Tonix Pharmaceuticals Announces Second Major Managed Medicare Payer Agreement for TONMYA®

Rhea-AI Summary

Tonix Pharmaceuticals (TNXP) announced a second major managed Medicare coverage agreement for TONMYA, its fibromyalgia treatment for adults, effective immediately and adding approximately 21 million Medicare lives, or 38% of about 55 million Medicare lives in the U.S.

This new agreement brings total TONMYA Medicare coverage to approximately 32 million lives, representing 58% of the U.S. Medicare population. Across commercial and government payers, TONMYA is now covered for about 166 million lives, or 53% of roughly 314 million total U.S. lives. The company previously secured commercial payer agreements with two group purchasing organizations and one major managed Medicare payer, and TONMYA is covered by Medicaid in nearly all states. Tonix reports that approximately 50 new sales representatives have been activated, increasing its sales force to 150 to support the product’s launch and capitalize on expanded access.

Positive

• New Medicare agreement adds ~21 million lives, 38% of U.S. Medicare population
• Total Medicare coverage for TONMYA now ~32 million lives, 58% of U.S. Medicare lives
• Overall payer coverage reaches ~166 million lives, 53% of total U.S. lives
• Sales force expansion to 150 representatives to support TONMYA launch
• TONMYA patents expected to provide U.S. market exclusivity until 2034

Negative

• None.

Market Context

On Aug 10, TNXP recorded a 4.66% 24-hour move alongside a reported TONMYA coverage base of 136 milli...

Analysis

On Aug 10, TNXP recorded a 4.66% 24-hour move alongside a reported TONMYA coverage base of 136 million lives; the current agreement disclosed expansion to 166 million covered lives.

Key Figures

Medicare lives added: 21 million Medicare lives Medicare coverage: 32 million Medicare lives Total payer coverage: 166 million covered lives +2 more

Medicare lives added

21 million Medicare lives

Second major managed Medicare agreement, effective immediately

Medicare coverage

32 million Medicare lives

58% of approximately 55 million U.S. Medicare lives

Total payer coverage

166 million covered lives

Commercial and government coverage, 53% of total U.S. lives

New sales representatives

50 representatives

Fully activated in the field

Total sales force

150 representatives

After the latest sales-force additions

Historical Context

1 past event · Latest: Aug 10

1 event

1. Aug 10

   Earnings report

   24h Move

   +4.7%

   Reported TONMYA coverage expansion to roughly 136 million U.S. covered lives.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

managed Medicare, transmucosal absorption, first-pass hepatic metabolism, serotonin syndrome

4 terms

managed Medicare regulatory

"adds approximately 21 million Medicare lives"

Medicare benefits delivered through private, managed-care plans—often called Medicare Advantage—where a health insurer contracts with Medicare to provide covered services, manage care with provider networks, and handle claims under set payment arrangements. Like hiring a home manager to coordinate contractors and schedules, these plans centralize care and payment rules; for investors, they affect enrollment trends, revenue predictability, network costs, and exposure to regulatory and reimbursement changes.

transmucosal absorption medical

"provides rapid transmucosal absorption of cyclobenzaprine"

Transmucosal absorption is the process by which a drug or compound is taken up through the body's mucous membranes (for example inside the mouth, nose, or rectum) and enters the bloodstream instead of going through the stomach and liver. Like taking a shortcut, this route can make medicines act faster, be easier to take, and avoid breakdown in the gut, factors that affect dosing, patient convenience, regulatory hurdles and the commercial competitiveness of a therapy.

first-pass hepatic metabolism medical

"due to bypassing first-pass hepatic metabolism"

First-pass hepatic metabolism is the process where an orally taken drug is substantially broken down by the liver before it reaches the general bloodstream, like a package inspected and partly opened at a checkpoint before delivery. It matters to investors because high first-pass loss can reduce a drug's effective dose, require higher or repeated dosing, alternative delivery methods, or more expensive development and regulatory hurdles, all of which affect commercial value and risk.

serotonin syndrome medical

"increases the risk of serotonin syndrome"

A potentially serious medical condition caused by excess serotonin activity in the nervous system, usually from certain medications or drug interactions; symptoms range from mild agitation, tremor and rapid heart rate to severe high fever, muscle rigidity, seizures or loss of consciousness. It matters to investors because occurrences, clinical-trial signals, or regulatory findings about serotonin syndrome can affect a drug’s safety profile, labeling, approval prospects and commercial marketability—similar to a product recall or defect report for a consumer good.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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New agreement, effective immediately, adds approximately 21 million Medicare lives (38% of approximately 55 million Medicare lives in the U.S.)

Commercial and government payer coverage for TONMYA now reaches approximately 166 million covered lives (53% of total U.S. lives)

BERKELEY HEIGHTS, N.J., Sept. 22, 2026 (GLOBE NEWSWIRE) -- Tonix Pharmaceuticals Holding Corp. (Nasdaq: TNXP) (“Tonix” or “the Company”), a fully integrated, commercial-stage biopharmaceutical company, today announced a second major managed Medicare agreement for TONMYA^® (cyclobenzaprine HCl sublingual tablets) for the treatment of fibromyalgia in adults that is effective immediately, adding approximately 21 million Medicare lives (38% of approximately 55 million Medicare lives in the U.S.). Medicare coverage now totals 32 million Medicare lives in the U.S. (58% of approximately 55 million Medicare lives in the U.S.).

Total commercial and government payer coverage for TONMYA now reaches approximately 166 million covered lives (53% of approximately 314 million total U.S. lives). Previously, Tonix announced commercial payer agreements with two leading group purchasing organizations, and one major managed Medicare agreement. In addition, TONMYA is covered by Medicaid in nearly all states.

“The second major managed Medicare agreement expands patient access to TONMYA, the first fibromyalgia treatment approved in over 15 years,” said Seth Lederman, M.D., President and Chief Executive Officer of Tonix Pharmaceuticals. “We believe the commercial and managed Medicare coverage agreements reflect TONMYA’s compelling value to patients and payers as a first-in-class, non-opioid analgesic designed for daily bedtime administration and long-term use in adults with fibromyalgia.”

Thomas Englese, MBA, Chief Commercial Officer of Tonix Pharmaceuticals, added, “We remain confident in the trajectory of the TONMYA launch. Our team is focused on executing our strategy across market access, sales, and marketing to improve access for TONMYA and raise awareness for fibromyalgia and TONMYA. This new Medicare coverage agreement is expected to increase patient access to TONMYA. Approximately 50 new sales force representatives have been fully activated in the field, bringing the total sales force to 150 representatives. We are focused on translating the new coverage into more opportunities for fibromyalgia patients to access TONMYA.”

About Fibromyalgia

Fibromyalgia is a chronic pain disorder that is understood to result from amplified sensory and pain signaling within the central nervous system. Fibromyalgia afflicts more than 10 million adults in the U.S., predominantly women. Symptoms of fibromyalgia include chronic widespread pain, nonrestorative sleep, fatigue, and morning stiffness. Other associated symptoms include cognitive dysfunction and mood disturbances, including anxiety and depression. Individuals suffering from fibromyalgia struggle with their daily activities, have impaired quality of life, and frequently are disabled. Physicians and patients report common dissatisfaction with currently marketed products.

About TONMYA^® (cyclobenzaprine HCl sublingual tablets)

TONMYA (cyclobenzaprine HCl sublingual tablets) was approved on August 15, 2025, by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia in adults. TONMYA is the first new prescription medicine approved for fibromyalgia in more than 15 years. TONMYA provides rapid transmucosal absorption of cyclobenzaprine and reduced production of a long half-life active metabolite, norcyclobenzaprine, due to bypassing first-pass hepatic metabolism. TONMYA is a multifunctional agent with potent binding and antagonist activities at the 5-HT2A serotonergic, alpha1-adrenergic, H1-histaminergic, and M1-muscarinic receptors. TONMYA was investigated as TNX-102 SL. TNX-102 SL is also being developed to treat acute stress disorder (ASD)/acute stress reaction (ASR), and major depressive disorder (MDD). The United States Patent and Trademark Office (USPTO) issued United States Patent No. 9636408 in May 2017, Patent No. 9956188 in May 2018, Patent No. 10117936 in November 2018, Patent No. 10,357,465 in July 2019, and Patent No. 10736859 in August 2020. The Protectic™ protective eutectic and Angstro-Technology™ formulation claimed in the patent are important elements of Tonix’s proprietary TONMYA composition. These patents are expected to provide TONMYA with U.S. market exclusivity until 2034.

Tonix Pharmaceuticals Holding Corp.

Tonix Pharmaceuticals* is a fully integrated, commercial-stage biopharmaceutical company focused on central nervous system (CNS) disorders, infectious diseases, and immunology conditions with high unmet medical needs. TONMYA^® (cyclobenzaprine HCl sublingual tablets 2.8mg), the Company’s flagship internally conceived and developed medicine, is the first treatment for fibromyalgia in more than 15 years. Tonix’s CNS commercial infrastructure supports its marketed products, including its acute migraine products, Zembrace^® SymTouch^® (sumatriptan injection 3 mg) and Tosymra^® (sumatriptan nasal spray 10 mg). Tonix is extending the science behind TONMYA in Phase 2 clinical studies to evaluate the potential of TNX-102 SL in major depressive disorder and acute stress disorder/acute stress reaction. Tonix is also advancing a pipeline of infectious disease programs, including Phase 2-ready monoclonal antibody TNX-4800 (anti-OspA mAb) for Lyme disease prevention in the U.S., and TNX-801 (horsepox, live virus vaccine), a vaccine in development for the prevention of mpox and smallpox. Within immunology, TNX-1500 (anti-CD40L mAb) is a Phase 2-ready, third-generation CD40 ligand inhibitor for the prevention of kidney transplant rejection. To learn more, visit www.tonixpharma.com.

*Tonix’s product development candidates, including TNX-102 SL for new, unapproved indications, are investigational new drugs or biologics. Their efficacy and safety have not been established and have not been approved for any indication.

Zembrace SymTouch and Tosymra are registered trademarks of Tonix Medicines. TONMYA is a registered trademark of Tonix Pharma Limited. All other marks are property of their respective owners.

Forward Looking Statements

Certain statements in this press release are forward-looking within the meaning of the Private Securities Litigation Reform Act of 1995. These statements may be identified by the use of forward-looking words such as “anticipate,” “believe,” “forecast,” “estimate,” “expect,” and “intend,” among others. There are a number of factors that could cause actual events to differ materially from those indicated by such forward-looking statements. These factors include, but are not limited to, risks related to the failure to successfully launch and commercialize TONMYA® and any of our approved products; risks related to the failure to obtain FDA clearances or approvals and noncompliance with FDA regulations; risks related to the timing and progress of clinical development of our product candidates; our need for additional financing; uncertainties of patent protection and litigation; uncertainties of government or third party payor reimbursement; limited research and development efforts and dependence upon third parties; and substantial competition. As with any pharmaceutical under development, there are significant risks in the development, regulatory approval and commercialization of new products. Tonix does not undertake an obligation to update or revise any forward-looking statement. Investors should read the risk factors set in the Company’s Annual Report on Form 10-K for the year ended December 31, 2025, as filed with the SEC on March 12, 2026, and periodic reports filed with the SEC on or after the date thereof. Tonix does not undertake an obligation to update or revise any forward-looking statement. All of Tonix’s forward-looking statements are expressly qualified by all such risk factors and other cautionary statements. The information set forth herein speaks only as of the date thereof.

Investor Contacts

Deborah Elson
Tonix Pharmaceuticals
deborah.elson@tonixpharma.com
investor.relations@tonixpharma.com

Brian Korb
astr partners
(917) 653-5122
brian.korb@astrpartners.com

Media Contacts

Andrea Cohen
Sam Brown Inc.
(917) 209-7163
andreacohen@sambrown.com

INDICATION

TONMYA is indicated for the treatment of fibromyalgia in adults.

CONTRAINDICATIONS

TONMYA is contraindicated:

In patients with hypersensitivity to cyclobenzaprine or any inactive ingredient in TONMYA. Hypersensitivity reactions may manifest as an anaphylactic reaction, urticaria, facial and/or tongue swelling, or pruritus. Discontinue TONMYA if a hypersensitivity reaction is suspected. With concomitant use of monoamine oxidase (MAO) inhibitors or within 14 days after discontinuation of an MAO inhibitor. Hyperpyretic crisis seizures and deaths have occurred in patients who received cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitors drugs.

During the acute recovery phase of myocardial infarction, and in patients with arrhythmias, heart block or conduction disturbances, or congestive heart failure. In patients with hyperthyroidism.

WARNINGS AND PRECAUTIONS

Embryofetal toxicity: Based on animal data, TONMYA may cause neural tube defects when used two weeks prior to conception and during the first trimester of pregnancy. Advise females of reproductive potential of the potential risk and to use effective contraception during treatment and for two weeks after the final dose. Perform a pregnancy test prior to initiation of treatment with TONMYA to exclude use of TONMYA during the first trimester of pregnancy.

Serotonin syndrome: Concomitant use of TONMYA with selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, tramadol, bupropion, meperidine, verapamil, or MAO inhibitors increases the risk of serotonin syndrome, a potentially life-threatening condition. Serotonin syndrome symptoms may include mental status changes, autonomic instability, neuromuscular abnormalities, and/or gastrointestinal symptoms. Treatment with TONMYA and any concomitant serotonergic agent should be discontinued immediately if serotonin syndrome symptoms occur and supportive symptomatic treatment should be initiated. If concomitant treatment with TONMYA and other serotonergic drugs is clinically warranted, careful observation is advised, particularly during treatment initiation or dosage increases.

Tricyclic antidepressant-like adverse reactions: Cyclobenzaprine is structurally related to TCAs. TCAs have been reported to produce arrhythmias, sinus tachycardia, prolongation of the conduction time leading to myocardial infarction and stroke. If clinically significant central nervous system (CNS) symptoms develop, consider discontinuation of TONMYA. Caution should be used when TCAs are given to patients with a history of seizure disorder, because TCAs may lower the seizure threshold. Patients with a history of seizures should be monitored during TCA use to identify recurrence of seizures or an increase in the frequency of seizures.

Atropine-like effects: Use with caution in patients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in patients taking anticholinergic drugs.

CNS depression and risk of operating a motor vehicle or hazardous machinery: TONMYA monotherapy may cause CNS depression. Concomitant use of TONMYA with alcohol, barbiturates, or other CNS depressants may increase the risk of CNS depression. Advise patients not to operate a motor vehicle or dangerous machinery until they are reasonably certain that TONMYA therapy will not adversely affect their ability to engage in such activities. Oral mucosal adverse reactions: In clinical studies with TONMYA, oral mucosal adverse reactions occurred more frequently in patients treated with TONMYA compared to placebo. Advise patients to moisten the mouth with sips of water before administration of TONMYA to reduce the risk of oral sensory changes (hypoesthesia). Consider discontinuation of TONMYA if severe reactions occur.

ADVERSE REACTIONS

The most common adverse reactions (incidence ≥2% and at a higher incidence in TONMYA-treated patients compared to placebo-treated patients) were oral hypoesthesia, oral discomfort, abnormal product taste, somnolence, oral paresthesia, oral pain, fatigue, dry mouth, and aphthous ulcer.

DRUG INTERACTIONS

MAO inhibitors: Life-threatening interactions may occur.

Other serotonergic drugs: Serotonin syndrome has been reported.

CNS depressants: CNS depressant effects of alcohol, barbiturates, and other CNS depressants may be enhanced.

Tramadol: Seizure risk may be enhanced.

Guanethidine or other similar acting drugs: The antihypertensive action of these drugs may be blocked.

USE IN SPECIFIC POPULATIONS

Pregnancy: Based on animal data, TONMYA may cause fetal harm when administered to a pregnant woman. The limited amount of available observational data on oral cyclobenzaprine use in pregnancy is of insufficient quality to inform a TONMYA-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Advise pregnant women about the potential risk to the fetus with maternal exposure to TONMYA and to avoid use of TONMYA two weeks prior to conception and through the first trimester of pregnancy. Report pregnancies to the Tonix Medicines, Inc., adverse-event reporting line at 1-888-869-7633 (1-888-TNXPMED).

Lactation: A small number of published cases report the transfer of cyclobenzaprine into human milk in low amounts, but these data cannot be confirmed. There are no data on the effects of cyclobenzaprine on a breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for TONMYA and any potential adverse effects on the breastfed child from TONMYA or from the underlying maternal condition.

Pediatric use: The safety and effectiveness of TONMYA have not been established.

Geriatric patients: Of the total number of TONMYA-treated patients in the clinical trials in adult patients with fibromyalgia, none were 65 years of age and older. Clinical trials of TONMYA did not include sufficient numbers of patients 65 years of age and older to determine whether they respond differently from younger adult patients.

Hepatic impairment: The recommended dosage of TONMYA in patients with mild hepatic impairment (HI) (Child Pugh A) is 2.8 mg once daily at bedtime, lower than the recommended dosage in patients with normal hepatic function. The use of TONMYA is not recommended in patients with moderate HI (Child Pugh B) or severe HI (Child Pugh C). Cyclobenzaprine exposure (AUC) was increased in patients with mild HI and moderate HI compared to subjects with normal hepatic function, which may increase the risk of TONMYA-associated adverse reactions.

Please see additional safety information in the full Prescribing Information. To report suspected adverse reactions, contact Tonix Medicines, Inc. at 1-888-869-7633, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What condition is TONMYA approved to treat and in which patient population?

TONMYA (cyclobenzaprine HCl sublingual tablets 2.8 mg) is indicated for the treatment of fibromyalgia in adults.

When was TONMYA approved by the FDA for fibromyalgia?

TONMYA was approved by the U.S. Food and Drug Administration on August 15, 2025 for the treatment of fibromyalgia in adults.

How is TONMYA described in terms of its pharmacology and formulation?

TONMYA is a sublingual formulation of cyclobenzaprine that provides rapid transmucosal absorption and reduces formation of the long half-life metabolite norcyclobenzaprine by bypassing first-pass hepatic metabolism. It has antagonist activity at 5-HT2A serotonergic, alpha1-adrenergic, H1-histaminergic, and M1-muscarinic receptors.

How long is TONMYA expected to have U.S. market exclusivity?

The TONMYA composition, which includes the Protectic protective eutectic and Angstro-Technology formulation, is covered by multiple U.S. patents that are expected to provide U.S. market exclusivity until 2034.

What other commercial CNS products does Tonix market besides TONMYA?

Tonix’s CNS commercial infrastructure also supports Zembrace SymTouch (sumatriptan injection 3 mg) and Tosymra (sumatriptan nasal spray 10 mg) for acute migraine.

What are key contraindications for TONMYA use?

TONMYA is contraindicated in patients with hypersensitivity to cyclobenzaprine or any inactive ingredient; with concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of MAOI discontinuation; during the acute recovery phase of myocardial infarction; in patients with arrhythmias, heart block or conduction disturbances, congestive heart failure, or hyperthyroidism.

What important warning is given regarding pregnancy and TONMYA?

Based on animal data, TONMYA may cause neural tube defects when used two weeks before conception and during the first trimester. Females of reproductive potential are advised to use effective contraception during treatment and for two weeks after the final dose, and a pregnancy test should be performed before starting treatment to avoid use during the first trimester.