Milestone Pharmaceuticals reported third quarter results on November 13 and paired them with a restructuring. Cardamyst (etripamil) nasal spray, its FDA approved self administered treatment for acute episodes of paroxysmal supraventricular tachycardia in adults, generated net product revenue of 1.0 million dollars in the quarter, up 73 percent from the second quarter, with about 3,400 total prescriptions written by about 1,600 unique prescribers since launch and payer coverage reaching about two thirds of commercially covered lives. Third quarter prescriptions were about 1,800, up 50 percent on the prior quarter.
The cost side is the story. Selling, general and administrative expense was 24.2 million dollars in the quarter, up from 7.9 million dollars a year earlier on launch spending, and the net loss widened to 25.8 million dollars, or 0.18 dollars per share, from 11.9 million dollars, or 0.12 dollars per share. Milestone will cut operating expenses by about 30 percent: it is bringing its field force of about 45 representatives in house from a contracted model (the force was already trimmed from about 60 in August), discontinuing less productive marketing and support programmes, internalising outsourced work and reducing headquarters headcount by about 20 percent, with about 2 million dollars of one time charges and completion expected in the first quarter of 2027. Chief Financial Officer Amit Hasija and Chief Medical Officer David Bharucha have left the leadership team, with Bharucha moving to an adviser role.
Two financing moves support the plan. An amendment with RTW Investments extends the payment in kind interest period on Milestone’s convertible notes from March 31, 2027 to March 2029, and cash, cash equivalents and short term investments of 145.4 million dollars at September 30 are now expected to fund operations into late 2028, more than a year beyond prior guidance. That runway is calibrated to one event: topline data from ReVeRA-301, the Phase 3 trial of etripamil in atrial fibrillation with rapid ventricular rate, a population Milestone estimates at 3 to 4 million patients in the United States, expected in the second half of 2028.