Milestone Pharmaceuticals Highlights AFib Push Amid PSVT Launch

Milestone Pharmaceuticals (MIST) highlighted progress at the H.C. Wainwright 28th Annual Global Investment Conference, focusing on the commercial launch of CARDAMYST—a novel drug for paroxysmal supraventricular tachycardia (PSVT) and its broader application in atrial fibrillation (AFib). The company’s CEO, Joseph Oliveto, and Chief Commercial Officer, Lorenz Muller, outlined strategic advantages in a market that has remained stagnant for over three decades, with no new PSVT-specific treatment approved since 2015. CARDAMYST, approved by the FDA in December 2025, entered the market in mid-February 2026, following a 2.5-month rollout of a field force to support distribution. The drug’s rapid onset and favorable safety profile have garnered early positive feedback from healthcare providers, who praise its efficacy and minimal off-target effects, such as syncopal episodes or blood pressure drops. Oliveto emphasized lessons learned from the PSVT program, including outpatient study methodologies and FDA regulatory insights that will inform future trials, including the ongoing Phase III AFib study, which is expected to deliver data in approximately two years. Muller noted the significant overlap between PSVT and AFib patient populations, with about 20% of SVT patients also experiencing AFib, creating a compelling commercial opportunity. The AFib market alone presents a conservative estimate of 3 million to 4 million patients requiring rate control, with over 1 million annual emergency department visits tied to AFib-related treatments. Muller anticipates refill rates to accelerate beyond initial projections, with early adopters likely to fill multiple prescriptions electronically, driving long-term adoption beyond the launch year. The company’s financial position remains cautious, with a negative leveraged free cash flow of $61.65 million over the past year and a market capitalization of $131.89 million. Despite a 53% year-to-date decline, analysts have set price targets ranging from $2 to $8, reflecting cautious optimism about the drug’s potential. The company’s cash runway extends into the second half of 2027, and its gross profit margin remains robust at 98%, underscoring operational efficiency in a niche but high-need therapeutic area.