A population estimate alone no longer sizes this market: Rezdiffra has already reported 42,250+ patients on therapy, and the model must triangulate that real uptake against the 6.7 million F2-F3 addressable pool.
The F2-F3 label-eligible MASH population in the US is estimated at 6.7 million adults, within a much larger base of 14.9 million with MASH and 86.3 million with MASLD overall (PMID 39821400). That F2-F3 pool is projected to grow to 11.7 million by 2050 as obesity and type 2 diabetes prevalence rise, and it defines the addressable population for both approved therapies, Rezdiffra (resmetirom) and Wegovy (semaglutide 2.4 mg), which share the same noncirrhotic F2-F3 accelerated-approval label.
A pure epidemiology-based estimate would overstate near-term revenue, since most of the 6.7 million pool remains undiagnosed or unstaged in primary care, and label-eligible does not mean treated. Madrigal reported more than 42,250 patients on Rezdiffra therapy and $311.3 million in net product revenue for Q1 2026, up 127% year over year, giving this model a real, reported uptake curve to triangulate against the population base rather than a modeled penetration assumption. At a WAC of approximately $47,400 per year, sitting inside ICER's $39,600-$50,100 value-based price range, that uptake already implies a specific penetration rate against the 6.7 million pool, the starting point for the revenue-scenario sheet. Wegovy's MASH-specific uptake cannot be isolated the same way: Novo Nordisk reports Wegovy revenue at the franchise level, commingled with obesity and type 2 diabetes indications, so a resmetirom-versus-semaglutide uptake split is a refinement opportunity for a future update, not a number this model invents.
US MASH sizing — epidemiology, reported uptake, and price triangulated
| Sizing Method | Estimate | Source |
|---|---|---|
| Epidemiology-based (F2-F3 label-eligible) | 6.7M patients, rising to 11.7M by 2050 | PMID 39821400 |
| Uptake-based (reported, Rezdiffra) | 42,250+ patients on therapy, Q1 2026 | Madrigal Q1 2026 earnings |
| Revenue-based (reported, Rezdiffra) | $311.3M net revenue, +127% YoY | Madrigal Q1 2026 earnings |
| Price anchor | ~$47,400 WAC vs $39,600-$50,100 ICER value range | Madrigal WAC disclosure; ICER 2024 NASH assessment |
Sources: Madrigal Pharmaceuticals Q1 2026 earnings release and call; PMID 39821400 (US MASH/MASLD epidemiology); ICER 2024 NASH value assessment (Midwest CEPAC); Madrigal Rezdiffra WAC disclosure.
What this model answers
Every section answers a named commercial question your team is asking, scoped to your asset.
Delivers
- The 6.7 million current F2-F3 estimate against the 14.9 million MASH and 86.3 million MASLD base
- the 2050 projection to 11.7 million
- the undiagnosed/unstaged gap in primary care
Delivers
- The population x reported uptake x price triangulation methodology
- the implied penetration rate against the 6.7 million pool
- the revenue-scenario build this supports
Delivers
- The Wegovy franchise-level revenue reporting issue
- why AXLRx flags the gap rather than estimating a split
- the refinement path for a future model update
Custom model delivered in 72 hours.
Commission This ModelWhat's inside
- Why reported uptake, not epidemiology alone, anchors this model
- Pressure-tested against Rezdiffra's Q1 2026 disclosure before the rest of the model is built out
- 6.7 million F2-F3 label-eligible patients within 14.9 million MASH and 86.3 million MASLD
- The 2050 projection to 11.7 million F2-F3 patients
- Rezdiffra's reported 42,250+ patients on therapy and $311.3 million Q1 2026 net revenue
- The 127% year-over-year growth rate as the near-term uptake trajectory
- ~$47,400 WAC against ICER's $39,600-$50,100 value-based price range
- The implied penetration rate against the 6.7 million addressable pool
- Why Novo Nordisk's franchise-level Wegovy reporting blocks a MASH-specific uptake split
- Flagged as a refinement opportunity, not an invented estimate
- Penetration rate and price ranked against the diagnosis/staging bottleneck
- Scenario ranges tied to the 2050 population projection
- The full triangulated model, re-runnable with your own assumptions
- The open sizing questions your team must close before the number is used in planning
Included with every brief
How AXLRx builds this model
Prepared by MoatRx analysts.
Every AXLRx market sizing model triangulates at least two independent methods, epidemiology-based and reported-uptake-based, before accepting a patient or revenue estimate. This is explicitly a sizing model (population and current uptake), distinct from a Forecast or Patient Flow model (multi-year dynamic revenue projection).
MASH US sizing sources: PMID 39821400 for F2-F3 epidemiology and the 2050 projection, Madrigal Pharmaceuticals' Q1 2026 earnings release for reported patient count and net revenue, and ICER's 2024 NASH value assessment for the WAC-to-value-based-price comparison.
- 6.7 million F2-F3 label-eligible population and 11.7 million 2050 projection verified against PMID 39821400
- 42,250+ patients on Rezdiffra therapy and $311.3 million Q1 2026 net revenue (+127% YoY) verified against Madrigal Pharmaceuticals' Q1 2026 earnings release
- $47,400 WAC and $39,600-$50,100 ICER value-based price range verified against Madrigal's WAC disclosure and ICER's 2024 NASH assessment
- Wegovy MASH-specific uptake confirmed not separable from Novo Nordisk's franchise-level revenue reporting, flagged rather than estimated
Frequently asked questions
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AXLRx delivers metabolic disease market sizing models built for forecasting and strategy teams sizing the US MASH opportunity. Custom model in 72 hours.
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