Core Insights - The company reported significant patient growth and net sales for its product Rezdiffra, indicating strong market performance and expansion opportunities [1][3][4] Patient Growth and Market Performance - The patient base for Rezdiffra increased to over 36,250 by the end of Q4 2025, up from over 29,500 at the end of Q3 2025, reflecting a net of new starts and discontinuations [1] - Rezdiffra achieved nearly $958 million in net sales during its first full year, with Q4 2025 net sales reaching $321 million, more than triple the prior-year quarter [3][7] - The U.S. F2/F3 target population has expanded by approximately 50% since the end of 2023, with expectations for continued double-digit growth in the market [7] Commercial Strategy and Pipeline Development - The company is focused on building the market from scratch through prescriber education, establishing care pathways, and expanding prescriber access [2] - Madrigal is developing a combination-focused pipeline with more than 10 programs, including an oral GLP-1 candidate and a DGAT2 inhibitor, with resmetirom as the anchor [6][13] - The company aims to expand into compensated MASH cirrhosis (F4c), which could potentially double the commercial opportunity if approved [9] Financial Outlook and Expenses - Management expects gross-to-net to rise to the high-30% range in 2026 due to payer contracting, with full-year 2025 gross-to-net results at the low end of the previously discussed 20%-30% range [5][17] - R&D expenses for Q4 2025 were reported at $116.3 million, with full-year expenses at $388.5 million, primarily due to business development upfront payments [23] - SG&A expenses for Q4 2025 were $240 million, reflecting ongoing support for the Rezdiffra launch [23] Cash Position and International Expansion - The company ended Q4 2025 with approximately $988.6 million in cash and equivalents, providing ample resources for ongoing launch and pipeline advancement [20] - International contributions, particularly from Germany, were negligible in 2025, with expectations for limited ex-U.S. contributions in 2026, focusing on the U.S. as the primary growth market [20]

Financial Data and Key Metrics Changes - Fourth quarter 2025 net sales reached $321.1 million, more than tripling from fourth quarter 2024 [5][23] - Full year 2025 net sales totaled $958.4 million, marking an exceptional launch by industry standards [5][23] - The gross to net impact increased from the third quarter to the fourth quarter, with a full year average at the low end of the 20%-30% range [23][24] Business Line Data and Key Metrics Changes - Rezdiffra established itself as the foundational therapy in MASH, with nearly $1 billion in net sales for its first full year [3][5] - The number of patients on Rezdiffra increased to over 36,250 by the end of the fourth quarter, up from more than 29,500 at the end of the third quarter [8][23] Market Data and Key Metrics Changes - The U.S. MASH market has grown nearly 50% since the end of 2023 and is expected to continue growing at a double-digit pace [3][9] - The target population of 315,000 representative patients seen by target specialists has expanded significantly, indicating a growing market [9] Company Strategy and Development Direction - The company aims to build a sustainable franchise around Rezdiffra, with a pipeline designed to extend leadership in the MASH category [4][5] - The strategy includes advancing combination therapies and leveraging a high-quality pipeline to address distinct patient subpopulations [12][17] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in robust net sales growth for 2026, despite anticipated increases in gross to net from contracting [24][40] - The company is well-positioned to lead in MASH, with expectations for continued patient additions and market expansion [27][63] Other Important Information - R&D expenses for 2025 were $388.5 million, primarily due to business development activities [25] - The company ended the fourth quarter with $988.6 million in cash and equivalents, providing strong resources for ongoing initiatives [26] Q&A Session Summary Question: What are the drivers of growth in diagnosed patients and expectations for category growth in 2026? - Management noted strong growth driven by increased awareness and the presence of competitors like Novo, leading to more diagnoses and a clearer path to peak [31][33] Question: What is the contribution of the Germany launch to worldwide revenues and patient numbers? - The contribution from Germany was negligible in 2025, with limited expectations for 2026 as the U.S. remains the primary market [39][40] Question: How is the company tracking blinded event rates for MAESTRO-NASH outcomes? - Management indicated that event rates are tracking as expected, with data delivery anticipated in 2027 [50] Question: What is the expected gross to net for Q1 and the rest of 2026? - The gross to net discount is expected to be in the high thirties for 2026, with broad first-line access and no step edits [57][59] Question: How important is maintaining adherence rates for revenue growth? - Management emphasized the importance of adherence, with ongoing initiatives to improve persistence rates among patients [62][66]

4Q25 Financial Results Feb. 19, 2026 NASDAQ: MDGL © 2026 Madrigal Pharmaceuticals, Inc. All rights reserved. Forward-looking Statements This presentation includes "forward-looking statements" made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, that are based on Madrigal's beliefs and assumptions and on information currently available to it but are subject to factors beyond its control. Forward-looking statements reflect management's current knowledge, assumpt ...

Core Viewpoint - Madrigal Pharmaceuticals is positioned as a leading company in the metabolic and liver disease sector, with significant accomplishments over the past two years and a strong outlook for the future [2][3]. Company Overview - Madrigal Pharmaceuticals has been recognized as one of the most consequential companies in the metabolic and liver disease space in recent years [2]. - The company is led by CEO Bill Sibold, CMO Dr. David Soergel, and CFO Mardi Dier, who are actively engaging with stakeholders to provide updates on the company's progress [2]. Strategic Focus - The company's primary mission is to lead the fight against MASH (Metabolic Associated Steatotic Hepatitis), which reflects its commitment to addressing critical health challenges in this area [4]. - Madrigal emphasizes the importance of leadership and innovation in its approach to tackling MASH, aiming to differentiate itself within the industry [4].