Shares of Milestone Pharmaceuticals (NASDAQ:MIST) dropped nearly 16% in premarket trading on Wednesday after the company reported first-quarter results that fell well below analyst revenue expectations following the initial launch of CARDAMYST.
The stock declined 15.92% after the earnings release.
Revenue falls far short of forecasts
Milestone reported a quarterly loss of -$0.20 per share for the period ended March 31, 2026, compared with analyst expectations for earnings of $0.23 per share.
Revenue totaled $238 thousand, significantly below the analyst consensus estimate of $56.34 million.
The company generated no revenue in the same quarter last year.
CARDAMYST launch underway
Milestone began the commercial rollout of CARDAMYST nasal spray for paroxysmal supraventricular tachycardia (PSVT) in mid-February 2026.
According to the company, approximately 600 prescriptions had been filled for around 560 patients through April.
“We’re excited to report on our first quarter of sales for CARDAMYST for paroxysmal supraventricular tachycardia, or PSVT,” said Joseph Oliveto, president and chief executive officer of Milestone Pharmaceuticals.
“Healthcare professionals’ initial reaction to the product is positive and we are very encouraged by the early breadth of unique prescribers writing for their patients.”
Insurance coverage expands
The company said it secured national formulary coverage from Express Scripts in March.
Milestone added that more than 25% of commercially insured individuals in the United States now have coverage access for CARDAMYST.
Approximately 400 unique prescribers have already initiated treatment for patients using the therapy.
Commercial launch costs weigh on results
Net loss for the quarter widened to $26.1 million from $20.8 million in the prior-year period.
Commercial expenses rose to $15.8 million from $10.4 million year-on-year, primarily due to costs associated with the launch of CARDAMYST.
Cash position supports operations into 2027
Milestone reported cash, cash equivalents and short-term investments totaling $184.2 million as of March 31, 2026.
The company said it expects existing resources to fund operations into the second half of 2027.
Phase 3 programme advances
Milestone has also initiated a Phase 3 registrational programme evaluating etripamil for atrial fibrillation with rapid ventricular rate.
Patient enrollment in the study is expected to begin during the second half of 2026.