Madrigal Pharmaceuticals (MDGL) opened Q1 2026 with total revenue of US$311.3 million, a basic EPS loss of US$4.13, and net income loss of US$94.4 million, setting the tone for how its growth story is feeding through to the income statement. The company has seen reported quarterly revenue move from US$137.3 million in Q1 2025 to US$311.3 million in Q1 2026. Over the same period, basic EPS ranged from a loss of US$1.90 in Q2 2025 to a loss of US$5.08 in Q3 2025, so investors are watching how rising revenue interacts with still sizeable losses and the path to better margins.

See our full analysis for Madrigal Pharmaceuticals.

Next up is how these results line up against the widely followed growth and profitability narratives, highlighting where the current numbers support the story and where they raise fresh questions for investors.

Trailing losses remain heavy at US$309 million

• On a trailing 12 month basis, Madrigal recorded US$1.1b in revenue and a net loss of US$309.4 million, with basic EPS at a loss of US$13.55.
• Consensus narrative sees this loss profile as a starting point for a margin turnaround, yet:
  • Analysts expect earnings to reach US$822.9 million with margins moving from a loss of 54.7% to 33.3% in three years. However, the latest trailing figures still show widening losses described at about 9.5% a year over five years.
  • This contrast means the current US$309.4 million loss and US$13.55 loss per share need to improve meaningfully to align with the idea of a much more profitable business within that time frame.

Revenue run rate tops US$1.1b but profitability lags

• Over the last year, revenue moved from US$180.1 million in Q4 2024 to US$311.3 million in Q1 2026. On a trailing 12 month basis it totals US$1.1b versus trailing losses of US$309.4 million.
• Bulls argue that rapid Rezdiffra uptake can support strong revenue growth and a swing to earnings, yet:
  • Bullish assumptions look for revenue to reach US$3.6b and earnings of US$1.5b by around 2028, compared with today’s US$1.1b in trailing revenue and a US$309.4 million loss. This would be a significant step up from what is currently in the income statement.
  • Forecast earnings growth of 58.7% a year and a move from a 54.7% loss margin to a 40.7% positive margin sit against the fact that quarterly net income has stayed in loss territory, from US$73.2 million in Q1 2025 to US$94.4 million in Q1 2026.

For readers who want to see how the optimistic case stacks up against the detailed forecasts and assumptions, 🐂 Madrigal Pharmaceuticals Bull Case

Mixed signals from losses, valuation and price targets

• The stock trades at a P/S of 10.9x versus a peer average of 33.4x and a US Biotech industry level of 10.8x. A DCF fair value of US$1,271.67 sits well above the current share price of US$539.73 and the single allowed analyst price target of US$660.50.
• Bears focus on ongoing losses to question how long this can be supported, yet:
  • The company is still unprofitable on a trailing basis, with losses widening about 9.5% a year over five years. Q1 2026 net loss of US$94.4 million compares with US$58.6 million in Q4 2025 and US$114.2 million in Q3 2025, so the loss pattern has not yet settled at a clearly improving level.
  • Recent insider selling is flagged as an additional risk. This fits with the cautious view that, despite a DCF fair value above both the share price and the US$660.50 target, investors still face execution risk while the company remains loss making.

If you want to see how the cautious view interprets these valuation gaps and ongoing losses, 🐻 Madrigal Pharmaceuticals Bear Case

Next Steps

To see how these results tie into long-term growth, risks, and valuation, check out the full range of community narratives for Madrigal Pharmaceuticals on Simply Wall St. Add the company to your watchlist or portfolio so you'll be alerted when the story evolves.

With such a split picture of risks and rewards, why not move quickly, review the underlying data yourself, and test the assumptions that matter most to you? To see that balance laid out clearly, take a closer look at the 2 key rewards and 1 important warning sign

See What Else Is Out There

Madrigal still carries sizeable trailing losses, an unprofitable margin profile and insider selling concerns, so the current story relies heavily on optimistic future assumptions.

If that mix of losses and execution risk feels uncomfortable, you can compare it with companies screened for resilient fundamentals by checking out the 74 resilient stocks with low risk scores.

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.