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Cirius joined some large players, most notably Gilead, who saw their NASH dreams dashed or set back in 2019. The California-based big biotech saw three different trial failures for its NASH drug, both as a monotherapy and in combination. Days ago, Boehringer dumped a NASH drug they acquired for $250 million after a Phase I raised safety concerns.

The struggles aren’t limited to the clinic. Investors have expressed skepticism about NASH drugs’ commercial prospects. Although NASH – or nonalcoholic steatohepatitis – is thought to affect about 50 million Americans and is marked by damaging liver scarring and fat buildup, most patients have never heard of the condition and don’t know they have it. It requires a painful biopsy to diagnose, limiting the number who will ever actually be diagnosed. Reimbursement is also a question; broadly, American payers have tried to limit their exposure to chronic therapies.

The result has been few NASH buyouts in 2019, although a couple biotechs proved successful on public markets with 89bio and Genfit fetching $85 million and $107 million respectively.

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