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This review examines the biological mechanisms underlying GLP-1 RA therapy in MASLD/MASH, analyzes the mechanistic distinctions between mono-, dual-, and triple agonists, and synthesizes current clinical evidence supporting their utilization in individuals with this condition.

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--- Here are some potential actions covered in the article for payers and employers to take as a result of this shift: Update formulary tiers and step therapy policies (consider the impact on comorbidities) Support members transitioning off GLP-1s after reaching their goals Create differentiated access pathways based on patient risk profiles Monitor realworld outcomes beyond A1C (cardiovascular, renal, adherence) Model the downstream impact on generics and legacy therapies --- Commercial plans are accelerating GLP-1 uptake and favoring the simplicity of a single therapy