Resmetirom is the only approved MASH drug today. Survodutide just read out phase 3 obesity at 16.6%; LIVERAGE + LIVERAGE-Cirrhosis pending. Pemvidutide IMPACT-MASH starting phase 3 H2 2026. Why we hold on MASH-specific routing recommendations and what we'd need to see to start.
What actually shifted in the last 60 days: Foundayo (orforglipron) approved early under the National Priority Voucher, oral Wegovy 25mg shipping, FDA proposes excluding tirzepatide from 503B bulks, RFK pulled 14 peptides off Category 2, survodutide phase 3 obesity readout. Routing impact for each.
Retatrutide, orforglipron, CagriSema, survodutide, MariTide, pemvidutide. Where each one sits in phase 3, the readout window, the mechanism, and what each approval would shift for routing decisions today. Bleeding edge of the science, conservative on the rating.