Madrigal Pharmaceuticals, Inc. (MDGL) · Nov 3, 2026 · Earnings
Beat — Diluted EPS $1.83 vs ~$0.86 loss consensus; revenue $431.3M vs ~$404.2M consensus
Madrigal’s third-quarter earnings beat expectations, with Rezdiffra sales reaching $431.3 million and a new Phase 3 F4c trial planned.
Madrigal is now a commercial-stage MASH company built around Rezdiffra, using an accelerating launch to fund the push into compensated cirrhosis, or F4c. Rezdiffra has already surpassed $1 billion in year-to-date sales, and the company is expanding its evidence base and late-stage trial footprint.
The quarter beat a fairly low bar by a wide margin. Revenue reached $431.3 million, about 6.7% above the published consensus of roughly $404.2 million, while diluted EPS was $1.83 versus an expected loss of about $0.86. The revenue beat confirms continued Rezdiffra demand; the swing to profit is the bigger surprise.
| Q3 2026 | Q3 2025 | Consensus | |
|---|---|---|---|
| Revenue (Financial Results) | $431.3M (+50%) | $287.3M | ~$404.2M |
| Diluted EPS (Financial Results) | $1.83 | $(4.01) | ~$(0.86) |
| Cash and securities (Balance Sheets) | $961.8M | — | $988.6M at Dec. 31, 2025 |
Profitability is real, but the quarter is not pure steady-state operating leverage. Madrigal reported $55.4 million of net income after a $114.2 million loss a year earlier. R&D fell sharply because the prior-year period included a one-time $117.3 million business-development expense, while SG&A rose as the company continued expanding its commercial organization and marketing. That makes the first profitable quarter an important milestone, but the durability of margins still depends on sales growth outpacing commercialization costs and Roche royalties.
The new F4c trial meaningfully extends the growth story rather than merely repeating it. MAESTRO-CSPH is planned as a second Phase 3 outcomes trial enrolling more than 2,000 patients, with initiation targeted for the first half of 2027 subject to regulatory discussions. It strengthens Madrigal’s position in the next potential indication, but it remains a development investment and does not change near-term revenue.
Bottom line: This is a clear execution beat: Rezdiffra demand is ahead of the market’s near-term benchmark, Madrigal reached profitability earlier than expected, and the company added a credible next-stage F4c growth initiative. The main caveat is that part of the earnings improvement reflects an unusually easy R&D comparison, not just mature operating leverage.
MAESTRO-CSPH initiation, expected in the first half of 2027
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