Madrigal Pharmaceuticals is a commercial-stage biopharmaceutical company focused on MASH (metabolic dysfunction-associated steatohepatitis), a progressive liver disease with no approved treatments until recently. Madrigal's sole product is Rezdiffra (resmetirom), the first and only FDA-approved therapy for MASH, approved in the US in March 2024 and in the EU in August 2025. Rezdiffra is a once-daily oral pill that works as a thyroid hormone receptor beta agonist, directly targeting the liver to reduce fat accumulation and slow fibrosis. It is approved for adults with noncirrhotic MASH with moderate to advanced liver fibrosis (F2-F3 stages). Madrigal sells Rezdiffra through specialty pharmacies in the US, targeting roughly 315,000 diagnosed F2-F3 patients managed by hepatologists, gastroenterologists, and select endocrinologists. As of year-end 2025, about 36,250 patients were on therapy. Revenue is driven by patient starts, retention on therapy, and payer reimbursement. Madrigal does not own manufacturing facilities, relying on contract manufacturers for both the active ingredient and finished tablets. The company is not yet profitable, with costs weighted toward commercial operations and R&D. Madrigal is pursuing label expansion into compensated MASH cirrhosis (F4c), which could roughly double its addressable market, with trial results expected in 2027. Madrigal is also building a combination therapy pipeline through licensing deals, including an oral GLP-1, a DGAT-2 inhibitor, and six siRNA programs, all intended to complement Rezdiffra. Rezdiffra's patent protection extends to February 2045.