NASH/MASH Deal Benchmarks 2026

The NASH/MASH therapeutic landscape was transformed by resmetirom's (Rezdiffra) FDA approval in March 2024 — the first approved therapy for metabolic dysfunction-associated steatohepatitis. This validated the category and unlocked a wave of licensing deals. Madrigal Pharmaceuticals' market cap exceeded $7B on approval, setting the commercial benchmark for the class.

Phase 2 MASH small molecule deals command median upfront payments of $654M, with total deal values of $3.1B. GLP-1-based MASH approaches (leveraging semaglutide's MASH data) push even higher at $4.7B total value, reflecting the dual obesity/MASH opportunity.

Key deal drivers include fibrosis improvement data (F2-F3 reversal), combination strategies with GLP-1 agonists, and the massive undiagnosed patient population (estimated 6-8M in the US alone). Efruxifermin (FGF21 agonist) was acquired by Novo Nordisk for $1.4B, while survodutide (GLP-1/glucagon dual agonist) is being developed by Boehringer Ingelheim in a $1.6B partnership with Zealand.