Chapter 1 · Growth
The first drug
for a disease
millions have.
No approved treatment existed before Rezdiffra. That's why the revenue ramp is so steep.
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✦ The bottom line
Madrigal sold $958M of its drug Rezdiffra in 2025, and the most recent quarter grew ~127% year-over-year — from $137M to $311M. Rezdiffra is the first and only approved drug for MASH, a fatty-liver disease that affects millions and previously had no treatment. A first-mover in a wide-open market grows like this.
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✦ Teach me
Why a first-mover ramps so fast
When a drug is the first approved for a common disease, there's a backlog of patients and doctors waiting for anything to prescribe. Revenue can ramp far faster than a normal product launch because the demand was already there — it just had nowhere to go.
MASH (a serious form of fatty-liver disease) is exactly this: millions of patients, and until 2024, no approved medicine. Rezdiffra walked into an empty market.
Wall Street calls this
Product revenue / first-mover launch
First-mover ramps are thrilling but they invite competition. The two questions that follow: how *big* can this get, and how long until rivals show up?
Revenue · most recent quarter vs. a year earlier
Q1 2026 revenue of $311M, up from $137M a year earlier. Rezdiffra is still early in its launch, and the patient backlog for a first-ever MASH treatment is enormous.
Source · 10-Q · Results of Operations · Q1 2026 · Filed May 6, 2026
Total revenue · fiscal year 2025
Approaching $1B in only its second year on the market — essentially all from a single drug, Rezdiffra.
Source · 10-K · Results of Operations · FY2025 · Filed Feb 19, 2026