Madrigal Pharmaceuticals (MDGL) investor relations material

Market opportunity and product positioning

• Rezdiffra addresses a high unmet need in MASH, with less than 10% of the diagnosed 315,000-patient U.S. target population currently treated.

• The disease category is expected to grow for decades, with potential for Rezdiffra to become a foundational therapy.

• Industry analogs suggest long-term penetration could reach 35%-65% of the target population.

• Consensus estimates for Rezdiffra's peak sales range from $5 billion to $10 billion, with significant long-term potential.

• The company is building a pipeline, including an oral GLP-1 fixed-dose combo, and has secured IP protection through 2045.

Commercial strategy and competitive landscape

• Focused on specialist prescribers (hepatologists, gastroenterologists), with recent expansion to endocrinologists due to demand.

• Differentiates from competitors like Novo by offering a single-indication, specialist-focused product and white-glove service.

• Adherence and persistency rates are high, with some real-world data showing up to 90% persistency at 12 months.

• Patient support and education are prioritized to ease prescription fulfillment and improve outcomes.

• Net patient additions are reported conservatively, focusing on steady growth rather than rapid acceleration.

Financial outlook and gross-to-net dynamics

• Commercial payer contracting began later than expected, with most contracts starting in Q4 2025 and full impact in 2026.

• Gross-to-net is projected to be in the high 30% range throughout 2026, with further Medicare contracting effects in 2027.

• Business mix is stable: 50%-55% commercial, 30%-35% Medicare, and the remainder Medicaid/government.

• Inventory levels remain steady, and net patient numbers reflect end-of-quarter totals, accounting for adherence and discontinuations.

• Revenue growth is expected to be steady, with acceleration possible as prescriber adoption deepens and access improves.