Key Takeaways:

• In a wastage model of 80 000 commercial health beneficiaries, researchers sought to evaluate the clinical and economic impact of semaglutide among patients with metabolic dysfunction-associated steatohepatitis (MASH).
• In the model, 100 members were diagnosed with MASH, with 3.25 maintaining optimal semaglutide therapy of 2.4 mg for 72 weeks.
• One optimal dose responder yielded an estimated $1.3 million in excess medical and pharmacy costs, a significant economic wastage.

At AASLD TLM 2026, researchers presented their findings from a study evaluating the real-world clinical and economic impact of semaglutide (Wegovy) on patients with MASH.

With MASH incidence projected to increase by 82.6% by 2039, understanding the cost burden and wastage associated with disease management can help inform treatment decisions and health plan policies.

Study Methods and Outcomes

Researchers conducted a Markov-based wastage model of 80 000 commercial beneficiaries to examine semaglutide’s clinical responders and progressors, discontinuations, and economic wastage among patients with MASH.

Wastage was defined as a commercial health plan’s excess medical and pharmacy costs for patients with MASH who did not achieve fibrosis improvement.

Patients with treatment adherence to semaglutide 2.4 mg dose for 72 weeks were considered optimal dose responders.

Optimized Dosage and Economic Wastage

Within the 80 000 sample, 100 members were diagnosed with MASH and eligible for semaglutide therapy. Of the 24 patients who adhere to treatment for 72 weeks, 3.25 were optimal dose responders.

In addition, 29 patients progressed to advanced fibrosis (9 with F3 and 20 with F4).

In a commercial health plan, the model estimated that a single optimal dose responder yielded a wastage of $1.3 million in medical and pharmacy costs.

Implications for Managed Care

These findings illustrate the economic wastage associated with MASH, particularly among patients maintaining optimal treatment dosing.

According to the authors, “Our wastage model demonstrates that the low persistence of MASH patients on an optimal dose of semaglutide (2.4 mg) in the real-world environment, compared to the clinical trial, results in a higher number of progressors, a lower number of responders, and significant economic wastage to be experienced by commercial health plans.”

Reference

Calderon F, Lachuk L, Atreja N, Lobo F. Estimating real world clinical and economic implications of GLP-1 persistence and dosing in metabolic dysfunction-associated steatohepatitis (MASH). Hepatology. 2026;84(S1):3522. doi:10.1097/HEP.0000000000001842. Abstract presented at: AASLD The Liver Meeting 2026; November 5-9, 2026; Denver, CO.