Madrigal Pharmaceuticals, Inc. (MDGL) Income Statement

The steep early growth rates reflect a near-zero revenue base rather than a durable run-rate, so the 50.1% figure in 2026Q3 is more informative about trajectory than the triple-digit percentages earlier in the series. Quarter-over-quarter revenue growth has moderated from the 126.8% jump in 2026Q1 to roughly 18% in 2026Q3, which appears to indicate that the commercial launch is maturing. Investors should monitor whether sequential growth holds above 15% as the base grows larger, since that is the threshold at which the revenue line begins to validate the current operating cost structure.

Gross margins above 89% are characteristic of a specialty therapeutic with limited direct product costs, so the margin level itself is not the concern. The decline of roughly 770 basis points from the 2025 peak warrants further investigation to determine whether it reflects channel, pricing, or inventory dynamics rather than a structural change in unit economics. Because COGS is small relative to revenue, even modest shifts in cost per unit can move the gross margin noticeably.

Operating income swung from a $114.0M loss in 2025Q3 to a $56.0M profit in 2026Q3 while SG&A rose more modestly, which indicates that gross profit growth is outpacing overhead expansion. The single positive quarter should be treated cautiously, given that 2026Q2 and 2026Q1 both recorded sizable operating losses, so sustained profitability has not yet been demonstrated. Whether the positive margin persists will depend on whether revenue continues to grow faster than the approximately $265M to $290M quarterly SG&A base.