The contract sales force has been hired so as to launch soon after approval, presuming approval occurs, which in the current climate I think it will though the data are not a slam dunk.
Note only about 20% of ALS pts are estimated to be in the group this was trialed in (early disease--eat/move/breathe independently, <2y out from dx). So the FDA and therefore PBMs (pharmacy managers for health plans) don't have to approve it for anyone else, but given the logistical barriers to starting an infused drug, and the long drought in ALS therapies, they will likely hold the door open for a while to see what the spend will be, then restrict more as needed.
The PBM pipeline updates are not suggesting that they will limit it to anything past an ALS dx so far. Then again, the FDA is the entity that approves the product labeling, so the PBMs haven't seen it yet, and that can influence what they do.