MMDGLMadrigal Pharmaceuticals, Inc.

Madrigal brought out the first approved drug for fatty liver disease — a condition with no treatment for decades.

The disease is far more widespread than is commonly thought: it develops alongside excess weight and diabetes and progresses without symptoms for years until it causes cirrhosis. Until now a doctor could only recommend weight loss, and many developers failed here.

Approval of the first drug opened the market, but its size will be determined not by science but by how many patients are identified and reimbursed by insurers: diagnosis requires a specialised liver assessment that is not available everywhere. The company is at the launch stage and unprofitable. Risks: adoption pace, competition and the need for capital.