomes trial is evaluating Rezdiffra for the treatment of compensated MASH cirrhosis (consistent with stage F4c).
About the author
Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
Madrigal Pharmaceuticals Q1 2026 Earnings Call Highlights
- Strong Sales Performance: Madrigal Pharmaceuticals reported net sales of $311.3 million in Q1 2026, a remarkable 127% increase year-over-year, indicating robust market demand for Rezdiffra despite challenges of low penetration and diagnosis rates.
- Growing Patient Base: The number of active patients on Rezdiffra exceeded 42,250 by the end of Q1, with CEO Sibold noting that this growth momentum is expected to carry into Q2, reflecting the company's positive progress in market expansion.
- Pipeline Update: The recent in-licensing of ARO-PNPLA3, a clinical-stage siRNA, aims to leverage Rezdiffra as a foundation for delivering better therapies, thereby strengthening its competitive position in the market with an industry-leading pipeline.
- Adjusted Financial Outlook: CFO Dier projected that R&D expenses for the full year 2026 will remain consistent with 2025, while SG&A expenses are expected to rise, highlighting the company's ongoing investment in commercial activities and marketing efforts for Rezdiffra.
See More
Madrigal Pharmaceuticals Q1 Earnings Exceed Expectations
- Earnings Highlights: Madrigal Pharmaceuticals reported a Q1 GAAP EPS of -$3.25, beating expectations by $0.79, indicating an improving trend in the company's profitability.
- Revenue Surge: The company achieved revenues of $311.3 million, representing a 126.7% year-over-year increase, surpassing market expectations by $10.38 million, reflecting strong market performance of its products.
- Patient Growth: As of March 31, 2026, over 42,250 patients are on Rezdiffra, a 2.5x increase from Q1 2025, demonstrating continued strong physician adoption and high patient demand.
- Market Outlook: The robust earnings report and patient growth data may boost investor confidence, although there remains divergence in market sentiment regarding the company's future performance.
See More
Madrigal Pharmaceuticals Q1 Earnings Preview
- Earnings Announcement Date: Madrigal Pharmaceuticals is set to release its Q1 earnings on May 6 before market open, with a consensus EPS estimate of -$4.14, indicating significant profitability challenges ahead.
- Revenue Expectations Comparison: The projected revenue for Q1 stands at $300.92 million, up from $137.3 million in Q1 2025, suggesting growth potential, yet market confidence in profitability remains low.
- Estimate Revision Trends: Over the past three months, EPS estimates have seen no upward revisions and three downward adjustments, reflecting analysts' pessimism about the company's future performance, while revenue estimates experienced one upward and eight downward revisions, indicating concerns about growth prospects.
- Market Sentiment Analysis: Madrigal Pharmaceuticals is currently among the most shorted large-cap stocks, with a bearish market sentiment prevailing, leading investors to adopt a cautious stance that could impact stock price movements.
See More
Three Biotech Companies Worth Watching
- Krystal Biotech's Breakthrough: In 2023, Krystal Biotech received approval for Vyjuvek, a gene therapy for Dystrophic Epidermolysis Bullosa, achieving $389.1 million in revenue, a 34% year-over-year increase, indicating strong market potential in rare diseases.
- Madrigal Pharmaceuticals' FDA Approval: In 2024, Madrigal gained FDA approval for Rezdiffra, the first drug for metabolic dysfunction-associated steatohepatitis, with 2025 revenue reaching $958.4 million, a staggering 432% increase, showcasing robust growth in an emerging market.
- Exelixis' Oncology Innovations: Exelixis' Cabometyx remains the leading treatment for liver and kidney cancers, with no generic competition expected until 2030, while the company plans to launch several next-gen cancer therapies in the next five years, further solidifying its market position.
- Significant Market Potential: The combination of innovation and market demand in these three companies suggests that their stocks could yield substantial returns in the future, particularly in the ongoing developments within rare diseases and oncology.
See More
Three Biotech Stocks Worth Watching
- Krystal Biotech's Breakthrough: Focused on rare diseases, Krystal Biotech received approval for Vyjuvek, a gene therapy for Dystrophic Epidermolysis Bullosa, achieving $389.1 million in revenue in 2023, a 34% year-over-year increase, indicating strong market performance.
- Madrigal Pharmaceuticals' Market Potential: Madrigal's Rezdiffra, approved by the FDA in 2024 as the first treatment for metabolic dysfunction-associated steatohepatitis, generated $958.4 million in revenue in 2025, a staggering 432% increase, showcasing its potential in a large patient market.
- Exelixis' Innovative Drugs: Exelixis' Cabometyx, a leading treatment for liver and kidney cancers, is expected to face no generic competition until 2030, while its development of next-gen cancer therapies could further drive growth in the coming years.
- Competitive Advantages: These three companies demonstrate significant market potential and innovation capabilities, with Krystal Biotech and Madrigal expanding their product lines to enhance market share, while Exelixis maintains a strong position in oncology through robust financial performance and R&D efforts.
See More
Analysis of XBI ETF Trading Dynamics
- Price Range Fluctuation: The XBI ETF has a 52-week low of $66.66 and a high of $132.09, with the current trading price at $127.30, indicating significant volatility over the past year that may influence investor buying decisions.
- Technical Analysis Tool: Comparing the current share price to the 200-day moving average provides investors with deeper market trend insights, aiding in the formulation of more effective trading strategies to enhance investment returns.
- ETF Unit Trading Mechanism: ETFs trade like stocks, where investors buy and sell 'units' that can be created or destroyed based on demand, offering flexibility that makes ETFs an effective tool for portfolio management.
- Inflows and Outflows Monitoring: Weekly monitoring of changes in shares outstanding helps track notable inflows (new units created) or outflows (old units destroyed), which directly impacts the underlying holdings of the ETF and consequently affects overall market performance.
See More
Madrigal Pharmaceuticals Q1 2026 Earnings Call Highlights
- Strong Sales Performance: Madrigal Pharmaceuticals reported net sales of $311.3 million in Q1 2026, a remarkable 127% increase year-over-year, indicating robust market demand for Rezdiffra despite challenges of low penetration and diagnosis rates.
- Growing Patient Base: The number of active patients on Rezdiffra exceeded 42,250 by the end of Q1, with CEO Sibold noting that this growth momentum is expected to carry into Q2, reflecting the company's positive progress in market expansion.
- Pipeline Update: The recent in-licensing of ARO-PNPLA3, a clinical-stage siRNA, aims to leverage Rezdiffra as a foundation for delivering better therapies, thereby strengthening its competitive position in the market with an industry-leading pipeline.
- Adjusted Financial Outlook: CFO Dier projected that R&D expenses for the full year 2026 will remain consistent with 2025, while SG&A expenses are expected to rise, highlighting the company's ongoing investment in commercial activities and marketing efforts for Rezdiffra.
See More
Madrigal Pharmaceuticals Q1 Earnings Exceed Expectations
- Earnings Highlights: Madrigal Pharmaceuticals reported a Q1 GAAP EPS of -$3.25, beating expectations by $0.79, indicating an improving trend in the company's profitability.
- Revenue Surge: The company achieved revenues of $311.3 million, representing a 126.7% year-over-year increase, surpassing market expectations by $10.38 million, reflecting strong market performance of its products.
- Patient Growth: As of March 31, 2026, over 42,250 patients are on Rezdiffra, a 2.5x increase from Q1 2025, demonstrating continued strong physician adoption and high patient demand.
- Market Outlook: The robust earnings report and patient growth data may boost investor confidence, although there remains divergence in market sentiment regarding the company's future performance.
See More
Madrigal Pharmaceuticals Q1 Earnings Preview
- Earnings Announcement Date: Madrigal Pharmaceuticals is set to release its Q1 earnings on May 6 before market open, with a consensus EPS estimate of -$4.14, indicating significant profitability challenges ahead.
- Revenue Expectations Comparison: The projected revenue for Q1 stands at $300.92 million, up from $137.3 million in Q1 2025, suggesting growth potential, yet market confidence in profitability remains low.
- Estimate Revision Trends: Over the past three months, EPS estimates have seen no upward revisions and three downward adjustments, reflecting analysts' pessimism about the company's future performance, while revenue estimates experienced one upward and eight downward revisions, indicating concerns about growth prospects.
- Market Sentiment Analysis: Madrigal Pharmaceuticals is currently among the most shorted large-cap stocks, with a bearish market sentiment prevailing, leading investors to adopt a cautious stance that could impact stock price movements.
See More
Three Biotech Companies Worth Watching
- Krystal Biotech's Breakthrough: In 2023, Krystal Biotech received approval for Vyjuvek, a gene therapy for Dystrophic Epidermolysis Bullosa, achieving $389.1 million in revenue, a 34% year-over-year increase, indicating strong market potential in rare diseases.
- Madrigal Pharmaceuticals' FDA Approval: In 2024, Madrigal gained FDA approval for Rezdiffra, the first drug for metabolic dysfunction-associated steatohepatitis, with 2025 revenue reaching $958.4 million, a staggering 432% increase, showcasing robust growth in an emerging market.
- Exelixis' Oncology Innovations: Exelixis' Cabometyx remains the leading treatment for liver and kidney cancers, with no generic competition expected until 2030, while the company plans to launch several next-gen cancer therapies in the next five years, further solidifying its market position.
- Significant Market Potential: The combination of innovation and market demand in these three companies suggests that their stocks could yield substantial returns in the future, particularly in the ongoing developments within rare diseases and oncology.
See More
Three Biotech Stocks Worth Watching
- Krystal Biotech's Breakthrough: Focused on rare diseases, Krystal Biotech received approval for Vyjuvek, a gene therapy for Dystrophic Epidermolysis Bullosa, achieving $389.1 million in revenue in 2023, a 34% year-over-year increase, indicating strong market performance.
- Madrigal Pharmaceuticals' Market Potential: Madrigal's Rezdiffra, approved by the FDA in 2024 as the first treatment for metabolic dysfunction-associated steatohepatitis, generated $958.4 million in revenue in 2025, a staggering 432% increase, showcasing its potential in a large patient market.
- Exelixis' Innovative Drugs: Exelixis' Cabometyx, a leading treatment for liver and kidney cancers, is expected to face no generic competition until 2030, while its development of next-gen cancer therapies could further drive growth in the coming years.
- Competitive Advantages: These three companies demonstrate significant market potential and innovation capabilities, with Krystal Biotech and Madrigal expanding their product lines to enhance market share, while Exelixis maintains a strong position in oncology through robust financial performance and R&D efforts.
See More
Analysis of XBI ETF Trading Dynamics
- Price Range Fluctuation: The XBI ETF has a 52-week low of $66.66 and a high of $132.09, with the current trading price at $127.30, indicating significant volatility over the past year that may influence investor buying decisions.
- Technical Analysis Tool: Comparing the current share price to the 200-day moving average provides investors with deeper market trend insights, aiding in the formulation of more effective trading strategies to enhance investment returns.
- ETF Unit Trading Mechanism: ETFs trade like stocks, where investors buy and sell 'units' that can be created or destroyed based on demand, offering flexibility that makes ETFs an effective tool for portfolio management.
- Inflows and Outflows Monitoring: Weekly monitoring of changes in shares outstanding helps track notable inflows (new units created) or outflows (old units destroyed), which directly impacts the underlying holdings of the ETF and consequently affects overall market performance.
See More
