MDGL Stock: Insider Activity, Filings & Research

Madrigal Pharmaceuticals, Inc. (MDGL) — Drillr’s hub for MDGL insider activity, SEC filings, earnings signals and AI research. Over the trailing 3 months, MDGL insiders filed 0 open-market buys and 13 sales (SEC Form 4).

Sentiment

0/100

Buys (3m)

Sells (3m)

Net (3m)

-$3.9M

Insider trades by month Buys Sells

Nov

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Jun

Context3-month price +12.3%Institutions accumulating (13F)

Date	Insider	Type	Shares	Price
Jun 1, 2026	Soergel Davidofficer: Chief Medical Officer	Sell	1,042	$495.74
May 22, 2026	Levy Richard Sdirector	Sell	80	$519.98
May 22, 2026	Levy Richard Sdirector	Sell	782	$518.76
May 22, 2026	Levy Richard Sdirector	Sell	320	$508.24
May 22, 2026	Levy Richard Sdirector	Sell	723	$516.87
May 22, 2026	Levy Richard Sdirector	Sell	610	$511.40
May 22, 2026	Levy Richard Sdirector	Sell	343	$514.67
May 22, 2026	Levy Richard Sdirector	Sell	657	$515.92
May 22, 2026	Levy Richard Sdirector	Sell	439	$512.50
May 22, 2026	Levy Richard Sdirector	Sell	151	$510.36
May 22, 2026	Levy Richard Sdirector	Sell	40	$506.68
May 22, 2026	Levy Richard Sdirector	Sell	1,497	$517.59
May 18, 2026	Soergel Davidofficer: Chief Medical Officer	Sell	844	$515.90
Mar 6, 2026	Kelley Shannon Tofficer: General Counsel	Sell	360	$431.94
Mar 6, 2026	Sibold William Johndirector, officer: President and CEO	Sell	1,663	$431.94

Source: MDGL SEC Form 4 filings, latest Jun 1, 2026. For informational purposes only — not investment advice.

Overview

Madrigal Pharmaceuticals, Inc. (NASDAQ:MDGL) is a clinical-stage biopharmaceutical company founded in 2007 and headquartered in West Conshohocken, Pennsylvania. The company focuses on developing and commercializing therapeutic treatments for cardiovascular, metabolic, and liver diseases. After nearly two decades of clinical development, Madrigal achieved a significant milestone in 2024 with the FDA approval and commercial launch of Rezdiffra (resmetirom), marking the first approved treatment for non-alcoholic steatohepatitis (NASH), a serious liver condition. The company has transitioned from a pure research and development organization to a commercial-stage biopharmaceutical company with established revenue streams and plans for international expansion.

Business

Madrigal operates in the specialized field of hepatology, focusing primarily on non-alcoholic steatohepatitis (NASH), a progressive liver disease that represents the inflammatory form of non-alcoholic fatty liver disease (NAFLD). NASH occurs when excess fat accumulation in the liver leads to inflammation and scarring (fibrosis), potentially progressing to cirrhosis, liver failure, or liver cancer if left untreated. The condition affects millions of people worldwide and has historically lacked approved pharmaceutical treatments. The company's flagship product is Rezdiffra (resmetirom), a liver-directed selective thyroid hormone receptor-β agonist. This medication works by mimicking the action of thyroid hormones specifically in liver tissue, helping to reduce liver fat, inflammation, and fibrosis. Resmetirom targets the underlying metabolic dysfunction that drives NASH progression, offering patients the first FDA-approved therapeutic option for this condition. Madrigal's current commercial focus centers on patients with moderate to advanced liver fibrosis (stages F2-F3), representing approximately 315,000 diagnosed patients in the United States. The company is also advancing clinical trials for patients with compensated cirrhosis (F4c stage), which would significantly expand the addressable patient population. Additionally, Madrigal has a backup compound, MGL-3745, in development as a potential follow-on therapy to resmetirom. The company generates revenue entirely from Rezdiffra sales, having achieved $180.1 million in net sales for 2024, with quarterly growth accelerating from $14.6 million in Q2 to $137.3 million in Q1 2025. This represents the company's transition from a pre-revenue clinical-stage entity to a commercial organization with established market presence.

Revenue model

Madrigal generates revenue through direct pharmaceutical product sales of Rezdiffra to patients with NASH. The company employs a traditional pharmaceutical commercial model, selling through specialty pharmacies and hospital systems to reach patients prescribed the medication by hepatologists, gastroenterologists, and other specialists treating liver diseases. The company's paying customers are primarily commercial insurance plans, government payers (Medicaid and Medicare), and patients paying out-of-pocket. Madrigal has successfully secured coverage from over 80% of commercial lives, with Medicare coverage beginning January 2025. The company has also established patient support programs called BRIDGE and PATH to help patients access the medication and manage costs. Rezdiffra is positioned as a specialty pharmaceutical product with pricing typical of innovative treatments for serious chronic conditions. The company expects gross-to-net adjustments to increase as the commercial launch matures, reflecting typical pharmaceutical industry dynamics including rebates, discounts, and patient assistance programs. Several factors influence Madrigal's revenue potential and margins. Positive factors include the large unmet medical need with 315,000 diagnosed F2-F3 NASH patients and minimal current market penetration (less than 4%), the first-mover advantage as the only approved NASH therapy, potential label expansion to cirrhotic patients which could double the addressable market, and planned European launch in mid-2025. Challenging factors include potential competition from GLP-1 diabetes/obesity medications that may receive NASH indications, the need for ongoing clinical monitoring and patient education, typical pharmaceutical pricing pressures from payers, and the requirement for specialized diagnostic testing to identify appropriate patients. The company's commercial success depends heavily on continued physician adoption, patient persistence on therapy, and successful navigation of competitive threats from well-established pharmaceutical companies developing competing NASH treatments.

Competitive moat

Madrigal's competitive moat is moderately strong but potentially vulnerable to future competition. The company's primary defensive position stems from its first-mover advantage as the only FDA-approved NASH treatment, which provides significant benefits in physician relationships, payer coverage establishment, and market education. This head start allows Madrigal to build deep relationships with the approximately 6,000 target prescribers and establish treatment protocols before competitors enter the market. The company's clinical expertise and regulatory pathway knowledge in NASH represent additional moat elements, as Madrigal has navigated the complex regulatory requirements for this novel indication and built specialized commercial infrastructure. The established payer coverage and patient support programs create switching costs and operational barriers for potential competitors. However, Madrigal's moat faces significant long-term challenges. The company operates in a large pharmaceutical market where major players like Novo Nordisk are developing competing therapies, particularly GLP-1 receptor agonists that may offer broader metabolic benefits beyond liver-specific effects. These competitors possess substantially greater financial resources, established commercial infrastructure, and existing relationships with relevant physician specialties. The NASH market's size and unmet medical need make it an attractive target for multiple pharmaceutical companies, suggesting inevitable competitive pressure. Additionally, Madrigal's moat is primarily time-based rather than technology-based, as the company's thyroid hormone receptor mechanism, while innovative, is not protected by insurmountable intellectual property barriers. The relatively straightforward oral medication format lacks the complexity that might deter generic competition once patents expire. The company's long-term competitive position will likely depend on expanding its pipeline, maintaining clinical superiority, and leveraging its first-mover advantage to build sustainable market share before well-resourced competitors launch alternative therapies.

Risks & safety

Madrigal demonstrates a strong financial safety profile with substantial cash resources and manageable debt levels, though the company operates with negative cash flows typical of recently commercialized biopharmaceutical companies. **Cash and Liquidity Position:** - Cash and short-term investments: $183.6 million as of Q1 2025 - Total cash and equivalents reported: $848.1 million - Strong current ratio of 5.91, indicating excellent short-term liquidity - Quick ratio of 5.58, confirming ability to meet immediate obligations **Debt and Solvency:** - Debt-to-equity ratio of 0.17, representing minimal leverage - Total liabilities of $286 million against $997 million in total assets - No significant solvency concerns given strong balance sheet position **Cash Flow and Burn Rate:** - Operating cash flow: -$88.9 million in Q1 2025 - Free cash flow: -$88.9 million in Q1 2025 - Improving cash flow trajectory as revenue scales with commercial launch **Valuation Considerations:** - Price-to-book ratio of 10.3, reflecting premium valuation - Negative EBITDA due to commercial launch investments and R&D spending - Revenue growth trajectory suggests improving fundamentals with $137.3 million Q1 2025 sales **Other Risk Factors:** - Single-product revenue dependence creates concentration risk - Competitive threats from larger pharmaceutical companies - Regulatory risks associated with ongoing clinical trials for label expansion

Recent development

Madrigal has undergone a fundamental transformation over the past few years, evolving from a clinical-stage research company to a commercial biopharmaceutical organization. The most significant milestone occurred in 2024 with the FDA approval and commercial launch of Rezdiffra, representing the culmination of nearly two decades of development work and marking the first approved treatment for NASH. The commercial launch has exceeded initial expectations, with the company achieving $180.1 million in net sales for 2024 and accelerating growth to $137.3 million in Q1 2025. Key commercial achievements include securing coverage from over 80% of commercial lives, penetrating 70% of the top 6,000 target prescribers, and building a patient base exceeding 17,000 individuals. The company has successfully established patient support programs and reduced prescription fulfillment times to 30 days or less. Strategically, Madrigal is pursuing geographic expansion into Europe, with regulatory approval expected mid-2025 and plans for a direct commercial launch starting in Germany. This represents a significant growth opportunity given the established clinical trial infrastructure across 125 European sites and favorable positioning in European liver disease treatment guidelines. The company is also advancing label expansion efforts through the ongoing MAESTRO-NASH OUTCOMES trial, targeting patients with compensated cirrhosis (F4c stage). Early two-year data showed promising results with 6.7 kilopascal reductions in liver stiffness and 51% of patients achieving significant improvement. Success in this indication could potentially double the addressable patient population. From an organizational standpoint, Madrigal has strengthened its leadership team with key appointments including Dr. Dave Soergel as Chief Medical Officer and Jackie Fouse joining the Board of Directors. The company has also signaled interest in expanding its pipeline through business development activities, focusing on complementary mechanisms for NASH treatment while maintaining financial discipline. These strategic moves position Madrigal to capitalize on its first-mover advantage while building a more diversified platform for long-term growth in the liver disease treatment market.

MDGL company profile · for informational purposes only — not investment advice.

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