Material Agreement (Form 8-K)

On January 29, 2026 (the "Effective Date"), Madrigal Pharmaceuticals, Inc. (the "Company"), F. Hoffmann-La Roche Ltd and Hoffmann-La Roche Inc. (together, "Roche") entered into the First Amendment (the "Amendment") to the Research, Development, and Commercialization Agreement dated as of December 18, 2008 between the Company and Roche. Pursuant to the terms of the Amendment, effective as of the Effective Date, the Company will have the full and exclusive right and discretion to control all patent term adjustments and patent term extensions applicable to Rezdiffra, including patents owned by Roche and jointly owned between the parties. In consideration of the foregoing, the royalty payable to Roche based on net sales of Rezdiffra will not be reduced until the expiration of certain patent term extensions that have been, or could have been, filed. The foregoing summary of the Amendment does not purport to be complete and is qualified in its entirety by reference to the Amendment, a copy of which is filed with this Current Report on Form 8-K as Exhibit 10.1.