MIST Milestone Pharmaceuticals Inc

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

$MIST another patient post, worked within minutes with only one spray in one nostril. It will be the standard of care-just a matter of time.

$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 In the second week of August, CARDAMYST reached roughly 300 prescriptions per week, even with insurance coverage still at only around 50%. If prescriptions continue rising at a similar pace, we could approach 480–500 prescriptions per week by December. That would translate to roughly 2,100–2,200 prescriptions per month, or an annualized run rate of more than 25,000 prescriptions — and that is before assuming any additional benefit from insurance coverage expanding beyond 50%. And importantly, this is based only on organic CARDAMYST growth in the current U.S. market. I’m not even including China, AFib-RVR, Europe, or any of the other upcoming catalysts.

$MIST - of the 21 drugs Up for the Prix Galien award for Best Pharmaceutical Product of 2026 Gemini Pro ranked CARDAMYST in the top 5. Public Health & Acute Care Solutions 4. NUZOLVENCE (Innoviva): Approved in late 2025, this first-in-class single-dose oral antibiotic specifically targets uncomplicated urogenital gonorrhea. With Neisseria gonorrhoeae rapidly mutating to resist standard treatments, Nuzolvence addresses a critical, escalating global public health threat. 5. CARDAMYST (Milestone Pharmaceuticals): In the realm of acute cardiovascular interventions, shifting paroxysmal supraventricular tachycardia (PSVT) management from the emergency room to an at-home nasal spray removes massive friction from the healthcare system. It provides immediate patient autonomy and drastically reduces hospital admissions during sudden arrhythmic episodes.

$MIST Another successful CARDAMYST experience posted today, kicked in within 7mins, helping the patient avoid an ER visit. I have strong conviction in this drug. If the product delivers, word spread, sales will eventually follow.

$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 - H.C. Wainwright analyst maintained $8 price target on 9/22/2026. We also have 2 (5) start analyst from TD Cowen and Wells Fargo that have an $8.00 and $7.00 price target as of August 13th. Let's hope they are more right than wrong. Keep in mind the revenue forecast is $1.14 Million to 1.17 Million. And we know that we already have $2 Million in the bag with the China revenue plus we had $1.034 Million in deferred revenue on the balance sheet. Maybe we see $1.5 Million in product revenue for Q3. It will be interesting to see if they have sold any product to Everest Medicines as an initial build for the China inventory, or if they can shed some light on how the China ramp is going.

$MIST unbelievable. Who would have thought that we’d see these levels again. I still think it has huge upside potential in the long run

$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 I bought some more. It’s 10th day below $1. But I do think this is more biotech sector related selling pressure than the individual stock of $MILESTONES. We should have moved up due to the good trial news from Canada. So I don’t blame the Company totally rather hope Joe learns to play the market a little better in PR release. You have to boost and market yourself if the street not recognizing you and your stock. Don’t get lazy and take for granted that somehow just because you have a FDA approved drug then all is good. I also agree that that top executives and Board members should buy 50-100 K shares in the open unless they have none public material news Btw during my buying in late hour in between $0.79-0.78 ranges I felt the MM was not really dumping per se because my BID were at 3000 -5000 shares per order and they didn’t dump on me but spread out in 100/200/300/500 multiple executions. Anyway the Marco market & record SI will play into day to day fluctuations. BL

$MIST We may see the 2027 Medicare formulary update on Oct 15. The key checkpoint is not the overall Medicare coverage percentage, but the Tier and copay structure. If the company does not offer sufficiently favorable pricing to payers, our the only product could end up on Tier 5 with 25~33% coinsurance+PA+QL. In that case, patients should pay several hundred dollars which would be a serious disaster for all. The company had already recognized this issue even before FDA approval. At the 2025 HCW conference , they mentioned that the goal for Medicare was to achieve Tier 2/3 with a $50–$80 copay. To secure a fixed-copay condition in Medicare, the net price would likely need to be closer to the lower end of the expected net price range. Even so, I believe that would be the better for us. Although the mgmt has not provided much detail on its Medicare strategy since then, I believe the negotiations have focused on prioritizing patient affordability over maximizing net price in Medicare.

$MIST FDA approval, China approval, insurance coverage at 50% and more is coming, AFIB phase 3 enrolled, EU approval next year, catalyst after catalyst and this bitch been only going down!

$MIST I think what a lot of retail fails to factor in appropriately, is that cardamist is designed to treat a condition that is both episodic and chronic. The episodic nature will impact when/how often it is prescribed proof of effectiveness and the speed of uptake. In turn, this necessarily dictates the ramp up pace and why it doesn't reflect the aggressive $$ modelling for a much higher post approval sp. So, I think we need to watch for at least another 2-3 quarters. It's a slow grind I know, but as long as the script trajectory continues upward, the company will establish a foothold and make money. For investors, the ramp up has to outpace cash burn and that will lead to additional income to extend the window for P3 Afib trials, reduce dilution potential and lead more quickly to a potential buy out. If the trajectory flatlines, then it's a whole other story. I am still counting on a buy out down the road. Adulting is hard.

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

$MIST forced fund selling under $1 last couple of days creates a unique opportunity. Cash on hand still $170 million Coverage doubled at the very end of last earnings. So you saw only 25% coverage on 16 weeks commercial launch. Fantastic position here. Gift

Interesting MIST angle after Novo’s Capital Markets Day Novo explicitly outlined a “disciplined bolt-on business development strategy” and wants to diversify its pipeline beyond diabetes/obesity, including cardiovascular disease. That’s potentially relevant to $MIST: FDA-approved CARDAMYST, China approval already secured, Europe pending, and a Phase 3 AFib-RVR program underway. Novo’s materials do not mention MIST specifically, so this is not evidence of a deal. But the strategic fit is worth watching—especially given MIST’s tiny valuation relative to Novo.

$MIST Have we found our bottom? If so, this will have proven to have been an outstanding opportunity to start or add to a position. I added another 40k in the low/mid $.90s . Hopefully a smart move, hard to think it won't be but 🤷🤷🤷