RZ358 is being developed as an add-on for diazoxide/SSA failures, not 1L. To displace a cheap oral 1L, you’d need head-to-head data and payers OK with a ~$300k/yr IV mAb. Co’s own funnel (~1,500 US kids) caps initial CHI sales at a few hundred million, not $1B.
1L = first line . Because of the expected cost of the drug , expect payors to insist patient fail on first line therapy first