MIST Milestone Pharmaceuticals Inc

$MIST Milestone Pharmaceuticals $MIST: HC Wainwright & Co. reiterated its Buy rating with a $8.00 price target.

$MIST Before judging the value of the China approval, take a look at Everest Medicines. Everest prefers to license in late-stage or early-commercial products and commercialize them quickly in China. They have spent years building their sales network, hospital access and commercial infrastructure, and that investment is finally starting to pay off. NEFECON sales are ramping fast and the company is now close to profitability. Everest is actively adding its next wave of commercial assets, and Cardamyst looks likely to be one of the more important ones in the portfolio. Let's keep an eye on how things develop in China. NRDL coverage may take some time due to the official process and timeline, but I believe the commercial launch could begin within weeks.

$MIST Some may argue that the early launch results have been disappointing. However, even the investment banks covering MIST are not expecting significant revenue in 2026, and the current TRx trajectory appears to be slightly above the consensus expectations. The announcement of 2027 Medicare coverage in October will be the next catalyst. I think at least 50% of Medicare plans will begin covering Cardamyst with PA and QL starting January 1, 2027. It would also not be surprising to see additional coverage news announced at any time. No matter what the bears are saying, keep the faith and wait for the real game to begin in 2027.

$MIST The financial return Milestone Pharmaceuticals receives from the China approval comes in two distinct forms: an immediate regulatory milestone cash payment and ongoing tiered royalties on commercial sales. 1. The Immediate Payout: Regulatory Milestone Payment Approval itself does not immediately generate commercial sales royalties; instead, it triggers a contractual regulatory milestone payment: * Milestone Deal Terms: Under the Greater China licensing agreement (originally structured with JiXing/Corxel and assumed by Everest Medicines in 2026), Milestone is eligible to receive up to $107.5 million in cumulative clinical, regulatory, and commercial milestone payments. * The Approval Trigger: Regulatory approval by the NMPA in China typically accounts for a one-time, non-dilutive milestone payment estimated between $5 million and $15 million (the exact individual milestone line items within the $107.5M package are maintained as confidential commercial terms in SEC filings). 2. Ongoing Royalties on Commercial Net Sales Once Everest Medicines formally launches the drug (expected in Q4 2026), Milestone will receive quarterly royalty checks based on net sales across Mainland China, Hong Kong, Macau, and Taiwan: * The Royalty Rate: The agreement structures tiered royalties in the mid-single to low-double digits (typically ranging from mid-single digits up to ~10%–12% on net sales as commercial volume tiers scale up). * Early Commercial Horizon (Late 2026 – 2027): * In the first year, sales will be driven primarily by out-of-pocket, self-pay patients in top-tier hospitals. * Assuming Everest generates initial China net sales of $10 million to $20 million in its first full year of rollout (2027), Milestone would earn roughly $700,000 to $2.0 million in annual sales royalties. * Post-NRDL Scale (2028+): If Everest successfully gets the drug onto the National Reimbursement Drug List (NRDL), volume can expand significantly. If peak annual net sales in China reach $100 million to $150 million, Milestone's annual royalty stream would grow to roughly $8 million to $15 million+ per year. Overview of Financial Flow | Component | Timing | Estimated Value to Milestone | Purpose / Impact | |---|---|---|---| | NMPA Approval Milestone | Immediate (Q3/Q4 2026) | ~$5M – $15M (One-time cash) | Offsets launch expenses and extends Milestone's cash runway. | | Near-Term Commercial Royalties | 2026 – 2027 | ~$0.5M – $2.0M / year | Early tiered percentage on self-pay market rollout. | | Long-Term Peak Royalties | 2028+ (Post-NRDL) | ~$8M – $15M+ / year | Scaled royalty stream alongside broader commercial adoption. |

$MIST So here's an interesting stat from the last Schedule 14A Proxy. Our favorite CEO Joseph Oliveto has 121,574 options that expire on 9/19/26 at 1.12. Here's the telling question of the day. Let's say the stock price is 1.20 on the 19th. Does he a) Exercise and hold meaning he has to come up with 112K in cash. That would be great news for us shareholders. b) Exercise and sell, keep the .08 profit and take his wife out to dinner with it. That would be great news for his wife c) Let them expire worthless without doing anything. That would spare him the embarrassment of choosing b d) Beg the board for an extension What does everyone think? My two cents is on an extension although it would be nice if his wife got a decent meal.

$MIST Cardamyst offers many advantages over ER (time/cost) and oral beta blockers (time, effectiveness) for PSVT; however, penetration to this point has been slow. MIST has $170M in Cash/ST presently against $140M LT debt and a 12mo burn rate of approximately $(60)M. Much of the upside here depends on global adoption (insurance companies), as the cost disparity $1600/pack v $5-10/mo beta blockers has created friction with insurers. The next level move here might be successful Phs-III data of the same molecule for AFIB. The SP is undervalued if either Phs-III proves successful (AFIB) or market penetration improves materially either in US or foreign markets. 50-100% upside from $1.0 IMO on traction, multiplier upside if/where either with positive AFIB data or market penetration on primary CARDAMYST molecule. Watch for support again at/around $1.0

$MIST - it is obvious that some people on this board want instant gratification. As I mentioned before this drug can't be expected to preform in script velocity like a GPL-1 or a new pain pill or some other general market drug. The population available to this drug is not a large, they have to meet a specific criteria not only from the doctor but from the insurance company as well. This will take time to build, it isn't a get rich quick investment in my opinion, it is a slow and steady build, changing a paradigm over night is not going to happen that fast. Doctors need to have experience with patients using the drug to feel confident that they are doing what is right by prescribing it for the patient and that the positive results will lead to the doctor writing more scripts for other patients.

$MIST expecting a partnership for the european market this year. New milestone payments incoming

$MIST The company already disclosed that the milestone payments under the China licensing agreement with Ji Xing were divided into development milestones and sales milestones (2Q 2021 10-Q). The company has received a total of $7.5M so far for several achieved development milestones, so a $2M payment in this case is in the reasonably predictable range. Any serious fund following the company know this already. Not an issue at all.

$MIST Also in October (10/29) is the international Prix Galien. Look at the companies we are listed with in Best Pharmaceutical Product https://www.prnewswire.com/news-releases/the-galien-foundation-announces-2026-prix-galien-usa-nominees-for-best-biotechnology-product-best-pharmaceutical-product-and-best-product-for-rareorphan-diseases-302848225.html Best Pharmaceutical Product (Nominees) Akebia Therapeutics Alcon Ardelyx, Inc. Boehringer Ingelheim Bristol Myers Squibb Eisai and Biogen Inc. Genentech, A Member of the Roche Group Gilead Sciences, Inc. Idorsia Pharmaceuticals Ltd. Innoviva Specialty Therapeutics, Inc. Innoviva Specialty Therapeutics, Inc. Innoviva Specialty Therapeutics, Inc. Insmed Incorporated Johnson & Johnson Johnson & Johnson Merck & Co., Inc. Milestone Pharmaceuticals Novartis Novartis Phathom Pharmaceuticals UroGen Pharma Zusduri® Companies listed more than once have multiple drugs nominated- see link

$MIST This post is primary example of why MIST is misunderstood and undervalued. 1- It doesn’t compete with the $5 PIP head to head. It fills the critical unserved niche for those that need reoccuring ER/UC visits. 200k-350k patients marking up annual revenues of at least 200,000 x $800 x 3 = $480,000,000 in the US + China + EU. Long term +$1B without Afib market. 2- that population is 60% Medicare’s and 40%. Most of this year only 10% of the addressable market was covered and now we are we are at 20%. For a non lifesaving medication, where we are is not a failure to launch. It’s typical part of the adoption process for new meds. The medicine adds 200 new patients a week with only fraction coverage, this scales to 1000 with coverage. 3- LT debt is misleading. the royalty was booked as debt. smart for tax purposes but the LT debt doesn’t become “due” for repayment. There is more but these misunderstanding is why in Q2 professionals added 10M share, likey more for Q3.

$MIST short squeeze! short squeeze! short squeeze! FDA approval drove 100M+ shares for 2 weeks. With the absurd amount of shorts, would have to imagine a similar impact. Would bet they hold off the 8K until Tuesday. They have 4 business days to file. This precedes the first of the many investor presentations and maximizes the ump!!

$MIST - CEO mentioned the patent protection with 3 different patents which will all go through 2042 and eluded to the ability to extend those patents. Also the patents would force any other drug company to create a totally new compound and they would have to go through the complete FDA trial process.

$MIST - Script pricing will get higher as the coverage expands. Average price will fall in the $500 to $1000 range in 2027.

$MIST About 2M shares shorted recently below $1.30. Looking at the chart, we are likely to go above that and head towards $1.80 by the end of October. Could be a painful ride for all those enthusiastic bears. 4th Qtr sales could start to accelerate.

$MIST from Milestone's Q2 2026 report (quarter ended June 30, 2026, released August 12, 2026) More than 1,500 scripts for CARDAMYST were filled for more than 1,300 patients with PSVT through June 30, 2026, compared to approximately 300 scripts for 300 patients at the end of Q1. Scripts grew from ~300 to ~1,500, which is 5x, or about +400%. Patients went ~300 to ~1,300, roughly 4.3x (+333%). Prescribers went ~200 to ~800, 4x (+300%). That puts Q2 revenue growth at roughly +135% sequentially (2.35x). Revenue is growing faster than scripts, which is the early sign of the gross-to-net and coverage story starting to work.

$MIST This just further proved the stock market is more than half based on speculation, engagement, and not truly a companies worth or value it brings. It’s sad when a shiddy company like Carvana can Wen to the moon but a valuable medical treatment bombs at the waist side.

$MIST Painful. Kept holding out for optimism and improved scripts, and these bozos sound like scripts remain bad, and said, and I quote: "We don't see scripts as the ultimate indicator for the success of this market" WTF?!?!

$MIST Guys, I know it doesn't mean squat, but don't forget to hit the bullish button on the sentiment, you can do it daily. I just get sick of seeing it show bearish daily.

$MIST With rising interest rates, rising inflation, rising and excessive debt levels, interest payments and an excessive demand for capital, remaining in the stock market remains dangerous, particularly when the Norwegian Sovereign Fund tells the world it is getting out of US Treasuries. That is an open message to Donald Trump that his current policies are actually hurting the US not benefiting it. So, if you want to remain in the market, you want companies that have at least a three to five year sales growth trajectory, have a product that is needed in both boom and bust, that has more than enough cash and that can withstand a large market drawdown. MIST meets that criteria. Five years from now, the stock should outperform both the devaluing dollar and the gyrations of the stock market spectacularly IMHO. If you are short term, you should be sitting in a chunk of cash.