Madrigal Pharmaceuticals (MDGL) drew fresh attention after reporting Q1 2026 results, with Rezdiffra reaching blockbuster territory and more than 42,000 patients on therapy, alongside new MASH focused licensing deals and pipeline additions.

The share price has been volatile, with a 30 day share price return of 4.49% and a 90 day share price return of 11.99%. Yet year to date it is down 9.94%, while the 1 year total shareholder return of 78.54% and 5 year total shareholder return above 3x the starting level point to momentum built over a longer horizon as investors respond to blockbuster Rezdiffra sales, recent Q1 results and ongoing pipeline expansion.

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With Rezdiffra already a blockbuster, a strong revenue run rate and Wall Street targets sitting above the current US$534.86 share price, investors now face a key question: is Madrigal undervalued or is future growth already priced in?

Most Popular Narrative: 20.3% Undervalued

Against the last close of $534.86, the most followed narrative pegs fair value at $671.07, framing Madrigal as undervalued on a discounted cash flow view using a 7.08% discount rate.

The analyst price target for Madrigal Pharmaceuticals has been revised higher to $671.07, up from $603.47. Analysts now factor in updated assumptions for fair value, discount rate, revenue growth, profit margins, and future P/E, following recent research that highlights both enthusiasm for Rezdiffra's commercial potential and some valuation concerns.

Want to see what is driving that higher fair value line? The narrative leans on ambitious revenue expansion, margin uplift and a richer future earnings multiple. Curious which specific forecasts and valuation levers have to hold for this pricing to make sense? The full story spells out the assumptions in detail.

Result: Fair Value of $671.07 (UNDERVALUED)

However, that upside story can crack if Rezdiffra underperforms in later stage MASH or if GLP 1 competitors and reimbursement pressure tighten pricing and margins.

Next Steps

With sentiment split between strong rewards and clear risks, it makes sense to move quickly and check the full risk reward balance for yourself by reviewing the 3 key rewards and 1 important warning sign.

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This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.