Madrigal revenue surges on Rezdiffra success despite earnings miss

Madrigal Pharmaceuticals (NASDAQ:MDGL), the West Conshohocken, Pennsylvania-based leader in liver disease therapies, reported fourth-quarter revenue that outpaced Wall Street estimates, driven by the explosive commercial trajectory of its flagship MASH treatment, Rezdiffra.

However, a significant spike in operating expenses resulted in a wider-than-expected loss for the period.

The biopharmaceutical firm posted a fourth-quarter net loss of $58.6 million, or $2.57 per share, failing to meet the analyst consensus of a 4-cent profit per share.

The miss was largely attributed to a surge in commercialization costs and expanded research and development as the company scales its pipeline.

Quarterly revenue reached $321.1 million, a substantial jump from the $103.3 million reported in the same period last year, exceeding the $313.4 million anticipated by analysts.

Rezdiffra, the first FDA-approved treatment for metabolic dysfunction-associated steatohepatitis (MASH), generated nearly $1 billion in its first full year of launch, with over 36,250 patients on therapy by year-end.

For the full year 2025, Madrigal reported a net loss of $288.3 million on revenue of $958.4 million.

The company ended the year with $988.6 million in cash and equivalents, bolstered by a $350 million credit facility intended to fund the upcoming launch of Rezdiffra in Europe and its entry into the MASH cirrhosis market.