Madrigal's Rezdiffra Growth Slows Even as Losses Widen
Madrigal Pharmaceuticals reported second-quarter Rezdiffra sales of $364.3 million, up 71% from a year earlier, but that growth rate marked the third straight quarterly deceleration even as net losses widened.
Madrigal Pharmaceuticals (MDGL) reported second-quarter Rezdiffra net sales of $364.3 million, up 71% from $212.8 million a year earlier and up 17% sequentially from $311.3 million in the first quarter.
The growth rate is decelerating. YoY sales gains have fallen for three consecutive quarters, from roughly 362% in the third quarter of 2024 to 127% in the first quarter of 2025 to 71% in the second quarter, as comparisons against the drug's early launch period get tougher. Patient counts show the same pattern: Madrigal treated more than 49,000 patients as of the second quarter, up from more than 42,250 in the first quarter and more than 36,250 at the end of 2024, but the year-over-year multiple compressed to about 2.1 times from 2.5 times, even as sequential patient adds ticked up to roughly 6,750 from about 6,000.
Net loss widened to $57.9 million, or $1.99 a share, from $42.3 million, or $1.50 a share, a year earlier, despite the revenue growth. The wider loss was largely due to a $25.0 million one-time business-development charge tied to pipeline expansion, worth $0.86 a share. That charge was smaller than the $54.3 million one-time upfront payment Madrigal booked in the first quarter for its Arrowhead siRNA licensing deal, a difference reflected in R&D expense of $91.2 million in the quarter, up from $54.1 million a year earlier but down from the first quarter's total that included the larger Arrowhead charge.
Operating expenses rose to $420.6 million, including $35.4 million in stock compensation, from $260.0 million a year earlier, a 62% increase that trailed the 71% revenue gain and pointed to modest operating leverage even as the company continued to post a loss. Cost of sales, however, outpaced revenue growth for the first time in recent quarters, surging to $40.0 million from $9.1 million a year earlier as higher Roche royalties on increased Rezdiffra sales combined with a write-down of work-in-process inventory. SG&A expense climbed 47% to $289.4 million from $196.9 million, linked to continued expansion of its endocrinology field force and a new direct-to-consumer marketing campaign.
Cash, cash equivalents, restricted cash and marketable securities fell to $838.9 million as of June 30 from $988.6 million at the end of 2024, a $149.7 million drawdown over two quarters. That reverses a prior buildup in which cash had risen from $802.0 million in the second quarter of 2024 to $1.1 billion by the third quarter, before the Arrowhead deal and ongoing operating losses drew the balance back down.
Madrigal's oral GLP-1 candidate, MGL-2086, entered human dosing in a Phase 1 single-ascending-dose trial in June, hitting a timeline the company had pushed back across three consecutive quarters — from an initial first-half-2025 target in the third quarter of 2024 to a second-quarter-2025 target reiterated in the fourth quarter and again in the first quarter. The company also disclosed three new resmetirom patents during the quarter: one covering an F2-F3 weight-threshold and CYP2C8 use extending to 2045, one covering rosuvastatin co-administration extending to 2042, and the first patent specific to F4c cirrhosis extending to 2042 — a broader IP filing than in prior quarters, which had centered on a single patent protecting the drug to 2045.
No new licensing or pipeline deal accompanied the second-quarter results, following the Arrowhead PNPLA3 siRNA licensing agreement in the first quarter and the ervogastat DGAT-2 inhibitor deal in the fourth quarter of 2024, suggesting a pause in business development after two straight quarters of dealmaking.