JAMA Netw Open

Screening and lifestyle interventions for MASH in T2DM are cost-effective

November 10, 2025

Study fndings suggest that screening followed by intensive lifestyle intervention plus either semaglutide or resmetirom was cost-effective for T2DM patients in the U.S. with metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis.

Study details: This economic evaluation assessed 14 diagnostic and treatment strategies for MASH and liver fibrosis in adults with T2DM across 12 countries. Using a state-transition model, the study simulated disease progression and evaluated cost-effectiveness from a health system perspective. Screening methods included Fibrosis-4 (FIB-4), Enhanced Liver Fibrosis (ELF), and vibration-controlled transient elastography (VCTE), followed by pharmacologic (semaglutide, resmetirom) and nonpharmacologic (intensive lifestyle interventions [ILIs]) treatments.

Results: Standard care was the most cost-effective in 8 countries. However, screening followed by ILIs was cost-effective in all 12 countries. ILIs combined with semaglutide was cost-effective in 11 countries, and ILIs with resmetirom in 8. Sensitivity analyses confirmed robustness across varying coverage levels and cost assumptions.

Source:

Lazarus JV, et al. (2025, November 6). JAMA Netw Open. Cost-Effectiveness of MASH Diagnosis and Management Approaches Among Those With Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/41196592/