Summary of Madrigal Pharmaceuticals FY Conference Call Company Overview - **Company**: Madrigal Pharmaceuticals (NasdaqGS:MDGL) - **Product**: Rezdiffra, a treatment for Metabolic Associated Steatotic Hepatitis (MASH) Key Points Financial Performance - Achieved a **$1 billion run rate** with **$287.3 million in sales** in the last quarter, indicating strong market uptake [2][20] - Over **10,000 prescribers** and **29,500 patients** on the drug, with a penetration rate of just under **10%** [2][20] - Projected revenue for **2026** is **$1.45 billion**, representing a **50% year-over-year growth** [26] Market Access and Payer Contracts - Secured favorable **payer contracting** for **2026**, ensuring first-line access with no step-throughs and improved utilization management criteria [3][20] - Gross-to-net discount expected to be in the **20%-30% range for 2025**, increasing to the **high 30% range for 2026** [21][22] Clinical Data and Product Efficacy - New data presented at the **AASLD conference** showed that discontinuation of Rezdiffra leads to a quick return of symptoms, emphasizing the need for chronic therapy [4][5] - Efficacy data from the **F4C population** showed a **decrease in liver stiffness of over 7 kPa**, providing confidence for the upcoming **MAESTRO-NASH outcomes study** in 2027 [6][8] Expansion into Endocrinology - Plans to expand focus from specialty GI and hepatologists to include **endocrinologists**, with a dedicated effort towards this specialty [10][12] - Approximately **2,000 high-target endocrinologists** have shown interest in prescribing Rezdiffra, indicating a potential market opportunity [12][13] Research and Development - Continued investment in **R&D** and **SG&A** to support the launch and pipeline development, with an increase in expenses expected [27] - The company is exploring **business development opportunities** to maintain leadership in the MASH space, including a recent deal for an oral GLP-1 asset [33][34] Future Outlook - The company believes it is at the beginning of a long growth trajectory, with significant unmet needs in the MASH market [41][42] - The potential for **multiple products** in the MASH category, with a strong pipeline and patent protection extending to **2045** [41][42] Additional Insights - The company has achieved **80% commercial coverage** within six months of launch, indicating strong market access [31] - There is a focus on maintaining excellent access for patients while navigating the complexities of payer contracts [20][21] This summary encapsulates the key insights and strategic directions discussed during the conference call, highlighting Madrigal Pharmaceuticals' strong market position and future growth potential in the MASH treatment landscape.