Milestone Pharmaceuticals Extends Cash Runway Through 2028 as It Reduces Operating Expenses

Milestone Pharmaceuticals Inc. reported financial results for the third quarter ended September 30, 2026, and announced a series of cost-efficiency measures designed to extend the company's cash runway beyond the anticipated readout of its Phase 3 trial for etripamil in atrial fibrillation with rapid ventricular rate (AFib-RVR).

The company reported net product revenue of $1.0 million for the third quarter of 2026, a 73% increase compared to the second quarter of 2026. Since the launch of CARDAMYST (etripamil) nasal spray, approximately 3,400 total prescriptions have been written by roughly 1,600 unique prescribers. Payer coverage has expanded to cover approximately two-thirds of commercially covered lives.

To extend its financial runway, Milestone announced plans to reduce operating expenses by approximately 30%. Key elements of this restructuring include bringing the sales force in-house by transitioning approximately 45 representatives from a contracted model to company employees, a move expected to lower overhead costs while maintaining current sales coverage. The company will also discontinue less productive marketing initiatives, rightsize outsourced activities, and reduce its headquarters workforce. These measures are expected to be complete by the first quarter of 2027 and will incur approximately $2 million in one-time charges.

As a result of these changes, Milestone expects its cash, cash equivalents, and short-term investments to be sufficient to cover operating expenses and capital expenditures into late 2028, more than one year beyond prior guidance. As of September 30, 2026, the company held $145.4 million in cash and equivalents.

The company also announced leadership changes, with Chief Financial Officer Amit Hasija and Chief Medical Officer David Bharucha departing from the leadership team. Anthony Krick, the Vice President of Finance, has been named Principal Financial and Principal Accounting Officer.

The ongoing Phase 3 pivotal trial (ReVeRA-301) evaluating etripamil nasal spray in AFib-RVR remains on schedule, with topline data expected in the second half of 2028. The company noted that the AFib-RVR patient population is estimated to be 3 to 4 million patients in the United States, approximately three to four times the size of the PSVT patient population.