{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:24:07Z","timestamp":1787063047369,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The approval of new pharmacotherapies for metabolic dysfunction\u2010associated steatohepatitis (MASH) presents a critical need for value assessment. We evaluated the cost\u2010effectiveness of resmetirom, semaglutide and tirzepatide for U.S. adults with MASH and F2\u2013F3 fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We developed a Markov cohort model with a lifetime horizon from the perspective of a U.S. healthcare payer. The model simulated biopsy\u2010confirmed patients with MASH progressing through liver\u2010specific health states. Efficacy inputs for fibrosis regression and MASH resolution were obtained from a Bayesian network meta\u2010analysis. Each pharmacotherapy was compared individually against standard of care; a formal sequential incremental analysis across active therapies was not performed. Cost\u2010effectiveness was assessed against the standard of care using a $100\u2009000\/QALY willingness\u2010to\u2010pay threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the base\u2010case analysis, tirzepatide had the largest QALY gain and the lowest incremental cost relative to standard of care, yielding an incremental cost\u2010effectiveness ratio of ($42\u2009705\/QALY). Semaglutide was also cost\u2010effective (ICER: $80\u2009076\/QALY). Resmetirom (ICER: $273\u2009445\/QALY) exceeded the WTP threshold. Drug price was the most influential parameter in sensitivity analyses; probabilistic sensitivity analysis showed a 99.5% probability of cost\u2010effectiveness for tirzepatide and 89.8% for semaglutide at $100\u2009000\/QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At current U.S. prices, tirzepatide and semaglutide are cost\u2010effective for MASH with F2\u2013F3 fibrosis, while resmetirom is not. The tirzepatide finding should be interpreted with caution, given that it is not yet FDA\u2010approved for MASH and its effect estimate is based on a network meta\u2010analysis of a phase 2 trial. Payer coverage and equitable access to MASH therapies require value\u2010based pricing strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71020","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:22:37Z","timestamp":1782400957000},"page":"8378-8389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost\u2010Effectiveness of Pharmacologic Therapies for Metabolic Dysfunction\u2013Associated Steatohepatitis With Significant Fibrosis in the United States"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1864-4867","authenticated-orcid":false,"given":"Ali A.","family":"Abdeen","sequence":"first","affiliation":[{"name":"Department of Industrial and Systems Engineering Georgia Institute of Technology  Atlanta Georgia USA"},{"name":"Information Systems and Operations Management Department Kuwait University  Al\u2010Shadadiya Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8720-0280","authenticated-orcid":false,"given":"Turgay","family":"Ayer","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aanan","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase J.","family":"Wehrle","sequence":"additional","affiliation":[{"name":"Division of Liver Transplantation Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobia N.","family":"Laique","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5756-9917","authenticated-orcid":false,"given":"Ali","family":"Aminian","sequence":"additional","affiliation":[{"name":"Bariatric and Metabolic Institute, Department of General Surgery Cleveland Clinic  Cleveland Ohio 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