MASLD has become the leading cause of chronic liver disease globally. Treatment options have expanded rapidly. Here is what's available at Class A hospitals in China and how the workflow compares to Western markets.
Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD, formerly NAFLD) affects an estimated 30% of adults globally per published epidemiology, with rising prevalence driven by obesity, type 2 diabetes, and metabolic syndrome. Approximately 20% of patients with steatosis progress to MASH (metabolic dysfunction-associated steatohepatitis), which carries fibrosis progression risk.
The Disease Burden
Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD, formerly NAFLD) affects an estimated 30% of adults globally per published epidemiology, with rising prevalence driven by obesity, type 2 diabetes, and metabolic syndrome. Approximately 20% of patients with steatosis progress to MASH (metabolic dysfunction-associated steatohepatitis), which carries fibrosis progression risk.
The Standard Workup
Class A hepatology departments run a structured MASLD workup:
- Liver ultrasound or MRI-PDFF for steatosis quantification
- FibroScan (transient elastography) for fibrosis staging
- Comprehensive labs: ALT, AST, GGT, lipid panel, HbA1c, fasting insulin, ferritin
- FIB-4 score calculation for fibrosis risk stratification
- Hepatology consultation with structured treatment plan
Cost: USD 200–340 all-in at a Class A international department.
Treatment Options Available in China
Several treatment categories are accessible:
- GLP-1 receptor agonists (semaglutide, tirzepatide) — strong evidence for steatosis improvement and modest fibrosis benefit; widely available
- Pioglitazone — established benefit for MASH histology; long-standing availability
- Resmetirom (Rezdiffra) — FDA-approved THR-β agonist for MASH with significant fibrosis; international access via select centres
- SGLT2 inhibitors — beneficial cardiometabolic effect with modest liver benefit; widely available
- Vitamin E in non-diabetic biopsy-confirmed MASH — established option with caveats
- Bariatric surgery in eligible patients — strongest durable evidence for MASH resolution
The GLP-1 Stack
The most common treatment combination at Class A endocrinology + hepatology MASLD clinics in China is:
- Semaglutide or tirzepatide for primary metabolic management
- SGLT2 inhibitor (empagliflozin or dapagliflozin) for cardiorenal protection in patients with T2DM
- Statin for cardiovascular protection if dyslipidaemia present
- Lifestyle programme (Mediterranean-style diet, structured exercise)
- FibroScan re-assessment at 6 and 12 months
For patients with significant fibrosis (F2–F3), resmetirom can be added if access is feasible.
Cost Considerations
For patients on multi-component therapy, China access typically saves 50–70% vs Western private-pay equivalents. A 12-month MASLD-focused therapy package at a Class A international department (consult + workup + 12 months of medications + 6-month follow-up) typically falls in the USD 4,500–8,500 range, depending on which agents are included.
Should You Get Tested?
Take our free NAFLD/MASLD risk self-assessment for a structured 3-minute screen. Patients with BMI ≥ 27, T2DM, dyslipidaemia, or known abnormal liver enzymes are appropriate for formal workup.
The Long Game
MASLD's long-term consequences are primarily cardiovascular, not hepatic — most MASLD-related death is from cardiovascular events, not liver failure. Effective management addresses both dimensions simultaneously. The China pathway makes that integrated approach more affordable than most Western alternatives.
Sources: AASLD 2023 MASLD practice guidance; FDA resmetirom approval documents; partner-hospital hepatology pricing 2026.