Rezdiffra Hits $1B First-Year Sales as Diagnosed Patients Grow 50%
Madrigal’s Rezdiffra achieved nearly $1 billion net sales in its first full year, with diagnosed patient numbers rising almost 50% over two years and double-digit growth forecast for 2026. Patient starts remain robust despite Wegovy’s launch, with compliance at 60–70% and gross-to-net expected around high-30% in Q1.
1. Record Sales Performance
Rezdiffra generated nearly $1 billion in net sales during its first full year, establishing it as the foundational therapy for MASH. The therapy also recorded its highest weekly prescription volume since launch, highlighting strong market penetration.
2. Patient Growth Dynamics
Diagnosed patient numbers increased by almost 50% over a two-year span, driven by heightened awareness campaigns and physician efforts, particularly among gastroenterologists and hepatologists. Patient starts remain steady despite the entry of competing obesity treatments, with a balanced mix of F2 and F3 cases.
3. Market Access and Pricing
Gross-to-net deductions are projected around 38% for Q1, consistent with specialty-medicine analogs and supported by broad first-line access without step edits. Germany’s revenue contribution was negligible in 2025, and potential Most Favored Nation pricing poses uncertainty for ex-US markets.
4. Pipeline and Clinical Development
Early-stage combination programs are under discussion with regulators, emphasizing non-invasive tests for Phase 2 assessments. In MAESTRO-NASH trials, annual event accrual in cirrhosis patients is tracking at 5–10%, with pivotal outcomes data expected in 2027.