Milestone Pharmaceuticals — Third Quarter 2026 Earnings Summary

Financial Performance:

• Net product revenue for CARDAMYST was $1.0 million for Q3 2026, up 73% from Q2 2026; total product revenue for the nine months ended September 30, 2026, was $1.8 million compared to $0 in the same period in 2025.
• Total revenues for Q3 2026 were $2.963 million (including $2.0 million in license revenue) compared to $0 in Q3 2025; total revenues for the nine months ended September 30, 2026, were $3.760 million compared to $0 in the same period in 2025.
• Net loss for Q3 2026 was $25.8 million ($0.18 per share) compared to $11.9 million ($0.12 per share) in Q3 2025; net loss for the nine months ended September 30, 2026, was $80.5 million ($0.59 per share) compared to $45.6 million ($0.60 per share) in 2025.
• Research and development expense, net of tax credits, was $3.5 million for Q3 2026 (down from $3.9 million in Q3 2025) and $10.2 million for the nine months ended September 30, 2026 (down from $12.6 million in 2025).
• Selling, general and administrative expense was $24.2 million for Q3 2026 (up from $7.9 million in Q3 2025) and $67.5 million for the nine months ended September 30, 2026 (up from $32.3 million in 2025).
• Cash and equivalents were $145.4 million as of September 30, 2026, compared to $106.0 million as of December 31, 2025.
• Deferred revenue was $1.321 million as of September 30, 2026, compared to $0 as of December 31, 2025.
• Senior secured convertible notes increased to $60.237 million as of September 30, 2026, from $57.191 million as of December 31, 2025.
• A new royalty financing obligation of $82.829 million was recorded as of September 30, 2026, compared to $0 as of December 31, 2025.
• Total liabilities increased to $168.912 million as of September 30, 2026, from $71.792 million as of December 31, 2025.

Guidance and Future Outlook:

• The company expects cash, cash equivalents, and short-term investments to be sufficient to cover operating expenses and capital expenditures into late 2028, extending the runway by more than one year beyond prior guidance.
• Topline data for the ReVeRA-301 Phase 3 trial in AFib-RVR is expected in the second half of 2028.
• Cost-efficiency measures are expected to reduce operating expenses by approximately 30% and be completed by the first quarter of 2027.

Business Segments and Product Lines:

• CARDAMYST (etripamil) nasal spray, approved for PSVT, saw prescription growth with approximately 3,400 total prescriptions written by approximately 1,600 unique prescribers since launch.
• Payer coverage for CARDAMYST has increased to approximately two-thirds of commercially covered lives.
• The sales force was optimized in August, reducing from approximately 60 representatives to 45 dedicated representatives, who are being transitioned from a contracted model to company employees.
• The AFib-RVR Phase 3 program (ReVeRA-301) remains fully funded, though non-essential short-term activities, including certain manufacturing scale-up work, have been deferred.
• Etripamil is in Phase 2 development for PSVT in pediatric patients.

Market and Competitive Landscape:

• The AFib-RVR indication has an estimated addressable patient population of approximately 3 to 4 million patients in the United States, which is approximately 3 to 4 times the size of the PSVT patient population.

Risks and Challenges:

• The company incurred approximately $2 million in one-time charges related to workforce reduction, severance, and conversion fees.
• Forward-looking statements note risks regarding the timing of clinical trials, potential differences in actual results from expectations, regulatory outcomes (including EMA interactions), and general economic conditions.

Management Commentary and Tone:

• Joseph Oliveto, President and CEO, stated the company is encouraged by early progress of CARDAMYST and believes the new approach will drive continued prescription growth and expand the prescriber base.
• Management described the actions as a "more efficient approach to capital allocation" designed to reduce operating expenses while preserving the sales force and core commercial activities.

Other Key Points:

• Amendment to the Note Purchase Agreement with RTW Investments LP extends the payment-in-kind interest period on convertible notes from March 31, 2027, to March 2029.
• Leadership changes include the departure of CFO Amit Hasija and CMO Dr. David Bharucha (who transitioned to an advisor role); Anthony Krick was named Principal Financial and Principal Accounting Officer.
• The company plans to discontinue less productive marketing, market access, and patient support initiatives while rightsizing and internalizing selected outsourced activities.