MARA rated sebetralstat (Ekterly) B++ (Marginal) before the G-BA published Beschluss 7763 on 2 April 2026. The G-BA recognized a non-quantifiable additional benefit under the orphan drug pathway — placing the outcome in the benefit-recognition scenario MARA’s signal identified as one of two plausible results. MARA correctly flagged both the HRQoL evidence gap (no data collected in KONFIDENT, confirmed ∅ by the G-BA) and the comparator limitation (placebo-only trial, accepted by the G-BA as the available basis). The B++ signal’s core prediction — that access was feasible but sensitive to evidence maturity — held: G-BA benefit recognition proceeded, with extent classified as non-quantifiable due to data reliability constraints on the morbidity endpoints. MARA’s general G-BA signal did not specifically account for the orphan drug legal protection that removed the standard comparative effectiveness hurdle; the actual outcome was therefore somewhat more structurally predictable than the 50/50 historical signal suggested.