Rezdiffra Sales Drive $321M Q4 Revenue, R&D and SG&A Soar, Shares Drop 11%
Madrigal reported a fourth-quarter 2025 loss of $2.57 per share on $321.1 million in revenues from Rezdiffra sales, beating consensus by $8.1 million. R&D expenses quadrupled to $116.3 million and SG&A nearly doubled to $240 million, driving an 11.1% stock sell-off.
1. Q4 Earnings and Revenues
Madrigal logged a fourth-quarter 2025 loss of $2.57 per share versus an expected profit of $0.04, primarily due to rising expenses. Revenues reached $321.1 million, up sharply year over year and $8.1 million above estimates, all from sales of its newly launched MASH therapy Rezdiffra.
2. Operating Expenses Rise Sharply
Research and development expenses jumped to $116.3 million, more than four times the prior year period, driven by upfront business development payments. Selling, general and administrative costs climbed to $240 million as commercial launch activities intensified, including significant hiring to support market rollout.
3. Full-Year 2025 Results and Cash Position
For full-year 2025, Madrigal generated $958.4 million in Rezdiffra sales, surpassing the $950.8 million estimate, while widening its loss per share to $12.85. The company held $988.6 million in cash, cash equivalents and marketable securities at year-end.
4. Pipeline Developments and Outlook
More than 36,250 patients were on Rezdiffra as of December 31, 2025, up from 29,500 three months earlier. Two pivotal phase III outcomes trials are underway, with top-line data expected in 2027 and confirmatory results in 2028 to support full approval and potential label expansion.