Madrigal Pharmaceuticals

What Madrigal Pharmaceuticals does

Madrigal Pharmaceuticals, Inc. is a publicly traded biopharmaceutical company (NASDAQ: MDGL) headquartered in Conshohocken, Pennsylvania, that develops and commercializes therapeutics for metabolic dysfunction-associated steatohepatitis (MASH) and related cardiovascular-metabolic diseases. Founded in 2008 by Rebecca Taub, M.D. and IPO'd on NASDAQ in 2016, the company spent the bulk of its pre-commercial history advancing a single liver-directed, oral, once-daily, beta-selective thyroid hormone receptor (THR-β) agonist — resmetirom — through Phase 1 (2011), Phase 2 (2016–2018), and the pivotal Phase 3 MAESTRO-NASH trial (initiated 2019, topline 2022). Resmetirom was approved by the FDA in March 2024 under accelerated approval and commercialized in the U.S. as Rezdiffra starting April 2024, followed by European Commission conditional marketing authorization in August 2025 and launch in Germany in September 2025. Rezdiffra remains the first and only approved therapy for MASH with moderate to advanced liver fibrosis (F2-F3) in both the U.S. and EU, with intellectual property protection extending to 2045.

Madrigal's commercial offering is anchored on Rezdiffra and supported by an integrated patient and physician services stack: the Madrigal Patient Support® program (copay assistance, affordability, education), Madrigal Medical/Madrigal Medical Affairs (HCP education at madrigalmedical.com, Defuse MASH and Melody platforms), the Taking on Fatty Liver & MASH patient-education site, and the Be Your Liver's #1 Fan awareness campaign. Distribution is handled through a specialty pharmaceutical sales force targeting hepatologists and liver specialists, with country-specific operations in Germany, Italy, Spain, the U.K., and a Swiss international headquarters. The company is actively building a combination MASH pipeline, having in-licensed an oral GLP-1 (CSPC, July 2025), a DGAT-2 inhibitor plus two MASH assets (Pfizer's ervogastat, January 2026), six preclinical siRNA programs (Ribo/Ribocure, February 2026), and the ARO-PNPLA3 siRNA asset (Arrowhead, May 2026), bringing the pipeline to more than 10 programs designed to be combined with or extend Rezdiffra.

Madrigal generates revenue almost entirely from Rezdiffra net product sales (FY2025: $958.4M, +432% YoY) at a 93% gross profit margin, with quarterly cadence demonstrating continued growth (Q4 2025: $321.1M, +211% YoY; Q1 2026: $311.3M, +127% YoY). The company has funded operations through a combination of post-IPO equity raises ($159M in 2022, $500M in 2023, $690M in 2024) and a $500M senior secured credit facility from Blue Owl Capital in July 2025. Pricing is not publicly disclosed but is supported by a copay-assistance and patient-access infrastructure. Leadership is led by CEO Bill Sibold (joined September 2023, ex-Sanofi EVP Specialty Care), CMO David Soergel (ex-Novartis cardiovascular/metabolism development head), CFO Mardi Dier, and a Baker Bros.-anchored board with Chairman Julian C. Baker.

Name

Madrigal Pharmaceuticals

Legal name

Madrigal Pharmaceuticals, Inc.

Website

https://madrigalpharma.com

Company type

Public

Founded year

2008

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Madrigal Pharmaceuticals is a biopharmaceutical company developing and commercializing resmetirom (Rezdiffra), the first FDA- and EU-approved oral THR-β agonist for adults with MASH with moderate to advanced liver fibrosis. It sells via a specialty sales force in the U.S. and select EU markets while building a combination MASH pipeline.

Ownership category

akta.pro rank

Product category

Specialty Biopharmaceuticals / Metabolic Liver Disease Therapeutics

NAICS

Pharmaceutical and Medicine Manufacturing (3254)

SIC

Pharmaceutical Preparations (2834)

akta.pro industry

PRIMARYHLAIAIAL

Rare Gastroenterology & Hepatology Disorder Therapies

Healthcare & Life Sciences/Pharmaceuticals/Orphan & Rare Disease Pharmaceuticals

SECONDARYHLAIAGAC

Theranostic Radiopharmaceutical Platforms (Paired Dx/Tx)

Healthcare & Life Sciences/Pharmaceuticals/Radiopharmaceuticals & Nuclear Medicine

SECONDARYHLAIALAA

Drug Discovery (Target ID/Validation & Hit Discovery)

Healthcare & Life Sciences/Pharmaceuticals/Pharmaceutical Research and Development

Keywords

• MASH therapeutics
• Liver fibrosis treatment
• Specialty biopharmaceuticals
• Metabolic disease drugs
• Thyroid receptor agonist

Headquarters

HQ city

Conshohocken

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Marketing or Sales, Personnel, Operations, Supply Chain

Revenue model

1. Rezdiffra (resmetirom) net product sales: Primary revenue stream from commercial sales of Rezdiffra, the first FDA- and European Commission-approved treatment for MASH with moderate to advanced fibrosis. Full-year 2025 net sales reached $958.4 million, with Q4 2025 net sales of $321.1 million (up 211% YoY) and Q1 2026 net sales of $311.3 million (up 127% YoY). Generated at 93% gross profit margin. Rezdiffra launched in Germany in September 2025 following EU conditional marketing authorization.
2. MASH pipeline licensing/milestone economics: Future revenue potential from in-licensed pipeline assets including milestone payments and royalties tied to development progress of siRNA programs (Ribo), ARO-PNPLA3 (Arrowhead), ervogastat (Pfizer), and MGL-2086 (CSPC); however, these are primarily expense/investment items rather than near-term revenue.

Pricing tiers

Go-to-market motion4 records

Core offering

Madrigal Pharmaceuticals develops and commercializes Rezdiffra (resmetirom), an oral, once-daily, liver-directed small-molecule selective thyroid hormone receptor-beta (THR-β) agonist that is the first U.S. FDA- and European Commission-approved treatment for adults with MASH (formerly NASH) with moderate to advanced liver fibrosis (F2-F3). The company is building a MASH combination-therapy pipeline that layers THR-β agonism with in-licensed mechanisms including siRNA gene-silencing (Arrowhead, Ribo), DGAT-2 inhibition (Pfizer's ervogastat), and oral GLP-1 receptor agonism (CSPC's MGL-2086).

Product overview

Madrigal Pharmaceuticals is a biopharmaceutical company whose commercial offering centers on a single integrated product portfolio anchored by Rezdiffra (resmetirom), the first U.S. FDA- and European Commission-approved oral THR-β agonist treatment for adults with MASH (formerly NASH) with moderate to advanced liver fibrosis. Rezdiffra is the only approved therapy in this indication in both the U.S. and EU and is supported by a layered commercial architecture comprising the Madrigal Patient Support® program (affordability, copay assistance, and education for patients), the Madrigal Medical / Madrigal Medical Affairs platform for healthcare professionals (madrigalmedical.com and the Defuse MASH and Melody education sites), the Taking on Fatty Liver & MASH patient-education site, and the Be Your Liver's #1 Fan awareness campaign. The product is currently positioned as a single approved product plus pipeline, but the company has executed multiple in-licensing deals (ervogastat from Pfizer, ARO-PNPLA3 from Arrowhead, MGL-2086 from CSPC, and six siRNA programs from Ribo/Ribocure) and is actively building a combination-therapy pipeline — including ervogastat/resmetirom, ARO-PNPLA3/resmetirom, MGL-2086/resmetirom, and siRNA/resmetirom combination candidates — designed to be paired with Rezdiffra to address the full spectrum of MASH patient needs.

Differentiator

Problem solved

Functional benefit

Brands

• Rezdiffra: FDA- and European Commission-approved oral THR-β agonist (resmetirom) for the treatment of MASH with moderate to advanced liver fibrosis; the company's first and only approved product.
• Madrigal Patient Support
• Madrigal Corporate Giving

Products and services

• Rezdiffra (resmetirom) Oral, once-daily, liver-directed, small-molecule selective thyroid hormone receptor-beta (THR-β) agonist. The first U.S. FDA- and European Commission-approved treatment for adults with MASH (formerly NASH) with moderate to advanced liver fibrosis (F2-F3). Approved under accelerated approval based on improvement of MASH and fibrosis. Full-year 2025 net sales reached $958.4 million, generated at 93% gross profit margin.
• Madrigal Patient Support® Registered-trademark patient support program offering copay assistance, affordability programs for uninsured/underinsured patients, and patient education to support patients on Rezdiffra throughout their treatment journey.

Segments1 record

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• Eli Lilly: Pharma incumbent with tirzepatide (Mounjaro/Zepbound) and retatrutide in MASH development; large market cap and commercial scale pose a major competitive threat to Madrigal's specialty positioning.
• Novo Nordisk: Global diabetes/obesity leader with semaglutide (Wegovy/Ozempic) advancing in MASH Phase 3 (ESSENCE); could reshape standard of care and pressure Rezdiffra positioning with massive commercial reach.
• Bristol-Myers Squibb: Large-cap pharma with historic hepatology franchise (via Celgene) and ongoing cardiometabolic R&D; comparable specialty-care commercial organization and an experienced international footprint that overlaps Madrigal's launch geographies.

Direct peers

• 89bio: MASH-focused biopharma developing pegozafermin (FGF21 analog) with Phase 3 ENLIGHTEN program; competes head-to-head with Rezdiffra in moderate-to-advanced MASH fibrosis.
• Viking Therapeutics: Clinical-stage biopharma developing VK2809, an oral THR-β agonist for MASH in the same mechanism class as resmetirom, plus an oral GLP-1/GIP dual agonist. The closest mechanistic competitor to Madrigal's core asset and pipeline.
• Akero Therapeutics: Late-stage MASH-focused biopharma developing efruxifermin (FGF21 analog) with Phase 3 HARMONY data; directly competing for share of the F2/F3 MASH market that Rezdiffra currently leads.

Emerging players

• Inventiva: Late-stage MASH-focused biopharma developing lanifibranor (pan-PPAR agonist); competes in the same F2/F3 MASH regulatory pathway as Rezdiffra.
• Terns Pharmaceuticals: Developing TERN-501, an oral THR-β agonist for MASH, plus TERN-601 oral GLP-1 — a direct mechanism overlap with both Madrigal's resmetirom and its CSPC-licensed GLP-1 program.

Others

• Arrowhead Pharmaceuticals: siRNA platform company that licensed ARO-PNPLA3 to Madrigal for combination development; a platform/licensing partner and emerging liver-targeted RNAi competitor.
• Pfizer: Global pharma that licensed ervogastat (DGAT-2 inhibitor) to Madrigal in January 2026; remains a strategic licensor rather than direct MASH competitor following its exit from primary MASH development.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xx.com/MadrigalPharma
• LinkedInlinkedin.com/company/madrigal-pharmaceuticals-inc-

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles19 records

Subsidiaries1 record

Funding overview

Funding rounds9 records

Investors3 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Madrigal Pharmaceuticals