How Many HO Start Forms Are We Expecting Going into Q2 EPS?

Research evidence excerpt

How Many HO Start Forms Are We Expecting Going into Q2 EPS?

orms, inclusive of all

75 clinical trial patients, which we assume to convert by the end of Q2. Investors seem comfortable

w/ 350, but the #1 question we're getting is whether revenue needs to beat at this valuation. We

think this is not important yet, as reimbursement will be slow. RYTM also isn't disaggregating US

revenue into BBS vs HO, so this will be difficult to compare.

FWIW, sell-side consensus per VA models $4.6M in Q2 and $47M for 2026. Assuming 350 start

forms in Q2, our illustrative model estimates $4M in Q2 - and this accounts for: (1) slower

reimbursement rate of 30-40% than Crenessity (70-75%), Vykat (65-70%), and Palsonify (50%) but

approximately in line w/ RYTM's BBS launch, (2) time for new patients to reach target dose + CT

patients converting at the target dose, and (3) modest attrition.

For Q3/Q4, we model 540/700 cumulative start forms. To be clear, we back into Q3/Q4 start forms

from cons rev using our own reimbursement rate assumptions (only modest improvement towards

55% by YE). These are thus conservative assumptions: (1) reimbursement could be higher (BBS was

~55-60% reimbursed after 4 Qs, on our math, and RYTM has said HO should be covered faster than

BBS). If this plays out, the 540/700 patient start forms should drive upside to rev,; and (2) patient

starts may be higher, too, since implied net adds decelerate from ~18/wk to 12-13/wk if there's no

bolus effect and the demand can remain linear through YE, which should also drive rev upside.

Other dynamics to watch in Q2. (1) RYTM will report Phase I RM-718 weekly subQ open-label 16-

wk HO data. The BMI "bar" is around 9-10%, which is what setmelanotide and bivamelagon showed Dennis Ding * | Equity Analyst

around this point.