Milestone Pharmaceuticals Announces that CARDAMYST™ (etripamil) Nasal Spray is Available on Express Scripts Commercial National Formularies
Rhea-AI Summary
Milestone Pharmaceuticals (Nasdaq: MIST) announced that Express Scripts added CARDAMYST (etripamil) nasal spray to its commercial national formularies, effective March 27, 2026. This inclusion makes CARDAMYST broadly accessible and more affordable for Express Scripts' commercially insured lives across the United States.
CARDAMYST is the first FDA‑approved self‑administered nasal spray for converting acute symptomatic PSVT to sinus rhythm in adults; Milestone said this represents the company's first contracted formulary acceptance by a major payor and expects coverage to expand with additional insurer engagements.
Positive
- Formulary inclusion by Express Scripts effective March 27, 2026
- Broader access for Express Scripts' commercially insured lives nationwide
- First major payor contract as Milestone's initial contracted formulary acceptance
Negative
- Coverage currently limited to Express Scripts commercial national formularies
- Broader insurer coverage not yet secured; company expects coverage to ramp up
News Market Reaction – MIST
In the Mar 31 session, MIST gained 17.82%, reflecting a significant positive market reaction. Argus tracked a peak move of +27.9% during that session. Our momentum scanner triggered 38 alerts that day, indicating elevated trading interest and price volatility. Trading volume was above average at 1.8x the daily average, suggesting increased trading activity.
Data tracked by StockTitan Argus on the day of publication.
Key Figures
Historical Context
| Date | Event | Sentiment | 24h Move | Catalyst |
|---|---|---|---|---|
| Mar 20 | Earnings & launch | Positive | -20.0% | Reported 2025 results, FDA approval, and U.S. CARDAMYST launch details. |
| Mar 16 | Clinical data | Positive | -0.9% | Announced ACC.26 presentation with minimal blood pressure effects data. |
| Mar 12 | Earnings date | Neutral | +2.3% | Scheduled Q4 and full-year 2025 earnings release and investor call. |
| Feb 26 | Conference appearance | Neutral | -0.6% | Announced participation in TD Cowen health care conference and webcast. |
| Feb 10 | Management change | Positive | +1.1% | Appointed new General Counsel and CCO alongside CARDAMYST launch. |
24h Move is the share-price change in the day after each event; other market factors may also have contributed.
Recent positive milestones around CARDAMYST—including FDA approval, launch, and favorable safety data—have sometimes coincided with negative or muted price reactions, suggesting a pattern where constructive news has not consistently translated into short-term gains.
Over the last few months, Milestone has transitioned into a commercial-stage company following FDA approval of CARDAMYST in December 2025, launched the product in the U.S., and steadily built its leadership and investor outreach. Key updates included full-year 2025 financials and launch commentary on Mar 20, safety data presentations on Mar 16, and conference participation and executive appointments in February. Today’s Express Scripts formulary inclusion follows this commercialization ramp, focusing specifically on payer access and coverage expansion.
Key Terms
paroxysmal supraventricular tachycardia medical
psvt medical
sinus rhythm medical
u.s. food and drug administration regulatory
fda regulatory
pharmacy benefit managers financial
formulary financial
AI-generated analysis. How Rhea-AI works. Not financial advice.
Decision Expands Coverage to National Preferred Formulary Commercially Insured Lives
MONTREAL and CHARLOTTE, N.C., March 31, 2026 (GLOBE NEWSWIRE) -- Milestone® Pharmaceuticals Inc. (Nasdaq: MIST), a biopharmaceutical company focused on the development and commercialization of innovative cardiovascular medicines, today announced that Express Scripts, one of the nation’s largest pharmacy benefit managers, has added CARDAMYST™ (etripamil) nasal spray to its commercial national formularies, effective March 27, 2026. This inclusion makes CARDAMYST broadly accessible and affordable for their commercially insured lives across the United States.
CARDAMYST is the first and only self-administered nasal spray approved by the U.S. Food and Drug Administration (FDA) for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm in adults.
“We have been working diligently to expand access to CARDAMYST for patients with PSVT since before the drug’s FDA approval in December 2025. This decision by Express Scripts represents the first contracted formulary acceptance of CARDAMYST by a major payor and thereby significantly improves access to this important new treatment option,” said Lorenz Muller, Chief Commercial Officer, Milestone Pharmaceuticals. “We are committed to making CARDAMYST affordable and accessible to the patient community, and we expect coverage to ramp up as we continue to engage with other insurance providers.”
About Paroxysmal Supraventricular Tachycardia (PSVT)
An estimated two million people in the United States are currently diagnosed with PSVT, which is a type of arrhythmia or abnormal heart rhythm. PSVT is characterized by episodes of sudden onset rapid heartbeats often exceeding 150 to 200 beats per minute. The heart rate spike is unpredictable and may last several hours. The rapid heart rate often causes disabling severe palpitations, shortness of breath, chest discomfort, dizziness or lightheadedness, and distress, forcing patients to limit their daily activities. The uncertainty of when an episode of PSVT will strike or how long it will persist can provoke anxiety in patients and negatively impact their day-to-day life between episodes. The impact and morbidity from an attack can be especially detrimental in patients with underlying cardiovascular or medical conditions, such as heart failure, obstructive coronary disease, or dehydration. Many health care providers are dissatisfied with the lack of effective treatment options, with patients often electing to pursue prolonged, burdensome, and costly trips to the emergency department or even undergo invasive cardiac ablation procedures.
About CARDAMYST
CARDAMYST™ (etripamil) nasal spray is approved by the U.S. Food and Drug Administration (FDA) for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm in adults. It is a novel calcium channel blocker nasal spray designed as a self-administered rapid response therapy for patients, thereby bypassing the need for immediate medical oversight. The product is intended to provide health care providers with a new treatment option to enable on-demand care and patient self-management. This portable treatment may provide patients with active management and a greater sense of control over their condition. CARDAMYST is well studied with a robust clinical trial program that includes a completed Phase 3 clinical-stage program for the treatment of PSVT. Currently, etripamil is in Phase 2 development for treatment of PSVT in pediatric patients and Phase 3 development for control of acute atrial fibrillation with rapid ventricular rate (AFib-RVR) in adults. For more information, please visit CARDAMYST.com.
Indication
CARDAMYST is indicated for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm in adults.
IMPORTANT SAFETY INFORMATION FOR CARDAMYST (etripamil) Nasal Spray
What is CARDAMYST?
CARDAMYST is a prescription medicine used to help restore normal sinus heart rhythm in adults who have symptoms of sudden episodes of fast heartbeat called paroxysmal supraventricular tachycardia (PSVT).
It is not known if CARDAMYST is safe and effective in children.
Do not use CARDAMYST if you:
- are allergic to CARDAMYST or any of its ingredients. See the Patient Information for a complete list of ingredients in CARDAMYST.
- have limitations in activities due to heart failure (moderate to severe heart failure).
- have Wolff-Parkinson-White (WPW) syndrome, Lown-Ganong-Levine syndrome, or an abnormal heart rhythm pattern called pre-excitation (delta wave) on an electrocardiogram (ECG).
- have sick sinus syndrome without a permanent pacemaker.
- have second degree or higher atrioventricular (AV) block.
Before using CARDAMYST, tell your healthcare provider about all of your medical conditions, including if you:
- have a history of fainting.
- have low blood pressure.
- are pregnant or plan to become pregnant. It is not known if CARDAMYST will harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known if CARDAMYST passes into your breast milk. You should stop breastfeeding for 12 hours after treatment with CARDAMYST. During this time, pump and throw away your breast milk. Talk to your healthcare provider about the best way to feed your baby after using CARDAMYST.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of CARDAMYST?
CARDAMYST may cause serious side effects, including:
- Fainting due to CARDAMYST effects on blood pressure, heart rate, and electrical activity of the heart. CARDAMYST may cause dizziness and fainting, especially in people with a history of fainting and certain heart problems, or people with a history of fainting during an episode of PSVT. Use CARDAMYST while sitting in a safe area where you will not fall if you become dizzy or lightheaded. Lie down if you feel dizzy or lightheaded after using CARDAMYST. If fainting occurs after using CARDAMYST, caregivers should place you on your back and seek medical help.
The most common side effects of CARDAMYST include:
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These are not all of the possible side effects for CARDAMYST. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Please see the full Prescribing Information https://milestonepharma.com/etripamilprescribinginformation.pdf for CARDAMYST.
Cautionary Note on Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Words such as “believe,” “continue,” “could,” “demonstrate,” “designed,” “develop,” “estimate,” “expect,” “may,” “pending,” “plan,” “potential,” “progress,” “will”, “intend” and similar expressions (as well as other words or expressions referencing future events, conditions, or circumstances) are intended to identify forward-looking statements. These forward-looking statements are based on Milestone’s expectations and assumptions as of the date of this press release. Each of these forward-looking statements involves risks and uncertainties. Actual results may differ materially from these forward-looking statements. Forward-looking statements contained in this press release include statements regarding: Milestone’s expectations regarding the benefits of Express Scripts adding CARDAMYST™ to its commercial national formularies; Milestone’s ability to make CARDAMYST broadly accessible and affordable; and other statements not related to historical facts. Important factors that could cause actual results to differ materially from those in the forward-looking statements include, but are not limited to, whether Milestone’s future interactions with the EMA will have satisfactory outcomes; whether and when, if at all, Milestone’s MMA for etripamil will be approved by the EMA; uncertainties related to the timing of initiation, enrollment, completion, evaluation and results of Milestone’s clinical trials; risks and uncertainty related to the complexity inherent in cleaning, verifying and analyzing trial data; and whether the clinical trials will validate the safety and efficacy of etripamil for PSVT or other indications, among others, general economic, political, and market conditions, including deteriorating market conditions due to investor concerns regarding inflation, international tariffs, Russian hostilities in Ukraine and ongoing disputes in the Middle East and overall fluctuations in the financial markets in the United States and abroad, risks related to pandemics and public health emergencies, and risks related the sufficiency of Milestone’s capital resources and its ability to raise additional capital in the current economic climate. These and other risks are set forth in Milestone’s filings with the U.S. Securities and Exchange Commission (SEC), including in its annual report on Form 10-K for the year ended December 31, 2025 under the caption “Risk Factors,” as such discussions may be updated from time to time by subsequent filings Milestone may make with the SEC. Except as required by law, Milestone assumes no obligation to update any forward-looking statements contained herein to reflect any change in expectations, even as new information becomes available.
About Milestone Pharmaceuticals
Milestone Pharmaceuticals Inc. (Nasdaq: MIST) is an emerging commercial-stage biopharmaceutical company advancing innovative cardiovascular medicines to benefit people living with certain heart conditions. Milestone’s lead product is CARDAMYST™ (etripamil) nasal spray, a novel calcium channel blocker, which is FDA approved for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm in adults. Etripamil is also in development for the control of symptomatic episodic attacks associated with AFib-RVR.
Contact:
Investor Relations
Kevin Gardner, kgardner@lifesciadvisors.com
Media Relations
Rebecca Novak, rnovak@milestonepharma.com
