Author: Collin Labar, Life Sciences and Data Strategy Executive
In the past year, leading pharmaceutical companies have invested more than 10 billion dollars in M&A and licensing deals focused on MASH (Metabolic Dysfunction-Associated Steatohepatitis). This marks a dramatic shift in how the industry views this chronic liver disease, once considered too risky and poorly understood to justify major investment.
Today, MASH is among the most dynamic and competitive therapeutic areas, with multiple late-stage therapies in development, strong regulatory tailwinds, and a significant global burden of disease. The race to capture this market has begun in full force.
Key MASH Transactions from the Past 12 Months
The scale of recent transactions speaks volumes about the momentum building around MASH:
- Novo Nordisk agreed to acquire Akero Therapeutics for up to $5.2 billion, including $4.7 billion upfront. Akero’s lead candidate, efruxifermin, is in late-stage trials and viewed as one of the most promising assets in the space.
 - Roche announced its acquisition of 89bio for up to $3.5 billion, securing rights to pegozafermin, a Phase 3-ready FGF21 analog.
 - GSK acquired efimosfermin from Boston Pharmaceuticals in a licensing deal worth $1.2 billion upfront and up to $800 million in milestone payments.
 - A VC syndicate entered a licensing and spinout arrangement for NGM Biopharma’s MASH asset (NGM313) valued at approximately $608 million in total deal consideration.
 - Eli Lilly formed a strategic collaboration with OliX, a company focused on cardiometabolic and MASH-relevant RNA programs. While the financials were not publicly disclosed, the deal represents Lilly’s ongoing push into the metabolic space.
 
Together, these transactions reflect a clear strategic shift. The MASH opportunity is no longer theoretical – it is real, immediate, and massive.
Real-World Data Is Becoming a Strategic Necessity
With multiple therapies expected to launch within a narrow timeframe, clinical differentiation may not be enough. Commercial success will increasingly depend on how well companies understand the real-world MASH population.
Real-world data (RWD) drawn from electronic health records, imaging reports, pathology summaries, and provider notes is already playing a crucial role in helping life sciences teams:
- Accurately size the eligible patient population
 - Identify undiagnosed or misdiagnosed MASH patients
 - Characterize disease severity and fibrosis progression
 - Map the patient journey from NAFL to cirrhosis
 - Understand comorbid conditions such as type 2 diabetes, obesity, and cardiovascular disease
 - Demonstrate real-world treatment patterns and gaps in care
 
Why Unstructured Data Matters
The challenge with MASH is that many of the most important clinical details are not captured in structured data fields. ICD codes for MASH and fibrosis stages are underused or inconsistently applied. As a result, structured data alone often misses key insights.
Unstructured clinical text, like biopsy reports, radiology findings, physician narratives, and progress notes can provide critical signals:
- Fibrosis scores (F1 to F4) and steatosis grades
 - Mentions of fatigue, abdominal discomfort, or weight changes
 - Documentation of lifestyle factors such as alcohol consumption or diet
 - Descriptions of patient-reported symptoms and longitudinal progression
 
Extracting and analyzing this data with natural language processing and AI tools enables a far more complete picture of the MASH patient population.
Looking Ahead
As more therapies reach the market, the ability to capture and interpret real-world signals will become a key source of competitive advantage.
- Companies that can integrate both structured and unstructured data will be better positioned to:
Support value-based contracts and payer negotiations - Identify subpopulations for label expansion
 - Conduct robust post-marketing surveillance
 - Understand treatment patterns across diverse care settings
 - Demonstrate real-world outcomes that matter to clinicians, regulators, and patients alike
 
Clinical trial data may be the foundation for approval, but real-world data will be essential for differentiation, adoption, and long-term success.