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The first CAR-T treatment to win approval from the Food and Drug Administration racked up just $12 million in sales last quarter, a reminder that the therapy has a long way to go if it’s ever going to meet Wall Street’s blockbuster expectations.

Analysts expect Novartis’ Kymriah, which costs $475,000 for a one-time dose, to bring in about $159 million this year, according to Evaluate Pharma, meaning the drug maker is going to need to pick up the commercial pace if it hopes to avoid disappointment.

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It’s facing two headwinds: complexity and scarcity.

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