Madrigal's MASH Drug Rezdiffra Shows Strong Launch Performance and Promising Long-Term Data

Madrigal Pharmaceuticals' metabolic dysfunction-associated steatohepatitis (MASH) treatment Rezdiffra has demonstrated impressive early market performance, with fourth-quarter sales reaching $103 million and total revenue of $180 million in its first nine months on the market. The Pennsylvania-based company's CEO, Bill Sibold, highlighted the drug's success during a recent earnings presentation, calling the progress "an incredible accomplishment."

Patient Adoption and Prescriber Engagement

By the end of 2024, more than 11,800 patients were receiving Rezdiffra treatment, a milestone Sibold referred to as "crossing the 10,000-patient threshold." The company reports steady patient additions at a rate consistent with other top-tier specialty medicine launches.

On the prescriber front, Madrigal has seen significant traction among its target audience of gastroenterologists and hepatologists. Of the top 6,000 specialists targeted, 60% had written prescriptions for Rezdiffra by the end of 2024, up from 40% at the end of September.

Market Coverage and Financial Performance

Madrigal achieved a key goal earlier than expected by securing 80% coverage of commercially insured lives in the U.S. This milestone, initially projected for the fourth quarter, was reached in the third quarter of 2024.

While the company is not providing specific revenue guidance for the first quarter or full year 2025, investor relations chief Tina Ventura indicated that analyst consensus estimates are expected to "narrow and go up a little bit" based on current performance. Analysts at Evercore ISI project Rezdiffra's 2025 sales at $593 million, surpassing the $520 million consensus.

Long-Term Clinical Data and Future Prospects

Madrigal recently presented new two-year data from a phase 3 trial of Rezdiffra, suggesting positive outcomes that could potentially lead to a label expansion for treating liver cirrhosis. The company stated that these results "add to the growing body of evidence supporting Rezdiffra's potential benefit in this high-risk patient population, for which there is no approved therapy."

When questioned about potential competition from incretin treatments developed by Eli Lilly and Novo Nordisk, CEO Sibold expressed confidence in Rezdiffra's position. He noted that 25% of Rezdiffra patients are already using diabetes/obesity drugs and emphasized the drug's unique profile in addressing severe liver disease.