MADRIGAL PHARMACEUTICALS, INC. Q3 FY2024 earnings call

Rezdiffra Launch Update - Delivered $62 million in net sales, with over 6,800 patients on Rezdiffra; time to fill prescriptions at 30 days or less; 80% of commercial lives covered by year-end; 40% of top targets prescribing. - Feedback from prescribers is positive, recognizing Rezdiffra as standard-of-care for NASH with moderate to advanced fibrosis. ### NASH Treatment Landscape - Rezdiffra compares favorably to GLP-1s like Semaglutide in terms of efficacy, safety, and patient persistency. GLP-1s may expand the NASH market but Rezdiffra is positioned as the foundational therapy. ### Progress in NASH Leadership - Completed enrollment in the NASH cirrhosis OUTCOMES trial; Michael Charlton joined as Head of Clinical Development; preparing for a strong presence at the AASLD Liver Meeting where Rezdiffra will be spotlighted. ### R&D Developments - Resmetirom development program produced many NASH abstracts; preparing for key industry events to advance NASH science.

In the third quarter, Madrigal Pharmaceuticals generated $62 million in net sales driven by the Rezdiffra launch. The Rezdiffra product segment is the key driver here, with over 6,800 patients on Rezdiffra by quarter end, and commercial coverage for over 80% of lives achieved ahead of schedule.

- Anticipated 2025 expectations to increase due to robust growth seen in 2024. ### - Based on performance since the third quarter, 2025 expectations are poised to rise to account for the strong growth generated.

- Competition from GLP-1s could impact patient persistency in the long term. ### - Regulatory uncertainties regarding labeling and coverage for new entrants in the NASH space. ### - Potential impacts on gross to net from insurance and plan changes, especially in early 2025.

Q: Given the strong performance, could you talk about forecasts for fourth quarter and 2025?

A: Bill and Mardi discussed strong launch progress, benchmarking against specialty launches, and 2025 expectations to increase due to robust growth.

Q: What's the cadence of new patients and expectations regarding GLP-1 step-through?

A: Bill mentioned steady patient addition, and no current requirements for step-throughs with GLP-1s, waiting for Essence data.

Q: Can you talk about the event rate in MAESTRO-NASH and expectations for the Essence trial?

A: Bill stated they are awaiting Essence data, noting top-line results don't always translate to labels, and discussed monitoring ongoing trials for insights.