The coast is clear for it to grow, for now.Madrigal Pharmaceuticals (MDGL 0.21%) is in a position that most other biotechs envy. Its first medicine just hit the market, sales are due to start rolling in, and there aren't any other companies that can slow it down -- for now, that is.By mid-2027, its shareholders will probably be richer than they are today. But beyond that time point, all bets are off, and in fact, it's very possible for things to start getting more difficult for Madrigal a bit sooner. Here's ...