Common Questions I Hear About Rezdiffra (resmetirom)

One of the tricky things about having a chronic health condition like nonalcoholic steatohepatitis (NASH) is sometimes, there are not a lot of treatment options out there. Basic NASH/MASH management focuses on healthy eating habits and exercise. In some cases, your doctor may recommend weight loss treatments, such as gastric bypass surgery or weight loss medications, to help control NASH. You may also be prescribed medications to help target liver fat.¹

As of 2024, Rezdiffra™ (resmetirom) is the only drug approved by the US Food and Drug Administration (FDA) to treat NASH. As a nurse, here are some common questions I hear people ask about Rezdiffra.²

I was prescribed Rezdiffra, but I thought I was already on a medication for my NASH?

While Rezdiffra is currently the only FDA-approved medication specifically for the treatment of NASH, it is not the only medication used to address liver fat. Other medications have been shown to be helpful in lowering the amounts of fat or fibrosis (scarring) in the liver, such as:^1-3

• Actos (pioglitazone)
• Rybelsus®, Ozempic®, Wegovy® (semaglutide)

The difference is these medications are used “off-label.” This means studies showed they helped with NASH, but they are not officially FDA-approved for use with this condition. While off-label sounds scary, it doesn’t mean you’re not receiving evidence-based care. It just means the drug manufacturer has not taken the steps to submit their medication to the FDA for additional uses. Your doctor may add Rezdiffra to your current NASH treatment plan for its additional benefits.⁴

Why hasn’t my provider prescribed me Rezdiffra?

Not every medication is the right fit for every person. Your primary care provider, along with any specialists you may see, are looking at lots of different factors when they make medication decisions.

For example, you can’t use Rezdiffra if you have liver cirrhosis or if you take certain medications like cyclosporine. That’s why talking to your providers about your use of supplements, over-the-counter medications, and recreational drugs or alcohol is SO important!^1,2

I’m a little worried that the FDA “fast-tracked” Rezdiffra. Do we really know enough about it yet?

Very valid question! Fast-tracking a medication through the FDA process usually happens when a medication is needed because no other treatment option exists and/or the medication can treat a life-threatening medical condition. Fast track doesn’t mean that safety or quality metrics were ignored.⁵

In this case, there are no other FDA treatment options for NASH. And studies show it’s a very effective medication. It’s hard to know everything about a medication and its impacts until we have years of data. With every medication, you and your doctor have to weigh the known benefits with the known risks.^1-3

Is taking Rezdiffra going to be complicated? I’m already overwhelmed by my medication plan.

It’s so common for people to get overwhelmed by their medication treatment plan. Ask your provider if you can set up a medication review time with them or be referred to a clinical pharmacist. Ask if any of your medications can be discontinued, come in combination form with your other medications, or have extended-release options.

While Rezdiffra isn’t complicated to take, it doesn’t mean you can’t benefit from a review of all your medications and see if there are ways we can help reduce your medication burden.

Is Rezdiffra expensive?

Sigh. I wish I could tell you it’s not, but like any brand-name medication, it’s pricey. If you’re not on government-funded insurance like Medicare or Medicaid, you can go to the manufacturer’s (Madrigal Pharmaceuticals) website and print off a savings or copay card. You can also use sources like GoodRx to find the lowest-cost pharmacies near you.

Unfortunately, for those on Medicare, you cannot use a savings card. You can try prescription assistance programs through the manufacturer or use the State Health Insurance Assistance Program (SHIP) in your state to compare supplemental coverage during your enrollment periods.