Madrigal Pharmaceuticals, Inc. · NASDAQ:MDGL

Madrigal Pharmaceuticals — Q4 2025 Earnings Presentation

22 slides from Madrigal Pharmaceuticals's earnings presentation, Feb 19, 2026

  1. Slide 1: 4Q25 Financial Results

    4Q25 Financial Results Feb. 19, 2026 NASDAQ: MDGL © 2026 Madrigal Pharmaceuticals, Inc. All rights reserved.

  2. Slide 2: Forward-looking Statements

    Forward-looking Statements This presentation includes “forward-looking statements” made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, that are based on Madrigal’s beliefs and assumptions and on information currently available to it but are subject to

  3. Slide 3: 4Q25 Earnings Call Agenda

    4Q25 Earnings Call Agenda Delivering on Best-in-Industry Rezdiffra Launch Accelerating U.S. MASH Market Growth Building an Industry-Leading MASH Pipeline 3

  4. Slide 4: As the Market Leader, We are Shaping Our Future and the Future of MASH

    As the Market Leader, We are Shaping Our Future and the Future of MASH 2024 2025 2026+ FDA Approval for Building the Shaping Our Future First MASH Medicine Foundational Therapy Continue to build pipeline through BD Rezdiffra + siRNA targets (6) Rezdiffra + DGAT-2 inhibitor Accelerate Rezdiffra Rezdi

  5. Slide 5: Rezdiffra: Executing on Best-in-Industry Launch

    Rezdiffra: Executing on Best-in-Industry Launch NetNet Sales: Sales:Continuing Continuing to Generate GenerateStrong Strong Uptake Uptake First full year of launch: $958.4M in net sales $287.3M $321.1M $321.1M 4Q25 net sales $212.8M $958.4M $137.3M $103.3M $62.2M $14.6M FY25 net sales 2Q24 3Q24 4Q24

  6. Slide 6: Successfully Building a Specialty Market and a Mega Blockbuster Brand

    Successfully Building a Specialty Market and a Mega Blockbuster Brand First MASH medicine; best-in- disease profile Built the right team; executed with long- term mindset; educated prescribers Wired the system practice by practice to establish care pathways Secured first-line access through discipli

  7. Slide 7: Steadily Adding Patients in a Market Positioned for Significant Expansion

    Steadily Adding Patients in a Market Positioned for Significant Expansion Patients on Rezdiffra: Significant Opportunity in 315,000 Target Market2 Steadily Adding Patients1 >17,000 >11,800 >23,000 >29,500 >36,250 <12 % Penetrated in F2/F3 MASH as of 4Q25 >6,800 >2,000 2Q24 3Q24 4Q24 1Q25 2Q25 3Q25 4

  8. Slide 8: U.S. F2/F3 MASH Population has Increased Nearly 50 Percent Since YE 2023

    U.S. F2/F3 MASH Population has Increased Nearly 50 Percent Since YE 2023 MASH Market Growth Since YE 20231 1.9M 46% 1.5M 460K 680K 315K 525K 460K 315K Diagnosed MASH Pop. Diagnosed w/ F2/F3 F2/F3 Target Market YE 2023 YE 2025 F2/F3 Target Market Key Drivers of MASH Market Growth Since Launch Increas

  9. Slide 9: MASH is Similar to Other Large Therapeutic Categories

    MASH is Similar to Other Large Therapeutic Categories Where Additional Therapies Grow the Market Over Time Total Global ~$26B ~$28B Sales by ~$23B Therapeutic Category in 2024 ~$0.2B Therapeutic Category MASH IBD RA Psoriasis # of approved therapies in 2025 2 19 13 14 Year first therapy was approved

  10. Slide 10: Rezdiffra is the Foundational Therapy in MASH Driven by its Compelling Profile

    Rezdiffra is the Foundational Therapy in MASH Driven by its Compelling Profile Rezdiffra Mechanism of Action Liver-directed Consistent across patient subtypes MASH Efficacy (e.g., T2D)1 Tolerability Well-tolerated1 Adherence High1 Route of Administration Once-daily pill; no titration 1. Harrison SA,

  11. Slide 11: Expansion into F4c has the Potential to Double the Opportunity for Rezdiffra

    Expansion into F4c has the Potential to Double the Opportunity for Rezdiffra1 Significant Unmet Need in Compensated MASH Cirrhosis (F4c) Estimated addressable F4c outcomes trial U.S. patient population data expected in Rezdiffra tracking to ~245,000 be first to market 2027 Higher urgency to No treat

  12. Slide 12: Madrigal is Shaping the Future of MASH

    Madrigal is Shaping the Future of MASH MASH is a complex, heterogeneous disease with a broad spectrum of comorbidities. Its future will include multiple therapies, combinations and personalized regimens. MASH Treatment Today MASH Treatment in the Future • Treatment available in F2/F3 • Treatment ava

  13. Slide 13: Madrigal is Uniquely Positioned to Extend its Leadership in MASH

    Madrigal is Uniquely Positioned to Extend its Leadership in MASH Our R&D strategy is to build the industry-leading MASH pipeline through targeted business development and internal innovation, leveraging Rezdiffra as the foundational therapy Deliver transformational Advance combination Invest in new

  14. Slide 14: Reducing CSPH Risk, Lowers Liver Related Events; Rezdiffra 2-Year F4c OLE Data

    Reducing CSPH Risk, Lowers Liver Related Events; Rezdiffra 2-Year F4c OLE Data Support its Potential in F4c Clinical Significance of CSPH as an Indicator of Outcomes in F4c • CSPH responsible for most severe complications of cirrhosis (F4c); precursor to decompensation CSPH CSPH 41% 35% • Event rate

  15. Slide 15: We're Building Our Pipeline with the Most Promising Targets

    We’re Building Our Pipeline with the Most Promising Targets MASH Disease Pathways and Potential Mechanisms Structurally Genetically focused PPAR THR-beta Cyclophilin engineered fatty acid drugs (e.g., siRNA) agonist agonist inhibitor Brain Targeting lipid carbohydrate metabolism GLP-1/glucagon ACC C

  16. Slide 16: Adding a New Modality to Our Portfolio: siRNA Targets for the Treatment of MASH

    Adding a New Modality to Our Portfolio: siRNA Targets for the Treatment of MASH Small Interfering Development Stage Rationale RNA (siRNA) Preclinical • siRNA is validated in MASH; offers broad efficacy or more tailored approaches Route of Administration • GalNAc-siRNA modality well- Injectable estab

  17. Slide 17: Oral DGAT-2 Inhibitor (Ervogastat) Rationale and Next Steps

    Oral DGAT-2 Inhibitor (Ervogastat) Rationale and Next Steps DGAT-2 Inhibitor Development Stage Rationale (ervogastat) Completed Phase 2b1 • Complementary mechanisms; potential to address production and clearance of liver fat Route of Administration • Phase 2b data demonstrate Oral impressive MRI-PDF

  18. Slide 18: Oral GLP-1 (MGL-2086) Rationale and Next Steps

    Oral GLP-1 (MGL-2086) Rationale and Next Steps Oral GLP-1 Development Stage Rationale (MGL-2086) IND complete • Strong real-world use supporting combo of GLP-1s and resmetirom • Resmetirom patients with ≥5% Route of Administration weight loss see enhanced Oral antifibrotic effect • Combine so the ri

  19. Slide 19: Advancing an Industry-Leading MASH Pipeline to Transform Patient Care

    Advancing an Industry-Leading MASH Pipeline to Transform Patient Care MOA Indication Preclinical Phase 1 Phase 2 Phase 3 Launched THR-β agonist MASH F2/F3 THR-β agonist MASH F4c Oral DGAT-2 Ervogastat/resmetirom combo1 inhibitor MASH Oral GLP-1 MGL-2086/resmetirom combo2 receptor MASH agonist siRNA

  20. Slide 20: Consolidated Statement of Operations: 4Q25

    Consolidated Statement of Operations: 4Q25 Three Months Ended Dec. 31 (in thousands)1 2025 2024 Revenues: Product revenue, net $321,083 $103,320 Operating expenses: Cost of sales $24,448 $3,445 Research and development $116,268 $25,648 Selling, general and administrative $239,976 $141,224 Total oper

  21. Slide 21: Madrigal is Well-Positioned for Continued Value Creation in 2026 and Beyond

    Madrigal is Well-Positioned for Continued Value Creation in 2026 and Beyond Rezdiffra F2/F3 Launch Indication Expansion Building Our Pipeline >10 F4c $958.4M Outcomes Data anticipated in 2027 could In first full year of launch double the opportunity1 Pipeline programs Leading the Fight Against MASH

  22. Slide 22: 4Q25 Financial Results

    4Q25 Financial Results Feb. 19, 2026 NASDAQ: MDGL © 2026 Madrigal Pharmaceuticals, Inc. All rights reserved.

Madrigal Pharmaceuticals — Q4 2025 Earnings Presentation on 6ix