Madrigal Pharmaceuticals (MDGL) 12th Annual Cantor Fitzgerald Global Healthcare Conference summary

Key business and market highlights

• Achieved $364 million in Q2 sales and surpassed 50,000 patients on therapy by July, marking significant milestones for a specialty product at this stage.

• MASH market remains underpenetrated, with only 10% diagnosed and 10% treatment penetration, representing just 1% of the total opportunity.

• Target prescriber pool grew from 315,000 in 2023 to 460,000 by end of 2025, indicating nearly 50% growth in two years.

• Double-digit market growth is expected to continue for the foreseeable future, with the product maintaining a first-mover advantage.

• Real-world evidence shows better-than-expected patient outcomes, supporting continued robust patient additions each quarter.

Competitive landscape and access

• Introduction of GLP-1 competitors like Wegovy has not negatively impacted growth; instead, it has helped expand the market and diagnosis rates.

• Product profile—effective, well-tolerated, safe, once-daily oral—remains a key differentiator and driver of uptake.

• Achieved broad first-line access with commercial payers in 2026, with no step edits and improved utilization criteria.

• Largest gross-to-net impact occurred in 2026 due to initial contracting; further degradation expected in 2027 but at a slower rate as Medicare contracts expand.

• Ongoing efforts to maintain favorable access and gross-to-net through 2045, with a dedicated team focused on payer relationships.

Prescriber engagement and market expansion

• Surpassed 10,000 prescribers, shifting focus from breadth to depth of prescribing as familiarity and real-world experience grow.

• Depth of prescribing is increasing as physicians gain experience and as more real-world data is generated and shared.

• Diagnosis rates are expected to rise gradually, with analogs suggesting potential for over 1 million diagnosed patients in the future.

• Market education and service model refinements are ongoing to ease prescribing and patient access.