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Thank you for the insightful reply. Appreciate it.
So are you thinking about it in these terms?
\- Wholesale Acqusition Cost (WAC): 5g vial = $3,050 = $610 per gram (via source 1)
\- Dose per course: 10 g/m² × 3 days × \~1.8m² (avg adult BSA) = \~54 grams
Gross WAC per course = $610 x 54g = $33k
Gross to net discount: \~15-25%
(A) Net implied price: \~$25-28k
(B) NTAP payment from Medicare: Up to $21.4k to hospitals; not received by Medexus and not part of net price
Total US allo-HSCT procedures: 9,000 <<- but Grafapex is only approved for AML and MDS, which amount to \~50-55% and that gives us 4,500-5,000 procedures (C)
Management says "27% market share of 9,000 procedures"; but that means 50-55% of addressable patients (as per C)
\*\*\*\*\*\*\*
If we have 27% market share of 9,000 procedures (equal to 50-55% of addressable patients; in line with the 56% penetration (albeit peadiatric) from Canada and obviously very bullish):
\~27% x 9,000 = 2,430 patients x $25-28k = $61m - $68m
\*\*\*\*\*\*\*
If we have 27% market share of 4,500-5,000 (which should be base case):
\~27% x 4,500-5,000 = 1,215-1,350 patients x $25-28k= $30m - $38m
\*\*\*\*\*\*\*
Where math breaks (basically we calculate total market size):
If we have \~56% (as per Canada) of 9,000 (this basically means 100% of AML+MDS):
\~56% x 9,000 = 5,040 patients x $25-28k = $126m - $141m
\*\*\*\*\*\*\*
The math just doesn't add up to me with these net price assumptions regardless of how I spin it.
So the key questions are:
1. Help me understand why they're using 27% of 9,000 instead of 27% of 4,500-5,000? Isn't that an obvious mistake they're using so their base case is actually quite bullish because it requires very high penetration even though Europe supports it?
2. NTAP payment is confirmed only for CMS fiscal year 2026, right? It can be renewed but not guaranteed. Once it expires, price falls and it may disappear before product is ramp so the tailwind from it may be limited? And my understanding is that NTAP goes to hospitals, and never to Medexus. So why would it form part of the "peak sales" calculation and Implied Price?
Source 1: [https://www.medexus.com/en\_US/news-media/press-releases/detail/183/medexus-announces-commercial-availability-of-grafapex](https://www.medexus.com/en_US/news-media/press-releases/detail/183/medexus-announces-commercial-availability-of-grafapex))

This is how news outlet CMS looks like haha.
That's why you can read the same article over multiple sources and languages.

Thank you for the insightful reply. Appreciate it.
So are you thinking about it in these terms?
\- Wholesale Acqusition Cost (WAC): 5g vial = $3,050 = $610 per gram (via source 1)
\- Dose per course: 10 g/m² × 3 days × \~1.8m² (avg adult BSA) = \~54 grams
Gross WAC per course = $610 x 54g = $33k
Gross to net discount: \~15-25%
(A) Net implied price: \~$25-28k
(B) NTAP payment from Medicare: Up to $21.4k to hospitals; not received by Medexus and not part of net price
Total US allo-HSCT procedures: 9,000 <<- but Grafapex is only approved for AML and MDS, which amount to \~50-55% and that gives us 4,500-5,000 procedures (C)
Management says "27% market share of 9,000 procedures"; but that means 50-55% of addressable patients (as per C)
\*\*\*\*\*\*\*
If we have 27% market share of 9,000 procedures (equal to 50-55% of addressable patients; in line with the 56% penetration (albeit peadiatric) from Canada and obviously very bullish):
\~27% x 9,000 = 2,430 patients x $25-28k = $61m - $68m
\*\*\*\*\*\*\*
If we have 27% market share of 4,500-5,000 (which should be base case):
\~27% x 4,500-5,000 = 1,215-1,350 patients x $25-28k= $30m - $38m
\*\*\*\*\*\*\*
Where math breaks (basically we calculate total market size):
If we have \~56% (as per Canada) of 9,000 (this basically means 100% of AML+MDS):
\~56% x 9,000 = 5,040 patients x $25-28k = $126m - $141m
\*\*\*\*\*\*\*
The math just doesn't add up to me with these net price assumptions regardless of how I spin it.
So the key questions are:
1. Help me understand why they're using 27% of 9,000 instead of 27% of 4,500-5,000? Isn't that an obvious mistake they're using so their base case is actually quite bullish because it requires very high penetration even though Europe supports it?
2. NTAP payment is confirmed only for CMS fiscal year 2026, right? It can be renewed but not guaranteed. Once it expires, price falls and it may disappear before product is ramp so the tailwind from it may be limited? And my understanding is that NTAP goes to hospitals, and never to Medexus. So why would it form part of the "peak sales" calculation and Implied Price?
Source 1: [https://www.medexus.com/en\_US/news-media/press-releases/detail/183/medexus-announces-commercial-availability-of-grafapex](https://www.medexus.com/en_US/news-media/press-releases/detail/183/medexus-announces-commercial-availability-of-grafapex))

This is how news outlet CMS looks like haha.
That's why you can read the same article over multiple sources and languages.

2026 STAR Rating Court Case Update: Court GRANTS Defendants’ (HSS / CMS) Motion and STAYS discovery and discovery-related deadlines.