Video Series

Welcome back to another AJMC Insights series. In this episode titled, 'The Financial and Clinical Cost of Delayed MASH Detection and Fragmented Care', Dr. Jaideep Behari led the conversation about the following questions: The estimated financial burden of metabolic dysfunction-associated steatohepatitis (MASH) is considerable. How does delayed detection and intervention impact the overall cost of MASH care? What financial and clinical benefits arise from implementing early detection programs for MASH? How does fragmentation within the MASH ecosystem affect value-based care outcomes? How can population health efforts optimize these outcomes?

1 expert is featured in this series.

For the first time, the 2026 ACC/AHA guideline provides strong, evidence-based recommendations for patients who cannot tolerate statins—a group historically underserved by prior guidance. Outcome data now support bempedoic acid (from the CLEAR trial), PCSK9 monoclonal antibodies, ezetimibe, and inclisiran as viable alternatives. Rather than defaulting to high-intensity statin doses, clinicians can consider combination strategies such as a moderate-intensity statin paired with ezetimibe—a pairing shown in the RACING trial to match the cardiovascular event reduction of high-intensity monotherapy while improving tolerability and LDL goal achievement. The "rule of sixes"—where doubling a statin dose yields only an additional 6% LDL reduction versus 18% from adding ezetimibe—further reinforces early combination thinking.

1 expert is featured in this series.

The 2026 update to the ACC/AHA guideline for dyslipidemia management represents a meaningful shift in how and when clinicians should begin lipid-lowering therapy, Erin D. Michos, MD, MHS, professor of medicine, director of Women's Cardiovascular Health and associate director of Preventive Cardiology in the Division of Cardiology at Johns Hopkins University School of Medicine, explains.