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Side-by-side financial comparison of Custom Truck One Source, Inc. (CTOS) and MADRIGAL PHARMACEUTICALS, INC. (MDGL). Click either name above to swap in a different company.

Custom Truck One Source, Inc. is the larger business by last-quarter revenue ($461.6M vs $321.1M, roughly 1.4× MADRIGAL PHARMACEUTICALS, INC.). Custom Truck One Source, Inc. runs the higher net margin — -0.9% vs -18.2%, a 17.4% gap on every dollar of revenue. On growth, MADRIGAL PHARMACEUTICALS, INC. posted the faster year-over-year revenue change (210.8% vs -12.6%).

Custom Truck One Source, Inc. is a leading provider of specialized heavy truck and equipment solutions in North America. It offers custom vehicle manufacturing, equipment sales and rentals, aftermarket parts, and maintenance services, serving core infrastructure, utility, construction, and energy industry segments.

Intercept Pharmaceuticals, Inc. is an American biopharmaceutical company incorporated in 2002, focusing on the development of novel synthetic bile acid analogs to treat chronic liver diseases, such as primary biliary cirrhosis (PBC) now called primary biliary cholangitis, non-alcoholic fatty liver disease, cirrhosis, portal hypertension, primary sclerosing cholangitis and also the intestinal disorder, bile acid diarrhea.

CTOS vs MDGL — Head-to-Head

Bigger by revenue
CTOS
CTOS
1.4× larger
CTOS
$461.6M
$321.1M
MDGL
Growing faster (revenue YoY)
MDGL
MDGL
+223.4% gap
MDGL
210.8%
-12.6%
CTOS
Higher net margin
CTOS
CTOS
17.4% more per $
CTOS
-0.9%
-18.2%
MDGL

Income Statement — Q1 FY2026 vs Q4 FY2025

Metric
CTOS
CTOS
MDGL
MDGL
Revenue
$461.6M
$321.1M
Net Profit
$-4.1M
$-58.6M
Gross Margin
22.3%
Operating Margin
6.8%
-18.6%
Net Margin
-0.9%
-18.2%
Revenue YoY
-12.6%
210.8%
Net Profit YoY
76.9%
1.4%
EPS (diluted)
$-0.02
$-2.55

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
CTOS
CTOS
MDGL
MDGL
Q1 26
$461.6M
Q4 25
$387.3M
$321.1M
Q3 25
$359.9M
$287.3M
Q2 25
$392.2M
$212.8M
Q1 25
$307.1M
$137.3M
Q4 24
$398.3M
$103.3M
Q3 24
$337.5M
$62.2M
Q2 24
$320.6M
Net Profit
CTOS
CTOS
MDGL
MDGL
Q1 26
$-4.1M
Q4 25
$20.9M
$-58.6M
Q3 25
$-5.8M
$-114.2M
Q2 25
$-28.4M
$-42.3M
Q1 25
$-17.8M
$-73.2M
Q4 24
$27.6M
$-59.4M
Q3 24
$-17.4M
$-107.0M
Q2 24
$-24.5M
Gross Margin
CTOS
CTOS
MDGL
MDGL
Q1 26
22.3%
Q4 25
31.8%
Q3 25
28.0%
Q2 25
26.1%
Q1 25
27.9%
96.7%
Q4 24
29.7%
Q3 24
27.2%
Q2 24
27.8%
Operating Margin
CTOS
CTOS
MDGL
MDGL
Q1 26
6.8%
Q4 25
13.4%
-18.6%
Q3 25
9.1%
-39.7%
Q2 25
7.1%
-22.2%
Q1 25
4.0%
-57.8%
Q4 24
16.9%
-64.8%
Q3 24
6.8%
-187.1%
Q2 24
5.5%
Net Margin
CTOS
CTOS
MDGL
MDGL
Q1 26
-0.9%
Q4 25
5.4%
-18.2%
Q3 25
-1.6%
-39.8%
Q2 25
-7.2%
-19.9%
Q1 25
-5.8%
-53.4%
Q4 24
6.9%
-57.5%
Q3 24
-5.2%
-172.0%
Q2 24
-7.6%
EPS (diluted)
CTOS
CTOS
MDGL
MDGL
Q1 26
$-0.02
Q4 25
$0.10
$-2.55
Q3 25
$-0.03
$-5.08
Q2 25
$-0.13
$-1.90
Q1 25
$-0.08
$-3.32
Q4 24
$0.11
$-2.50
Q3 24
$-0.07
$-4.92
Q2 24
$-0.10

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
CTOS
CTOS
MDGL
MDGL
Cash + ST InvestmentsLiquidity on hand
$9.6M
$198.7M
Total DebtLower is stronger
$5.1M
$339.9M
Stockholders' EquityBook value
$805.2M
$602.7M
Total Assets
$3.5B
$1.3B
Debt / EquityLower = less leverage
0.01×
0.56×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
CTOS
CTOS
MDGL
MDGL
Q1 26
$9.6M
Q4 25
$6.3M
$198.7M
Q3 25
$13.1M
$295.7M
Q2 25
$5.3M
$186.2M
Q1 25
$5.4M
$183.6M
Q4 24
$3.8M
$100.0M
Q3 24
$8.4M
$232.7M
Q2 24
$8.1M
Total Debt
CTOS
CTOS
MDGL
MDGL
Q1 26
$5.1M
Q4 25
$1.6B
$339.9M
Q3 25
$1.6B
$339.8M
Q2 25
$1.6B
$118.4M
Q1 25
$1.6B
$118.0M
Q4 24
$1.5B
$117.6M
Q3 24
$1.6B
$117.1M
Q2 24
$1.5B
Stockholders' Equity
CTOS
CTOS
MDGL
MDGL
Q1 26
$805.2M
Q4 25
$809.1M
$602.7M
Q3 25
$784.7M
$625.7M
Q2 25
$790.1M
$696.0M
Q1 25
$813.4M
$710.6M
Q4 24
$861.3M
$754.4M
Q3 24
$837.5M
$777.2M
Q2 24
$856.7M
Total Assets
CTOS
CTOS
MDGL
MDGL
Q1 26
$3.5B
Q4 25
$3.4B
$1.3B
Q3 25
$3.5B
$1.4B
Q2 25
$3.6B
$1.0B
Q1 25
$3.5B
$996.6M
Q4 24
$3.5B
$1.0B
Q3 24
$3.6B
$1.1B
Q2 24
$3.5B
Debt / Equity
CTOS
CTOS
MDGL
MDGL
Q1 26
0.01×
Q4 25
2.03×
0.56×
Q3 25
2.10×
0.54×
Q2 25
2.04×
0.17×
Q1 25
1.97×
0.17×
Q4 24
1.77×
0.16×
Q3 24
1.87×
0.15×
Q2 24
1.79×

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
CTOS
CTOS
MDGL
MDGL
Operating Cash FlowLast quarter
$-133.5M
Free Cash FlowOCF − Capex
$-133.8M
FCF MarginFCF / Revenue
-41.7%
Capex IntensityCapex / Revenue
0.1%
Cash ConversionOCF / Net Profit
TTM Free Cash FlowTrailing 4 quarters

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
CTOS
CTOS
MDGL
MDGL
Q1 26
Q4 25
$47.3M
$-133.5M
Q3 25
$81.5M
$79.8M
Q2 25
$125.7M
$-47.1M
Q1 25
$55.6M
$-88.9M
Q4 24
$82.1M
$-104.5M
Q3 24
$16.5M
$-67.0M
Q2 24
$37.8M
Free Cash Flow
CTOS
CTOS
MDGL
MDGL
Q1 26
Q4 25
$-133.8M
Q3 25
$79.0M
Q2 25
Q1 25
Q4 24
$-104.7M
Q3 24
$-67.8M
Q2 24
FCF Margin
CTOS
CTOS
MDGL
MDGL
Q1 26
Q4 25
-41.7%
Q3 25
27.5%
Q2 25
Q1 25
Q4 24
-101.3%
Q3 24
-109.0%
Q2 24
Capex Intensity
CTOS
CTOS
MDGL
MDGL
Q1 26
Q4 25
0.1%
Q3 25
0.3%
Q2 25
0.0%
Q1 25
0.0%
Q4 24
0.2%
Q3 24
1.3%
Q2 24
Cash Conversion
CTOS
CTOS
MDGL
MDGL
Q1 26
Q4 25
2.27×
Q3 25
Q2 25
Q1 25
Q4 24
2.98×
Q3 24
Q2 24

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

CTOS
CTOS

Equipment sales$292.6M63%
Rental revenue$137.2M30%
Parts sales and services$31.8M7%

MDGL
MDGL

Rebates Customer Fees Credits Co Pay Assistance And Other$208.5M65%
Other$76.0M24%
Chargebacks Discounts For Prompt Pay And Other Allowances$36.6M11%

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