I think Baldy's concerns are theoretical rather than practical....

I think Baldy's concerns are theoretical rather than practical. Acadia has the rights to Trofinetide for Fragile X but has done nothing with them. In fact, you say they have paid hansomely for the rights to Rett and FX in 2591. It is therefore difficult to envisage what other indications they might wish to develop Trofinetide for.
The panic merchants are worried that Acadia could stymie any development in 2591 simply by shoving a proposal through the JSC for the same indication with Trofinetide. But that ignores the practicalities. The cost of developing a proposal through to the point of approval by the JSC will be high. The costs of carrying out a bona fide development would be even higher.The presence of Neuren reps on the JSC will ensure oversight by Neuren to ensure that any proposal is genuine. And if a fraudulent proposal were to be pushed through by Acadia's casting vote, then the courts would intevene to stop it. So while it looks worryting to a lawyer, to the businessmen who signed the agreement, it is not a problem.
I'l go with the businessmen.