Madrigal pairs the first FDA-approved MASH therapy with Courier Health’s purpose-built technology
Madrigal Pharmaceuticals made history in 2024 with Rezdiffra, the first FDA-approved treatment for MASH (metabolic dysfunction-associated steatohepatitis), a serious liver disease that impacts an estimated 6 million to 8 million people in the United States and between 400 and 500 million people worldwide. With the launch outperforming expectations, Rezdiffra became the de facto category leader almost overnight.
But a first-in-class therapy brings unique challenges, including no established care pathway and needing to scale patient access as fast as demand. Here's why Madrigal chose Courier Health as the backbone of their patient experience.
Key Results
- 20% faster time-to-therapy
- 50% faster SP inquiry turnaround time since launch
- One platform connecting ARMs, field development managers, sales, and specialty pharmacies
- 2025 Patient Innovators of the Year
The Challenge
A first-in-class therapy
Rezdiffra didn't just enter the MASH market, it created it. As the first approved therapy for a disease that can progress silently for years, Madrigal had to build the care pathway itself: educating providers on how to stage the disease, connecting patients to specialists, and overcoming barriers like cost and awareness that keep many patients from ever starting.
The complexity is structural, too. Rezdiffra is prescribed across two distinct specialties (Hep/GI and endocrinology), and Madrigal's team is organized to match. This effectively means running the operational equivalent of a multi-therapy program under one drug. Each patient requires prior authorization, and the path to approval looks different for every payer, with step edits and policy changes landing all the time.
Madrigal's legacy platform made managing this harder than it needed to be. Information was scattered across systems, visibility into KPI achievement was limited, and coordinating with partners like specialty pharmacies was a constant lift. The teams responsible for pulling patients through simply couldn't see or reach one another in one place.
“With our previous platform, we couldn't communicate through secure messaging with our internal partners, our customers, or our specialty pharmacies,” said Mike O’Connor, Executive Director / National Head, Hep/GI Access & Reimbursement. “That was a huge challenge. Being able to do that through Courier Health has been a game changer. Knowing exactly what's required for each patient’s prior authorization, and where each patient is in that journey, is everything. Every patient is different, and every patient matters.”
The Solution
Purpose-built for the patient journey
Madrigal moved to Courier Health for a purpose-built solution designed to drive efficiency and collaboration – and, critically, to pull a fragmented process into a single view. Instead of stitching together systems and chasing status across teams, Access & Reimbursement Managers (ARMs), field development managers, hub, sales, and SPs now work from one shared source of truth.
Three things immediately stood out to the Madrigal users:
- The platform is intuitive, meaning ARMs aren’t hunting for information
- Communications tools natively and securely connect them to both internal and external partners across the patient access journey
- Recommended Actions (RAs) surface exactly which cases need attention and why, helping teams to prioritize their days
“First and foremost, it's visually appealing,” said Mike. “The information is easy to digest and right there – you don’t have to go hunting for it. In addition, Recommended Actions let our ARMs act quickly on the cases that need attention and move patients to the next step.”
Rolling out any new system is challenging, but Madrigal credits Courier Health's hands-on support for getting adoption to stick.
“Any system requires change management and setting and managing expectations. Courier Health helped us through that with ongoing training. Having a partner there to help us educate our field teams, who is always available to answer our questions, was critical to hitting our stride.”
The Results
Absorbing growth without losing the patient
A unified system pays off most when the business is moving fast. It gave Madrigal's field development managers a national view, which is essential in a market that's constantly evolving. “With a holistic readout of the business, we can spot opportunities, cover territories, and set strategy,” added Mike.
Rezdiffra's success also created the challenge of supporting demand. Courier Health became core to holding conversion, fulfillment, and time-to-therapy steady as volume climbed – the difference between a growth brand that scales and one that buckles under its own momentum.
“Some of the KPIs we watch most closely are conversion and fulfillment rates and time-to-therapy. As the program grows and the payer landscape gets more complex, a platform like Courier Health is essential to improving them. When we have a Recommended Action for even a single case, we can act quickly to move that patient to the next step.”
Since implementing Courier Health, Madrigal has cut time-to-therapy by 20%. There’s also been a 50% improvement in SP inquiry response time since launching with the solution.
One example of the visibility and technology in action is a patient who needed a dosing correction before therapy could begin. The specialty pharmacy had faxed the office, but in a busy practice, the fax went unseen. At the same time, the ARM received an RA in Courier Health flagging the dosing adjustment and the need for a new prescription. The ARM was immediately able to call the office, and the updated prescription reached the SP the same day.
For Mike, “that's the difference between reactive and proactive. The fax might have sat for days. Instead, the ARM saw the Recommended Action, made one call, and the patient started therapy.”
Ultimately for Mike and the Madrigal team, the throughline is the partnership itself.
“In 26 years in this industry, including 15 in access and reimbursement, I've worked with many platforms. What impresses me most about Courier Health is how they partner with us. When we identify a problem, the team is responsive and willing to find a solution. Madrigal is leading the way in the fight against MASH, and we can't do it without great partners like Courier Health to help patients start, stay, and thrive on Rezdiffra.”