There is one big difference between a sell side report and a buy side report. 

A sell side analyst has to convince the buy side to buy his/her favorite stock, and not be too excited about it.  The reason is simple.  If the analyst turns out to be wrong...he/she can always point to all the caution he/she threw into the report. If on the other hand, the analyst is right, he/she needs credible reasons to upgrade the stock to a higher price.  So the Roth Analyst did this by using a high discount rate and giving zero value to the CKD, Dementia etc. potential.  

The hedge fund on the other hand, does not need to convince any buy side...he/she IS the buy side. So he is telling you what the potential for the upside is...while of course noting that it all depends on Phase 3 coming out as he thinks it will.  So the Makalu analyst target is very credible...somewhat low if you believe the CKD and Dementia results come out as we think it will.  But a great report anyway.  I wish Makalu had pointed to eGFR and ALP data from Phase 2...but presumably that was kept in their back pocket for discussions with potential investors.