Milestone Pharmaceuticals (MIST) Corporate presentation summary

Product overview and clinical profile

• CARDAMYST (etripamil) is an FDA-approved, portable, on-demand nasal spray for rapid conversion of acute symptomatic PSVT episodes in adults, with a fast onset and well-tolerated safety profile.

• Demonstrated robust efficacy, with a 2x greater likelihood of conversion to sinus rhythm within 30 minutes compared to placebo and a >3x faster median time to conversion.

• Most adverse events are mild and localized to the nasal administration site, with low rates of hypotension and syncope.

• Patent protection extends until 2042, and the product has a shelf life of up to 36 months.

Market landscape and unmet need

• PSVT affects over 2 million people in the US, with more than $5 billion in annual healthcare costs and significant patient burden due to unpredictable, symptomatic attacks.

• Current treatments are often inconvenient, invasive, or poorly effective, with no new drug therapies approved since 1989.

• CARDAMYST addresses a sizable market with ~1 million patients treated annually and no anticipated branded competition.

Commercial strategy and opportunity

• Commercial launch is planned for February 2026, targeting new patient starts, prescription growth, and broad commercial coverage.

• Cardiologists expect to prescribe CARDAMYST to most unablated PSVT patients, with potential to reach half of annually treated patients via ~10,000 prescribers and ~60 sales reps.

• Market access strategy focuses on payer efficiency, rational pricing, and patient affordability, including copay assistance and retail distribution.

• Represents a >$1 billion net sales opportunity, assuming $750 per prescription and ~1.5 million episodes treated annually.