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OGEN:Investors
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
☒ |
ANNUAL
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE
ACT OF 1934 |
For
the fiscal year ended
December 31, 2022
☐ |
TRANSITION
REPORT PURSUANT TO SECTIONS 13 OR 15(d) OF THE SECURITIES EXCHANGE
ACT OF 1934 |
For
the transition period from__________ to ___________
Commission
file number
001-32188
ORAGENICS, INC.
(Exact
name of registrant as specified in its charter)
Florida |
|
59-3410522 |
(State
or Other Jurisdiction of
Incorporation
or Organization)
|
|
(IRS
Employer
Identification
No.)
|
|
|
4902 Eisenhower Blvd.,
Suite 125
Tampa,
FL
|
|
33634 |
(Address
of Principal Executive Offices) |
|
(Zip
Code) |
813-286-7900
(Registrant’s
Telephone Number, Including Area Code)
SECURITIES
REGISTERED PURSUANT TO SECTION 12(b) OF THE ACT:
Title
of each class |
|
Trading
Symbol |
|
Name
of each exchange on which registered |
Common Stock $0.001 par value per share |
|
OGEN |
|
NYSE AMERICAN |
SECURITIES
REGISTERED PURSUANT TO SECTION 12(g) OF THE ACT:
None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as
defined in Rule 405 of the Securities Act.
Yes ☐ No ☒
Indicate
by check mark if the registrant is not required to file reports
pursuant to Section 13 or Section 15(d) of the Exchange Act.
Yes ☐ No ☒
Indicate
by check mark whether the Registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities
Exchange Act of 1934 during the preceding 12 months (or for such
shorter period that the Registrant was required to file such
reports), and (2) has been subject to such filing requirements for
the past 90 days.
Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically
every Interactive Data File required to be submitted pursuant to
Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the
preceding 12 months (or for such shorter period that the registrant
was required to submit such files).
Yes ☒ No ☐
Indicate
by check mark whether the registrant is a large accelerated filer,
an accelerated filer, a non-accelerated filer, smaller reporting
company, or an emerging growth company. See the definitions of
“large accelerated filer,” “accelerated filer,” “smaller reporting
company,” and “emerging growth company” in Rule 12b-2 of the
Exchange Act.
☐ |
Large
accelerated filer |
☐ |
Accelerated
filer |
☒ |
Non-accelerated filer |
☒ |
Smaller
reporting company |
|
☐ |
Emerging
growth company |
If an
emerging growth company, indicate by check mark if the registrant
has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided
pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and
attestation to its management’s assessment of the effectiveness of
its internal control over financial reporting under Section 404(b)
of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit
report. ☐
Indicate
by check mark whether the registrant is a shell company (as defined
in Exchange Act Rule 12b-2). Yes ☐ No ☒
The
aggregate market value of the voting and non-voting common equity
stock held by non-affiliates of the registrant, was approximately
$41,703,585
computed based upon a last sales price of $21.00 as reported by the
NYSE American as of June 30, 2022.
As of April 14, 2023, there were
2,024,657 shares of the registrant’s Common stock
outstanding.
Note Regarding Reverse Stock Splits
We
filed an amendment to our Amended and Restated Articles of
Incorporation with the Secretary of State of the State of Florida
to effect a reverse split of our authorized and outstanding common
stock at a ratio of one for sixty effective January 20, 2023. All
historical share and per share amounts reflected in this report
have been adjusted to reflect the reverse stock split.
TABLE
OF CONTENTS
FORWARD LOOKING STATEMENTS AND CERTAIN
CONSIDERATIONS
This
report, along with other documents that are publicly disseminated
by us, contains or might contain forward-looking statements within
the meaning of the Securities Exchange Act of 1934, as amended (the
“Exchange Act”). All statements included in this report and in any
subsequent filings made by us with the Securities and Exchange
Commission (the “SEC”) other than statements of historical fact,
that address activities, events or developments that we or our
management expect, believe or anticipate will or may occur in the
future are forward-looking statements. These statements represent
our reasonable judgment on the future based on various factors and
using numerous assumptions and are subject to known and unknown
risks, uncertainties and other factors that could cause our actual
results and financial position to differ materially. We claim the
protection of the safe harbor for forward-looking statements
provided in the Private Securities Litigation Reform Act of 1995,
Section 27A of the Securities Act and Section 21E of the Exchange
Act. Examples of forward-looking statements include: (i)
projections of revenue, earnings, capital structure and other
financial items, (ii) statements of our plans and objectives, (iii)
statements of expected future economic performance, and (iv)
assumptions underlying statements regarding us or our business.
Forward-looking statements can be identified by, among other
things, the use of forward-looking language, such as “believes,”
“expects,” “estimates,” “may,” “will,” “should,” “could,” “seeks,”
“plans,” “intends,” “anticipates” or “scheduled to” or the
negatives of those terms, or other variations of those terms or
comparable language, or by discussions of strategy or other
intentions.
Forward-looking
statements are subject to known and unknown risks, uncertainties
and other factors that could cause the actual results to differ
materially from those contemplated by the statements. The
forward-looking information is based on various factors and was
derived using numerous assumptions. Important factors that could
cause our actual results to be materially different from the
forward-looking statements include the following risks and other
factors discussed under the Item 1A “Risk Factors” in this Annual
Report on Form 10-K. These factors include:
|
● |
We
have incurred significant operating losses since our inception and
cannot assure you that we will generate revenues or achieve
profitability; |
|
|
|
|
● |
We
will need to raise additional capital to continue to implement our
business strategy and we may not be able to do so; |
|
|
|
|
● |
Our
financial capacity and performance, including our ability to obtain
funding, non-dilutive or otherwise, necessary to do the research,
development, manufacture and commercialization of any one or all of
our product candidates; |
|
|
|
|
● |
The
timing, progress and results of clinical trials of our product
candidates, including statements regarding the timing of initiation
and completion of pre-clinical studies or clinical trials or
related preparatory work, the period during which the results of
the trials will become available and our research and development
programs; |
|
|
|
|
● |
The
timing of any submission of filings for regulatory approval of our
product candidates and our ability to obtain and maintain
regulatory approvals for our product candidates for any
indication; |
|
|
|
|
● |
Our
expectations regarding the potential benefits, activity,
effectiveness and safety of our product candidates including as to
administration, distribution and storage; |
|
|
|
|
● |
Our
expectations regarding the size of the patient populations, market
acceptance and opportunity for and clinical utility of our product
candidates, if approved for commercial use; |
|
|
|
|
● |
Our
manufacturing capabilities and strategy, including the scalability
and commercial viability of our manufacturing methods and
processes, and those of our contractual partners; |
|
|
|
|
● |
Our
expectations regarding the scope of any approved indications for
our product candidates; |
|
|
|
|
● |
Our
ability to successfully commercialize our product
candidates; |
|
|
|
|
● |
The
potential benefits of, and our ability to maintain, our
relationships and collaborations with the NIAID, the NIH, the NRC
and other potential collaboration or strategic
relationships; |
|
|
|
|
● |
Our
ability to use our lantibiotic platform to develop future product
candidates; |
|
● |
Our
estimates of our expenses, ongoing losses, future revenue, capital
requirements and our needs for or ability to obtain additional
funding, including any application for future grants or
funding; |
|
|
|
|
● |
Our
ability to identify, recruit and retain key personnel and
consultants; |
|
|
|
|
● |
Our
ability to obtain, retain, protect and enforce our intellectual
property position for our product candidates, and the scope of such
protection; |
|
|
|
|
● |
Our
ability to advance the development of our new NT-CoV2-1 vaccine
product candidate under the timelines and in accord with the
milestones projected; |
|
|
|
|
● |
Our
inability to achieve success in our identification of lantibiotic
homologs or the manufacture and nonclinical testing of our
lantibiotic product candidates; |
|
|
|
|
● |
Our
need to comply with extensive and costly regulation by worldwide
health authorities, who must approve our product candidates prior
to substantial research and development and could restrict or delay
the future commercialization of certain of our product
candidates; |
|
|
|
|
● |
Our
ability to successfully complete pre-clinical and clinical
development of, and obtain regulatory approval of our product
candidates and commercialize any approved products on our expected
timeframes or at all; |
|
|
|
|
● |
The
safety, efficacy and benefits of our product
candidates; |
|
|
|
|
● |
The
content and timing of submissions to and decisions made by the FDA,
other regulatory agencies and nongovernmental bodies and actors,
such as investigational review boards; |
|
|
|
|
● |
The
effects of government regulation and regulatory developments, and
our ability and the ability of the third parties with whom we
engage to comply with applicable regulatory
requirements; |
|
|
|
|
● |
The
capacities and performance of our suppliers and manufacturers and
other third parties over whom we have limited control; |
|
|
|
|
● |
Our
ability to maintain our listing on the NYSE American and the
effects of our 1 for 60 reverse stock split on our price per share
and the trading market of our common stock; |
|
|
|
|
● |
The
impact of the COVID-19 pandemic on our financial condition and
business operations and our ability to continue research and
development for existing product candidates on previously-projected
timelines or in accord with ordinary practices, as well as the
broader governmental, global health and macro- and microeconomic
responses to and consequences of the pandemic; |
|
|
|
|
● |
We
may be adversely impacted by any significant broad-based financial
crises and its impact on consumers, retailers and equity and debt
markets as well as our inability to obtain required additional
funding to conduct our business; |
|
|
|
|
● |
As a
public company, we must implement additional and expensive finance
and accounting systems, procedures and controls as we grow our
business and organization to satisfy reporting requirements, which
add to our costs and require additional management time and
resources; |
|
|
|
|
● |
Our
competitive position and the development of and projections
relating to our competitors or our industry; and |
|
|
|
|
● |
The
impact of laws and regulations, including those that may not yet
exist. |
We
caution investors that actual results or business conditions may
differ materially from those projected or suggested in
forward-looking statements as a result of various factors
including, but not limited to, those described above and in the
Risk Factors section of this report. We cannot assure you that we
have identified all the factors that create uncertainties.
Moreover, new risks emerge from time to time and it is not possible
for our management to predict all risks, nor can we assess the
impact of all risks on our business or the extent to which any
risk, or combination of risks, may cause actual results to differ
from those contained in any forward-looking statements. Readers
should not place undue reliance on forward-looking statements.
Except as required by applicable law, we undertake no obligation to
publicly release the result of any revision of these
forward-looking statements to reflect events or circumstances after
the date they are made or to reflect the occurrence of
unanticipated events.
PART I
ITEM 1. BUSINESS.
This
description contains certain forward-looking statements that
involve risks and uncertainties. Our actual results could differ
materially from the results discussed in the forward-looking
statements as a result of certain of the risks set forth herein. We
assume no obligation to update any forward-looking statements
contained herein.
Overview
We
are a development-stage company dedicated to the research and
development of potential therapies to fight infectious diseases
including coronaviruses and multidrug-resistant organisms. Our lead
product (NT-CoV2-1) is an intranasal vaccine candidate to prevent
coronavirus disease (“COVID-19”) from the SARS-CoV-2 virus and
variants thereof. The NT-CoV2-1 program leverages coronavirus spike
protein research licensed from the National Institutes of Health
and the National Research Council of Canada with a focus on
reducing viral transmission and offering a more patient-friendly
intranasal administration. Our proprietary lantibiotics program
features a novel class of antibiotics against bacteria our research
has shown may be applicable to multiple antibiotic-resistant
organisms.
Our
SARS-CoV-2 Vaccine Product Candidate – NT-CoV2-1
Following
our May 2020 acquisition of one hundred percent (100%) of the total
issued and outstanding common stock of Noachis Terra, Inc.
(“Noachis Terra”) we are focused on the development and
commercialization of a vaccine product candidate to provide
long-lasting immunity from SARS-CoV-2, which causes COVID-19.
Noachis Terra is a party to a worldwide, nonexclusive intellectual
property and biological materials license agreement with the
National Institute of Allergy and Infectious Diseases (“NIAID”), an
institute within the National Institutes of Health (“NIH”),
relating to certain research, patent applications and biological
materials involving pre-fusion stabilized coronavirus spike
proteins and their use in the development and commercialization of
a vaccine to provide specific, long lasting immunity from
SARS-CoV-2. Since the acquisition we have conducted testing in
animal models, including SARS-CoV-2 challenge studies in hamsters,
using specific formulations for intramuscular administration (our
Terra CoV-2 vaccine candidate) and intranasal administration (our
NT-CoV2-1 vaccine candidate), both based on the NIAID pre-fusion
stabilized spike protein antigens. Following consideration of a
number of factors, including but not limited to the competitive
landscape, we determined to bring the intranasal vaccine candidate
NT-CoV2-1 into further development due to the greater
differentiation versus current COVID-19 vaccines and the potential
benefits of intranasal over intramuscular administration. We
believe these benefits could include a higher reduction of
transmission of SARS-CoV-2 and would offer a needle-free delivery
option. We therefore are currently focusing our development efforts
on our more highly differentiated NT-CoV2-1 vaccine
candidate.
On
July 26, 2021, we entered into a licensing agreement with the
National Research Council of Canada (“NRC”) that enables us to
pursue the development of next-generation vaccines against the
SARS-CoV-2 virus and its variants. The license was subsequently
amended to include the Omicron variant, broaden the non-exclusive
field of use to include all diseases caused by coronaviruses and
any genetic variants thereof, add research protocol developed by
the NRC, and add reagents as part of the NRC technologies licensed
by us. We extended the license in April 2022. The NRC technologies,
in combination with the licensed technologies from the U.S. NIH
used in our NT-CoV2-1 vaccine candidate, provide us with a platform
that can generate cell lines for high-yield production of spike
protein antigens for existing and emerging variants of concern.
This platform should allow production of cell lines within six to
eight weeks of spike gene sequence availability, compared with six
to nine months for traditional production of such cell lines. The
NRC technologies, developed with support from the NRC’s Pandemic
Response Challenge Program, are expected to enable expedited
evaluation of SARS-CoV-2 antigen candidates in pre-clinical and
clinical studies.
Coronaviruses
are a family of viruses that can lead to upper-respiratory
infections in humans. Recent clinical reports also suggest that the
SARS-CoV-2 virus can affect other body-systems, including the
nervous, cardiovascular, gastrointestinal and renal systems. Among
the recent iterations of coronaviruses to move from animal to human
carriers is SARS-CoV-2, which, beginning in Wuhan, China, in late
2019, caused a global pandemic due to its rapid spread and the
relatively high mortality rate (as compared to the seasonal
influenza). Pfizer-BioNTech received approval from the U.S. Food
and Drug Administration (“FDA”) for their COVID-19 vaccines in
August of 2021 and the Moderna vaccine in January 2022. The Janssen
vaccine is currently available in the United States under Emergency
Use Authorizations (“EUA”) by the FDA. In July 2022, the FDA
granted EUA for the Novavax COVID-19 vaccine as well. Current
vaccines have reduced the rates of hospitalization and death due to
COVID-19 in vaccinated individuals, but the transmission levels,
even in vaccinated individuals, has allowed SARS-CoV-2 variants to
continue to circulate. We believe, given the size of the worldwide
spread of COVID-19, that even with additional vaccines available,
there will be demand for the highly differentiated NT-CoV2-1
vaccine once development is successfully completed. We intend to
combine the research, patent applications and biological materials
covered by our NIAID license with our NRC license and our existing
clinical research and manufacturing capabilities to respond to this
ongoing, global, public health issue. We believe our NT-CoV2-1
vaccine holds the possibility of playing an important role in
addressing this issue.
Coronaviruses,
such as SARS-CoV-2, possess signature protein spikes on their outer
capsule. Our NIAID license covers patents and data on a vaccine
candidate that were created based on a stabilized pre-fusion spike
trimeric protein. By stabilizing the spike protein in the
pre-fusion state, the number of immunogenic centers is increased
thereby allowing for a greater likelihood of successful antibody
binding, resulting in an improved immunogenic response. Spike
protein antigens stabilized in the pre-fusion state have been used
successfully in the leading COVID-19 vaccines from Pfizer-BioNTech
and Moderna, which we believe reduces the risk of using the same
approach in our NT-CoV2-1 vaccine candidate. The genetic code,
acquired from the NIH, for the stabilized pre-fusion spike protein
was provided to Aragen Bioscience, Inc. (“Aragen”) for the purpose
of insertion of the spike protein gene sequence into a Chinese
Hamster Ovary (“CHO”) cell line. Aragen is a leading contract
research organization focused on accelerating pre-clinical
biologics product development, has extensive experience building
CHO cell lines for recombinant proteins, such as monoclonal
antibodies. Aragen successfully inserted the NIH pre-fusion spike
protein gene sequence into a CHO cell line and we are currently
producing Phase 1 clinical material based upon this cell
line.
We
entered into both a material transfer agreement and a non-exclusive
research license agreement with Inspirevax Inc. for the use of
intranasal mucosal adjuvants in our NT-CoV2-1 vaccine candidates.
Regarding the intranasal mucosal adjuvants of interest, BDX300 and
BDX301 are proteosome-based adjuvants comprised of proteins and
lipopolysaccharides with improved attributes including enhanced
immune response, manufacturing efficiency and the benefits of
intranasal vaccine administration. More recently, we entered an
exclusive global license agreement with Inspirevax for its BDX301
adjuvant. These agreements allow for collaboration and research
regarding the intranasal delivery of the vaccine during clinical
development with the opportunity to enter into a commercial
agreement upon regulatory approval of the intranasal vaccine. In
particular, under the exclusive license agreement, we will be
forming a joint committee with Inspirevax to oversee the clinical
development efforts collaboratively. The NT-CoV2-1 vaccine
containing Inspirevax’s intranasal mucosal adjuvant BDX301 has been
studied in pre-clinical animal studies, including hamster viral
challenge studies and mouse immunogenicity studies. A rabbit
toxicology study has been initiated and is required for regulatory
approval prior to the Phase 1 clinical study.
We
began pre-clinical studies in June of 2021 through our
collaboration and material transfer agreement with the NRC. We
initiated an immunogenicity study in mice to evaluate several
adjuvant candidates. On August 30, 2021, we announced the
successful completion of these mouse immunogenicity studies that
supported further development using either the intramuscular or
intranasal routes of administration. A hamster challenge study was
initiated in September of 2021 to assess inhibition of viral
replication using adjuvants specific for intramuscular and
intranasal administration. In December of 2021, we announced that
both formulations generated robust immune responses and reduced the
SARS-CoV-2 viral loads to undetectable levels in the nasal passages
and lungs five days following a viral challenge. By contrast,
hamsters in the control groups that had received saline or
adjuvants alone had no detectable immune response and substantial
viral loads. The vaccines delivered by intranasal and intramuscular
routes generated immune responses as measured by multiple assays.
On June 14, 2022, we announced that the results of these studies
were published in Scientific Reports, a Nature
journal.
In
March 2022, following a positive assessment of a rabbit-based pilot
study, we initiated a Good Laboratory Practice (GLP) toxicology
study to evaluate the safety profile and immunogenicity of
NT-CoV2-1 in rabbits. This important preclinical study is designed
to provide data required to advance our intranasal vaccine
candidate into human clinical studies. We announced favorable
preliminary results in August 2022 and, as of December 2022, the
study has concluded and we completed the full set of toxicology
data, which is needed to support the filing of an Investigational
New Drug (“IND”) application for NT-CoV2-1. Based on the findings
of the final toxicology report, including a full histopathology
evaluation, we were able to confirm a safety and immunogenicity
profile that further support our plan to submit regulatory filings
required to progress to a Phase 1 clinical study.
While
we previously had a Type B Pre-IND Meeting with the FDA on our
intramuscular vaccine product candidate, we again met with the FDA
in a Type B Pre-IND Meeting request to discuss our intranasal
vaccine product candidate. As a result of this meeting, the FDA
indicated that we could file an IND application for NT-CoV2-1
following the availability of the final GLP toxicology report for
inclusion in the IND.
We
believe the benefits of our NT-CoV2-1 vaccine product candidate
through its intranasal delivery mechanism to be:
|
● |
Targeted
Mucosal Immunity – Conventional injectable vaccines are poor
inducers of mucosal immunity, whereas intranasal immunization can
induce strong mucosal immunity by enhancing the immune response at
the entry sites of mucosal pathogens. When the SARS-CoV-2 virus
enters the nasal cavity, the respiratory epithelial layer is the
first barrier against viral infection. The intranasal route of
vaccination provides two additional layers of protection over
intramuscular shots because (i) it produces immunoglobulin A and
resident memory B and T cells in the respiratory mucosa that are an
effective barrier to infection at those sites, and (ii)
cross-reactive resident memory B and T cells can respond earlier
than other immune cells should a viral variant start an
infection. |
|
● |
Needle-Free
Administration – As an obvious benefit, intranasal
administration means needle-free delivery, resulting in meaningful
differentiation for children and needle-phobic populations,
improved compliance and the potential for
self-administration. |
|
● |
Storage
& Transport – The currently available mRNA-based vaccines
have been delivered globally via stringent storage and transport
requirements that strain distribution logistics under the best of
circumstances. A key benefit of our NT-CoV2-1 vaccine candidate is
a significantly reduced handling burden, allowing transport at a
more manageable refrigeration temperature (5°C) that improves
access globally including remote and under-vaccinated
geographies. |
|
● |
Durability
– Broad initial success with mRNA vaccines has significantly
diminished COVID-19’s impact and death, but the trade-off has been
fleeting efficacy. By benefitting from the immunological properties
of the hybrid NIH/NRC construct, NT-CoV2-1 is potentially much more
durable and long-lasting than currently available mRNA-based
therapies. |
Through
assessment of a variety of factors, including our pre-clinical
testing to date, the expected benefits noted above, and evolving
variants and available vaccines in use, we determined to focus our
development efforts on the intranasal delivery of our vaccine
product candidate, NT-CoV2-1, which we believe is more highly
differentiated than the currently available and late-stage COVID-19
vaccines. We are currently evaluating formulation options and
considering regulatory pathways to advance the program. In
connection therewith, we are strategically assessing multiple
opportunities inclusive of further regulatory guidance and
requirements, and the potential implications thereof. As a result,
we now anticipate being in a position to file an IND application in
the United States and/or a Clinical Trial Application in Canada and
to thereafter commence a Phase 1 clinical study with NT-CoV2-1 in
the back half of 2023.
We
expect to use our currently available cash resources to continue to
advance the development of NT-CoV2-1 through IND-enabling studies
and commencement of a Phase 1 clinical trial with further clinical
development being contingent upon the receipt of additional
funding, including non-dilutive government grant funding which we
continue to pursue or partnering or out-licensing
opportunities.
Our
Antibiotic Product Candidate – Oragenics Derived Compound
(ODC-x)
Members
of our scientific team discovered that a certain bacterial strain
of Streptococcus mutans, produces Mutacin 1140 (MU1140), a
molecule belonging to the novel class of antibiotics known as
lantibiotics. Lantibiotics, such as MU1140, are highly modified
peptide antibiotics made by a small group of Gram-positive
bacterial species. Over 60 lantibiotics have been discovered, to
date. We believe lantibiotics are generally recognized by the
scientific community to be potent antibiotic agents.
In
nonclinical testing, MU1140 has shown activity against all
Gram-positive bacteria against which it has been tested, including
those responsible for a number of healthcare associated infections,
or HAIs. A high percentage of hospital-acquired infections are
caused by highly antibiotic-resistant bacteria such as
methicillin-resistant Staphylococcus aureus (MRSA) or
multidrug-resistant Gram-negative bacteria. We believe the need for
novel antibiotics is increasing as a result of the growing
resistance of target pathogens to existing FDA approved antibiotics
on the market.
Lantibiotics
have been difficult to investigate for their clinical usefulness as
therapeutic agents in the treatment of infectious diseases due to a
general inability to produce or synthesize sufficient quantities of
pure amounts of these molecules. Traditional fermentation methods
can only produce minute amounts of the lantibiotic.
The
timing of the filing of an IND regarding any future lantibiotic
candidate is subject to our having sufficient available human,
material and financing capital, which includes research subjects,
both animal and human, given all of our anticipated needs and
expected requirements in connection with our ongoing research and
development initiatives. We expect to seek to continue to advance
our lantibiotics program to an IND filing subject to the
availability of both human and financial capital. Based upon the
current funding, we expect to reduce our focus on the
identification of new potential product lantibiotic product
candidates, efficient and cost-effective improvements in the
manufacturing processes and pre-clinical studies required to
support a first in human Phase 1 clinical study until such time as
we raise additional capital.
In
October 2021, we were awarded a small business innovation research
grant in the amount of $250,000 (“Computer-aided Design for
Improved Lantibiotics” R41GM136034) for the Company’s continued
research and development of lantibiotics, including its
collaborative program with the Biomolecular Sciences Institute at
Florida International University (FIU). The grant provides the
Company with funding to develop novel lantibiotics for the
treatment of ESKAPE pathogens (defined as Enterococcus faecium,
Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter
baumannii, Pseudomonas aeruginosa, and Enterobacter
spp.).
In
March 2023, we reported favorable findings from third party
laboratory testing of several compounds in our lantibiotics
platform to combat multiple pathogens despite the resistance of
those pathogens to standard-of-care antibiotics. Lantibiotics are a
novel class of antibiotics with the potential to treat serious,
life-threatening infections. Through our platform, we have created
more than 700 potential lantibiotic structures.
Our
lantibiotics platform is focused on the development of new
antibiotics effective against certain pathogens including
Enterococcus faecium (VRE) and Staphylococcus aureus
(MRSA). This preclinical testing was conducted through our
collaboration with Linnaeus Bioscience Inc.
Product
Candidates.
Through
our wholly-owned subsidiary, Noachis Terra, we began the research
and development stage for our new Terra CoV-2 and NT-CoV2-1 vaccine
product candidates. We hold a non-exclusive, worldwide intellectual
property license agreement for certain research, patent
applications and biological materials relating to the use of
pre-fusion coronavirus spike proteins for the development and
commercialization of a vaccine against SARS-CoV-2. We also hold a
non-exclusive license with the NRC that enables us to pursue the
rapid development of next-generation vaccines against SARS-CoV-2
(the “NIH License”) and its variants (the “NRC License”) and an
exclusive global license with Inspirevax (the “Inspirevax License”
and, together with the NIH License and NRC License, the “License
Agreements”).
Additionally,
we are developing semi-synthetic lantibiotic analogs that may be
effective against systemic Gram-positive multidrug infections, and
analogs that may be effective in treating Gram-negative infections.
We seek to protect our product candidates through patents and
patent applications, pursuant to the terms of the License
Agreements.
Product/Candidate |
|
Description |
|
Application |
|
Status |
NT-CoV2-1 |
|
Intranasal
vaccine candidate (plasmid + adjuvant) to provide long lasting
immunity against SARS-CoV-2
|
|
Broad,
community-based vaccine immunity against SARS-CoV-2 |
|
Pre-clinical |
|
|
|
|
|
|
|
Antibiotics |
|
Semi-synthetic
analogs of MU1140: Member of lantibiotic class of
antibiotics |
|
Healthcare-associated
infections |
|
Pre-clinical |
Our Business Development Strategy
Success
in the biopharmaceutical and product development industry relies on
the continuous development of novel product candidates. Most
product candidates do not make it past the clinical development
stage, which forces companies to look externally for innovation.
Accordingly, we expect, from time to time, to seek strategic
opportunities through various forms of business development, which
can include strategic alliances, licensing deals, joint ventures,
collaborations, equity or debt-based investments, dispositions,
mergers and acquisitions. We view these business development
activities as a necessary component of our strategies, and we seek
to enhance shareholder value by evaluating business development
opportunities both within and complementary to our current
business, as well as opportunities that may be new and separate
from the development of our existing product candidates.
Our
SARS-CoV-2 Vaccine Product Candidate-NT-CoV2-1
Market
Opportunity
The
worldwide revenues for the Pfizer-BioNTech and Moderna mRNA
COVID-19 vaccines in 2022 were $37.8 billion and $18.4 billion,
respectively. In January 2023, the World Health Organization’s
estimates indicated that, as of January 8, 2023, the number of
worldwide COVID-19 infections exceeded 659,000,000 and the number
of deaths directly attributed to COVID-19 have exceeded
6,600,000.
The
overall disease burden has continued to increase in the US despite
91% of those 65 years of older being fully vaccinated and 71% of
those 5 years of age or older. Current vaccines have reduced the
rates of hospitalization and death due to COVID-19 in vaccinated
individuals, but the transmission levels even in vaccinated
individuals has allowed the SARS-CoV-2 variants to continue to
circulate. We believe an intranasally-administered vaccine against
COVID-19 has the potential to reduce transmission more effectively
than those delivered intramuscularly because the intranasal is
expected to induce mucosal immunity in the nose and throat, which
are the early entry points for SARS-CoV-2. The inclusion of
COVID-19 vaccines in the routine childhood immunization schedule
may be anticipated assuming COVID-19 enters an endemic phase.
Intranasal COVID-19 vaccines could play an important role in
routine pediatric immunization since they create less anxiety in
needle-phobic children and can more easily fit into an increasingly
crowded schedule of injected vaccines.
COVID-19
disease epidemiology is closely monitored and, as such,
recommendations as to vaccinations and treatments have been
evolving accordingly. The possibility of new COVID-19 variants, and
the potential spread of such variants have altered the dynamics of
disease spread and led to the requirement of booster shots in the
US and other countries to help facilitate control of the newer
viral strains.
Our
Strategy
We
seek to continue developing the NT-CoV2-1 vaccine candidate to the
point of entering into a licensing deal or strategic partnership.
In connection with the development of our NT-CoV2-1 vaccine
candidate, we expect to focus on differentiation of our vaccine
product candidate by using intranasal administration, which none of
the currently available intramuscular vaccines can offer. We
believe that development of a vaccine that has differentiated
attributes to those currently being used will be beneficial in
helping to control the spread of SARS–CoV-2. We anticipate that the
main use of NT-CoV2-1 will be as a booster dose for those already
vaccinated with a different COVID-19 vaccine, since the vaccination
coverage rates in developed countries is already very high. A
potential longer-term objective would be to offer NT-CoV2-1 as an
intranasal vaccine for the primary immunization of infants or
children in the routine childhood immunization schedule.
Should
the spread of SARS-CoV-2 be controlled to such extent that it would
potentially impact our efforts to commercialize our NT-CoV2-1 as a
vaccine candidate, we believe we could identify and pursue other
vaccines to develop that are capable of preventing new infectious
disease threats.
Regulatory
We
held a pre-IND meeting with the FDA on our Terra CoV-2 vaccine
candidate. The broad support for our approach by the FDA included a
number of activities, including: (i) use of the Research Cell Bank
in the early manufacturing process development; (ii) Use of early
pilot batch manufacture under Good Manufacturing Processes (GMP)
for the anticipated Phase 1 clinical trials; and, (iii) submission
of draft toxicology reports during IND filing. We have conducted
the pre-clinical studies including the Syrian Hamster virus
challenge study, the mouse immunogenicity study with positive
results for both the intramuscular formulation (Terra CoV-2) and
the intranasal formulation (NT-CoV2-1). Due to the potential for
greater differentiation with the intranasal vaccine NT-Cov2-1, we
are moving that candidate forward into a rabbit toxicology study.
Data from the hamster and mouse studies and the rabbit toxicology
study will be submitted as part of the IND filing prior to
initiation of the Phase 1 human clinical trial for
NT-CoV2-1.
Manufacturing
The
creation of a stable pool Master Cell Bank is complete and GMP
manufacturing of the bulk drug substance has been completed by our
Phase 1 biologics contract development and manufacturing
organization, Biodextris, Inc. Creation of the clonal Research Cell
Bank, required for later stage manufacturing, is completed and will
be followed by manufacturing of the clonal Master Cell Bank prior
to Phase 2 GMP manufacturing. We use third-party suppliers for the
development of our vaccine product candidate, including with
respect to the manufacturing of our vaccine candidate for use in
pre-clinical studies and expected clinical trials. We enter into
agreements with these third-party suppliers as part of, and in
connection with, our product development plans and timing. In order
to have sufficient product available for anticipated future
clinical trials we need to enter into agreements with GMP certified
manufactures that have the capability and capacity to meet our
expected product needs and timing in advance of when our actual
needs will arise in order for us to be positioned to continue
development without delays due to the manufacturing process and
capabilities of qualified manufacturers.
In
March 2022 we entered into an agreement with KBI Biopharma, Inc.
for the process transfer, process optimization and cGMP
manufacturing of our vaccine candidate in anticipation of a future
Phase 2 clinical trial. This agreement obligates us to make certain
payments to KBI in connection with the manufacture of our vaccine
product candidate based upon our current expected timing. If the
timing of our current development plans changes, we could be
required to make additional payments to KBI associated with such
delays and/or associated with the cancellation of the agreement
without achieving the benefits anticipated from the agreement.
Additionally, a fill/finish, packaging and labeling company has
been identified to support the Phase 1 program and is scheduled for
GMP manufacturing of clinical material in 2Q22.
Homologs
of MU1140 and Other Lantibiotics
In
the course of research and development, MU1140 was found to be a
potent antibiotic that is naturally produced by the parent of the
SMaRT strain. MU1140 shows antibacterial activity against all
Gram-positive bacteria against which it has been tested, including
those responsible for a variety of multi-drug resistant organisms
and healthcare-associated infections, or HAIs.
We
intend to develop lantibiotics, a novel class of antibiotics, as
active pharmaceutical ingredients toward the goal of
commercialization for the treatment of infectious diseases in
humans, focusing on infections caused by the most dangerous
bacteria identified by the WHO and CDC priority list. Antibiotic
resistance is spurred by overuse and misuse of antibiotics and
worsened by the lack of scientific innovation. The timing of the
filing of an IND regarding homologs of MU1140 is subject to our
having sufficient available capital given all of our anticipated
needs and expected requirements in connection with our ongoing
research and development initiatives. We expect to seek to continue
to advance our lantibiotics program to an IND filing subject to the
availability of both human and financial capital. Based upon the
current funding, we expect to reduce our focus on the
identification of new potential product lantibiotic candidates,
efficient and cost-effective improvements in the manufacturing
processes and pre-clinical studies required to support a first in
human Phase 1 clinical study until such time as we raise additional
capital. In addition, we have undertaken research
programs to expand our capabilities to improve the physical
chemical characteristics (i.e., solubility and stability) of
lantibiotics for use to treat systemic Gram-positive infections and
also exploring lantibiotics that may be efficient against Gram
negative bacteria.
Market
Opportunity
Many
Gram-positive related HAIs are caused by drug-resistant bacteria,
including methicillin-resistant Staphylococcus aureus, or
MRSA; vancomycin-resistant Enterococcus faecalis, or VRE;
and Clostridium difficile, or C. diff. According to
the most recent Centers for Disease Control and Prevention, (“CDC”)
report on Antibiotic Resistance Threats in the US (2019), the
number of people facing antibiotic resistance in the United States
is too high. More than 2.8 million antibiotic-resistant infections
occur in the United States each year, and more than 35,000 people
die as a result. In addition, nearly 223,900 people in the United
States required hospital care for C. difficile and at least
12,800 people died in 2017.
Antimicrobial
resistance is one of the greatest threats to global health. Without
innovation, we risk falling into a post-antimicrobial era in which
minor infections will become life threatening, and routine medical
procedures will be nearly impossible to perform. The World Health
Organization predicts that by 2050, antimicrobial resistance could
cause 10 million deaths each year, surpassing the projected number
of deaths due to cancer. Notably, antimicrobials have a prominent
role in the treatment of secondary bacterial infection
complications of viral respiratory infections, such as the novel
coronavirus.
The
literature review findings indicate that the cost of AMR across the
globe is extremely high. The CDC estimated that the cost of
antimicrobial resistance is $55 billion every year in the United
States, $20 billion for health care and about $35 billion for loss
of productivity. Recent research by the World Bank indicates that
antimicrobial resistance would elevate the rate of poverty and
impact low-income countries compared to the rest of the world.
Studies show that annual global GDP could decrease by approximately
1% and there would be a 5–7% loss in developing countries by 2050.
This percentage ultimately translates into $100-210
trillion.
The
need for novel antibiotics is increasing but unfortunately, the
worldwide rise of bacterial pathogens resistant to antibacterial
agents cannot be counteracted by the current low development pace
of therapeutics with new mode(s) of action. While there are nearly
4,000 immuno-oncology agents in development, only about 30–40 new
antibacterial compounds are currently in the clinical trial phases
of development, and, notably, those candidates targeting World
Health Organization (WHO) priority pathogens are derivatives of
existing classes. Less than 25% of current drugs in the clinical
development pipeline represent a novel class or act through a novel
mechanism, and none of these are potentially active against
Gram-negative ESKAPE or WHO critical threat pathogens. Only a small
fraction of the antibiotics approved over the past 40 years
represents new compound classes, while the majority were derived
from already known chemical structures, and the most recent new
class of antibiotics was discovered during the 1980s. According to
Nature.com, no new class of Gram-negative antibiotics has
been launched for more than 50 years.
Lantibiotics
such as MU1140 are highly modified peptide antibiotics made by a
small group of Gram-positive bacterial species. Over 60
lantibiotics have been discovered since the first lantibiotic,
nisin, was discovered. Lantibiotics are generally known to be
potent antibiotic agents; however, attempts to investigate their
clinical usefulness have generally met with failure due to the
inability to produce sufficient pure amounts of any of these
molecules to be able to test them as a therapeutic agent for the
treatment of infectious diseases. Standard fermentation methods,
such as those used to make a variety of other antibiotics, have
historically resulted in the production of only minute amounts of
the lantibiotic.
Our
Solution
To
develop homologs of MU1140 and, engineered in parallel, high
producing strains to the point of partnership, and to develop
additional lantibiotics in connection with our work on MU1140.
MU1140 has demonstrated activity against a wide variety of
disease-causing Gram-positive bacteria, including MRSA, VRE, and
C. difficile.
To
develop homologs of MU1140 paired with high producing strains to
the point of partnership, and to develop additional lantibiotics in
connection with our work on MU1140. MU1140 has demonstrated
activity against a wide variety of disease-causing Gram-positive
bacteria, including MRSA, VRE, C. difficile, Mycobacterium
tuberculosis and Bacillus anthracis.
To
develop new antibiotics effective against certain pathogens
including Enterococcus faecium (VRE) and Staphylococcus
aureus (MRSA).
Our
Strategy
We
are developing and testing recombinantly derived homologs of the
native MU1140 molecule and its chemical derivative with improved
therapeutic profiles and physical-chemical characteristics. The
data generated over the past few years enabled us to engineer
hundreds of homologs of MU1140, and select those homolog candidates
with improved profiles, including homologs of higher activity and
stability, lower toxicity and with a scalable manufacturability.
The best homolog candidates were further developed internally and
through the use of several Contract Research Organizations
(“CROs”). We believe that this strategy represented the best and
most efficient path to produce sufficient quantities of MU1140
homologs, to support continued research, selection of a lead
candidate, nonclinical studies, clinical studies and ultimately
commercialization. We intend to continue to follow this proven
discovery path to identify novel MU1140 derivatives to treat other
multi-drug resistant infections and HAIs.
Regulatory
Status
We
have performed nonclinical testing on MU1140 and several of its
homologs, which has demonstrated the molecule’s novel mechanism of
action. We expect to continue our research and pre-clinical
development activities on derivatives of MU1140 subject to the
availability of adequate financing as we move towards the filing of
an IND.
Manufacturing
While
we have been able to produce a significant increase in the
fermentation titer of homologs of MU1140, we continue to work to
improve on the manufacturing through collaborations with
fermentation and purification experts and third party CROs. We will
need to further optimize and scale up the production/purification
scheme internally and through third party vendors. The need to
examine many new homologs of MU1140 has resulted in the need to
reproduce the fermentation and purification steps on each
individual homolog candidate being studied. Each homolog requires
different optimizations for both the fermentation, purification and
chemical derivatization steps and in some cases requires a new
approach. As such, our work on the research and development of new
lantibiotic homologs using genetically modified bacteria continues.
We believe these developments represent progress toward our goal of
commercial production of sufficient quantities of our MU1140
homologs and deliver a step in validating the lantibiotics platform
targeting infectious diseases.
We
are working with a third-party manufacturer to produce additional
quantities of designated homologs, based upon the developments
achieved from our work with our outside contractors. The production
of additional quantities of designated homologs, that are needed
for the consummation and pursuit of our nonclinical testing
activities supporting the IND filing, are ongoing. We will continue
to explore improved methods of manufacturing and synthesis to
improve our yields and ultimately, potentially reduce our cost of
manufacture.
Our
License Agreements
Our
NIH License Agreement
Through
our wholly-owned subsidiary, Noachis Terra, we are party to a
Patent License and Biological Materials License Agreement (the
“License Agreement” or “NIH License”), dated March 23, 2020, with
the United States Department of Health and Human Services (the
“HHS”), as represented by the NIAID, an Institute of the NIH. Under
the terms of the License Agreement, we hold a nonexclusive,
worldwide license to certain specified patent rights (including
patent applications, provisional patent applications and Patent
Cooperation Treaty (“PCT”) patent applications) and biological
materials relating to the use of prefusion coronavirus spike
proteins to exploit products (“Licensed Products”) and practice
processes (“Licensed Processes”) that are covered by the licensed
patent rights and biological materials for the purpose of
developing and commercializing a vaccine product candidate for
SARS-CoV-2. The License Agreement is subject to certain statutory
limits and reserved rights, as required under federal law and NIH
requirements, including the requirement to provide reasonable
quantities of Licensed Products or materials made through the
Licensed Processes for NIH research and to manufacture Licensed
Products or materials made through the Licensed Processes
substantially in the United States. We may not sublicense the
intellectual property or biological materials licensed to us under
the License Agreement.
Pursuant
to the License Agreement, we must use reasonable commercial efforts
to manufacture, practice or operate the Licensed Products and the
Licensed Processes, including adhering to a commercial development
plan and achieving certain benchmarks. Additionally, following the
first commercial sale of any Licensed Products or the practice of
any Licensed Processes, we must use reasonable commercial efforts
to make the Licensed Products and the Licensed Processes reasonably
accessible to the United States public and reasonable quantities of
the Licensed Products and the Licensed Processes available to
patient assistance program, among other educational support
activities. The NIAID has agreed to assume responsibility for the
preparation, filing, prosecution and maintenance of all patent
applications and patents covered by the licensed patent
rights.
Under
the terms of the License Agreement, the NIAID is entitled to
receive a non-creditable, nonrefundable upfront license issue
royalty (which has already been paid), as well as reimbursement for
our pro rata share of the NIAID’s past and future patent
prosecution-related expenses. Additionally, the NIAID is entitled
to receive nonrefundable minimum annual royalties, which increase
each year after the first commercial sale of any Licensed Products
or the practice of any Licensed Processes, as well as benchmark
royalties following our completion of certain commercial
development and sales-related benchmarks. The NIH is entitled to
receive earned royalties on the annual net sales of Licensed
Products and the practice of any Licensed Processes (subject to
certain reductions), at certain low- to mid-single digit royalty
rates, which rates vary based on the total amount of annual net
sales and the geographic market in which those sales occur. We must
provide regular written reports to the NIAID on the development
status of and royalty payments relating to the Licensed Products
and the Licensed Processes.
We
must indemnify and hold the NIAID and its associates harmless from
and against all liability and damages in connection with or arising
out of (a) the use or beneficial use of the Licensed Patent rights
by us, our Directors, employees or third parties and (b) the
design, manufacture, distribution or use of any Licensed Products
or Licensed Processes, including other products or processes
developed in connection with the Licensed Patent Rights.
Unless
terminated earlier, the License Agreement will terminate upon the
earlier of (a) twenty (20) years from the first commercial sale
where no licensed patent rights exist or have ceased to exist or
(b) the expiration of the last to expire of any licensed patent
rights. At this time, no patents covered by the licensed patent
rights have been issued. We may terminate the License Agreement at
any time, subject to advance notice. Subject to certain cure and
appeal rights, the NIAID may terminate or modify the License
Agreement in the event of a material breach or default, including,
among others, the following:
(i) |
We
become insolvent or the subject of a bankruptcy
petition; |
|
|
(ii) |
We
fail to follow the commercial development plan, fail to achieve
certain commercial development and sales-related benchmarks or
cannot otherwise demonstrate progress toward a practical
application of the Licensed Products or Licensed
Processes; |
|
|
(iii) |
We
fail to keep any Licensed Products or Licensed Processes reasonably
available to the public following the commencement of commercial
use or fail to reasonably justify noncompliance with its domestic
production obligation; |
|
|
(iv) |
We
cannot reasonably satisfy public health and safety needs;
or |
|
|
(v) |
The
NIAID determines termination or modification is necessary because
we cannot meet federal public use regulatory requirements, as
issued after the effective date of the License
Agreement. |
Our
NRC License Agreement
On
July 26, 2021, we entered into a non-exclusive Technology License
Agreement (the “License Agreement”) with the NRC pursuant to which
the NRC granted us a license to use NRC’s inventions, patents,
trade secrets, know-how, copyright, biological material, designs,
and/or technical information created by or on behalf of the NRC
(the “NRC Technologies”) relating to the derivatives of CHO 2353 TM
Cell Line listed in the License Agreement (the “Stable Cells”) to:
(i) make, research, and develop SARS-CoV-2 spike protein
manufactured by a Stable Cell (the “Drug Substance”) within Canada,
Australia, the United Kingdom, the European Union and the United
States (U.S.) (collectively the “Territory”); (ii) file regulatory
approval, export and sell the final formulation of the Drug
Substance (“Products”) and (iii) engage contractors to use the
Stable Cells to make Drug Substance or Products on our behalf to be
used and sold, worldwide, by us. The License Agreement was
subsequently amended to include the Delta and Omicron variants. In
addition, we subsequently amended the License Agreement to broaden
the non-exclusive field of use to include all diseases caused by
coronaviruses and any genetic variants thereof.
As
consideration for the grant of the license, we will pay to the NRC
an annual (low five digits) license fee, with the initial portion
of the fee covering the first three years of the license.
Additionally, we will pay certain milestone payments (a) upon
transfer of each Stable Cell listed in the Agreement and (b) with
regard to each of the first three Products, (i) upon submission of
the IND application related thereto, (ii) upon dosing the first
patient in a Phase 1 or Phase 2 clinical trial, (iii) upon dosing
the first patient in a Phase 3 clinical trial and (iv) upon first
regulatory approval. Milestone payments range from the low five
digits to high six digits. In addition, Oragenics will pay a low
single-digit royalty to the NRC for the sale of Products, based on
sales revenue, commencing after the first commercial
sale.
Pursuant
to the License Agreement, the NRC is required to bear the
responsibility and pay the costs to obtain and maintain patents
related to the NRC Technologies in the U.S., Canada, Brazil,
European Union, Japan, South Korea, Singapore, Australia, China,
and India, and the NRC shall use reasonable efforts to obtain and
maintain those patents. Additional countries may be requested by
us, in which event, the NRC will file and maintain such patents, at
our expense.
Pursuant
to the License Agreement, we are required to indemnify and hold the
NRC and its employees and agents harmless from and against all
liability and damages in connection with or arising out of all
claims, demands, losses, damages, costs including solicitor and
client costs, actions, suits or proceedings brought by any third
party that are in any manner based upon, arising out of, related
to, occasioned by, or attributable to the manufacturing,
distribution, shipment, offering for sale, sale, or use of
Products, services based on the NRC Technologies and product
liability and infringement of intellectual property rights other
than copyright, if any, licensed under the License
Agreement.
Unless
terminated earlier, the License Agreement will terminate twenty
(20) years from the effective date of the License Agreement. Either
party may terminate the License Agreement, by giving written notice
to the other party, if the other party defaults or is in breach of
the License Agreement, provided that if the defaulting party cures
the breach within 60 days after the notice is given, the License
Agreement shall continue in full force and effect. The NRC may
terminate the License Agreement if we become bankrupt, or
insolvent, or has a receiver appointed to continue its operations,
or passes a resolution for winding up. The License Agreement
contains customary confidentiality obligations.
Our
Inspirevax License Agreement
On
February 23, 2023, we entered into a Commercial License Agreement
(the “License Agreement”) with Inspirevax Inc. (“Inspirevax”)
pursuant to which Inspirevax granted us an exclusive worldwide
license to use Inspirevax’s inventions, patents, trade secrets,
know-how, copyright, biological material, designs, and/or technical
information created by or on behalf of Inspirevax (the “Inspirevax
Technologies”) relating to its novel lipid-protein based intranasal
adjuvants, to make, research, and develop an intra-nasal vaccine in
combination with an antigen (“Combination Product”) to be used in
an intranasal vaccine for use against diseases caused by
coronaviruses and any genetic variants thereof to be sold by
us.
As
consideration for the grant of the license, we will pay an upfront
signing fee of $50,000. We will be subject to certain milestone
payments as follows: (a) $75,000 upon our decision on an
appropriate nasal spray device, (b) $100,000 upon a first patient
being dosed in a phase 2a clinical trial, (c) $200,000 upon a first
patient being dosed in a Phase 2b/3 clinical trial, (d) $800,000
upon a biologics License Application being submitted to the FDA,
(e) $400,000 upon first filing of marketing authorization outside
of the United States, and $200,000 for each such additional filing
up to five filings, (f) $2,000,000 upon first commercial sale in
the United States, (g) $1,000,000 upon first commercial sale in
Europe, (h) $500,000 upon first commercial sale outside of United
States and Europe and $250,000 for each other country or region up
to five. Additionally, during the term we will pay to Inspirevax a
7% royalty on net sales subject to certain gross revenue
limitations at which time the royalty will decrease to
4%.
We
will be required to use our best efforts to develop a product using
the Inspirevax technology including the following: (a) first
subject enrollment in first clinical study by December 31, 2023,
(b) the first subject enrolled in a Phase 2a study by September 30,
2024, (c) first subject enrolled in a phase 3 registration trial by
December 31, 2026, and (d) first marketing approval application
submitted by June 30, 2028.
Pursuant
to the License Agreement, Inspirevax is required to bear the
responsibility and pay the costs to obtain and maintain patents
related to the Inspirevax Technologies.
Pursuant
to the License Agreement, any and all intellectual property rights
in any invention conceived, reduced to practice, or developed
during the Term of the License Agreement solely arising from or
solely related to the Combination Product or the antigen will be
owned by us, and we will bear the responsibility and pay the costs
to obtain and maintain patents related to these
inventions.
Pursuant
to the License Agreement, we are required to indemnify and hold
Inspirevax and its employees and agents harmless from and against
all liability and damages in connection with or arising out of all
claims, demands, losses, damages, costs including solicitor and
client costs, actions, suits or proceedings brought by any third
party that are in any manner based upon, arising out of, related
to, occasioned by, or attributable to the manufacturing,
distribution, shipment, offering for sale, sale, or use of
Products, services based on the Inspirevax Technologies and product
liability and infringement of intellectual property rights other
than copyright, if any, licensed under the License
Agreement.
Unless
terminated earlier, the License Agreement will terminate the later
of (i) twenty (20) years from the first commercial sale of a
product, (ii) the last date a product is covered by a valid patent
claim, or (iii) the expiration of regulatory exclusivity. We may
terminate the License Agreement, by giving thirty (30) days written
notice to Inspirevax. Either party may terminate, if the other
party defaults or is in breach of the License Agreement, provided
that if the defaulting party cures the breach within sixty (60)
days after the notice is given, the License Agreement shall
continue in full force and effect. The License Agreement contains
customary confidentiality obligations.
The
companies formed a Joint Development Committee (JDC) comprising
representatives of both companies to oversee the development
efforts collaboratively. Additionally, the agreement provides a
certain period of time for the companies to expand their
collaboration to pursue the development of additional intranasal
vaccine candidates using Inspirevax’s adjuvants.
Other
Product Candidates and Technologies
We
have historically developed other product candidates and potential
product candidates. For example, we developed a weight loss
candidate, LPT3-04, and a topical treatment to prevent dental
carries which we refer to as SMaRT Replacement Therapy. We out
licensed LPT3-04 to a third party and continue to monitor our
licensee’s performance under the license. We do not expect the
LPT3-04 license to have a material effect on our business or
operations. While we retain certain intellectual property rights
with respect to homologs through our (i) prior relationship with
Texas A&M University Systems and (ii) ILH Holdings (as assignee
of Precigen) that could allow for the continued research and
development of compounds for the SMaRT replacement Therapy, we do
not intend to pursue further development of SMaRT Replacement
Therapy and as such we do not consider these rights to be a
material part of our business and operations.
Government
Regulations
In
the United States, foods (including dietary supplements), drugs
(including biological products), medical devices, cosmetics,
tobacco products and radiation-emitting products are subject to
extensive regulation by the FDA. The FDC Act and other federal and
state statutes and regulations govern, among other things, the
manufacture, distribution and sale of these products. These laws
and regulations prescribe criminal and civil penalties that can be
assessed, and violation of these laws and regulations can result in
enforcement action by the FDA and other regulatory
agencies.
FDA
Regulation of Drugs-New Drug Approval Process
Pharmaceutical
products are subject to extensive regulation by the FDA. The FDC
Act, and other federal and state statutes and regulations, govern,
among other things, the research, development, testing,
manufacture, storage, recordkeeping, approval, labeling, promotion
and marketing, distribution, post-approval monitoring and
reporting, sampling, and import and export of pharmaceutical
products. Failure to comply with applicable U.S. requirements may
subject a company to a variety of administrative or judicial
sanctions, such as FDA refusal to approve pending NDAs or Biologics
License Applications (“BLA “)s, warning or untitled letters,
product recalls, product seizures, total or partial suspension of
production or distribution, injunctions, fines, civil penalties and
criminal prosecution.
Pharmaceutical
product development for a new product or certain changes to an
approved product in the United States typically involves the
following steps before a biological product or new drug may be
marketed in the United States:
|
● |
pre-clinical
laboratory tests, animal studies and formulation studies in
compliance with the FDA’s Good Laboratory Practice and Good
Manufacturing Practice regulations; |
|
● |
submission
to the FDA of an IND application for human clinical testing, which
must become effective before human clinical trials may
commence; |
|
● |
performance
of adequate and well-controlled clinical trials in three phases, as
described below, to establish the safety and efficacy of the drug
for each indication according to Good Clinical
Practices; |
|
● |
submission
of an NDA or BLA to the FDA for review; |
|
● |
random
inspections of clinical sites to ensure validity of clinical safety
and efficacy data; |
|
● |
satisfactory
completion of an FDA inspection of the manufacturing facility or
facilities at which the drug is produced to assess compliance with
current good manufacturing practices; |
|
● |
FDA
approval of the NDA or BLA; and |
|
● |
payment
of user and establishment fees, if applicable. |
Satisfaction
of FDA pre-market approval requirements typically takes many years
and the actual time required may vary substantially based upon the
type, complexity and novelty of the product or disease.
Pre-clinical
tests include laboratory evaluation of product chemistry,
formulation and toxicity, as well as animal trials to assess the
characteristics and potential safety and efficacy of the product.
The conduct of the pre-clinical tests must comply with federal
regulations and requirements, including good laboratory practices.
The results of pre-clinical testing are submitted to the FDA as
part of an IND along with other information, including information
about product chemistry, manufacturing and controls, and a proposed
clinical trial protocol. Long term pre-clinical tests, such as
animal tests of reproductive toxicity and carcinogenicity, may
continue after the IND is submitted.
A
30-day waiting period after the submission of each IND is required
prior to the commencement of clinical testing in humans. If the FDA
has neither commented on nor questioned the IND within this 30-day
period, the clinical trial proposed in the IND may
begin.
Clinical
trials involve the administration of the IND to healthy volunteers
or patients under the supervision of a qualified investigator.
Clinical trials must be conducted: (i) in compliance with federal
regulations; (ii) in compliance with good clinical practice, or
GCP, an international standard meant to protect the rights and
health of patients and to define the roles of clinical trial
sponsors, administrators, and monitors; as well as (iii) under
protocols detailing the objectives of the trial, the parameters to
be used in monitoring safety, and the effectiveness criteria to be
evaluated. Each protocol involving testing on U.S. patients and
subsequent protocol amendments must be submitted to the FDA as part
of the IND.
The
FDA may order the temporary, or permanent, discontinuation of a
clinical trial at any time, or impose other sanctions, if it
believes that the clinical trial is not being conducted in
accordance with FDA requirements or presents an unacceptable risk
to the clinical trial patients. The trial protocol and informed
consent information for patients in clinical trials must also be
submitted to an institutional review board or IRB for approval. An
IRB may also require the clinical trial at the site to be halted,
either temporarily or permanently, for failure to comply with the
IRB’s requirements, or may impose other conditions.
Clinical
trials to support NDAs or BLAs for marketing approval are typically
conducted in three sequential phases, but the phases may overlap.
In Phase 1, after the initial introduction of the drug into healthy
human subjects or patients, the drug is tested to assess
metabolism, pharmacokinetics, pharmacological actions, side effects
associated with increasing doses, and, if possible, early evidence
on effectiveness. Phase 2 usually involves trials in a limited
patient population to determine the effectiveness of the drug for a
particular indication, dosage tolerance, and optimum dosage, and to
identify common adverse effects and safety risks. If a compound
demonstrates evidence of effectiveness and an acceptable safety
profile in Phase 2 evaluations, Phase 3 trials are undertaken to
obtain the additional information about clinical efficacy and
safety in a larger number of patients, typically at geographically
dispersed clinical trial sites, to permit the FDA to evaluate the
overall benefit-risk relationship of the drug and to provide
adequate information for the labeling of the drug. In most cases
the FDA requires two adequate and well-controlled Phase 3 clinical
trials to demonstrate the efficacy of the drug. A single Phase 3
clinical trial with other confirmatory evidence may be sufficient
in rare instances where the trial is a large multicenter trial
demonstrating internal consistency and a statistically very
persuasive finding of a clinically meaningful effect on mortality,
irreversible morbidity or prevention of a disease with a
potentially serious outcome and confirmation of the result in a
second trial would be practically or ethically
impossible.
The
length of time and related costs necessary to complete clinical
trials varies significantly and may be difficult to predict.
Clinical trial results are frequently susceptible to varying
interpretations that may delay, limit or prevent regulatory
approvals. Additional factors that can cause delay or termination
of our clinical trials, or cause the costs of these clinical trials
to increase, include:
|
● |
slow
patient enrollment due to the nature of the protocol, the proximity
of patients to clinical sites, the eligibility criteria for the
trial, competition with clinical trials for other drug candidates
or other factors; |
|
● |
inadequately
trained or insufficient personnel at the trial site to assist in
overseeing and monitoring clinical trials; |
|
● |
delays
in approvals from a trial site’s IRB; |
|
● |
longer
than anticipated treatment time required to demonstrate
effectiveness or determine the appropriate product
dose; |
|
● |
lack
of sufficient supplies of the drug candidate for use in clinical
trials; |
|
● |
adverse
medical events or side effects in treated patients; and |
|
● |
lack
of effectiveness of the drug candidate being tested. |
Any
drug is likely to produce some toxicities or undesirable side
effects in animals and in humans when administered at sufficiently
high doses and/or for sufficiently long periods of time.
Unacceptable toxicities or side effects may occur at any dose
level, and at any time in the course of animal studies designed to
identify unacceptable effects of a drug candidate, known as
toxicological studies, or in clinical trials of our drug
candidates. The appearance of any unacceptable toxicity or side
effect could cause us or regulatory authorities to interrupt,
limit, delay or abort the development of any of our drug
candidates, and could ultimately prevent their marketing approval
by the FDA or foreign regulatory authorities for any or all
targeted indications.
The
FDA’s fast track and breakthrough therapy designation programs are
intended to facilitate the development and expedite the review of
drug candidates intended for the treatment of serious or
life-threatening conditions and that demonstrate the potential to
address unmet medical needs for these conditions. Under these
programs, FDA can, for example, review portions of an NDA or BLA
for a drug candidate before the entire application is complete,
thus potentially beginning the review process at an earlier
time.
We
cannot guarantee that the FDA will grant any of our requests for
fast track or breakthrough therapy designations, that any such
designations would affect the time of review or that the FDA will
approve the NDA or BLA submitted for any of our drug candidates,
whether or not these designations are granted. Additionally, FDA
approval of a fast track/breakthrough product can include
restrictions on the product’s use or distribution (such as
permitting use only for specified medical conditions or limiting
distribution to physicians or facilities with special training or
experience). Approval of such designated products can be
conditioned on additional clinical trials after
approval.
In
addition, the manufacturer of an investigational drug in a Phase 2
or Phase 3 clinical trial for a serious or life-threatening disease
is required to make available, such as by posting on its website,
its policy on evaluating and responding to requests for expanded
access.
After
completion of the required clinical testing, an NDA or BLA is
prepared and submitted to the FDA. FDA approval of the NDA or BLA
is required before marketing of the product may begin in the U.S.
The NDA or the BLA must include the results of all pre-clinical,
clinical and other testing and a compilation of data relating to
the product’s pharmacology, chemistry, manufacture and controls.
The cost of preparing and submitting an NDA is substantial. The
submission of most NDAs and BLAs is additionally subject to a
substantial application user fee, currently approximately
$3,242,026 for fiscal year 2023. These fees typically increase
annually.
The
FDA has 60 days from its receipt of an NDA or BLA to determine
whether the application will be filed based on the agency’s
threshold determination that it is sufficiently complete to permit
substantive review. If the NDA or BLA submission is filed, the FDA
reviews the NDA or BLA to determine, among other things, whether
the proposed product is safe and effective for its intended use.
The FDA has agreed to certain performance goals in the review of
NDAs or BLAs. Most such applications for standard review drug
products are reviewed within ten to twelve months; most
applications for priority review drugs are reviewed in six to eight
months. Priority review can be applied to drugs that the FDA
determines offer major advances in treatment, or provide a
treatment where no adequate therapy exists. For biologics, priority
review is further limited to drugs intended to treat a serious or
life-threatening disease relative to the currently approved
products. The review process for both standard and priority review
may be extended by the FDA for three additional months to consider
certain late-submitted information, or information intended to
clarify information already provided in the submission.
The
FDA may also refer applications for novel drug products, or drug
products that present difficult questions of safety or efficacy, to
an advisory committee – typically a panel that includes clinicians
and other experts – for review, evaluation and a recommendation as
to whether the application should be approved. The FDA is not bound
by the recommendation of an advisory committee, but it generally
follows such recommendations. Before approving an NDA or BLA, the
FDA will typically inspect one or more clinical sites to assure
compliance with GCP. Additionally, the FDA will inspect the
facility or the facilities at which the drug is manufactured. The
FDA will not approve the product unless compliance with cGMPs is
satisfactory and the NDA or BLA contains data that provide
substantial evidence that the drug is safe and effective in the
indication studied.
After
the FDA evaluates the NDA or BLA and the manufacturing facilities,
it issues either an approval letter or a complete response letter.
A complete response letter generally outlines the deficiencies in
the submission and may require substantial additional testing, or
information, in order for the FDA to reconsider the application.
If, or when, those deficiencies have been addressed to the FDA’s
satisfaction in a resubmission of the NDA or BLA, the FDA will
issue an approval letter. The FDA has committed to reviewing such
resubmissions in two or six months depending on the type of
information included.
An
approval letter authorizes commercial marketing of the drug with
specific prescribing information for specific indications. As a
condition of NDA or BLA approval, the FDA may require a risk
evaluation and mitigation strategy, or REMS, to help ensure that
the benefits of the drug outweigh the potential risks. REMS can
include medication guides, communication plans for healthcare
professionals, and elements to assure safe use, or ETASU. ETASU can
include, but is not limited to, special training or certification
for prescribing or dispensing, dispensing only under certain
circumstances, special monitoring and the use of patient
registries. The requirement for a REMS can materially affect the
potential market and profitability of the drug. Moreover, product
approval may require substantial post-approval testing and
surveillance to monitor the drug’s safety or efficacy. Once
granted, product approvals may be withdrawn if compliance with
regulatory standards is not maintained or problems are identified
following initial marketing.
Changes
to some of the conditions established in an approved application,
including changes in indications, labeling, or manufacturing
processes or facilities, require submission and FDA approval of a
new NDA or BLA supplement before the change can be implemented. An
NDA or BLA supplement for a new indication typically requires
clinical data similar to that in the original application, and the
FDA uses the same procedures and actions in reviewing NDA or BLA
supplements as it does in reviewing NDAs or BLAs.
The
required testing, data collection, analysis and compilation of an
IND and a BLA or NDA are labor intensive and costly and may take a
great deal of time. Tests may have to be redone or new tests
performed in order to comply with FDA requirements. It can take
considerable time (e.g., 5-10 years) and resources to achieve
enrollment sufficient to commence such trials and complete Phase 2
or 3 clinical trials. Moreover, there is no guarantee a product
will be approved.
In
Canada, the Therapeutic Products Directorate and the Biologics and
Genetic Therapies Directorate of HC ensure that clinical trials are
properly designed and undertaken and that subjects are not exposed
to undue risk. Regulations define specific Investigational New Drug
Submission (or IND) application requirements, which must be
complied with before a new drug can be distributed for trial
purposes. The Directorates currently review the safety, efficacy
and quality data submitted by the sponsor and approve the
distribution of the drug to the investigator. The sponsor of the
trial is required to maintain accurate records, report adverse drug
reactions, and ensure that the investigator adheres to the approved
protocol. Trials in humans should be conducted according to
generally accepted principles of good clinical practice. Management
believes that these standards provide assurance that the data and
reported results are credible and accurate, and that the rights,
integrity, and privacy of clinical trial subjects are
protected.
Sponsors
wishing to conduct clinical trials in Phases 1 to 3 of development
must apply under a 30-day default system. Applications must contain
the information described in the regulations, including: a clinical
trial attestation; a protocol; statements to be contained in each
informed consent form, that set out the risks posed to the health
of clinical trial subjects as a result of their participation in
the clinical trial; an investigator’s brochure; applicable
information on excipients (delivery vehicles); and chemistry and
manufacturing information.
The
sponsor can proceed with the clinical trial if the Directorates
have not objected to the sale or importation of the drug within 30
days after the date of receipt of the clinical trial application
and Research Ethics Board approval for the conduct of the trial at
the site has been obtained. Additional information is available on
Health Canada’s website - www. hc-sc.gc.ca.
Outside
the United States and Canada, our ability to market a product is
contingent upon receiving a marketing authorization from the
appropriate regulatory authorities. The requirements governing the
conduct of clinical trials, marketing authorization, pricing and
reimbursement vary widely from country to country. At present,
foreign marketing authorizations are applied for at a national
level, although within the European Union (EU) registration
procedures are available to companies wishing to market a product
in more than one EU member state. If the regulatory authority is
satisfied that adequate evidence of safety, quality and efficacy
has been presented, a marketing authorization may be granted. This
foreign regulatory approval process involves all of the risks
associated with FDA approval discussed above and may also include
additional risks.
The
Orphan Drug Act provides incentives to manufacturers to develop and
market drugs for rare diseases and conditions affecting fewer than
200,000 persons in the United States at the time of application for
orphan drug designation. The first developer to receive FDA
marketing approval for an orphan drug is entitled to a seven-year
exclusive marketing period in the United States for the orphan drug
indication. However, a drug that the FDA considers to be clinically
superior to, or different from, another approved orphan drug, even
though for the same indication, may also obtain approval in the
United States during the seven-year exclusive marketing
period.
Under
the FDA Modernization Act of 1997, designation as a Fast-Track
product for a new drug or biological product means that the FDA
will take such actions as are appropriate to expedite the
development and review of the application for approval of such
product.
Legislation
similar to the Orphan Drug Act has been enacted in other countries
outside of the United States, including the EU. The orphan
legislation in the EU is available for therapies addressing
conditions that affect five or fewer out of 10,000 persons, are
life-threatening or chronically debilitating conditions and for
which no satisfactory treatment is authorized. The market
exclusivity period is for ten years, although that period can be
reduced to six years if, at the end of the fifth year, available
evidence establishes that the product does not justify maintenance
of market exclusivity.
Expedited Development and Review Programs
The
FDA has the authority to facilitate and expedite the development
and review of a drug through various programs, such as fast track
designation, breakthrough therapy designation and priority review
designation. Each program may be utilized by the FDA in the context
of particular circumstances. For example, fast track designation
would generally be used to facilitate the development and review of
a drug that addresses an unmet medical need. Breakthrough therapy
designation applies similarly in cases where a drug demonstrates
substantial improvement over existing and available therapies.
Priority review designation suggests the FDA will take action on an
application within six months of filing.
Accelerated
approval is also possible in the event a product treats a serious
or life threatening condition, and provides a meaningful advantage
over available therapies. Products in this category must also meet
a number of additional requirements. While a product may qualify
for one or more of the foregoing programs, the FDA reserves the
right to later decide the product no longer qualifies or that the
product is no longer subject to priority regarding its review or
approval.
Emergency Use Authorization
The
FDA also has the authority to grant an Emergency Use Authorization
(“EUA”) to allow unapproved medical products to be used in an
emergency to diagnose, treat, or prevent serious or
life-threatening diseases or conditions when there are no adequate,
approved, and available alternatives, as designated by the U.S.
government. An EUA granted by the FDA would permit a drug candidate
to be able to be distributed under the conditions set forth in the
EUA prior to FDA approval. In response to the COVID-19 pandemic,
certain of our competitors have sought and obtained EUA from the
FDA for their COVID-19 vaccines. Furthermore, the FDA may revoke an
EUA for a variety of reasons, including where it is determined that
the underlying health emergency no longer exists or warrants such
authorizations.
Pediatric Information
Under
the Pediatric Research Equity Act, or PREA, NDAs, BLAs or
supplements to NDAs or BLAs must contain data to assess the safety
and effectiveness of the drug for the claimed indications in all
relevant pediatric subpopulations and to support dosing and
administration for each pediatric subpopulation for which the drug
is safe and effective. The FDA may grant full or partial waivers,
or deferrals, for submission of data. Unless otherwise required by
regulation, PREA does not apply to any drug for an indication for
which orphan designation has been granted, except a product with a
new active ingredient that is a molecularly targeted cancer product
intended for the treatment of an adult cancer and directed at a
molecular target determined by FDA to be substantially relevant to
the growth or progression of a pediatric cancer that is subject to
an NDA submitted on or after August 18, 2020.
The
Best Pharmaceuticals for Children Act, (“BPCA”), provides NDA
holders a six-month extension of any exclusivity – patent or
non-patent – for a drug if certain conditions are met. For BLAs,
the BPCA provides a six-month extension for non-patent exclusivity
if certain conditions are met. Conditions for exclusivity include
the FDA’s determination that information relating to the use of a
new drug in the pediatric population may produce health benefits in
that population, the FDA making a written request for pediatric
studies, and the applicant agreeing to perform, and reporting on,
the requested studies within the statutory timeframe. Applications
under the BPCA are treated as priority applications, with all of
the benefits that designation confers.
Disclosure of Clinical Trial Information
Sponsors
of clinical trials of FDA-regulated products, including drugs, are
required to register and disclose certain clinical trial
information. Information related to the product, patient
population, phase of investigation, study sites and investigators,
and other aspects of the clinical trial is then made public as part
of the registration. Sponsors are also obligated to discuss the
results of their clinical trials after completion. Disclosure of
the results of these trials can be delayed in certain circumstances
for up to two years after the date of completion of the trial.
Competitors may use this publicly available information to gain
knowledge regarding the progress of development
programs.
The Hatch-Waxman Amendments
Orange
Book Listing
In
seeking approval for a drug through an NDA, applicants are required
to list with the FDA each patent with claims covering the
applicant’s product or method of using the product. Upon approval
of a drug, each of the patents listed in the application for the
drug is then published in the FDA’s Approved Drug Products with
Therapeutic Equivalence Evaluations, commonly known as the Orange
Book. Drugs listed in the Orange Book can, in turn, be cited by
potential generic competitors in support of approval of an
abbreviated new drug application, or ANDA. An ANDA provides for
marketing of a drug product that has the same active ingredients in
the same strengths and dosage form as the listed drug and has been
shown to be bioequivalent to the listed drug. Other than the
requirement for bioequivalence testing, ANDA applicants are not
required to conduct, or submit results of, pre-clinical or clinical
tests to prove the safety or effectiveness of their drug product.
Drugs approved in this way are commonly referred to as “generic
equivalents” to the listed drug, and can often be substituted by
pharmacists under prescriptions written for the original listed
drug.
The
ANDA applicant is required to certify to the FDA concerning any
patents listed for the approved product in the FDA’s Orange Book.
Specifically, the applicant must certify that: (i) the required
patent information has not been filed; (ii) the listed patent has
expired; (iii) the listed patent has not expired, but will expire
on a particular date and approval is sought after patent
expiration; or (iv) the listed patent is invalid or will not be
infringed by the new product. The ANDA applicant may also elect to
submit a section viii statement certifying that its proposed ANDA
labeling does not contain (or carves out) any language regarding
the patented method-of-use rather than certify to a listed
method-of-use patent. If the applicant does not challenge the
listed patents, the ANDA application will not be approved until all
the listed patents claiming the referenced product have
expired.
A
certification that the new product will not infringe the already
approved product’s listed patents, or that such patents are
invalid, is called a Paragraph IV certification. If the ANDA
applicant has provided a Paragraph IV certification to the FDA, the
applicant must also send notice of the Paragraph IV certification
to the NDA and patent holders once the ANDA has been received by
the FDA. The NDA and patent holders may then initiate a patent
infringement lawsuit in response to the notice of the Paragraph IV
certification. The filing of a patent infringement lawsuit within
45 days of the receipt of a Paragraph IV certification
automatically prevents the FDA from approving the ANDA until the
earlier of 30 months, expiration of the patent, settlement of the
lawsuit or a decision in the infringement case that is favorable to
the ANDA applicant.
The
ANDA application also will not be approved until any applicable
non-patent exclusivity listed in the Orange Book for the referenced
product has expired.
Exclusivity
Exclusivity
provisions under the FDC Act also can delay the submission or the
approval of certain applications. The FDC Act provides a five-year
period of non-patent exclusivity within the United States to the
first applicant to gain approval of an NDA for a new chemical
entity, or NCE. A drug is entitled to NCE exclusivity if it
contains a drug substance no active moiety of which has been
previously approved by the FDA. During the exclusivity period, the
FDA may not accept for review an ANDA or file a 505(b)(2) NDA
submitted by another company for another version of such drug where
the applicant does not own or have a legal right of reference to
all the data required for approval. However, an application may be
submitted after four years if it contains a Paragraph IV
certification. The FDC Act also provides three years of market
exclusivity for an NDA, including a 505(b)(2) NDA, or supplement to
an existing NDA if new clinical investigations, other than
bioavailability studies, that were conducted or sponsored by the
applicant are deemed by the FDA to be essential to the approval of
the application, for example, for new indications, dosages or
strengths of an existing drug. This three-year exclusivity covers
only the conditions for use associated with the new clinical
investigations and does not prohibit the FDA from approving ANDAs
for drugs for the original conditions of use, such as the
originally approved indication. Five-year and three-year
exclusivity will not delay the submission or approval of a full
NDA; however, an applicant submitting a full NDA would be required
to conduct or obtain a right of reference to all the non-clinical
studies and adequate and well-controlled clinical trials necessary
to demonstrate safety and effectiveness.
Patent
Term Extension
After
NDA approval, the owner of relevant drug patent may apply for up to
a five-year patent term extension. Only one patent may be extended
for each regulatory review period, which is composed of two parts:
a testing phase, and an approval phase. The allowable patent term
extension is calculated as half of the drug’s testing phase – the
time between the day the IND becomes effective and NDA submission –
and all of the review phase – the time between NDA submission and
approval up to a maximum of five years. The time can be shortened
if the FDA determines that the applicant did not pursue approval
with due diligence. The total patent term after the extension may
not exceed 14 years and only one patent may be extended.
For
patents that might expire during the application phase, the patent
owner may request an interim patent extension. An interim patent
extension increases the patent term by one year and may be renewed
up to four times. For each interim patent extension granted, the
post-approval patent extension is reduced by one year. The Director
of the U.S. Patent and Trademark Office must determine that
approval of the drug covered by the patent for which a patent
extension is being sought is likely. Interim patent extensions are
not available for a drug for which an NDA has not been
submitted.
Section 505(b)(2) New Drug Applications
Most
drug products obtain FDA marketing approval pursuant to an NDA or
an ANDA. A third alternative is a special type of NDA, commonly
referred to as a Section 505(b)(2), or 505(b)(2), NDA, which
enables the applicant to rely, in part, on studies not conducted
by, or for, the applicant and for which the applicant has not
obtained a right of reference or use, such as the FDA’s findings of
safety and/or effectiveness for a similar previously approved
product, or published literature, in support of its
application.
505(b)(2)
NDAs often provide an alternate path to FDA approval for new or
improved formulations or new uses of previously approved products.
Section 505(b)(2) permits the filing of an NDA where at least some
of the information required for approval comes from studies not
conducted by, or for, the applicant and for which the applicant has
not obtained a right of reference. If the 505(b)(2) applicants can
establish that reliance on the FDA’s previous approval is
scientifically appropriate, it may eliminate the need to conduct
certain pre-clinical or clinical trials of the new product. The FDA
may also require companies to perform additional studies or
measurements to support the change from the approved product. The
FDA may then approve the new product candidate for all, or some, of
the label indications for which the referenced product has been
approved, as well as for any new indication sought by the Section
505(b)(2) applicant.
To
the extent that the Section 505(b)(2) applicant is relying on
studies conducted for an already approved product, the applicant is
required to certify to the FDA concerning any patents listed for
the approved product in the Orange Book to the same extent that an
ANDA applicant would. Thus approval of a 505(b)(2) NDA can be
stalled until all the listed patents claiming the referenced
product have expired, until any non-patent exclusivity, such as
exclusivity for obtaining approval of a new chemical entity, listed
in the Orange Book for the referenced product has expired, and, in
the case of a Paragraph IV certification and subsequent patent
infringement suit, until the earlier of 30 months, settlement of
the lawsuit or a decision in the infringement case that is
favorable to the Section 505(b)(2) applicant.
Post-Approval Requirements
Once
an NDA or BLA is approved, a product will be subject to certain
post-approval requirements. For instance, the FDA closely regulates
the post-approval marketing and promotion of drugs, including
standards and regulations for direct-to-consumer advertising,
off-label promotion, industry-sponsored scientific and educational
activities and promotional activities involving the internet. Drugs
may be marketed only for the approved indications and in accordance
with the provisions of the approved labeling.
Adverse
event reporting and submission of periodic reports are required
following FDA approval of an NDA or BLA. The FDA also may require
post-marketing testing, known as Phase 4 testing, REMS, and
surveillance to monitor the effects of an approved product, or the
FDA may place conditions on an approval that could restrict the
distribution or use of the product. In addition, quality-control,
drug manufacture, packaging and labeling procedures must continue
to conform to cGMPs after approval. Drug manufacturers and certain
of their subcontractors are required to register their
establishments with the FDA and certain state agencies.
Registration with the FDA, subjects entities to periodic
unannounced inspections by the FDA, during which the agency
inspects manufacturing facilities to assess compliance with cGMPs.
Accordingly, manufacturers must continue to expend time, money and
effort in the areas of production and quality-control to maintain
compliance with cGMPs. Regulatory authorities may withdraw product
approvals or request product recalls if a company fails to comply
with regulatory standards, if it encounters problems following
initial marketing or if previously unrecognized problems are
subsequently discovered. In addition, prescription drug
manufacturers in the United States must comply with applicable
provisions of the Drug Supply Chain Security Act and provide and
receive product tracing information, maintain appropriate licenses,
ensure they only work with other properly licensed entities, and
have procedures in place to identify and properly handle suspect
and illegitimate products.
Failure
to comply with the applicable FDA requirements may subject
manufacturers and distributors to administrative or judicial
sanctions. These sanctions could include, among other things,
warning letters, product seizures, total or partial suspension of
production or distribution, injunctions, civil money penalties,
fines, restitution, disgorgement, or civil or criminal penalties.
Further, the FDA has authority to issue mandatory recalls for
medical devices and biologics, and we may need to undertake a
voluntary recall for any of our products.
In
addition to regulations enforced by the FDA, we are also subject to
regulation under the Occupational Safety and Health Act, the
Environmental Protection Act, the Toxic Substances Control Act, the
Resource Conservation and Recovery Act and other federal, state and
local regulations. Our research and development activities involve
the controlled use of hazardous materials, chemicals, biological
materials and radioactive compounds.
Biologics
Biological
products used for the prevention, treatment or cure of a disease or
condition of a human being are subject to regulation under the FDC
Act, except the section of the FDC Act which governs the approval
of NDAs. Biological products are approved for marketing under
provisions of the Public Health Service Act, or PHSA, via a BLA.
However, the application process and requirements for approval of
BLAs are very similar to those for NDAs, and biologics are
associated with similar approval risks and costs as drugs. To help
reduce the increased risk of the introduction of adventitious
agents, the PHSA emphasizes the importance of manufacturing
controls for products whose attributes cannot be precisely defined.
The PHSA also provides authority to the FDA to immediately suspend
licenses in situations where there exists a danger to public
health, to prepare or procure products in the event of shortages
and critical public health needs, and to authorize the creation and
enforcement of regulations to prevent the introduction or spread of
communicable diseases in the US and between states.
After
a BLA is approved, the product may also be subject to official lot
release as a condition of approval. As part of the manufacturing
process, the manufacturer is required to perform certain tests on
each lot of the product before it is released for distribution. If
the product is subject to official release by the FDA, the
manufacturer submits samples of each lot of product to the FDA
together with a release protocol showing a summary of the history
of manufacture of the lot and the results of all of the
manufacturer’s tests performed on the lot. The FDA may also perform
certain confirmatory tests on lots of some products, such as viral
vaccines, before releasing the lots for distribution by the
manufacturer. In addition, the FDA conducts laboratory research
related to the regulatory standards on the safety, purity, potency,
and effectiveness of biological products. As with drugs, after
approval of biologics, manufacturers must address any safety issues
that arise, are subject to recalls or a halt in manufacturing, and
are subject to periodic inspection after approval.
The
Biologics Price Competition and Innovation Act of 2009, or BPCIA,
creates an abbreviated approval pathway for biological products
shown to be highly similar to or interchangeable with an
FDA-licensed reference biological product. Biosimilarity sufficient
to reference a prior FDA-approved product requires that there be no
differences in conditions of use, route of administration, dosage
form, and strength, and no clinically meaningful differences
between the biological product and the reference product in terms
of safety, purity and potency. Biosimilarity must be shown through
analytical studies, animal studies, and at least one clinical
trial, absent a waiver by the Secretary. A biosimilar product may
be deemed interchangeable with a prior approved product if it meets
the higher hurdle of demonstrating that it can be expected to
produce the same clinical results as the reference product and, for
products administered multiple times, the biologic and the
reference biologic may be switched after one has been previously
administered without increasing safety risks or risks of diminished
efficacy relative to exclusive use of the reference biologic. To
date, only four biosimilar products and no interchangeable products
have been approved under the BPCIA. Complexities associated with
the larger, and often more complex, structures of biological
products, as well as the process by which such products are
manufactured, particularly with respect to interchangeability, are
still being evaluated by the FDA.
A
reference biologic is granted twelve years of exclusivity from the
time of first licensure of the reference product, and no
application for a biosimilar can be submitted for four years from
the date of licensure of the reference product. The first biologic
product submitted under the abbreviated approval pathway that is
determined to be interchangeable with the reference product has
exclusivity against a finding of interchangeability for other
biologics for the same condition of use for the lesser of (i) one
year after first commercial marketing of the first interchangeable
biosimilar, (ii) eighteen months after the first interchangeable
biosimilar is approved if there is no patent challenge, (iii)
eighteen months after resolution of a lawsuit over the patents of
the reference biologic in favor of the first interchangeable
biosimilar applicant, or (iv) 42 months after the first
interchangeable biosimilar’s application has been approved if a
patent lawsuit is ongoing within the 42-month period.
Regulation
Outside the United States
In
order to market any product outside of the United States, a company
must also comply with numerous and varying regulatory requirements
of other countries and jurisdictions regarding quality, safety and
efficacy and governing, among other things, clinical trials,
marketing authorization, commercial sales and distribution of drug
products. Whether or not it obtains FDA approval for a product, the
company would need to obtain the necessary approvals by the
comparable foreign regulatory authorities before it can commence
clinical trials or marketing of the product in those countries or
jurisdictions. The approval process ultimately varies between
countries and jurisdictions and can involve additional product
testing and additional administrative review periods. The time
required to obtain approval in other countries and jurisdictions
might differ from and be longer than that required to obtain FDA
approval. Regulatory approval in one country or jurisdiction does
not ensure regulatory approval in another, but a failure or delay
in obtaining regulatory approval in one country or jurisdiction may
negatively impact the regulatory process in others.
Regulation and Marketing Authorization in the European
Union
The
process governing approval of medicinal products in the European
Union follows essentially the same lines as in the United States
and, likewise, generally involves satisfactorily completing each of
the following:
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pre-clinical
laboratory tests, animal studies and formulation studies all
performed in accordance with the applicable EU Good Laboratory
Practice regulations; |
|
● |
submission
to the relevant national authorities of a clinical trial
application, or CTA, which must be approved before human clinical
trials may begin; |
|
● |
performance
of adequate and well-controlled clinical trials to establish the
safety and efficacy of the product for each proposed
indication; |
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● |
submission
to the relevant competent authorities of a marketing authorization
application, or MAA, which includes the data supporting safety and
efficacy as well as detailed information on the manufacture and
composition of the product in clinical development and proposed
labeling; |
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● |
satisfactory
completion of an inspection by the relevant national authorities of
the manufacturing facility or facilities, including those of third
parties, at which the product is produced to assess compliance with
strictly enforced current cGMP; |
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potential
audits of the non-clinical and clinical trial sites that generated
the data in support of the MAA; and |
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review
and approval by the relevant competent authority of the MAA before
any commercial marketing, sale or shipment of the
product. |
Pre-clinical Studies
Pre-clinical
tests include laboratory evaluations of product chemistry,
formulation and stability, as well as studies to evaluate toxicity
in animal studies, in order to assess the potential safety and
efficacy of the product. The conduct of the pre-clinical tests and
formulation of the compounds for testing must comply with the
relevant EU regulations and requirements. The results of the
pre-clinical tests, together with relevant manufacturing
information and analytical data, are submitted as part of the
CTA.
Clinical Trial Approval
Requirements
for the conduct of clinical trials in the European Union including
GCP are implemented in the Clinical Trials Directive 2001/20/EC and
the GCP Directive 2005/28/EC. Pursuant to Directive 2001/20/EC and
Directive 2005/28/EC, as amended, a system for the approval of
clinical trials in the European Union has been implemented through
national legislation of the member states. Under this system,
approval must be obtained from the competent national authority of
an EU member state in which a study is planned to be conducted, or
in multiple member states if the clinical trial is to be conducted
in a number of member states. To this end, a CTA is submitted,
which must be supported by an investigational medicinal product
dossier, or IMPD, and further supporting information prescribed by
Directive 2001/20/EC and Directive 2005/28/EC and other applicable
guidance documents. Furthermore, a clinical trial may only be
started after a competent ethics committee has issued a favorable
opinion on the clinical trial application in that
country.
In
April 2014, the EU legislators passed the new Clinical Trials
Regulation, (EU) No 536/2014, which replaced the current Clinical
Trials Directive 2001/20/EC. To ensure that the rules for clinical
trials are identical throughout the European Union, the new EU
clinical trials legislation was passed as a regulation that is
directly applicable in all EU member states. All clinical trials
performed in the European Union are required to be conducted in
accordance with the Clinical Trials Directive 2001/20/EC until the
new Clinical Trials Regulation (EU) No 536/2014 becomes applicable.
According to the current plans of the European Medicines Agency, or
EMA, the new Clinical Trials Regulation became applicable in 2019.
The Clinical Trials Directive 2001/20/EC will, however, still apply
three years from the date of entry into application of the Clinical
Trials Regulation to (i) clinical trials applications submitted
before the entry into application and (ii) clinical trials
applications submitted within one year after the entry into
application if the sponsor opts for old system.
The
new Regulation (EU) No 536/2014 aims to simplify and streamline the
approval of clinical trials in the European Union. The main
characteristics of the regulation include:
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A
streamlined application procedure via a single-entry point, the EU
portal. |
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A
single set of documents to be prepared and submitted for the
application as well as simplified reporting procedures that will
spare sponsors from submitting broadly identical information
separately to various bodies and different member
states. |
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A
harmonized procedure for the assessment of applications for
clinical trials, which is divided into two parts. Part I is
assessed jointly by all member states concerned. Part II is
assessed separately by each member state concerned. |
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Strictly
defined deadlines for the assessment of clinical trial
application. |
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The
involvement of the ethics committees in the assessment procedure in
accordance with the national law of the member state concerned but
within the overall timelines defined by the Regulation (EU) No
536/2014. |
Marketing Authorization
Authorization
to market a product in the member states of the European Union
proceeds under one of four procedures: a centralized authorization
procedure, a mutual recognition procedure, a decentralized
procedure or a national procedure.
Centralized Authorization Procedure
The
centralized procedure enables applicants to obtain a marketing
authorization that is valid in all EU member states based on a
single application. Certain medicinal products, including products
developed by means of biotechnological processes, must undergo the
centralized authorization procedure for marketing authorization,
which, if granted by the European Commission, is automatically
valid in all 28 EU member states. The EMA and the European
Commission administer this centralized authorization procedure
pursuant to Regulation (EC) No 726/2004.
Pursuant
to Regulation (EC) No 726/2004, this procedure is mandatory
for:
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medicinal
products developed by means of one of the following
biotechnological processes: |
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recombinant
DNA technology; |
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controlled
expression of genes coding for biologically active proteins in
prokaryotes and eukaryotes including transformed mammalian cells;
and |
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hybridoma
and monoclonal antibody methods; |
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● |
advanced
therapy medicinal products as defined in Article 2 of Regulation
(EC) No. 1394/2007 on advanced therapy medicinal
products; |
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● |
medicinal
products for human use containing a new active substance that, on
the date of effectiveness of this regulation, was not authorized in
the European Union, and for which the therapeutic indication is the
treatment of any of the following diseases: |
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● |
acquired
immune deficiency syndrome; |
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neurodegenerative
disorder; |
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auto-immune
diseases and other immune dysfunctions; and |
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medicinal
products that are designated as orphan medicinal products pursuant
to Regulation (EC) No 141/2000. |
The
centralized authorization procedure is optional for other medicinal
products if they contain a new active substance or if the applicant
shows that the medicinal product concerned constitutes a
significant therapeutic, scientific or technical innovation or that
the granting of authorization is in the interest of patients in the
European Union.
Administrative Procedure
Under
the centralized authorization procedure, the EMA’s Committee for
Human Medicinal Products, or CHMP, serves as the scientific
committee that renders opinions about the safety, efficacy and
quality of medicinal products for human use on behalf of the EMA.
The CHMP is composed of experts nominated by each member state’s
national authority for medicinal products, with an expert appointed
to act as Rapporteur for the co-ordination of the evaluation with
the possible assistance of a further member of the Committee acting
as a Co-Rapporteur. After approval, the Rapporteur(s) continue to
monitor the product throughout its life cycle. The CHMP has 210
days to adopt an opinion as to whether a marketing authorization
should be granted. The process usually takes longer in case
additional information is requested, which triggers clock-stops in
the procedural timelines. The process is complex and involves
extensive consultation with the regulatory authorities of member
states and a number of experts. When an application is submitted
for a marketing authorization in respect of a drug that is of major
interest from the point of view of public health and in particular
from the viewpoint of therapeutic innovation, the applicant may
pursuant to Article 14(9) Regulation (EC) No 726/2004 request an
accelerated assessment procedure. If the CHMP accepts such request,
the time-limit of 210 days will be reduced to 150 days but it is
possible that the CHMP can revert to the standard time-limit for
the centralized procedure if it considers that it is no longer
appropriate to conduct an accelerated assessment. Once the
procedure is completed, a European Public Assessment Report, or
EPAR, is produced. If the opinion is negative, information is given
as to the grounds on which this conclusion was reached. After the
adoption of the CHMP opinion, a decision on the MAA must be adopted
by the European Commission, after consulting the E.U. member
states, which in total can take more than 60 days.
Conditional Approval
In
specific circumstances, EU legislation (Article 14(7) Regulation
(EC) No 726/2004 and Regulation (EC) No 507/2006 on Conditional
Marketing Authorizations for Medicinal Products for Human Use)
enables applicants to obtain a conditional marketing authorization
prior to obtaining the comprehensive clinical data required for an
application for a full marketing authorization. Such conditional
approvals may be granted for product candidates (including
medicines designated as orphan medicinal products) if (1) the
risk-benefit balance of the product candidate is positive, (2) it
is likely that the applicant will be in a position to provide the
required comprehensive clinical trial data, (3) the product
fulfills unmet medical needs and (4) the benefit to public health
of the immediate availability on the market of the medicinal
product concerned outweighs the risk inherent in the fact that
additional data are still required. A conditional marketing
authorization may contain specific obligations to be fulfilled by
the marketing authorization holder, including obligations with
respect to the completion of ongoing or new studies, and with
respect to the collection of pharmacovigilance data. Conditional
marketing authorizations are valid for one year, and may be renewed
annually, if the risk-benefit balance remains positive, and after
an assessment of the need for additional or modified conditions
and/or specific obligations. The timelines for the centralized
procedure described above also apply with respect to the review by
the CHMP of applications for a conditional marketing
authorization.
Marketing Authorization under Exceptional
Circumstances
Under
Article 14(8) Regulation (EC) No 726/2004, products for which the
applicant can demonstrate that comprehensive data (in line with the
requirements laid down in Annex I of Directive 2001/83/EC, as
amended) cannot be provided (due to specific reasons foreseen in
the legislation) might be eligible for marketing authorization
under exceptional circumstances. This type of authorization is
reviewed annually to reassess the risk-benefit balance. The
fulfillment of any specific procedures/obligations imposed as part
of the marketing authorization under exceptional circumstances is
aimed at the provision of information on the safe and effective use
of the product and will normally not lead to the completion of a
full dossier/approval.
Market Authorizations Granted by Authorities of E.U. Member
States
In
general, if the centralized procedure is not followed, there are
three alternative procedures as prescribed in Directive
2001/83/EC:
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The
decentralized procedure allows applicants to file identical
applications to several EU member states and receive simultaneous
national approvals based on the recognition by EU member states of
an assessment by a reference member state. |
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The
national procedure is only available for products intended to be
authorized in a single EU member state. |
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A
mutual recognition procedure similar to the decentralized procedure
is available when a marketing authorization has already been
obtained in at least one E.U. member state. |
A
marketing authorization may be granted only to an applicant
established in the European Union.
Pediatric Studies
Prior
to obtaining a marketing authorization in the European Union,
applicants have to demonstrate compliance with all measures
included in an EMA-approved Pediatric Investigation Plan, or PIP,
covering all subsets of the pediatric population, unless the EMA
has granted a product-specific waiver, a class waiver, or a
deferral for one or more of the measures included in the PIP. The
respective requirements for all marketing authorization procedures
are set forth in Regulation (EC) No 1901/2006, which is referred to
as the Pediatric Regulation. This requirement also applies when a
company wants to add a new indication, pharmaceutical form or route
of administration for a medicine that is already authorized. The
Pediatric Committee of the EMA, or PDCO, may grant deferrals for
some medicines, allowing a company to delay development of the
medicine in children until there is enough information to
demonstrate its effectiveness and safety in adults. The PDCO may
also grant waivers when development of a medicine in children is
not needed or is not appropriate, such as for diseases that only
affect the elderly population.
Before
a marketing authorization application can be filed, or an existing
marketing authorization can be amended, the EMA determines that
companies actually comply with the agreed studies and measures
listed in each relevant PIP.
Periods of Authorization and Renewals
A
marketing authorization is valid for five years in principle and
the marketing authorization may be renewed after five years on the
basis of a re-evaluation of the risk-benefit balance by the EMA or
by the competent authority of the authorizing member state. To this
end, the marketing authorization holder must provide the EMA or the
competent authority with a consolidated version of the file in
respect of quality, safety and efficacy, including all variations
introduced since the marketing authorization was granted, at least
six months before the marketing authorization ceases to be valid.
Once renewed, the marketing authorization is valid for an unlimited
period, unless the European Commission or the competent authority
decides, on justified grounds relating to pharmacovigilance, to
proceed with one additional five-year renewal. Any authorization
which is not followed by the actual placing of the drug on the EU
market (in case of centralized procedure) or on the market of the
authorizing member state within three years after authorization
ceases to be valid (the so-called sunset clause).
Regulatory Data Protection
EU
legislation also provides for a system of regulatory data and
market exclusivity. According to Article 14(11) of Regulation (EC)
No 726/2004, as amended, and Article 10(1) of Directive 2001/83/EC,
as amended, upon receiving marketing authorization, new chemical
entities approved on the basis of complete independent data package
benefit from eight years of data exclusivity and an additional two
years of market exclusivity. Data exclusivity prevents regulatory
authorities in the European Union from referencing the innovator’s
data to assess a generic (abbreviated) application. During the
additional two-year period of market exclusivity, a generic
marketing authorization can be submitted, and the innovator’s data
may be referenced, but no generic medicinal product can be marketed
until the expiration of the market exclusivity. The overall
ten-year period will be extended to a maximum of 11 years if,
during the first eight years of those ten years, the marketing
authorization holder, or MAH, obtains an authorization for one or
more new therapeutic indications which, during the scientific
evaluation prior to their authorization, are held to bring a
significant clinical benefit in comparison with existing therapies.
Even if a compound is considered to be a new chemical entity and
the innovator is able to gain the period of data exclusivity,
another company nevertheless could also market another version of
the drug if such company obtained marketing authorization based on
an MAA with a complete independent data package of pharmaceutical
test, pre-clinical tests and clinical trials. However, products
designated as orphan medicinal products enjoy, upon receiving
marketing authorization, a period of ten years of orphan market
exclusivity. Depending upon the timing and duration of the EU
marketing authorization process, products may be eligible for up to
five years’ supplementary protection certificates, or SPCs,
pursuant to Regulation (EC) No 469/2009. Such SPCs extend the
rights under the basic patent for the drug.
Regulatory Requirements After a Marketing Authorization has been
Obtained
If we
obtain authorization for a medicinal product in the European Union,
we will be required to comply with a range of requirements
applicable to the manufacturing, marketing, promotion and sale of
medicinal products:
Pharmacovigilance and other requirements
We
will, for example, have to comply with the EU’s stringent
pharmacovigilance or safety reporting rules, pursuant to which
post-authorization studies and additional monitoring obligations
can be imposed. Other requirements relate, for example, to the
manufacturing of products and APIs in accordance with good
manufacturing practice standards. EU regulators may conduct
inspections to verify our compliance with applicable requirements,
and we will have to continue to expend time, money and effort to
remain compliant. Non-compliance with EU requirements regarding
safety monitoring or pharmacovigilance, and with requirements
related to the development of products for the pediatric
population, can also result in significant financial penalties in
the European Union. Similarly, failure to comply with the EU’s
requirements regarding the protection of individual personal data
can also lead to significant penalties and sanctions. Individual EU
member states may also impose various sanctions and penalties in
case we do not comply with locally applicable
requirements.
Manufacturing
The
manufacturing of authorized drugs, for which a separate
manufacturer’s license is mandatory, must be conducted in strict
compliance with the EMA’s Good Manufacturing Practices, or GMP,
requirements and comparable requirements of other regulatory bodies
in the European Union, which mandate the methods, facilities and
controls used in manufacturing, processing and packing of drugs to
assure their safety and identity. The EMA enforces its current GMP
requirements through mandatory registration of facilities and
inspections of those facilities. The EMA may have a coordinating
role for these inspections while the responsibility for carrying
them out rests with the member states competent authority under
whose responsibility the manufacturer falls. Failure to comply with
these requirements could interrupt supply and result in delays,
unanticipated costs and lost revenues, and could subject the
applicant to potential legal or regulatory action, including but
not limited to warning letters, suspension of manufacturing,
seizure of product, injunctive action or possible civil and
criminal penalties.
Marketing and Promotion
The
marketing and promotion of authorized drugs, including
industry-sponsored continuing medical education and advertising
directed toward the prescribers of drugs and/or the general public,
are strictly regulated in the European Union under Directive
2001/83/EC. The applicable regulations aim to ensure that
information provided by holders of marketing authorizations
regarding their products is truthful, balanced and accurately
reflects the safety and efficacy claims authorized by the EMA or by
the competent authority of the authorizing member state. Failure to
comply with these requirements can result in adverse publicity,
warning letters, corrective advertising and potential civil and
criminal penalties.
Patent Term Extension
In
order to compensate the patentee for delays in obtaining a
marketing authorization for a patented product, a supplementary
certificate, or SPC, may be granted extending the exclusivity
period for that specific product by up to five years. Applications
for SPCs must be made to the relevant patent office in each E.U.
member state and the granted certificates are valid only in the
member state of grant. An application has to be made by the patent
owner within six months of the first marketing authorization being
granted in the European Union (assuming the patent in question has
not expired, lapsed or been revoked) or within six months of the
grant of the patent (if the marketing authorization is granted
first). In the context of SPCs, the term “product” means the active
ingredient or combination of active ingredients for a medicinal
product and the term “patent” means a patent protecting such a
product or a new manufacturing process or application for it. The
duration of an SPC is calculated as the difference between the
patent’s filing date and the date of the first marketing
authorization, minus five years, subject to a maximum term of five
years.
A
six-month pediatric extension of an SPC may be obtained where the
patentee has carried out an agreed pediatric investigation plan,
the authorized product information includes information on the
results of the studies and the product is authorized in all member
states of the European Union.
Pharmaceutical Coverage, Pricing and
Reimbursement
Significant
uncertainty exists as to the coverage and reimbursement status of
products approved by the FDA and other government authorities.
Sales of products will depend, in part, on the extent to which the
costs of the products will be covered by third-party payors,
including government health programs in the United States such as
Medicare and Medicaid, commercial health insurers and managed care
organizations. The process for determining whether a payor will
provide coverage for a product may be separate from the process for
setting the price or reimbursement rate that the payor will pay for
the product once coverage is approved. Third-party payors may limit
coverage to specific products on an approved list, or formulary,
which might not include all of the approved products for a
particular indication.
In
order to secure coverage and reimbursement for any product that
might be approved for sale, a company may need to conduct expensive
pharmacoeconomic studies in order to demonstrate the medical
necessity and cost-effectiveness of the product, in addition to the
costs required to obtain FDA or other comparable regulatory
approvals. A payor’s decision to provide coverage for a drug
product does not imply that an adequate reimbursement rate will be
approved. Third-party reimbursement may not be sufficient to
maintain price levels high enough to realize an appropriate return
on investment in product development.
There
has been an increased focus on drug pricing in recent years in the
United States. Although there are no direct government price
controls over private sector purchases in the United States, there
are rebates and other financial requirements for federal and state
health care programs. The Medicare Modernization Act, enacted in
December 2003, established the Medicare Part D outpatient
prescription drug benefit, which is provided primarily through
private entities that attempt to negotiate price concessions from
pharmaceutical manufacturers. The health care reform legislation
enacted in 2010, known as the Affordable Care Act, requires drug
manufacturers to pay 50% of the Medicare Part D coverage gap, also
known as the “donut hole,” on prescriptions for branded products
filled when the beneficiary reaches this coverage. The Deficit
Reduction Act of 2005 resulted in changes to the way drug prices
are reported to the government and the formula using such
information to calculate the required Medicaid rebates. The
Affordable Care Act increased the minimum basic Medicaid rebate for
branded prescription drugs from 15.1% to 23.1% and requires
pharmaceutical manufacturers to pay states rebates on prescription
drugs dispensed to Medicaid managed care enrollees. In addition,
the Affordable Care Act increased the additional Medicaid rebate on
“line extensions” (such as extended-release formulations) of solid
oral dosage forms of branded products, revised the definition of
average manufacturer price by changing the classes of purchasers
included in the calculation, and expanded the entities eligible for
discounted pricing under the federal 340B drug pricing program.
Current orphan drugs are excluded from the expanded 340B hospitals
eligible for discounts.
The
Affordable Care Act imposes a significant annual fee on companies
that manufacture or import branded prescription drug products. The
fee (which is not deductible for federal income tax purposes) is
based on the manufacturer’s market share of sales of branded drugs
and biologics (excluding orphan drugs) to, or pursuant to coverage
under, specified U. S. government programs. The Affordable Care Act
also contains a number of provisions, including provisions
governing the way that health care is financed by both governmental
and private insurers, enrollment in federal health care programs,
reimbursement changes, the increased use of comparative
effectiveness research in health care decision-making, and
enhancements to fraud and abuse requirements and enforcement, that
are affecting existing government health care programs and will
result in the development of new programs. The Affordable Care Act
also contains requirements for manufacturers to publicly report
certain payments or other transfers of value made to physicians and
teaching hospitals. We are unable to predict the future course of
federal or state health care legislation and regulations, including
regulations that will be issued to implement provisions of the
Affordable Care Act. The Affordable Care Act and further changes in
the law or regulatory framework that reduce our revenues or
increase our costs could also have a material adverse effect on our
business, financial condition and results of operations and cash
flows.
Public
and private health care payers control costs and influence drug
pricing through a variety of mechanisms, including through
negotiating discounts with the manufacturers and through the use of
tiered formularies and other mechanisms that provide preferential
access to certain drugs over others within a therapeutic class.
Payers also set other criteria to govern the uses of a drug that
will be deemed medically appropriate and therefore reimbursed or
otherwise covered. Payers may require physicians to seek approval
from them before a product will be reimbursed or covered, commonly
referred to as prior authorization. In particular, many public and
private health care payers limit reimbursement and coverage to the
uses of a drug that are either approved by the FDA or appear in a
recognized drug compendium. Drug compendia are publications that
summarize the available medical evidence for particular drug
products and identify which uses of a drug are supported or not
supported by the available evidence, whether or not such uses have
been approved by the FDA. For example, in the case of Medicare Part
D coverage for oncology drugs, the Medicare Modernization Act, with
certain exceptions, provides for Medicare coverage of unapproved
uses of an FDA-approved drug if the unapproved use is reasonable
and necessary and is supported by one or more citations in
CMS-approved compendia, such as the National Comprehensive Cancer
Network Drugs and Biologics Compendium. Different pricing and
reimbursement schemes exist in other countries. For example, in the
European Union, governments influence the price of pharmaceutical
products through their pricing and reimbursement rules and control
of national health care systems that fund a large part of the cost
of such products to consumers. The approach taken varies from
member state to member state. Some jurisdictions operate positive
or negative list systems under which products may only be marketed
once a reimbursement price has been agreed. Other member states
allow companies to fix their own prices for medicines, but monitor
and control company profits and may limit or restrict
reimbursement. The downward pressure on health care costs in
general, and prescription drugs in particular, has become very
intense. As a result, increasingly high barriers are being erected
to the entry of new products, as exemplified by the actions of the
National Institute for Clinical Excellence in the United Kingdom,
which evaluates the data supporting new medicines and passes
reimbursement recommendations to the government. In addition, in
some countries cross-border imports from low-priced markets
(parallel imports) exert a commercial pressure on pricing within a
country.
In
the European Union, pricing and reimbursement schemes vary widely
from country to country. Some countries provide that drug products
may be marketed only after a reimbursement price has been agreed.
Some countries may require the completion of additional studies
that compare the cost-effectiveness of our drug candidate to
currently available therapies (so called health technology
assessment) in order to obtain reimbursement or pricing approval.
For example, the European Union provides options for its member
states to restrict the range of drug products for which their
national health insurance systems provide reimbursement and to
control the prices of medicinal products for human use. E.U. member
states may approve a specific price for a drug product or it may
instead adopt a system of direct or indirect controls on the
profitability of the company placing the drug product on the
market. Other member states allow companies to fix their own prices
for drug products, but monitor and control prescription volumes and
issue guidance to physicians to limit prescriptions. The downward
pressure on health care costs in general, particularly prescription
drugs, has become intense. As a result, increasingly high barriers
are being erected to the entry of new products. In addition, there
can be considerable pressure by governments and other stakeholders
on prices and reimbursement levels, including as part of cost
containment measures. Political, economic and regulatory
developments may further complicate pricing negotiations, and
pricing negotiations may continue after reimbursement has been
obtained. Reference pricing used by various E.U. member states, and
parallel distribution (arbitrage between low-priced and high-priced
member states), can further reduce prices. Any country that has
price controls or reimbursement limitations for drug products may
not allow favorable reimbursement and pricing
arrangements.
Healthcare Law and Regulation
Healthcare
providers, physicians and third-party payors play a primary role in
the recommendation and prescription of drug products that are
granted marketing approval. Arrangements with third-party payors
and customers are subject to broadly applicable fraud and abuse and
other healthcare laws and regulations. Such restrictions under
applicable federal and state healthcare laws and regulations,
include the following:
|
● |
the
federal Anti-Kickback Statute prohibits, among other things,
persons from knowingly and willfully soliciting, offering,
receiving or providing remuneration, directly or indirectly, in
cash or in kind, to induce or reward either the referral of an
individual for, or the purchase, order or recommendation of, any
good or service, for which payment may be made, in whole or in
part, under a federal healthcare program such as Medicare and
Medicaid; |
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the
federal False Claims Act imposes civil penalties, and provides for
civil whistleblower or qui tam actions, against individuals or
entities for knowingly presenting, or causing to be presented, to
the federal government, claims for payment that are false or
fraudulent or making a false statement to avoid, decrease or
conceal an obligation to pay money to the federal
government; |
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the
federal Health Insurance Portability and Accountability Act of
1996, or HIPAA, imposes criminal and civil liability for executing
a scheme to defraud any healthcare benefit program or making false
statements relating to healthcare matters; |
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● |
HIPAA,
as amended by the Health Information Technology for Economic and
Clinical Health Act and its implementing regulations, also imposes
obligations, including mandatory contractual terms, with respect to
safeguarding the privacy, security and transmission of individually
identifiable health information; |
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the
federal false statements statute prohibits knowingly and willfully
falsifying, concealing or covering up a material fact or making any
materially false statement in connection with the delivery of or
payment for healthcare benefits, items or services; |
|
● |
the
federal transparency requirements under the Health Care Reform Law
requires manufacturers of drugs, devices, biologics and medical
supplies to report to the Department of Health and Human Services
information related to payments and other transfers of value to
physicians and teaching hospitals and physician ownership and
investment interests; and |
|
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● |
analogous
state and foreign laws and regulations, such as state anti-kickback
and false claims laws, may apply to sales or marketing arrangements
and claims involving healthcare items or services reimbursed by
non-governmental third-party payors, including private
insurers. |
An
increasing number of states have enacted legislation requiring
pharmaceutical and biotechnology companies to file periodic reports
of expenses relating to the marketing and promotion of drug
products and gifts and payments to individual healthcare
practitioners in these states; to make periodic public disclosures
on sales, marketing, pricing, clinical trials and other activities;
to report information pertaining to and justifying price increases;
or to register their sales representatives. Other states prohibit
various marketing-related activities, such as the provision of
certain kinds of gifts or meals; price gouging; or pharmacies and
other healthcare entities from providing certain physician
prescribing data to pharmaceutical and biotechnology companies for
use in sales and marketing. In addition, states such as California,
Connecticut, Nevada, and Massachusetts require pharmaceutical
companies to implement compliance programs and/or marketing codes.
State and foreign laws also govern the privacy and security of
health information in some circumstances, many of which differ from
each other in significant ways and often are not preempted by
HIPAA, thus complicating compliance efforts.
Environmental,
Health and Safety Matters
The
manufacturing facilities of the third-parties that develop our
product candidates are subject to extensive environmental, health
and safety laws and regulations in a number of jurisdictions,
governing, among other things: the use, storage, registration,
handling, emission and disposal of chemicals, waste materials and
sewage; chemicals, air, water and ground contamination; air
emissions and the cleanup of contaminated sites, including any
contamination that results from spills due to our failure to
properly dispose of chemicals, waste materials and
sewage.
These
laws, regulations and permits could potentially require the
expenditure by us of significant amounts for compliance or
remediation if, among other things, our operations result in
contamination of the environment or breach of regulatory
obligations, or expose individuals to harm. If the third-party
manufacturers fail to comply with such laws, regulations or
permits, we may be subject to fines and other civil, administrative
or criminal sanctions, including the revocation of permits and
licenses necessary to continue our business activities. In
addition, we may be required to pay damages or civil judgments in
respect of third-party claims, including those relating to personal
injury (including exposure to hazardous substances we use, store,
handle, transport, manufacture or dispose of), property damage or
contribution claims. Some environmental, health and safety laws
allow for strict, joint and several liability for remediation
costs, regardless of comparative fault. We may be identified as a
responsible party under such laws. Such developments could have a
material adverse effect on our business, financial condition and
results of operations.
In
addition, laws and regulations relating to environmental, health
and safety matters are often subject to change. In the event of any
changes or new laws or regulations, we could be subject to new
compliance measures or to penalties for activities that were
previously permitted.
Competition
Our
industry is subject to rapid and intense technological change.
Competition is intense among manufacturers of nutritional,
non-prescription, and prescription pharmaceuticals. We face, and
will continue to face, competition from nutraceutical,
pharmaceutical, biopharmaceutical, medical device and biotechnology
companies developing similar products and technologies both in the
United States and abroad, as well as numerous academic and research
institutions, governmental agencies and private organizations
engaged in drug funding or research and discovery activities both
in the United States and abroad. Academic institutions, government
agencies and other public and private research organizations may
also conduct research, seek patent protection and establish
collaborative arrangements for discovery, research and clinical
development of technologies and products similar to ours. We also
face competition from entities and healthcare providers using more
traditional methods. We believe there are a substantial number of
products under development by numerous nutraceutical,
pharmaceutical, biopharmaceutical, medical device and biotechnology
companies, and it is likely that other competitors will
emerge.
Many
of our existing and potential competitors are large, well
established pharmaceutical, chemical or healthcare companies with
considerably greater research and product development capabilities
and financial, scientific, marketing and human resources than we
have. Large and established companies, such as Merck & Co.,
Inc., GlaxoSmithKline plc, CSL Ltd., Sanofi Pasteur, SA, Pfizer
Inc., Johnson & Johnson, AstraZeneca, and Moderna, among
others, compete in the vaccine market. In particular, these
companies have greater experience and expertise in securing
government contracts and grants to support their research and
development efforts, conducting testing and clinical trials,
obtaining regulatory approvals to market products, manufacturing
such products on a broad scale and marketing approved products. As
a result, these competitors may succeed in developing competing
products earlier than we do; obtain patents that block or otherwise
inhibit our ability to further develop and commercialize our
product candidates; obtain approvals from the FDA or other
regulatory agencies for products more rapidly than we do; or
develop treatments or cures that are safer or more effective than
those we propose to develop. These competitors may also devote
greater resources to marketing or selling their products and may be
better able to withstand price competition. In addition, these
competitors may introduce or adapt more quickly to new technologies
or scientific advances, which could render our technologies
obsolete, and may introduce products or technologies that make the
continued development, production, or marketing of our product
candidates uneconomical. These competitors may also be more
successful in negotiating third-party licensing or collaborative
arrangements and may be able to take advantage of acquisitions or
other strategic opportunities more readily than we can. These
actions by competitors or potential competitors could materially
affect our business, financial condition and results of operations.
We cannot assure you that we will be able to compete
successfully.
Regardless
of the disease, smaller or early-stage companies and research
institutions also may prove to be significant competitors,
particularly through collaborative arrangements with large and
established pharmaceutical companies. As these companies develop
their technologies, they may develop proprietary positions, which
may prevent or limit our product development and commercialization
efforts. We will also face competition from these parties in
recruiting and retaining qualified scientific and management
personnel, establishing clinical trial sites and participant
registration for clinical trials and in acquiring and in-licensing
technologies and products complementary to our programs or
potentially advantageous to our business. If any of our competitors
succeed in obtaining approval from the FDA or other regulatory
authorities for their products sooner than we do or for products
that are more effective or less costly than ours, our commercial
opportunity could be significantly reduced. Additionally, the
threat of COVID-19 may subside before we are able to successfully
bring a vaccine product candidate to market, which may influence
public perception of the use of vaccine product candidates in
connection with COVID-19 and adversely affect our
business.
We
have a limited ability to predict how competitive our products and
product candidates will be in the marketplace. The competition we
believe currently exists with respect to each of our products is as
follows:
Our
NT-CoV2-1 Vaccine
The
COVID-19 vaccine market is intensely competitive, characterized by
rapid technological progress. The SARS-CoV-2 pandemic is also
evolving rapidly with the generation of new virus variants that
impact vaccine efficacy. This creates a changing competitive
landscape for the Terra CoV-2 and NT-CoV2-1 vaccine candidates. We
compete with worldwide research-based biopharmaceutical companies
and smaller companies that manufacture and sell products that treat
diseases or indications similar to those treated by our vaccine
candidate. In December 2020, Pfizer and Moderna both received EUAs
to begin distributing their vaccines. Pfizer received full FDA
approval in August 2021 and Moderna in January 2022. Johnson &
Johnson has developed a single dose vaccine and received an EUA in
the US in February 2021.
In
July 2022, the FDA issued an EUA for the Novavax adjuvanted
vaccine. As of early March 2023, the WHO has granted 11 vaccines an
Emergency Use Listing.
According
to the WHO, there are 183 vaccines currently in clinical
development, and there are currently 199 vaccines which are in the
pre-clinical development phase. There are just 16 vaccines in
active clinical development that contemplate use of intranasal
administration. Our intranasal NT-CoV2-1 vaccine candidate is in
pre-clinical development.
Additionally,
several companies are working on antiviral drugs, some of which are
already in use against other illnesses, to treat people who have
COVID-19. The FDA has also issued EUAs for several other
treatments, including antivirals, monoclonal antibodies,
convalescent plasma therapy, a drug used to sedate people placed on
a ventilator, and drugs for people undergoing a type of blood
purification known as continuous renal replacement therapy. To the
extent these drug treatments are effective there can reduce demand
for vaccines against the disease and the potential market for our
vaccine product candidate.
Our
vaccine development will depend on our ability to identify key
points of product differentiation relative to our competitors and
conduct pre-clinical testing and file an IND followed by proceeding
to a Phase 1 clinical trial. If the Phase 1 trial results support
further development, a Phase 2 clinical trial may be initiated
and/or a partnership to advance further development may be sought.
The competition we face with the development of our vaccines is
extensive and could adversely affect us in many ways including the
increased numbers of vaccines currently being administered under
emergency use authorizations, supplies of raw materials including
adjuvants for clinical testing, timing of manufacturers to make our
vaccine for testing, available government funding and other funding
through partnerships. In addition, several companies are in the
process of developing various treatments to treat or prevent
COVID-19. For example, Pfizer and Merck & Co., Inc. have
developed antiviral pills for the treatment of COVID-19. To the
extent that these or other treatments are viewed as an alternative
to vaccination against COVID-19, our competitive position could be
harmed.
MU1140
Homologs and Other Lantibiotics
MU1140
will likely compete directly with antibiotic drugs such as
vancomycin and newer drugs, including Cubicin® (daptomycin) and
Zyvox ® (linezolid). Given the growing resistance of target
pathogens to even new antibiotics, we believe that there is ample
room in the marketplace for additional antibiotics. Many of our
competitors are taking approaches to drug development differing
from our approach, including using traditional screening of natural
products; genomics to identify new targets, and combinatorial
chemistry to generate new chemical structures. Competition in the
pharmaceutical industry is based on drug safety, efficacy, ease of
use, patient compliance, price, marketing, and distribution. Our
lantibiotic development will depend on our success in developing
MU1140 homologs and to the point of commercialization or
partnership and in the process securing and protecting our
intellectual property.
Our
Intellectual Property
We
rely upon a combination of licenses, patents, trade secrets,
know-how, and licensing opportunities to develop our business. Our
future prospects depend on our ability to protect our intellectual
property. We also need to operate without infringing the
proprietary rights of third parties.
Patents
We
attempt to protect our technology and products through patents and
patent applications pursuant to the terms of our license
agreements. We have a worldwide, nonexclusive intellectual property
and biological materials license agreement with NIAID, an institute
within the NIH, relating to certain research, patent applications
and biological materials involving prefusion coronavirus spike
proteins and their use in the development and commercialization of
vaccine to provide specific, lifetime immunity from SARS-CoV-2. We
also have worldwide, nonexclusive intellectual property and
biological materials license agreement with the NRC which provides
us with a platform that can generate cell lines for high-yield
production of spike protein antigens for existing and emerging
variants of concern. This platform should allow production of cell
lines within six to eight weeks of spike gene sequence
availability, compared with six to nine months for traditional
production of such cell lines. We co-own the intellectual property
for certain homologs of our MU1140 product candidate with the Texas
A&M University System.
The
effect of issued patents is that they provide patent protection for
the claims covered by the patents. While the expiration of a
product patent normally results in a loss of market exclusivity for
the covered product or product candidate, commercial benefits may
continue to be derived from: (i) later-granted patents on processes
and intermediates related to the most economical method of
manufacture of the active ingredient of such product; (ii) patents
relating to the use of such product; (iii) patents relating to
novel compositions and formulations; and (iv) in the United States
and certain other countries, market exclusivity that may be
available under relevant law. The effect of patent expiration on
products or product candidates also depends upon many other factors
such as the nature of the market and the position of the product in
it, the growth of the market, the complexities and economics of the
process for manufacture of the active ingredient of the product and
the requirements of new drug provisions of the Federal Food, Drug
and Cosmetic Act or similar laws and regulations in other
countries.
We
believe that the protection of discoveries in connection with our
development activities, our proprietary products, technologies,
processes and know-how and all of our intellectual property are
important to our business. To achieve a competitive position, we
rely on trade secrets, non-patented proprietary know-how and
continuing technological innovation, where patent protection is not
believed to be appropriate or attainable. In addition, as outlined
above, we have a number of patent licenses from third parties, some
of which may be important to our business. There can be no
assurance that any of our patents, licenses or other intellectual
property rights will afford us any protection from
competition.
Trademarks
Our
trademarks are important to our business. We currently use the
following unregistered trademarks: SMaRT Replacement Therapy™,
MU1140™, and LPT3-04™. In March 2022, the USPTO issued a Notice of
Allowance in connection with our application for registration of
the mark of ORAGENICS™ (therapeutic products; anti-infectives and
vaccine products). Registration of the mark of ORAGENICS™ is
pending, subject to our filing of a Statement of Use and the
subsequent acceptance thereof by the USPTO. We also have rights to
use other names essential to our business. Federally registered
trademarks have a perpetual life, as long as they are maintained
and renewed on a timely basis and used properly as trademarks,
subject to the rights of third parties to seek cancellation of the
trademarks if they claim priority or confusion of usage. We regard
our trademarks and other proprietary rights as valuable assets and
believe they have significant value to us.
Protection
of Trade Secrets
We
attempt to protect our trade secrets, including the processes,
concepts, ideas and documentation associated with our technologies,
through the use of confidentiality agreements and non-competition
agreements with our current employees and with other parties to
whom we have divulged such trade secrets. There can be no assurance
that these agreements will not be breached, that we will have
adequate remedies for any breach, that others will not
independently develop equivalent proprietary information or that
other third parties will not otherwise gain access to our trade
secrets and other intellectual property. If our employees or other
parties breach our confidentiality agreements and non-competition
agreements or if these agreements are not sufficient to protect our
technology or are found to be unenforceable, our competitors could
acquire and use information that we consider to be our trade
secrets and we may not be able to compete effectively. Most of our
competitors have substantially greater financial, marketing,
technical and manufacturing resources than we have and we may not
be profitable if our competitors are also able to take advantage of
our trade secrets.
We
may find it necessary to initiate litigation to enforce our patent
rights, to protect our intellectual property or to determine the
scope and validity of the proprietary rights of others. Litigation
is costly and time-consuming, and there can be no assurance that
our litigation expenses will not be significant in the future or
that we will prevail in any such litigation.
Government
Grants
We
have previously received funding from government agencies under the
National Science Foundation’s and National Institute of Health’s
Small Business Innovation Research, or SBIR, grants. Eligibility of
public companies to receive such grants is based on size and
ownership criteria which are under review by the Small Business
Administration, or SBA. As a result, our eligibility may change in
the future and additional funding from this source may not be
available. We have also applied for funding pursuant to BARDA but
did not receive a grant award. While we continue to pursue grants
and or government funding related to COVID-19 it may not be
available to us. In addition, although we seek to protect the
competitive benefits we derive from our patents, proprietary
information, and other intellectual property, we may not have the
right to prohibit the U.S. government from using certain
technologies developed or acquired by us due to federal research
grants or to prohibit third-party companies, including our
competitors, from using those technologies in providing products
and services to the U.S. government. The U.S. government could have
the right to royalty-free use of technologies that we may develop
under such grants. We may commercially exploit those
government-funded technologies and may assert our intellectual
property rights against other non-government users of technology
developed by us, but we may not be successful in our efforts to do
so.
In
October 2021, we were awarded a small business innovation research
grant in the amount of $250,000 (“Computer-aided Design for
Improved Lantibiotics” R41GM136034) for our continued research and
development of lantibiotics, including its collaborative program
with the Biomolecular Sciences Institute at Florida International
University (FIU). The grant provides us with funding to develop
novel lantibiotics for the treatment of ESKAPE pathogens (defined
as Enterococcus faecium, Staphylococcus aureus, Klebsiella
pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and
Enterobacter spp.).
Human
Capital
Employees
We
have six full-time employees. We enjoy good relations with our
employees. None of our employees are a member of any labor union,
and we are not a party to any collective bargaining
agreement.
Consultants
We
have consulting agreements with a number of scientists, clinicians
and regulatory experts. They serve as important contacts for us
throughout the broader scientific and clinical communities. They
are distinguished individuals with expertise in numerous fields,
including vaccine development and regulatory matters.
We
retain each consultant according to the terms of a consulting
agreement. Under such agreements, we pay them a consulting fee and
reimburse them for out-of-pocket expenses incurred in performing
their services for us. In addition, some consultants hold options
to purchase our common stock, subject to the vesting requirements
contained in separate award agreements. Our consultants may be
employed by other entities and therefore may have commitments to
their employer or may have other consulting or advisory agreements
that may limit their availability to us.
Corporate
Information
We
were incorporated in November 1996 and commenced operations in
1999. We consummated our initial public offering in June 2003. Our
corporate office is located at 4902 Eisenhower Boulevard, Suite
125, Tampa, Florida 33634.
Available
Information
Our
website is www.oragenics.com. On our website we make available at
no cost our annual reports on Form 10-K, quarterly reports on Form
10-Q, current reports on Form 8-K and amendments to those reports
filed or furnished as soon as reasonably practicable after we
electronically file such material with, or furnish them to, the
United States Securities and Exchange Commission (“SEC”). The
information contained on our website is not a part of this annual
report on Form 10-K.
ITEM 1A. RISK
FACTORS.
An
investment in our common stock involves a high degree of risk. You
should carefully consider the risks described below before making
an investment decision in our securities. These risk factors are
effective as of the date of this Form 10-K and shall be deemed to
be modified or superseded to the extent that a statement contained
in our future filings modifies or replaces such statement. All of
these risks may impair our business operations. The forward-looking
statements in this Form 10-K involve risks and uncertainties and
actual results may differ materially from the results we discuss in
the forward-looking statements. If any of the following risks
actually occur, our business, financial condition or results of
operations could be materially adversely affected. In that case,
the trading price of our stock could decline, and you may lose all
or part of your investment.
Risk
Factor Summary
The
below summary of risk factors provides an overview of many of the
risks we are exposed to in the normal course of our business
activities. As a result, the below summary risks do not contain all
of the information that may be important to you, and you should
read the summary risks together with the more detailed discussion
of risks set forth following this section as well as elsewhere in
this Annual Report. Additional risks, beyond those summarized below
or discussed elsewhere in this Annual Report, may apply to our
activities or operations as currently conducted or as we may
conduct them in the future or in the markets in which we operate or
may in the future operate. Consistent with the foregoing, we are
exposed to a variety of risks, including risks associated with the
following:
We have identified a material weakness in our internal control over
financial reporting which could, if not remediated, adversely
impact the reliability of our financial statements, result in
material misstatements in our financial statements and cause
current and potential stockholders to lose confidence in our
financial reporting, which in turn could adversely affect the
trading price of our common stock.
Risks
Related to Our Business
● |
We
have incurred significant losses since our inception and expect to
continue to experience losses for the foreseeable
future. |
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● |
The restatement of certain of our
financial statements may subject us to risks and uncertainties,
including the increased possibility of legal proceedings. |
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● |
We have identified a material weakness in our internal control over
financial reporting which could, if not remediated, adversely
impact the reliability of our financial statements, result in
material misstatements in our financial statements and cause
current and potential stockholders to lose confidence in our
financial reporting, which in turn could adversely affect the
trading price of our common stock.
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● |
We
will need to raise additional capital in the future to complete the
development and commercialization of our product candidates and
operate our business. |
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● |
We
have a limited number of authorized shares of common stock and may
be unable to achieve the requisite approval for an increase of such
authorized shares. |
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● |
Substantial
uncertainties regarding future funding and financial performance
presents uncertainty as a going concern. |
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● |
We
were denied funding from the Biomedical Advanced Research and
Development Authority (“BARDA”) and we may be unable to win any
government contracts, grants, agreement or other funding in the
future. Even if we are successful in obtaining such contracts,
grants, agreements or other funding, we cannot assure the success
of our NT-CoV2-1 vaccine product candidate, that it will be
approved by the FDA or other public health regulatory authority or
that any funding provided will be sufficient to complete
development and successful commercialization. |
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● |
We
may rely on government funding and collaboration with government
entities for our vaccine development, which adds uncertainty to our
research and development efforts and may impose requirements that
increase the costs of development, commercialization and production
of any programs developed under those government-funded
programs. |
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● |
We
have limited vaccine-specific research, development, manufacturing,
testing, regulatory, commercialization, sales, distribution, and
marketing experience, and we may need to invest significant
financial and management resources to establish these capabilities.
Despite such investments and our best efforts, our strategic
acquisition of Noachis Terra may turn out to be
unsuccessful. |
● |
We
have limited financial resources and we may not be able to maintain
our current level of operations or be able to fund the further
development of our new NT-CoV2-1 vaccine product
candidate. |
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|
● |
Our
vaccine product candidate is at the pre-clinical stage and has not
been approved for sale. We have not conducted substantial research
and development for a vaccine product candidate, and we may be
unable to produce a vaccine that successfully prevents the virus in
a timely and economical manner, if at all. |
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|
● |
Many
of our competitors have significantly greater resources and
experience, which may negatively impact our commercial
opportunities. |
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● |
The
market opportunities for our vaccine product candidate may be
smaller than we believe them to be. Moreover, any pandemic threat
may abate, the underlying virus may mutate, or alternative vaccines
or technologies may be adopted, before our vaccines achieve
regulatory approval. |
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● |
If we
are unable to successfully develop our product candidates, our
operating results and competitive position could be harmed.
Research and development involves a lengthy and complex process,
and we may not be successful in our efforts to develop and
commercialize our product candidates. The further development and
ultimate commercialization of product candidates for SARS-CoV-2 and
COVID-19, as well as our other product candidates, are keys to our
strategy. |
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● |
If we
are successful in producing a vaccine against SARS-CoV-2, we may
need to devote significant resources to its scale-up and
development, including for use by the U.S. government or other
foreign authorities. Moreover, government involvement may limit the
commercial success of our vaccine product candidate. |
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● |
Our
product candidates, if approved, will face significant competition
and our failure to compete effectively may prevent us from
achieving significant market penetration. |
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● |
Because
our vaccine product development efforts depend on new and rapidly
evolving technologies, we cannot be certain that our efforts will
be successful. |
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● |
Our
SARS-CoV-2 vaccine product candidate may face competition from
biosimilars approved through an abbreviated regulatory
pathway. |
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● |
We
may be unable to refine a method to produce MU1140 homologs in
large-scale commercial quantities. If we cannot, we will be unable
to generate significant revenues from sales of a MU1140 homolog
product candidate. |
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● |
Our
success will depend on our ability to obtain regulatory approval of
our product candidate under our Lantibiotics Program and its
successful commercialization. |
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● |
We
may choose not to continue developing or commercializing any of our
product candidates at any time during development or after
approval, which would reduce or eliminate our potential return on
investment for those product candidates. |
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● |
We
have limited experience in the conduct of clinical trials. We have
never initiated a vaccine-related clinical trial. We have never
obtained approval of any product candidates. We may be unable to
undertake any of those actions successfully. |
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● |
We
cannot assure you that the market and consumers will accept our
products or product candidates. If they do not, we will be unable
to generate significant revenues from our products or product
candidates and our business, financial condition and results of
operations will be materially adversely affected. |
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● |
Failure
to obtain marketing approval in international jurisdictions would
prevent our product candidates from being marketed
abroad. |
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● |
We
will need to further increase the size and complexity of our
organization in the future, and we may experience difficulties in
executing our growth strategy and managing our growth. |
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● |
If
our manufacturers and suppliers in general fail to meet our
requirements and the requirements of regulatory authorities, our
research and development may be materially adversely
affected. |
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● |
We
rely on the significant experience and specialized expertise of our
senior management and scientific team and the loss of any of our
key personnel or our inability to successfully hire their
successors could harm our business. |
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● |
We
need to hire and retain additional qualified scientists and other
highly skilled personnel to maintain and grow our
business. |
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● |
If
any of our product candidates are shown to be ineffective or
harmful in humans, we will be unable to generate revenues from
these product candidates. |
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● |
Because
we are new to vaccine development, we must identify vaccines for
development with our technologies and establish successful
third-party relationships. |
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● |
We
intend to seek licensing partners to cover a portion of the costs
associated with obtaining regulatory approval for, and
manufacturing and marketing of, our product candidates. If we are
unable to obtain agreements with third parties to fund these costs,
we will have to fund such costs ourselves or we may be unable to
extract any value from these technologies. |
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● |
We
might not be successful at acquiring, investing in or integrating
businesses, entering into joint ventures or divesting
businesses. |
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● |
We
may face product liability exposure, and if successful claims are
brought against us, we may incur substantial liability if our
insurance coverage for those claims is inadequate. |
● |
We
may be adversely affected by natural disasters, pandemics and other
catastrophic events, and by man-made problems such as terrorism,
that could disrupt our business operations and our business
continuity and disaster recovery plans may not adequately protect
us from a serious disaster. |
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● |
Our
ability to use our net operating loss carryforwards and certain
other tax attributes may be limited, each of which could harm our
business. |
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● |
Our
auditor has previously expressed substantial doubt about our
ability to continue as a going concern and absent additional
financing we may be unable to remain a going concern. |
Risks
Related to Our Intellectual Property and Data Security and
Privacy
● |
Our
vaccine research and development efforts are to a large extent
dependent upon our intellectual property and biologicals materials
license with the NIAID, the NIH, and the
NRC(“Licensors”). |
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● |
We
may incur additional expenses and obligations in connection with
our NIH and NRC licenses (“Licenses Agreements”). |
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● |
The
intellectual property covered by our License Agreements concerns
patent applications and provisional applications. We cannot assure
investors that any of the currently pending or future patent
applications will result in granted patents, nor can we predict how
long it will take for such patents to be granted. |
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● |
We
cannot prevent the Licensors or other companies, including our
competitors, from licensing the same intellectual property and
biological materials that we have licensed or from otherwise
duplicating our business model and operations. |
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● |
Our
Lantibiotic Development program development efforts are to a large
extent dependent upon our intellectual property and is based on
early-stage technology in its field. |
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● |
We
may be subject to claims challenging the inventorship of our
patents and other intellectual property. |
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● |
Changes
in patent law or patent jurisprudence could diminish the value of
patents in general, thereby impairing our ability to protect our
product candidates. |
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● |
If we
are unable to protect our trademarks or other intellectual property
from infringement, our business prospects may be
harmed. |
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● |
We
may not be able to protect our intellectual property rights
throughout the world. |
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● |
If we
fail to comply with our obligations under our intellectual property
license agreements, we could lose our license rights that are
important to our business and development of our product
candidates. |
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● |
If we
are sued for infringing intellectual property rights of third
parties, it will be costly and time-consuming and an unfavorable
outcome in that litigation could have a material adverse effect on
our business. |
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● |
We
may become involved in lawsuits to protect or enforce our patents
or other intellectual property or the patents of our licensors,
which could be expensive and time-consuming. |
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● |
Our
success will depend on our ability to partner or sub-license our
product candidates and their subsequent successful
commercialization. |
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● |
If
our intellectual property rights do not adequately protect our
products or product candidates, or if third parties claim we are
infringing their intellectual property rights, others could compete
against us more directly or we could be subject to significant
litigation. Such results could prevent us from marketing our
products or product candidates and hurt our
profitability. |
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● |
Our
business and operations would suffer in the event of
cybersecurity/information systems risk. |
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● |
Security
breaches and other disruptions to our information technology
systems or those of the vendors on whom we rely could compromise
our information and expose us to liability, reputational damage, or
other costs. |
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● |
We
may incur costs of addressing a cybersecurity incident. |
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● |
Our
business and operations would suffer in the event of failures in
our internal computer systems or those of our
collaborators. |
Risks
Related to Government Regulations
● |
Our
product candidates are subject to substantial government
regulation, including the regulation of nonclinical testing and
clinical trials. If we are unable to obtain regulatory approval for
our product candidates, we will be unable to generate
revenues. |
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● |
We
may be unable to obtain regulatory approval for our SARS-CoV-2
vaccine product candidate, or other early-stage product candidates
under applicable regulatory requirements. The FDA and foreign
regulatory bodies have substantial discretion in the approval
process, including the ability to delay, limit or deny approval of
product candidates. The delay, limitation or denial of any
regulatory approval would adversely impact commercialization, our
potential to generate revenue, our business and our operating
results. |
● |
Delays
or difficulties in the enrollment of patients in clinical trials
may result in additional costs and delays in our ability to
generate significant revenues, and may delay or prevent our receipt
of any regulatory approvals necessary to commercialize our planned
and future products. |
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● |
Any
product candidates that we commercialize will be subject to ongoing
and continued regulatory review. |
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● |
Our
product candidates may cause serious or undesirable side effects or
possess other unexpected properties that could delay or prevent
their regulatory approval, limit the commercial profile of approved
labeling or result in post-approval regulatory action. |
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● |
If
any of our product candidates are approved for marketing and we are
found to have improperly promoted off-label uses, or if physicians
misuse our products or use our products off-label, we may become
subject to prohibitions on the sale or marketing of our products,
product liability claims and significant fines, penalties and
sanctions, and our brand and reputation could be
harmed. |
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● |
We
may also be subject to healthcare laws, regulation and enforcement
and our failure to comply with those laws could adversely affect
our business, operations and financial condition. |
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● |
Our
employees, independent contractors, principal investigators,
consultants, vendors and CROs may engage in misconduct or other
improper activities, including noncompliance with regulatory
standards and requirements. |
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● |
Even
if our current product candidates or any future product candidates
obtain regulatory approval, they may fail to achieve the broad
degree of health care payers, physician and patient adoption and
use necessary for commercial success. |
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● |
If we
are unable to achieve and maintain coverage and adequate levels of
reimbursement for any of our product candidates for which we
receive regulatory approval, or any future products we may seek to
commercialize, their commercial success may be severely
hindered. |
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● |
If
our products do not receive favorable third-party reimbursement, or
if new restrictive legislation is adopted, market acceptance of our
products may be limited and we may not generate significant
revenues. |
Risks
Related to Coronavirus Disease (COVID-19)
● |
Our
business is subject to risks arising from public health crises,
epidemic or pandemic diseases, such as the recent global outbreak
of the coronavirus disease (COVID-19). |
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● |
Our
ability to conduct clinical trials may be impeded, delayed, limited
or prevented entirely due to the spread of COVID-19, the imposition
of government restrictions and the concurrent disruptions to
ordinary business activities globally. |
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● |
Our
business involves international components, and we are exposed to
various global and local risks related to the coronavirus disease
2019 (COVID-19) that could have a material adverse effect on our
financial condition and results of operations. |
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● |
Macroeconomic
pressures in the markets in which we operate, including, but not
limited to, the effectives of the coronavirus disease (COVID-19)
may alter the ways in which we conduct our business operations and
manage our financial capacities. |
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● |
Economic
uncertainty may adversely affect our access to capital, cost of
capital and ability to execute our business plan as
scheduled. |
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● |
Inadequate
funding for the FDA, the SEC and other government agencies could
hinder their ability to hire and retain key leadership and other
personnel, prevent new products and services from being developed
or commercialized in a timely manner or otherwise prevent those
agencies from performing normal business functions on which the
operation of our business may rely, which could negatively impact
our business. |
Risks
Related to Our Common Stock
● |
The
issuance of additional equity securities by us in the future would
result in dilution to our existing common shareholders. |
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● |
We
cannot assure we will continue to be listed on the NYSE
American. |
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● |
Our
financial results could vary significantly from quarter to quarter
and are difficult to predict. |
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● |
Our
Series A and Series B preferred stock, if not converted into common
stock, has a distribution and liquidation preference senior to our
common stock in liquidation which could negatively affect the value
of our common stock and impair our ability to raise additional
capital. |
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● |
The
conversion of our Series A Preferred Stock, and Series B Preferred
Stock and the exercise of currently outstanding warrants and
options could result in significant dilution to the holders of our
common stock. |
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● |
Certain
provisions of our articles of incorporation, bylaws, executive
employment agreements and stock option plan may prevent a change of
control of our company that a shareholder may consider
favorable. |
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● |
The
price and volume of our common stock has been volatile and
fluctuates substantially, which could result in substantial losses
for stockholders. |
● |
We
may be subject to securities litigation, which is expensive and
could divert management attention. |
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● |
Future
sales or issuances of our common stock in the public markets, or
the perception of such sales, could depress the trading price of
our common stock. |
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● |
The
requirements of being a public company may strain our resources,
divert management’s attention and affect our ability to attract and
retain qualified members for our Board of Directors. |
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● |
If we
fail to maintain an effective system of internal controls, we may
not be able to accurately report our financial results or prevent
fraud which could subject us to regulatory sanctions, harm our
business and operating results and cause the trading price of our
stock to decline. |
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● |
We
will continue to incur significant costs as a result of and devote
substantial management time to operating as a public company listed
on the NYSE American. |
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● |
If
securities or industry analysts publish research or publish
inaccurate or unfavorable research about our business, our stock
price and trading volume could decline. |
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● |
We
may issue debt or debt securities convertible into equity
securities, any of which may be senior to our common stock as to
distributions and in liquidation, which could negatively affect the
value of our common stock. |
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● |
We
are a “smaller reporting company” and, as a result of the reduced
disclosure and governance requirements applicable to smaller
reporting companies, our common stock may be less attractive to
investors. |
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● |
We
have never paid cash dividends on our capital stock, and we do not
anticipate paying any cash dividends in the foreseeable
future. |
Risks
Related to Our Business
The restatement of certain of our financial statements may subject
us to risks and uncertainties, including the increased possibility
of legal proceedings.
On
April 4, 2023, the management and the Audit Committee of the
Company’s Board of Directors concluded that the following financial
statements should be restated and should no longer be relied
upon:
|
i. |
The
Company’s unaudited consolidated financial statements for the three
months ended March 31, 2022 included in the Company’s Quarterly
Report on Form 10-Q, filed with the SEC on May 13 2022 (the “Q1
2022 10-Q”); and |
|
ii. |
The
Company’s unaudited consolidated financial statements for the three
and six months ended June 30, 2022 included in the Company’s
Quarterly Report on Form 10-Q, filed with the SEC on August 9, 2022
(the “Q2 2022 10-Q”); and |
|
iii. |
The
Company’s unaudited consolidated financial statements for the three
and nine months ended September 30, 2022 included in the Company’s
Quarterly Report on Form 10-Q, filed with the SEC on November 14,
2022 (the “Q3 2022 10-Q”). |
The
following errors impacted such filings: (i) not properly analyzing research and
development contracts.
The
Company determined that the reporting effects of the above errors
had a material impact to the Company’s unaudited consolidated
financial statements of the Company for the Q1 2022 10-Q, Q2 2022
10-Q, and Q3 2022 10-Q. As a result, the Company determined that
the unaudited consolidated financial statements for the Q1 2022
10-Q, Q2 2022 10-Q, and Q3 2022 10-Q should be restated, and the
Company should file an amendment to the Q1 2022 10-Q, Q2 2022 10-Q,
and Q3 2022 10-Q with the SEC. All such amendments were filed with
the SEC on April 14, 2023.
As a
result of the restatement, we may become subject to additional
risks and uncertainties, including, among others, the increased
possibility of legal proceedings or a review by the SEC and other
regulatory bodies. The costs of defending against such legal
proceedings or administrative actions could be significant. In
addition, we could face monetary judgments, penalties or other
sanctions that could have a material adverse effect on our
business, financial condition and operating results. In addition,
the restatements:
|
● |
May
have the effect of eroding the investor confidence in us and our
financial reporting and accounting practice and
processes; |
|
● |
May
negatively impact the trading price of our common
stock; |
|
● |
Diverted,
and may continue to divert management’s attention from the
operation of our business; |
|
● |
Requiring
that we incur additional expenses and may require that we incur
significant expenses relating to any litigation or regulatory
examinations, investigations, proceedings or orders; |
|
● |
May
make it more difficult, expensive and time consuming for us to
raise capital, if necessary, on acceptable terms, if at all;
and |
|
● |
May
make it more difficult to pursue transactions or implement business
strategies that might otherwise be beneficial to our
business. |
The
occurrence or continued occurrence of any of the foregoing could
have a material adverse effect on our business, results of
operations and financial condition.
We have identified a material weakness in our internal control over
financial reporting which could, if not remediated, adversely
impact the reliability of our financial statements, result in
material misstatements in our financial statements and cause
current and potential stockholders to lose confidence in our
financial reporting, which in turn could adversely affect the
trading price of our common stock.
The
Company has restated certain information contained in its
previously issued unaudited interim consolidated financial
statements for the Q1 2022 10-Q, Q2 2022 10-Q, and Q3 2022 10-Q.
All such amendments were filed with the SEC on April 14,
2023.
We
have concluded that there is a material weakness related to the
review of research and development contracts. For additional
information on the material weakness identified and our remedial
efforts, see “Item 9A. Controls and Procedures”. The material
weakness resulted in material errors in the unaudited financial
statements for the three-month period ended March 31, 2022, the
three- and six- month periods ended June 30, 2022, and the three-
and nine- month periods ended September 30, 2022, Thus, management
determined that our disclosure controls and procedures and internal
control over financial reporting were not effective. Under Public
Company Accounting Oversight Board standards, a material weakness
is a deficiency, or combination of deficiencies, in internal
control over financial reporting, such that there is a reasonable
possibility that a misstatement of our consolidated annual or
interim financial statements will not be prevented or detected on a
timely basis. The existence of this issue could adversely affect
us, our reputation or investor perceptions of us. We will take
measures to remediate the underlying cause of the material weakness
noted above. As we continue to evaluate and work to remediate the
material weakness, we may determine to take additional measures to
address the control deficiencies.
Although
we plan to complete this remediation process as quickly as
possible, we cannot provide any assurance as to when the
remediation process will be complete, and our measures may not
prove to be successful in remediating the material weakness. If our
remedial measures are insufficient to address the material
weakness, or if additional material weaknesses or significant
deficiencies in our internal control over financial reporting are
discovered or occur in the future, our consolidated financial
statements may contain misstatements and we could be required to
restate our financial results. In addition, if we are unable to
successfully remediate the material weakness or if we are unable to
produce accurate consolidated financial statements in the future,
our stock price, liquidity and access to the capital markets may be
adversely affected and we may be unable to maintain compliance with
applicable stock exchange listing requirements. Further, because of
its inherent limitations, even our remediated and effective
internal control over financial reporting may not prevent or detect
all misstatements. Also, projections of any evaluation of
effectiveness to future periods are subject to the risk that
controls may become inadequate because of changes in our
conditions, or that the degree of compliance with our policies or
procedures may deteriorate.
We have incurred significant losses since our inception and expect
to continue to experience losses for the foreseeable
future.
We
have incurred significant net losses and negative cash flow in each
year since our inception, including net losses of approximately
$14.3 million and $15.7 million for the years ended December 31,
2022, and 2021, respectively. As of December 31, 2022, our
accumulated deficit was approximately $185.6 million. We have
devoted a significant amount of our financial resources to research
and development, including our nonclinical development activities
and clinical trials, as well as licensing and acquisitions related
to our product candidates. We expect that the costs associated with
our plans to continue pre-clinical research, contract manufacturing
and file an IND for our vaccine product candidate and the research
and development of our product candidates in the area of
lantibiotics (“Lantibiotics Program”) will increase the level of
our overall expenses significantly going forward. Additionally, our
License Agreements also require the payment of certain recurring
and performance-based royalties that may negatively impact our
financial capabilities. As a result, we expect to continue to incur
substantial net losses and negative cash flow for the foreseeable
future. These losses and negative cash flows have had, and will
continue to have, an adverse effect on our shareholders’ equity and
working capital. Because of the numerous risks and uncertainties
associated with product development and commercialization, we are
unable to accurately predict the timing or amount of substantial
expenses or when, or if, we will be able to generate the revenue
necessary to achieve or maintain profitability.
We will need to raise additional capital in the future to complete
the development and commercialization of our product candidates and
operate our business.
Developing
and commercializing biopharmaceutical products, including
conducting nonclinical studies and clinical trials and establishing
manufacturing capabilities, and the progress of our efforts to
develop and commercialize our product candidates, is expensive, and
can cause us to use our limited, available capital resources faster
than we currently anticipate. We anticipate that our cash resources
of approximately $11.4 million as of December 31, 2022, will be
sufficient to fund our operations as presently structured through
the fourth quarter of 2023. We are currently evaluating cost-saving
initiatives, including restructuring that could allow further cash
runway through the first quarter of 2024 to the extent such
initiatives are undertaken. Our actual costs may ultimately vary
from our current expectations, which could materially impact our
use of capital and our forecast of the period of time through which
our financial resources will be adequate to support our operations.
Our current cash, cash equivalents and short-term investments are
not sufficient to fully implement our business strategy and sustain
our operations. Accordingly, we will need to seek additional
sources of financing and such additional financing may not be
available on favorable terms, if at all. Until we can generate a
sufficient amount of product revenue, if ever, we expect to finance
future cash needs through public or private equity offerings, debt
financings or corporate or government collaboration and licensing
arrangements. If we do not succeed in raising additional funds on
acceptable terms, we may be unable to complete existing nonclinical
and planned clinical trials or obtain approval of our product
candidates from the FDA and other regulatory authorities. We expect
capital outlays and operating expenditures to increase over the
next several years as we expand our infrastructure, and research
and development activities. Specifically, we need to raise
additional capital to, among other things:
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conduct
pre-clinical research for our NT-CoV2-1 vaccine product candidate,
file an IND with the FDA and, if approved, engage in Phase 1
clinical trials; |
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engage
in GMP and non-GMP manufacturing for our product candidates at the
pre-clinical research and clinical trial stages; |
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expand
our clinical laboratory operations and conduct further research and
development in lantibiotics; |
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fund
our clinical validation study activities; |
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expand
our research and development activities; and |
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finance
our capital expenditures and general and administrative
expenses. |
Our
present and future funding requirements will depend on many
factors, including:
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the
level of research and development investment budgeted to develop
our current and future product candidates through each phase of
development; |
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the
timing, scope, progress, results and cost of research and
development, testing, screening, manufacturing, preclinical and
non-clinical studies and clinical trials, including any impacts
related to the COVID-19 pandemic;
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costs
of filing, prosecuting, defending and enforcing patent claims and
other intellectual property rights; |
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our
need or decision to acquire or license complementary technologies
or acquire complementary businesses; |
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changes
in test development plans needed to address any difficulties in
product candidate selection for commercialization; |
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competing
vaccines and technological and market developments; |
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our
interaction and relationship with the FDA, or other, regulatory
agencies; and |
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changes
in regulatory policies or laws that affect our
operations. |
Additional
capital may not be available on satisfactory terms, or at all. Even
if we enter third-party arrangements for the purpose of raising
capital through the issuance of equity, such as our At the Market
Offering Agreement with Ladenburg, Thalmann & Co., Inc., we may
not be successful in raising capital through such efforts.
Furthermore, if we raise additional capital by issuing equity
securities, dilution to our existing stockholders would result. Any
equity securities issued also may provide for rights, preferences
or privileges senior to those of holders of our common stock. If we
raise additional funds by issuing debt securities, these debt
securities would have rights, preferences and privileges senior to
those of holders of our common stock, and the terms of the debt
securities issued could impose significant restrictions on our
operations. If we raise additional funds through collaborations and
licensing arrangements, we might be required to relinquish
significant rights to our technologies or our products under
development, or grant licenses on terms that are not favorable to
us, which could lower the economic value of those programs to us.
If adequate funds are not available, we may have to scale back our
operations or limit our research and development activities, which
may cause us to progress at a slower pace, or not at all, and our
business could be adversely affected.
In
addition, we could be forced to discontinue product development and
commercialization of one or more of our product candidates, and/or
forego licensing attractive business opportunities.
We have a limited number of authorized shares of common stock
available and may be unable to achieve the requisite approval for
an increase of such authorized shares now or in the
future.
We
rely on the issuance of our equity securities to investors for
purposes of raising additional capital, including the issuance of
shares of our common stock. As of February 28, 2023, 4,166,666
shares of common stock were authorized, of which 2,024,657 shares
were issued and outstanding. Approximately 1,236,772 are reserved
for issuance pursuant to our 2021 Equity Incentive Plan and
outstanding options and warrants, and our at-the-market program
with only 905,237 remaining for issuance. The remaining shares of
common stock available for issuance may not be sufficient to raise
the necessary capital for purposes of maintaining or continuing our
operations. At the 2021 annual meeting of shareholders, we were
unable to achieve the requisite approval for an increase in the
number of authorized shares of common stock. As a result, our
access to additional capital through the issuance of shares of
common stock will be limited. We cannot guarantee that we will
achieve such requisite approval to increase the number of
authorized shares of common stock in future, if ever.
Given our current cash position and significant uncertainties
related to future funding opportunities and our 2022 financials,
substantial doubt exists regarding our ability to continue as a
going concern through one year from the date that the financial
statements included in this Annual Report were
issued.
Our
management must evaluate whether there are conditions or events,
considered in the aggregate, that raise substantial doubt about our
ability to continue as a going concern within one year after the
date the financial statements are issued. As of December 31, 2022,
we had $11.4 million in cash and cash equivalents. During 2022, we
incurred a net loss of $14.3 million. As of December 31, 2022, our
accumulated deficit was approximately $185.6 million.
Our
ability to fund our operations is dependent upon funding from
grants and equity financings. New financings may not be available
to us on commercially acceptable terms, or at all. Also, any
collaborations, strategic alliances, and marketing, distribution,
or licensing arrangements may require us to give up some or all of
our rights to a product candidate, which in some cases may be at
less than the full potential value of such rights. In addition, the
regulatory and commercial success of our vaccine candidates remains
uncertain. If we are unable to obtain additional capital, we will
assess our capital resources and may be required to delay, pivot,
reduce the scope of, or eliminate some or all of our operations, or
downsize our organization, any of which may have a material adverse
effect on our business, financial condition, results of operations,
and ability to operate as a going concern.
Our
management believes that, given the significance of these
uncertainties, substantial doubt exists regarding our ability to
continue as a going concern through one year from the date that
these financial statements are issued.
We were denied funding from the Biomedical Advanced Research and
Development Authority (“BARDA”) and we may be unable to win any
government contracts, grants, agreement or other funding in the
future. Even if we are successful in obtaining such contracts,
grants, agreements or other funding, we cannot assure the success
of our NT-CoV2-1 vaccine product candidate, that it will be
approved by the FDA or other public health regulatory authority or
that any funding provided will be sufficient to complete
development and successful commercialization.
From
time to time, we may apply for contracts, grants, agreements or
other funding from government agencies, academic institutions and
non-profit organizations. Such contracts or grants can be highly
attractive because they provide capital to fund the ongoing
development of our technologies and vaccine candidates without
diluting our stockholders. However, significant competition exists
for these contracts, grants, agreements or other funding. Entities
offering such contracts, grants, agreements or other funding may
have requirements to apply for or to otherwise be eligible to
receive such contracts, grants, agreements or other funding that
our competitors may be able to satisfy that we cannot. In addition,
such entities have limited funding available to award and may make
arbitrary decisions as to whether to offer contracts or make
grants, to whom the contracts or grants will be awarded and the
size of the contracts or grants to each awardee. Even if we are
able to satisfy the award requirements, we may not be a successful
awardee. Therefore, we may not be able to win any contracts or
grants in a timely manner, if at all. For example, we applied for
BARDA funding in connection with our license with the NIH and
received notification that are request for BARDA funding had been
denied.
Even
if we receive a financing through one of the aforementioned
mechanisms, the success of our NT-CoV2-1 vaccine product candidate
cannot be assured solely by our ability to obtain such financing,
nor can it assure that any vaccine product candidate so financed
will succeed in clinical trials and receive regulatory approval
from the FDA or other public health regulatory authorities.
Moreover, we cannot guarantee that our receipt of such financing
will obviate the need for future financial resources to support the
further development of our NT-CoV2-1 vaccine product candidate, as
additional development activities may be needed, and the vaccine
approval and development process can be costly and unpredictable.
We have no control over the resources and funding that government
agencies may devote to these agreements, which may be subject to
annual renewal and which generally may be terminated by the
government agencies at any time. Accordingly, our receipt of such
funding cannot be relied upon solely as an indicator or guarantee
of the success of our NT-CoV2-1 vaccine product
candidate.
We may rely on government funding and collaboration with government
entities for our vaccine development, which adds uncertainty to our
research and development efforts and may impose requirements that
increase the costs of development, commercialization and production
of any programs developed under those government-funded
programs.
Because
we anticipate the resources necessary to develop our new NT-CoV2-1
vaccine product candidate will be substantial, we may explore
funding and development collaboration opportunities with the U.S.
government and its agencies. For example, we may continue to apply
for certain grant funding from BARDA, the NIH or other government
agencies to further the research, development, manufacture,
testing, and regulatory approval of our NT-CoV2-1 vaccine product
candidate. We have no control or input over whether an application
for BARDA grant funding or any other funding will be accepted or
approved, in full or in part, and we cannot provide investors with
any assurances that we will receive such funding.
Similar
to the requirements imposed by our new NIH license, contracts and
grants funded by the U.S. government and its agencies, contain
provisions that reflect the government’s substantial rights and
remedies, many of which are not typically found in commercial
contracts, including powers of the government to:
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reduce
or modify the government’s obligations under such agreements
without the consent of the other party; |
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claim
rights, including IP rights, in products and data developed under
such agreements; |
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audit
contract-related costs and fees, including allocated indirect
costs; |
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suspend
the contractor or grantee from receiving new contracts pending
resolution of alleged violations of procurement laws or
regulations; |
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impose
U.S. manufacturing requirements for products that embody inventions
conceived or first reduced to practice under such
agreements; |
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suspend
or debar the contractor or grantee from doing future business with
the government; |
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control
and potentially prohibit the export of products; |
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pursue
criminal or civil remedies under the False Claims Act, False
Statements Act, and similar remedy provisions specific to
government agreements; and |
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limit
the government’s financial liability to amounts appropriated by the
U.S. Congress on a fiscal-year basis, thereby leaving some
uncertainty about the future availability of funding for a program
even after it has been funded for an initial period. |
In
addition, government contracts and grants, ordinarily contain
additional requirements that may increase our costs of doing
business, reduce our profits, and expose us to liability for
failure to comply with these terms and conditions, including the
following:
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specialized
accounting systems unique to government contracts and
grants; |
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mandatory
financial audits and potential liability for price adjustments or
recoupment of government funds after such funds have been
spent; |
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public
disclosures of certain contract and grant information, which may
enable competitors to gain insights into our research program;
and |
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mandatory
socioeconomic compliance requirements, including labor standards,
non-discrimination, and affirmative action programs, and
environmental compliance requirements. |
If we
received such grants or agreements, we may not have the right to
prohibit the U.S. government from using certain technologies
developed by us, and we may not be able to prohibit third-parties,
including our competitors, from using those technologies in
providing products and services to the U.S. government. Further,
under such agreements we could be subject to obligations to and the
rights of the U.S. government set forth in the Bayh-Dole Act of
1980, meaning the U.S. government may have rights in certain
inventions developed under these government-funded agreements,
including a non-exclusive, non-transferable, irrevocable worldwide
license to use inventions for any governmental purpose. In
addition, the U.S. government could have the right to require us to
grant exclusive, partially exclusive, or nonexclusive licenses to
any of these inventions to a third party if it determines that: (i)
adequate steps have not been taken to commercialize the invention;
(ii) government action is necessary to meet public health or safety
needs; or (iii) government action is necessary to meet requirements
for public use under federal regulations, also referred to as
“march-in rights.” Although the U.S. government’s historic
restraint with respect to these rights indicates they are unlikely
to be used, any exercise of the march-in rights could harm our
competitive position, business, financial condition, results of
operations, and prospects. In the event we would be subject to the
U.S. government’s exercise such march-in rights, we may receive
compensation that is deemed reasonable by the U.S. government in
its sole discretion, which may be less than what we might be able
to obtain in the open market.
Additionally,
as is the case under our new NIH license, the U.S. government
requires that any products embodying any invention generated
through the use of U.S. government funding be manufactured
substantially in the United States. The license with the NRC also
contains similar manufacturing requirements which may conflict with
the NIH license. The manufacturing preference requirement can be
waived if the owner of the intellectual property can show that
reasonable but unsuccessful efforts have been made to grant
licenses on similar terms to potential licensees that would be
likely to manufacture substantially in the United States or that
under the circumstances domestic manufacture is not commercially
feasible. This preference for U.S. manufacturers may limit our
ability to contract with non-U.S. manufacturers for products
covered by such intellectual property. Obligations relating to
manufacturing preferences and vaccine availability in Canada are
included in the NRC license agreement.
Although
we will need to comply with some of these obligations in relation
to our NIH license, not all of the aforementioned obligations may
be applicable to us unless and only to the extent that we receive a
government grant, contract or other agreement. However, as an
organization, we are relatively new to government contracting and
new to the regulatory compliance obligations that such contracting
entails. If we were to fail to maintain compliance with those
obligations, we may be subject to potential liability and to
termination of our contracts, including the NIH license, which may
have a materially adverse effect on our ability to develop our
NT-CoV2-1 vaccine product candidate.
We have limited vaccine-specific research, development,
manufacturing, testing, regulatory, commercialization, sales,
distribution, and marketing experience, and we may need to invest
significant financial and management resources to establish these
capabilities. Despite such investments and our best efforts, our
strategic acquisition of Noachis Terra may turn out to be
unsuccessful.
As
part of our business strategy, we monitor and analyze strategic
acquisition opportunities that we believe will be strategic fits
for the Company and beneficial to the Company’s shareholders. As
demonstrated by our acquisition of Noachis Terra in May of 2020, we
may acquire companies, businesses, products and technologies that
complement, augment or transform our existing business. However,
such acquisitions could involve numerous risks that may prevent us
from fully realizing the benefits that we anticipated as a result
of such transactions.
Prior
to our acquisition of Noachis Terra, we had little-to-no experience
in the development and commercialization of vaccines. Although, in
connection with the acquisition, we added experienced vaccine
researchers and consultants and appointed an experienced vaccine
industry professional to our Board of Directors, given our size and
current pre-clinical stage of development, we still have limited
vaccine-specific research, development, manufacturing, testing,
regulatory, commercialization, sales, distribution, and marketing
experience. To successfully develop our NT-CoV2-1 vaccine product
candidate, we will need to dedicate significant amounts of our
limited financial and management resources to bolster our expertise
in this area. Our success depends significantly on the continued
contributions of our executive officers, financial, scientific and
technical personnel and consultants, and on our ability to attract
additional personnel.
During
our operating history, many essential responsibilities have been
assigned to a relatively small number of individuals, and we
currently depend heavily upon the efforts and abilities of our
management team. However, as we advance into vaccine development,
the demands on our key employees will expand and we will need to
recruit additional qualified employees or consultants for our
Company. The competition for such qualified personnel is intense,
particularly in light of the demand for vaccines or other treatment
for SARS-CoV-2 and/or COVID-19. The loss of services of any of our
existing consultants or our inability to attract additional
personnel to fill critical positions could adversely affect our
ability to efficiently develop our NT-CoV2-1 vaccine product
candidate. The loss or unavailability of the services of any of
these individuals could have a material adverse effect on our
business, prospects, financial condition and results.
Alternatively,
or in addition to the above, we may enter into strategic alliances
or partnership with other vaccine industry entities to utilize
their research, development, manufacturing, testing, regulatory or
commercialization skills, but we may be unable to enter into such
agreements on favorable terms, if at all. If our future strategic
collaborators do not commit sufficient resources to our alliances
or partnerships and the progress of our vaccine development, if
any, and we are unable to develop the necessary capabilities on our
own, we may be unable to advance the development of our NT-CoV2-1
vaccine product candidate to the point of commercialization, even
if we obtain regulatory approval. We will be competing with many
companies that currently have existing, extensive and well-funded
operations, and without a significant internal team or the support
of a third party to perform essential functions related to vaccine
research, development, manufacturing, testing, regulatory approval,
and commercialization, we may be unable to compete successfully
against these more established companies and our NT-CoV2-1 vaccine
product candidate may fail.
Any
failure by us to effectively limit such risks as we implement our
strategic acquisition could have a material adverse effect on our
business, financial condition or results of operations and cause
the price of our securities to fall.
We have limited financial resources and we may not be able to
maintain our current level of operations or be able to fund the
further development of our new NT-CoV2-1 vaccine product
candidate.
To
date, we have never developed a vaccine product candidate, and we
cannot assure investors that we will be able to successfully
develop a vaccine to prevent SARS-CoV-2 or COVID-19 with our
current resources and capabilities. Because our new NT-CoV2-1
vaccine product candidate is in early stages of development, and
contemplates nasal administration it will require extensive
pre-clinical and clinical testing, and we will need significant
additional funding to conduct such research and testing. We do not
expect to generate revenue from product sales, licensing fees,
royalties, milestones, contract research or other sources of funds
in amounts sufficient to fully fund our operations for the
foreseeable future, and we will therefore use our cash resources,
and expect to require additional funds, to maintain our existing
operations, continue our research and development programs,
commence future pre-clinical studies and clinical trials for our
NT-CoV2-1 vaccine product candidate, and to seek regulatory
approvals.
We
anticipate seeking such additional funds through a combination of
public or private equity or debt financings, as well as potential
collaborations, strategic alliances and marketing, distribution or
licensing arrangements and non-dilutive funding from government and
nongovernment funding entities, as well as other sources to further
the research, development, manufacturing, testing, and regulatory
approval of vaccine product candidates. While we may continue to
apply for contracts or grants from academic institutions, nonprofit
organizations and governmental entities, we may not be successful.
Adequate additional funding may not be available to us on
acceptable terms, if at all. If we cannot raise the additional
funds required for our anticipated operations or to support our
development efforts, we may be required to delay significantly,
reduce the scope of or eliminate one or more of our research or
development programs, downsize our organization, or seek
alternative measures to avoid insolvency, including arrangements
with collaborative partners or others that may require us to
relinquish rights to certain of our technologies or our vaccine
candidate. If we raise additional funds through future offerings of
shares of our common stock or other debt or equity securities, such
offerings would cause dilution of current stockholders’ percentage
ownership in the Company, which could be substantial. Additionally,
future offerings also could have a material and adverse effect on
the price of our common stock.
Our vaccine product candidate is at the pre-clinical stage and has
not been approved for sale. We have not conducted substantial
research and development for a vaccine product candidate, and we
may be unable to produce a vaccine that successfully prevents the
virus in a timely and economical manner, if at
all.
Our
NT-CoV2-1 vaccine development program is in the early stages of
research and development, and currently includes only one product
candidate, which is in the pre-clinical stage. Limited data exist
regarding the safety and efficacy of our vaccine product candidate,
and we must conduct a substantial amount of additional research,
development and clinical testing before any regulatory authority
will approve our vaccine product candidate. The success of our
efforts to develop and commercialize our product candidates could
fail for a number of reasons. For example, we could experience
delays in product development and clinical trials or unsatisfactory
clinical trial results.
In
addition, adverse events, or the perception of adverse events,
relating to a vaccine product candidate administered intranasally
and delivery technologies may negatively impact our ability to
develop commercially successful products. For example,
pharmaceutical companies have been subject to claims that the use
of some pediatric vaccines has caused personal injuries, including
brain damage, central nervous system damage and other ailments.
Regardless of the veracity of or the data supporting these claims,
these and other claims may influence public perception of the use
of vaccine product candidates and could result in greater
governmental regulation, stricter labeling requirements and
potential regulatory delays in the testing or approval of our
potential vaccine product candidate. Such greater government
regulation could have a material effect on our ability to develop
and market our NT-CoV2-1 vaccine product candidate.
We
have not conducted substantial research on the NT-CoV2-1 vaccine
product candidate and we lack experience in the research,
development, manufacture, regulatory approval, marketing,
commercialization and implementation of a vaccine product
candidate. Also, uncertainties exist surrounding the longevity and
severity of COVID-19 as a global health concern. The success of our
efforts to develop and commercialize our product candidates could
fail for a number of reasons. Accordingly, we may be unable to
produce a vaccine that successfully targets SARS-CoV-2 in a timely
and economical manner, if at all.
For
example, we expect to commit significant financial resources and
personnel to the development of our NT-CoV2-1 vaccine product
candidate, which may cause delays in or otherwise negatively impact
our other product candidate development program. The outcome of any
research and development program is highly uncertain. Only a small
fraction of biotechnology and vaccine development programs
ultimately result in commercial products or even product candidates
and a number of events could delay our development efforts and
negatively impact our ability to obtain regulatory approval for,
and to manufacture, market and sell, a nasally administered
vaccine. Additionally, our ability to develop an effective vaccine
will depend on our ability to work on an accelerated timeline, with
uncertain access to financial resources beyond those that we
currently possess, and in competition with a significant number of
better-funded and more experienced vaccine-development companies.
Moreover, if the COVID-19 pandemic is effectively contained or the
risk of further spread is diminished or eliminated before we can
successfully develop, manufacture and commercialize NT-CoV2-1, we
may be unable to identify strategic partners willing to work with
and support us in our development efforts and, even if we obtain
regulatory approval, the market that we anticipate for this product
candidate may not exist or may be much smaller than we previously
anticipated. Alternatively, even if a market exists, our vaccine
product candidate could be found to be ineffective or unsafe, or
otherwise fail to receive necessary regulatory clearances. Our
vaccine product candidate, even if safe and effective, could be
difficult to manufacture on a large scale or uneconomical to
market, or our competitors could develop superior products more
quickly and efficiently or more effectively market their competing
products. Accordingly, our inability to develop a
commercially-successful vaccine product will materially harm our
business. In addition, other parties are currently producing and
administering approved vaccines for the treatment for SARS-CoV-2 or
under the FDA’s Emergency Use Authorization and other competitive
vaccines are expected to seek such authorization as well. Such
competitive vaccines already in the market may also lead to the
diversion of governmental and nongovernmental resources away from
us and toward our competitors.
Many of our competitors have significantly greater resources and
experience, which may negatively impact our commercial
opportunities.
The
biotechnology and pharmaceutical industries are subject to intense
competition and rapid and significant technological change. We have
many potential competitors, including major pharmaceutical
companies, specialized biotechnology firms, academic institutions,
government agencies and private and public research institutions.
Many of our competitors have significantly greater financial and
technical resources, experience and expertise in:
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pre-clinical
testing; |
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designing
and implementing clinical trials; |
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regulatory
processes and approvals; |
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production
and manufacturing; and |
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sales
and marketing of approved products. |
Principal
competitive factors in our industry include:
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the
quality and breadth of an organization’s technology; |
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management
of the organization and the execution of the organization’s
strategy; |
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the
skill and experience of an organization’s employees and its ability
to recruit and retain skilled and experienced
employees; |
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an
organization’s intellectual property portfolio; |
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the
range of capabilities, from target identification and validation to
drug discovery and development to manufacturing and marketing;
and |
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the
availability of substantial capital resources to fund discovery,
development and commercialization activities. |
Large
and established companies, such as Merck & Co., Inc.,
GlaxoSmithKline plc, CSL Ltd., Sanofi Pasteur, SA, Pfizer Inc.,
Johnson & Johnson, AstraZeneca, and Moderna, among others,
compete in the vaccine market. In particular, these companies have
greater experience and expertise in securing government contracts
and grants to support their research and development efforts,
conducting testing and clinical trials, obtaining regulatory
approvals to market products, manufacturing such products on a
broad scale and marketing approved products.
Regardless
of the disease, smaller or early-stage companies and research
institutions also may prove to be significant competitors,
particularly through collaborative arrangements with large and
established pharmaceutical companies. As these companies develop
their technologies, they may develop proprietary positions, which
may prevent or limit our product development and commercialization
efforts. If any of our competitors succeed in obtaining approval
from the FDA or other regulatory authorities for their products
sooner than we do or for products that are more effective or less
costly than ours, our commercial opportunity could be significantly
reduced.
In
order to effectively compete, we will have to make substantial
investments in development, testing, manufacturing and sales and
marketing or partner with one or more established companies. We may
not be successful in gaining any market share for any vaccine. Our
technologies and vaccine product candidates also may be rendered
obsolete or non-competitive as a result of products introduced by
our competitors to the marketplace more rapidly and at a lower
cost.
The market opportunities for our vaccine product candidate may be
smaller than we believe them to be. Moreover, any pandemic threat
may abate, or alternative vaccines or technologies may be adopted,
before our vaccines achieve regulatory approval.
The
primary area of focus for our future research and product
development activities is the development of a nasally administered
vaccine candidate to prevent SARS-CoV-2 and the disease it
principally causes, COVID-19. Our current projections of both the
number of people who are or will be affected by this disease, as
well as the subset of people who may be affected by this disease
and who have the potential to benefit from immunity through our
NT-CoV2-1 vaccine product candidate, are based on estimates. These
estimates have been derived from a variety of sources, including
scientific literature, surveys of clinics, patient foundations, or
market research, and may prove to be incorrect. Further, because
coronaviruses have evolved in recent decades and research on
SARS-CoV-2 and COVID-19 are continuously changing due to the
complicated nature of the virus, new studies may change the
estimated incidence or prevalence of COVID-19. The number of
clinical trial participants in the United States, Europe, and
elsewhere may turn out to be lower than expected, potential
clinical trial participants may not be otherwise amenable to
treatment with our products, or new clinical trial participants may
become increasingly difficult to identify or gain access to, all of
which would adversely affect our ability to conduct the research
and development necessary to complete the vaccine product
candidate.
Moreover,
the threat of the COVID-19 pandemic outbreak may subside before we
are able to complete research and development for our NT-CoV2-1
vaccine product candidate, obtain regulatory approval for the
vaccine product candidate and realize any return on our investment
in the research and development. Other organizations some of which
are currently broadly administering vaccines under the FDA
approval, or Emergency Use Authorization authority, may obtain
licenses for their own pandemic vaccines, or government health
organizations may acquire adequate stockpiles of pandemic vaccines
or adopt other technologies or strategies to prevent or limit
outbreaks before our NT-CoV2-1 vaccine product candidate reaches
the marketplace. We may not achieve a return on our investment
before the threat of the COVID-19 pandemic subsides or a competing
product is adopted.
If we are unable to successfully develop our product candidates,
our operating results and competitive position could be harmed.
Research and development involves a lengthy and complex process,
and we may not be successful in our efforts to develop and
commercialize our product candidates. The further development and
ultimate commercialization of product candidates for SARS-CoV-2 and
COVID-19, as well as our other product candidates, are keys to our
strategy.
A key
element of our business strategy is to discover, develop, validate
and commercialize a vaccine product candidate to provide immunity
from SARS-CoV-2, which we aim to market globally to both public and
private payers. Additionally, our focus concerns the development of
a portfolio of additional antibiotic product candidates to combat
multi drug resistant organism, or MDRO, outbreaks and the
associated costs to patients, inpatient facilities and the health
care industry. We cannot assure you that we will be able to
successfully complete development of, or commercialize any or all
of our planned future product candidates, or that they will be
clinically usable. The product development process involves a high
degree of risk and may take up to several years or more. Our new
product development efforts may fail for many reasons,
including:
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our
recent entry into the vaccine research and development
industry; |
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failure
of future tests at the research or development stages; |
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lack
of clinical validation data to support effectiveness; |
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delays
resulting from the failure of third-party suppliers or contractors
to meet their obligations in a timely and cost-effective
manner; |
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regulatory
delays at the FDA or from other independent oversight authorities,
particularly in light of the demands placed on public health
resources during and following the COVID-19 pandemic; |
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failure
to obtain or maintain necessary certifications, licenses,
clearances or approvals to market or perform the test;
or |
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lack
of commercial acceptance by the health care
marketplace. |
Few
research and development projects result in commercial products,
and success in early clinical trials often is not replicated in
later trials. At any point, we may abandon development of products
in favor of the development or acquisition of new products, or we
may be required to expend considerable resources repeating clinical
studies or trials, which would adversely impact the timing for
generating potential revenues from those new products. In addition,
as we advance the development of new products through to the
commercialization stage, we will have to make additional
investments in our sales and marketing operations, which may be
prematurely or unnecessarily incurred if the commercial launch of a
product is abandoned or delayed.
If we are successful in producing a vaccine against SARS-CoV-2, we
may need to devote significant resources to its scale-up and
development, including for use by the U.S. government or other
foreign authorities. Moreover, government involvement may limit the
commercial success of our vaccine product
candidate.
Because
the COVID-19 outbreak has been classified as a pandemic by public
health authorities, it is possible that one or more government
entities may take actions that directly or indirectly have the
effect of abrogating some of our rights or opportunities with
respect to the research, development and commercialization of our
NT-CoV2-1 vaccine product candidate. We have not manufactured a
pandemic vaccine to date, but if we were to do so, the economic
value of such a vaccine to us could be limited by such government
action or inaction. Various government entities, including the U.S.
government, are offering, but may not continue to offer,
incentives, grants and contracts to encourage additional investment
by commercial organizations into preventative and therapeutic
agents against SARS-CoV-2 and/or COVID-19, which may have the
effect of increasing the number of competitors and/or providing
advantages to known competitors. Accordingly, there can be no
assurance that we will be able to successfully establish a
competitive market share for our NT-CoV2-1 vaccine product
candidate.
In
the event that any of the pre-clinical research or, if an IND is
accepted by the FDA, the Phase 1 clinical trials for our SARS-CoV-2
vaccine product candidate are perceived to be successful, we may
need to work toward the large-scale technical development,
manufacturing scale-up and larger scale deployment of this
potential vaccine through a variety of U.S. government-sponsored
mechanisms, such as an Expanded Access Program or an Emergency Use
Authorization program. In this case we may need to divert
significant resources to this program, which would require
diversion of resources from our other existing product candidate
programs. In addition, since the path to licensure of any vaccine
against SARS-CoV-2 is unclear, and widely-used vaccines in
circulation in the United States and other countries could impact
our receipt of marketing approval. Unexpected safety issues in
these circumstances could lead to significant reputational damage
for us and our technology platform going forward and other issues,
including delays in our other programs, the need for re-design of
our clinical trials and the need for significant additional
financial resources.
Our product candidates, if approved, will face significant
competition and our failure to compete effectively may prevent us
from achieving significant market penetration.
The
pharmaceutical industry is characterized by rapidly advancing
technologies, intense competition and a strong emphasis on
developing proprietary therapeutics. Numerous companies are engaged
in the development, patenting, manufacturing and marketing of
healthcare products competitive with those that we are developing.
We face competition from a number of sources, such as
pharmaceutical companies, including generic drug companies,
biotechnology companies and academic and research institutions,
many of which have greater financial resources, marketing
capabilities, sales forces, manufacturing capabilities, research
and development capabilities, clinical trial expertise,
intellectual property portfolios, experience in obtaining patents
and regulatory approvals for product candidates and other resources
than us. Some of the companies that offer competing products also
have a broad range of other product offerings, large direct sales
forces and long-term customer relationships with our target
physicians, which could inhibit our market penetration efforts. In
addition, certain of our product candidates, if approved, may
compete with other products, for a share of some patients’
discretionary budgets and for physicians’ attention within their
clinical practices.
We
anticipate that, if we obtain regulatory approval of our product
candidates, we will face significant competition from other
approved therapies and may need to compete with unregulated,
unapproved and off-label treatments. Certain of our product
candidates, if approved, will present novel therapeutic approaches
for the approved indications and will have to compete with existing
therapies, some of which are widely known and accepted by
physicians and patients. To compete successfully in this market, we
will have to demonstrate that the relative cost, safety and
efficacy of our approved products, if any, provide an attractive
alternative to existing and other new therapies. Such competition
could lead to reduced market share for our product candidates and
contribute to downward pressure on the pricing of our product
candidates, which could harm our business, financial condition,
operating results and prospects.
Due
to less stringent regulatory requirements in certain foreign
countries, there are many more products and procedures available
for use in those international markets than are approved for use in
the United States. In certain international markets, there are also
fewer limitations on the claims that our competitors can make about
the effectiveness of their products and the manner in which they
can market them. As a result, we expect to face more competition in
these markets than in the United States.
Because our vaccine product development efforts depend on new and
rapidly evolving technologies, we cannot be certain that our
efforts will be successful.
Currently,
the FDA has given full approval to Moderna and Pfizer for their
vaccines and Janssen has an EUA. A number of other vaccine
manufacturers, academic institutions and other organizations
currently have programs to develop such a vaccine. The WHO
currently lists 10 COVID-19 vaccines approved for use and 65
COVID-19 vaccine candidates in Phase 3 evaluation. These companies
have greater experience and expertise in securing government
contracts and grants to support their research and development
efforts, conducting testing and clinical trials, obtaining
regulatory approvals to market products, manufacturing such
products on a broad scale and marketing approved products. These
companies may also partner or collaborate with large and
established companies, such as Merck & Co., Inc.,
GlaxoSmithKline plc, CSL Ltd, Pfizer Inc. and AstraZeneca, among
others, or they may partner or collaborate with or obtain funding
from governments, academic institutions or other nongovernmental
organizations. In order to effectively compete, we will have to
make substantial investments in development, testing, manufacturing
and sales and marketing or partner with one or more established
companies.
Moreover,
our new vaccine development efforts depend on new, rapidly evolving
technologies. Our development efforts and, if those are successful,
commercialization of our NT-CoV2-1 vaccine product candidate could
fail for a variety of reasons, and include the possibility
that:
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Our
SARS-CoV-2 vaccine product candidate or technologies, any or all of
the products based on such technologies or any manufacturing
process will be ineffective or unsafe, or otherwise fail to receive
necessary regulatory approvals or achieve commercial
viability; |
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third-party
supplier or manufacturer facilities will be unable or unwilling to
provide necessary supplies or scale-up manufacturing capabilities
for our products in a cost-effective manner or at all; |
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the
products, if safe and effective, may be difficult to manufacture on
a large-scale or uneconomical to market; |
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third-party
manufacturing facilities will fail to continue to pass regulatory
inspections; |
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proprietary
rights of third-parties will prevent us or our collaborators from
exploiting technologies, and manufacturing or marketing products;
and |
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third-party
competitors with approval or Emergency Use Authorization from the
FDA and use of vaccines will gain greater market share and limit or
impair development efforts. |
We may be unable to refine a method to produce MU1140 homologs in
large-scale commercial quantities. If we cannot, we will be unable
to generate significant revenues from sales of an MU1140 homolog
product candidate.
Our
antibiotic product candidates, all homologs of MU1140, are produced
by our strain of S. mutans and variants thereof. We have
successfully developed a methodology for producing MU1140 in
quantities sufficient to undertake its nonclinical testing. If we
are not able to further adequately scale up fermentation and
purification methodologies for large-scale manufacture, we will be
unable to partner and generate revenues from this product candidate
and our business, financial condition and results of operations
will be materially adversely affected. The manufacturing of MU1140
homologs or any other possible antibiotic product candidates based
on lantibiotics, is a highly exacting and complex process.
Manufacturing MU1140 homologs or any other antibiotic candidates
derived from lantibiotics on a commercial scale has not yet been
achieved to our knowledge, so there are additional risks that such
efforts will not be successful. Third-party manufacturers must have
additional technical skills and must take multiple steps to attempt
to control the manufacturing processes. If we are unable to
identify and produce MU1140 homologs in large-scale commercial
quantities, we will be unable to generate significant revenues from
sales of our MU1140 product candidate and our financial condition
and results of operations will be materially adversely
affected.
Our success will depend on our ability to obtain regulatory
approval of our product candidate under our Lantibiotics Program
and its successful commercialization.
We
have not received regulatory approval in any jurisdiction for
lantibiotic product candidate and we may never receive approval or,
if approvals are obtained, may never be commercialized
successfully. We have incurred and will continue to incur
significant costs relating to the nonclinical development of our
antibiotic product candidates (including MU1140 homologs we may
develop). We have performed extensive nonclinical testing using
native MU1140 and continue to seek to identify homologs as
potential product candidates which would require additional
nonclinical testing. This work will be done solely by us through
the use of outside contractors. If our nonclinical work is
successful, we would expect the IND for a first-in-human clinical
trial of a lantibiotic compound to be filed with the FDA based on
our ability to complete the requisite studies, contingent on
sufficient funding.
Even
if we are able to conduct successful clinical trials or the
required regulatory approvals are obtained, we may never be able to
generate significant revenues from our product candidates. If our
product candidates are unsuccessful, we may be unable to generate
sufficient revenues to sustain and grow our business, and our
business, financial condition and results of operations will be
materially adversely affected.
We may choose not to continue developing or commercializing any of
our product candidates at any time during development or after
approval, which would reduce or eliminate our potential return on
investment for those product candidates.
At
any time, we may decide to discontinue the development or
commercialization of any of our products or product candidates for
a variety of reasons, including inadequate financial resources the
appearance of new technologies that render our product obsolete,
competition from a competing product or changes in or failure to
comply with applicable regulatory requirements. If we terminate a
program in which we have invested significant resources, we will
not receive any return on our investment and we will have missed
the opportunity to allocate those resources to potentially more
productive uses. For example, we mutually agreed to terminate our
Exclusive Channel Collaboration Agreement with Eleszto Genetika,
Inc. in September 2021 and in connection therewith ceased future
development of our lead lantibiotic homolog candidate.
We have limited experience in the conduct of clinical trials. We
have never initiated a vaccine-related clinical trial. We have
never obtained approval of any product candidates. We may be unable
to undertake any of those actions successfully.
As a
company, we have limited experience and capacity for the conduct of
pre-clinical research and clinical trials, as well as the
progression of a product candidate through to regulatory approval.
Because we are in the early stages of development for NT-CoV2-1 and
because the SARS-CoV-2 vaccine landscape continues to evolve, our
clinical trials may require more time and incur greater costs than
we anticipate. We cannot be certain that planned clinical trials
will begin or conclude on time, if at all. Large-scale trials would
require significant additional financial and management resources,
and reliance on third-party clinical investigators, CROs and/or
consultants. Any performance failure on the part of such third
parties could delay clinical development or delay or prevent us
from obtaining regulatory approval or commercializing our current
or future product candidates, depriving us of potential product
revenue and resulting in additional losses. By contrast, larger
pharmaceutical and biopharmaceutical companies often have
substantial staff or departments with extensive experience in
conducting clinical trials with multiple product candidates across
multiple indications and obtaining regulatory approval in various
countries. In addition, these companies may have greater financial
resources to compete for the same clinical investigators, sites and
patients that we may attempt to recruit or retain for our
pre-clinical research and clinical trials. As a result, we may be
at a competitive disadvantage that could delay the initiation,
recruitment, timing and completion of our pre-clinical research and
clinical trials and obtaining regulatory, marketing and related
approvals, if achieved at all, for our NT-CoV2-1 vaccine product
candidate.
We cannot assure you that the market and consumers will accept our
products or product candidates. If they do not, we will be unable
to generate significant revenues from our products or product
candidates and our business, financial condition and results of
operations will be materially adversely
affected.
The
commercial success of our NT-CoV2-1 vaccine product candidate, our
MU1140 homologs antibiotic product candidates, and any of our other
product candidates and technologies, will depend in part on market
acceptance by consumers. Biopharmaceutical companies have received
substantial support from the scientific community, regulatory
agencies and many governmental officials in the United States and
internationally. Future scientific developments, media coverage and
political events may diminish such support. Public attitudes may be
influenced by claims that health products are unsafe for
consumption or pose unknown risks to the environment or to
traditional social or economic practices. Securing governmental
approvals for, and consumer confidence in, such products pose
numerous challenges, particularly outside the United States. The
market success of product candidates developed by biopharmaceutical
companies could be delayed or impaired in certain geographical
areas as a result. Products based on our product candidates may
compete with a number of traditional therapies and drugs
manufactured and marketed by major pharmaceutical companies and
biotechnology companies. Market acceptance of products based on our
product candidates will depend on a number of factors including
potential advantage over alternative treatment methods. We can
offer you no assurance that physicians, patients or the medical
communities in general will accept and utilize products developed
from our product candidates. If they do not, we may be unable to
generate significant revenues from our product candidates and our
business, financial condition and results of operations will be
materially adversely affected.
Failure to obtain marketing approval in international jurisdictions
would prevent our product candidates from being marketed
abroad.
In
order to market and sell our products in the European Union and
many other jurisdictions, we or our third-party collaborators must
obtain separate marketing approvals and comply with numerous and
varying regulatory requirements. The approval procedure varies
among countries and can involve additional testing. The time
required to obtain approval may differ substantially from that
required to obtain FDA approval. The regulatory approval process
outside the United States generally includes all of the risks
associated with obtaining FDA approval. In addition, in many
countries outside the United States, it is required that the
product be approved for reimbursement before the product can be
approved for sale in that country. We or these third parties may
not obtain approvals from regulatory authorities outside the United
States on a timely basis, if at all. Approval by the FDA does not
ensure approval by regulatory authorities in other countries or
jurisdictions, and approval by one regulatory authority outside the
United States does not ensure approval by regulatory authorities in
other countries or jurisdictions or by the FDA. We may not be able
to file for marketing approvals and may not receive necessary
approvals to commercialize our products in any market.
We will need to further increase the size and complexity of our
organization in the future, and we may experience difficulties in
executing our growth strategy and managing our
growth.
Our
current management, personnel, systems and facilities are not
adequate to support our future growth plans. We will need to
further expand our scientific, sales and marketing, operational,
financial and other resources to support our planned research,
development, clinical trial work, and commercialization
activities.
To
manage our operations, growth and various projects effectively, we
must:
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continue
to improve our operational, financial, management and regulatory
compliance controls and reporting systems and
procedures; |
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attract
and retain sufficient numbers of talented employees; |
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develop
a plan for marketing, sales, and distribution
capability; |
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manage
our commercialization activities for our product candidates
effectively; |
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establish
and maintain relationships with development and commercialization
partners; |
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manage
our pre-clinical and clinical trials effectively; |
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manage
our third-party supply and manufacturing operations effectively and
in a cost-effective manner, while increasing production
capabilities for our current product candidates to commercial
levels; and |
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manage
our development efforts effectively while carrying out our
contractual obligations to partners and other third
parties. |
In
addition, we have utilized and continue to utilize the services of
part-time outside consultants to perform a number of tasks for us,
including tasks related to pre-clinical and clinical testing. Our
growth strategy may also entail expanding our use of consultants to
implement these and other tasks going forward. We rely on
consultants for certain functions of our business and will need to
effectively manage these consultants to ensure that they
successfully carry out their contractual obligations and meet
expected deadlines. There can be no assurance that we will be able
to manage our existing consultants or find other competent outside
consultants, as needed, on economically reasonable terms, or at
all. If we are not able to manage our growth effectively and expand
our organization by hiring new employees and expanding our use of
consultants, we might be unable to implement successfully the tasks
necessary to execute effectively on our planned research,
development and commercialization activities and, accordingly,
might fail to achieve our research, development and
commercialization goals.
If we, or our manufacturers and suppliers in general, fail to meet
contractual obligations, requirements and the requirements of
regulatory authorities, our research and development may be
materially adversely affected.
We do
not have the internal capability to manufacture our SARS-CoV-2
vaccine, MU1140 homologs, or any other product candidates and all
of their constituent parts under GMPs, as required by the FDA and
other regulatory agencies. In order to continue to develop and
commercialize our product candidates and to apply for regulatory
approvals for our product candidates, we will need to contract with
third parties that have, or otherwise develop, the necessary
manufacturing capabilities in full compliance with applicable
regulatory requirements.
We
enter into agreements with these third-party suppliers as part of,
and in connection with, our product development plans and timing.
In order to have sufficient product available for anticipated
future clinical trials we need to enter into agreements with GMP
certified manufactures that have the capability and capacity to
meet our expected product needs and timing in advance of when our
actual needs will arise in order for us to be positioned to
continue development without delays due to the manufacturing
process and capabilities of qualified manufacturers. These
agreements may obligate us to make certain payments in connection
with the manufacture of our vaccine product candidate based upon
our current expected timing. If the timing of our current
development plans changes, we could be required to make additional
payments to associated with such delays and/or associated with the
cancellation of the agreement without achieving the benefits
anticipated from the agreement.
There
are a limited number of manufacturers that operate under GMPs that
are capable of manufacturing our product candidates. Due to the
early-stage development of our SARS-CoV-2 vaccine product
candidate, we cannot at this time accurately predict the numbers
and capabilities of manufacturers that will be required and capable
of manufacturing the vaccine product candidate and any of its
components. Manufacturing on a commercial scale has not yet been
undertaken and there are additional technical skills needed for the
manufacture of MU1140 homologs that will further limit the number
of potential manufacturers. As such, if we are unable to enter into
supply and processing contracts with any of these manufacturers or
processors for our NT-CoV2-1 vaccine product candidate, our MU1140
product candidates, or our other product candidates for the conduct
of clinical trials on such product candidate we may incur
additional costs and delays in development and
commercialization.
Problems
with these manufacturing processes such as equipment malfunctions,
facility contamination, labor problems, raw material shortages or
contamination, natural disasters, power outages, terrorist
activities, or disruptions in the operations of our suppliers and
even minor deviations from normal procedures, could result in
product defects or manufacturing failures that result in lot
failures, product recalls, product liability claims and
insufficient inventory or supply of product for the conduct of
clinical trials. For example, the COVID-19 pandemic and government
shutdowns in response have interrupted supply chains, the
manufacture and transmission of goods and the regularity with which
manufacturers ordinarily operate. Such interruptions, unless
remedied entirely, can disrupt our research and development efforts
and our clinical trials, and even if remedied, could create delays
that materially impact our business.
If we
are required to find an additional or alternative source of supply,
there may be additional costs and delays in the development,
clinical trial timing, or commercialization of our product
candidates. Additionally, the FDA and other regulatory agencies
routinely inspect manufacturing facilities before approving a New
Drug Application, or NDA, or Biologic License Application, or BLA,
for a drug or biologic manufactured at those sites. If any of our
manufacturers or processors fails to satisfy regulatory
requirements, the approval and eventual commercialization of our
commercial products and product candidates may be
delayed.
All
of our contract manufacturers must comply with the applicable GMPs,
which include quality control and quality assurance requirements as
well as the corresponding maintenance of records and documentation.
If our contract manufacturers do not comply with the applicable
GMPs and other FDA regulatory requirements, we may be subject to
product liability claims, the availability of marketed products for
sale could be reduced, our product commercialization could be
delayed or subject to restrictions, we may be unable to meet demand
for our products and may lose potential revenues and we could
suffer delays in the progress of nonclinical testing and clinical
trials for products under development. We do not have control over
our third-party manufacturers’ compliance with these regulations
and standards. Moreover, while we may choose to manufacture our
products ourselves in the future, we have no experience in the
manufacture of pharmaceutical or biological products for clinical
trials or commercial purposes. If we decide to manufacture
products, we would be subject to the regulatory requirements
described above. In addition, we would require substantial
additional capital and would be subject to delays or difficulties
encountered in manufacturing pharmaceutical or biological products.
Regardless of the manufacturer of our products, we will be subject
to continuing obligations regarding the submission of safety
reports and other post-market information.
In
March 2022 we entered into an agreement with KBI Biopharma, Inc.
for the process transfer, process optimization and cGMP
manufacturing of our vaccine candidate in anticipation of a future
Phase 2 clinical trial. This agreement obligates us to make certain
payments to KBI in connection with the manufacture of our vaccine
product candidate based upon our current expected timing. If the
timing of our current development plans changes, we could be
required to make additional payments to KBI associated with such
delays and/or associated with the cancellation of the agreement
without achieving the benefits anticipated from the agreement.
Additionally, a fill/finish, packaging and labeling company has
been identified to support the Phase 1 program and is schedule for
GMP manufacturing of clinical material in 2Q22.
We rely on the significant experience and specialized expertise of
our senior management and scientific team and the loss of any of
our key personnel or our inability to successfully hire their
successors could harm our business.
Our
performance is substantially dependent on the continued services
and on the performance of our senior management and scientific
team, who have extensive experience and specialized expertise in
our business. Our performance also depends on our ability to retain
and motivate our other key employees. In June 2022, we retained our
director, Ms. Kimberly Murphy as our Chief Executive Officer and on
March 7, 2023, we retained Ms. Janet Huffman as our Chief Financial
Officer. The loss of the services of senior management or any key
employees could harm our ability to develop and commercialize our
product candidates. We have no key person life insurance
policies.
In
connection with our acquisition of Noachis Terra, we added vaccine
consultants and advisors, who were engaged in various capacities
related to the research and development of a SARS-CoV-2 vaccine
product candidate. Our ability to successfully continue the vaccine
development depends in large part on our ability to retain certain
consultants. Despite our efforts to retain these consultants, one
or more may terminate their engagement with us on short notice. The
loss of the services of any of these consultants could have
substantial negative effects on our research and development
efforts, which are necessary to further development of our
NT-CoV2-1 vaccine product candidate.
We need to hire and retain additional qualified scientists and
other highly skilled personnel to maintain and grow our
business.
Our
future success depends on our ability to identify, attract, hire,
train, retain and motivate highly skilled technical, managerial and
research personnel in all areas within our organization. We plan to
continue to execute on our business strategy and expect to hire
additional personnel to support our product development efforts. We
believe that there are only a limited number of individuals with
the requisite skills to serve in many of our key positions, and we
compete for key personnel with other more established biotechnology
companies, as well as universities and research institutions. It is
often difficult to hire and retain these persons, and we may be
unable to replace key persons if they leave or be unable to fill
new positions requiring key persons with appropriate experience. If
we fail to attract, integrate and retain the necessary personnel,
our ability to maintain and grow our business could suffer
significantly.
If any of our product candidates are shown to be ineffective or
harmful in humans, we will be unable to generate revenues from
these product candidates.
Before
obtaining regulatory approvals for the commercial sale of our
product candidates, we must demonstrate through nonclinical testing
and clinical trials that our products are safe and effective for
use in humans. To date the testing of the antibiotic substance
MU1140 homologs has been undertaken solely in the laboratory and in
animals. We have not yet conducted human trials with any MU1140
homolog nor have we initiated clinical trials for our NT-CoV2-1
vaccine product candidate. It is possible that when and if future
lantibiotic trials and/or our NT-CoV2-1 vaccine product candidate
trials are conducted in humans, they will show that our antibiotic
or vaccine candidates are ineffective or harmful in humans. If
MU1140 homologs or our vaccine product candidate are shown to be
ineffective or harmful in humans, we will be unable to
commercialize and generate revenues from sales of such product
candidates. If we are unable to generate revenues from the first
generation of MU1140 and homologs, or any other product candidates,
our business, financial condition and results of operations will be
materially adversely affected.
Because we are new to vaccine development, we must identify
vaccines for development with our technologies and establish
successful third-party relationships.
Because
we are new to vaccine development and lack substantial experience
in the research and development of vaccines, the near and long-term
viability of our SARS-CoV-2 vaccine product candidate will depend
in part on our ability to successfully establish new strategic
collaborations with biotechnology companies, non-profit
organizations. government agencies and other vaccine industry
entities. Establishing and maintaining strategic collaborations and
obtaining government funding is difficult and time-consuming.
Potential collaborators may reject collaborations based upon their
assessment of our financial, regulatory or intellectual property
position or based on their internal pipeline; government agencies
may reject contract or grant applications based on their assessment
of public need, the public interest, our products’ ability to
address these areas, or other reasons beyond our expectations or
control. If we fail to establish a strategic collaborations or
government relationships on acceptable terms, we may not be able to
develop and commercialize our NT-CoV2-1 vaccine product candidate
or generate sufficient revenue to fund further research and
development efforts.
Additionally,
we do not have our own clinical research and development facilities
dedicated to vaccine development and manufacture. We have in the
past and may in the future engage consultants and independent
contract research organizations, subject to regulatory
considerations, to design and conduct our clinical trials in
connection with the development of our SARS-CoV-2 vaccine product
candidate. As a result, these important aspects of a product’s
development will be outside of our direct control. Even if we
establish new collaborations or obtain government funding, these
relationships may never result in the successful development or
commercialization of our vaccine product candidate for several
reasons, including the fact that:
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we
may not have the ability to control the activities of our partners
and cannot provide assurance that they will fulfill their
obligations to us, including with respect to the license,
development and commercialization of our vaccine product candidate,
in a timely manner or at all; |
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such
partners may not devote sufficient resources to our vaccine product
candidate or properly maintain or defend our intellectual property
rights; |
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any
failure on the part of our partners to perform or satisfy their
obligations to us could lead to delays in the development or
commercialization of our vaccine product candidate and affect our
ability to realize product revenue; and |
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disagreements,
including disputes over the ownership of technology developed with
such collaborators, could result in litigation, which would be time
consuming and expensive, and may delay or terminate research and
development efforts, regulatory approvals and commercialization
activities. |
Our
collaborators will be subject to the same regulatory approval of
their manufacturing facility and process as us. Before we could
begin commercial manufacturing of any of our vaccine candidates, we
and our collaborators must pass a pre-approval inspection before
FDA approval and comply with the FDA’s GMP regulations. If our
collaborators fail to comply with these requirements, our vaccine
candidate may not be approved. If our collaborators fail to comply
with these requirements after approval, we could be subject to
possible regulatory action and may be limited in the jurisdictions
in which we are permitted to sell our products. If we or our
collaborators fail to establish agreements as necessary, we could
be required to undertake research, development, manufacturing and
commercialization activities solely at our own expense. These
activities would significantly increase our capital requirements
and, given our lack of sales, marketing and distribution
capabilities, significantly delay the commercialization of our
vaccine product candidate.
We intend to seek licensing partners to cover a portion of the
costs associated with obtaining regulatory approval for, and
manufacturing and marketing of, our product candidates. If we are
unable to obtain agreements with third parties to fund these costs,
we will have to fund such costs ourselves or we may be unable to
extract any value from these technologies.
As we
continue our development of product candidates, we intend to either
license these product candidates to, or partner with, one or more
major pharmaceutical companies at the earliest possible time in
their product development. If we do so, we intend for these
licensees or partners to pay the costs associated with any
remaining development work, regulatory submissions, clinical trials
and the manufacturing and marketing of our product candidates. If
we are unable to license our product candidates or otherwise
partner with third parties, we will have to fund the costs of our
clinical trials ourselves or we will be unable to extract any value
from these technologies. We may also have to establish our own
manufacturing facilities and find our own distribution channels.
This would greatly increase our future capital requirements and we
cannot assure you that we would be able to obtain the necessary
financing to pay these costs. If we are unable to cover the
associated costs or we cannot obtain financing on acceptable terms
or at all, our business, financial condition and results of
operations will be materially adversely affected.
Our
dependence on collaborative arrangements with third parties
subjects us to a number of risks. These collaborative arrangements
may not be on terms favorable to us. Agreements with collaborative
partners typically allow partners significant discretion in
electing whether or not to pursue any of the planned activities. We
cannot control the amount and timing of resources our collaborative
partners may devote to products based on the collaboration, and our
partners may choose to pursue alternative products. Our partners
may not perform their obligations as expected. Business
combinations or significant changes in a collaborative partner’s
business strategy may adversely affect a partner’s willingness or
ability to complete its obligations under the arrangement.
Moreover, we could become involved in disputes with our partners,
which could lead to delays or termination of the collaborations and
time-consuming and expensive litigation or arbitration. Even if we
fulfill our obligations under a collaborative agreement, our
partner may be able to terminate the agreement under certain
circumstances. If any collaborative partner were to terminate or
breach our agreement with it, or otherwise fail to complete its
obligations in a timely manner, our chances of successfully
commercializing our product candidates would be materially and
adversely affected.
We might not be successful at acquiring, investing in or
integrating businesses, entering into joint ventures or divesting
businesses.
We
expect to continue pursuing strategic acquisitions, investments and
joint ventures to enhance or add to our skills and capabilities or
offerings of services and solutions, or to enable us to expand in
certain geographic and other markets. Depending on the
opportunities available, we may increase the amount of capital
invested in such opportunities. We may not succeed in completing
targeted transactions, including as a result of the market becoming
increasingly competitive, or achieve desired results of operations.
Furthermore, we face risks in successfully integrating any
businesses we might acquire or create through a joint venture.
Ongoing business may be disrupted, and our management’s attention
may be diverted by acquisition, investment, transition or
integration activities. In addition, we might need to dedicate
additional management and other resources, and our organizational
structure could make it difficult for us to efficiently integrate
acquired businesses into our ongoing operations and assimilate and
retain employees of those businesses into our culture and
operations. The loss of key executives, employees, customers,
suppliers, vendors and other business partners of businesses we
acquire may adversely impact the value of the assets, operations or
businesses. Furthermore, acquisitions or joint ventures may result
in significant costs and expenses, including those related to
retention payments, equity compensation, severance pay, early
retirement costs, intangible asset amortization and asset
impairment charges, assumed litigation and other liabilities, and
legal, accounting and financial advisory fees, which could
negatively affect our profitability. We may have difficulties as a
result of entering into new markets where we have limited or no
direct prior experience or where competitors may have stronger
market positions. We might fail to realize the expected benefits or
strategic objectives of any acquisition, investment or joint
venture we undertake. We might not achieve our expected return on
investment or may lose money. We may be adversely impacted by
liabilities that we assume from a company we acquire or in which we
invest, including from that company’s known and unknown
obligations, intellectual property or other assets, terminated
employees, current or former clients or other third parties. In
addition, we may fail to identify or adequately assess the
magnitude of certain liabilities, shortcomings or other
circumstances prior to acquiring, investing in or partnering with a
company, including potential exposure to regulatory sanctions or
liabilities resulting from an acquisition target’s previous
activities, internal controls and security environment. If any of
these circumstances occurs, they could result in unexpected legal
or regulatory exposure, unfavorable accounting treatment,
unexpected increases in taxes or other adverse effects on our
business. In addition, we have a lesser degree of control over the
business operations of the joint ventures and businesses in which
we have made minority investments or in which we have acquired less
than 100% of the equity. This lesser degree of control may expose
us to additional reputational, financial, legal, compliance or
operational risks. Litigation, indemnification claims and other
unforeseen claims and liabilities may arise from the acquisition or
operation of acquired businesses. For example, we may face
litigation or other claims as a result of certain terms and
conditions of the acquisition agreement, such as earnout payments
or closing net asset adjustments. Alternatively, shareholder
litigation may arise as a result of proposed acquisitions. If we
are unable to complete the number and kind of investments for which
we plan, or if we are inefficient or unsuccessful at integrating
any acquired businesses into our operations, we may not be able to
achieve our planned rates of growth or improve our market share,
profitability or competitive position in specific markets or
services. We also periodically evaluate, and have engaged in, the
disposition of assets and businesses. Divestitures could involve
difficulties in the separation of operations, services, products
and personnel, the diversion of management’s attention, the
disruption of our business and the potential loss of key employees.
After reaching an agreement with a buyer for the disposition of a
business, the transaction may be subject to the satisfaction of
pre-closing conditions, including obtaining necessary regulatory
and government approvals, which, if not satisfied or obtained, may
prevent us from completing the transaction. Divestitures may also
involve continued financial involvement in or liability with
respect to the divested assets and businesses, such as indemnities
or other financial obligations, in which the performance of the
divested assets or businesses could impact our results of
operations. Any divestiture we undertake could adversely affect our
results of operations.
We may face product liability exposure, and if successful claims
are brought against us, we may incur substantial liability if our
insurance coverage for those claims is
inadequate.
We
face an inherent risk of product liability as a result of the
clinical testing of our product candidates and will face an even
greater risk if we commercialize any products. This risk exists
even if a product is approved for commercial sale by the FDA and
manufactured in facilities regulated by the FDA or an applicable
foreign regulatory authority. Our products and product candidates
are designed to affect bodily functions and processes. Any side
effects, manufacturing defects, misuse or abuse associated with our
product candidates could result in injury and possibly death to a
patient. An inability to obtain sufficient insurance coverage on
commercially reasonable terms or otherwise to protect against
potential product liability claims could inhibit our
business.
In
addition, a liability claim may be brought against us even if our
product candidates merely appear to have caused an injury. Product
liability claims may be brought against us by consumers, healthcare
providers, pharmaceutical companies or others selling or otherwise
coming into contact with our product candidates, among others. If
we cannot successfully defend ourselves against product liability
claims we will incur substantial liabilities and reputational harm.
In addition, regardless of merit or eventual outcome, product
liability claims may result in:
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withdrawal
of clinical trial participants; |
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termination
of clinical trial sites or entire trial programs; |
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the
inability to commercialize our product candidates; |
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decreased
demand for our product candidates; |
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impairment
of our brand and/or reputation; |
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product
recall or withdrawal from the market or labeling, marketing or
promotional restrictions; |
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substantial
costs of any related litigation or similar disputes; |
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distraction
of management’s attention and other resources from our primary
business; |
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substantial
monetary awards to patients or other claimants against us that may
not be covered by insurance; or |
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loss
of potential revenue. |
Although
we may maintain product liability insurance coverage for clinical
trials, our insurance coverage may not be sufficient to cover all
of our product liability-related expenses or losses and may not
cover us for any expenses or losses we suffer. Moreover, insurance
coverage is becoming increasingly expensive, and, in the future, we
may not be able to maintain insurance coverage at a reasonable
cost, in sufficient amounts or upon adequate terms to protect us
against losses due to product liability, particularly if any of our
product candidates receive regulatory approval. Further, a
successful product liability claim or series of claims brought
against us could cause our stock price to decline and, if judgments
exceed our insurance coverage, could decrease our cash and harm our
business, financial condition, operating results and
prospects.
We may be adversely affected by natural disasters, pandemics and
other catastrophic events, and by man-made problems such as
terrorism, that could disrupt our business operations and our
business continuity and disaster recovery plans may not adequately
protect us from a serious disaster.
Our
corporate headquarters is located in Tampa, Florida, a hurricane
zone. If a disaster, power outage or other event occurred that
prevented us from using all or a significant portion of our
headquarters, that damaged critical infrastructure, such as
enterprise financial systems, manufacturing resource planning or
enterprise quality systems, or that otherwise disrupted operations,
it may be difficult or, in certain cases, impossible for us to
continue our business for a substantial period of time. Our
contract manufacturers’ and suppliers’ facilities are located in
multiple locations, where other natural disasters or similar
events, such as blizzards, tornadoes, fires, explosions or
large-scale accidents or power outages, and other public health
emergencies could severely disrupt our operations and have a
material adverse effect on our business, financial condition,
operating results and prospects. For example, the recent COVID-19
pandemic may cause significant disruption to our business
operations, the operations of our third-party contractors and
suppliers and the operations of our clinical trials, including as a
result of significant restrictions or bans on travel into and
within the geographic areas in which our manufacturers product our
product candidates or where we conduct our clinical trials. A
public health emergency could also affect the operations of the FDA
and other regulatory or public health authorities, resulting in
delays to meetings related to planned or completed clinical trials
and ultimately of reviews and approvals of our product candidates.
Such disruption could impede, delay, limit or prevent our employees
and third-party contractors from beginning or continuing research
and development or clinical trial-related activities, which may
impede, delay, limit or prevent initiation or completion of our
ongoing clinical trials and pre-clinical research and ultimately
lead to the delay or denial of regulatory approval of our product
candidates, which could seriously harm our operations and financial
condition.
In
addition, acts of terrorism and other geo-political unrest could
cause disruptions in our business or the businesses of our
partners, manufacturers or the economy as a whole. All of the
aforementioned risks may be further increased if we do not
implement a disaster recovery plan or our partners’ or
manufacturers’ disaster recovery plans prove to be inadequate. To
the extent that any of the above should result in delays in the
regulatory approval, manufacture, distribution or commercialization
of our product candidates, our business, financial condition,
operating results and prospects would suffer.
Our ability to use our net operating loss carryforwards and certain
other tax attributes may be limited, each of which could harm our
business.
As of
December 31, 2022, we had U.S. federal and state net operating loss
carryforwards of approximately $150,083,903. We also accumulated
U.S. federal and state research tax credits of approximately
$4,834,850 as of December 31, 2022 Under Sections 382 and 383 of
the Internal Revenue Code (the “Code”), if a corporation undergoes
an “ownership change,” the corporation’s ability to use its
pre-ownership change net operating loss carryforwards and other
pre-ownership change tax attributes, such as research tax credits,
to offset its post-ownership change income and taxes may be
limited. In general, an ownership change will occur when the
percentage of the Corporation’s ownership (by value) of one or more
“5-percent shareholders” (as defined in the Code) has increased by
more than 50 percent over the lowest percentage owned by such
shareholders at any time during the prior three years (calculated
on a rolling basis). Similar rules may apply under state tax laws.
An entity that experiences an ownership change generally will be
subject to an annual limitation on its pre-ownership change tax
loss and credit carryforwards equal to the equity value of the
corporation immediately before the ownership change, multiplied by
the long-term, tax-exempt rate posted monthly by the IRS (subject
to certain adjustments). The annual limitation would be increased
each year to the extent that there is an unused limitation in a
prior year. In the event that it is determined that we have in the
past experienced an ownership change as a result of transactions in
our stock, or if we experience one or more ownership changes as a
result of future transactions in our stock, then we may be limited
in our ability to use our net operating loss carryforwards and
other tax assets to reduce taxes owed on the net taxable income
that we earn. Any limitations on the ability to use our net
operating loss carryforwards and other tax assets could harm our
business.
Our auditor has expressed substantial doubt about our ability to
continue as a going concern and absent additional financing we may
be unable to remain a going concern.
In
light of our recurring losses, accumulated deficit and negative
cash flow as described in our notes to our audited consolidated
financial statements, the report of our independent registered
public accounting firm on our consolidated financial statements for
the year ended December 31, 2022 contained an explanatory paragraph
raising substantial doubt about our ability to continue as a going
concern. Our financial statements did not include any adjustments
that may have been necessary in the event we were unable to
continue as a going concern. If we are unable to establish to the
satisfaction of our independent registered public accounting firm
that the net proceeds from our financing efforts will be sufficient
to allow for the removal of this going concern qualification, we
may need to significantly modify our operational plans for us to
continue as a going concern. We believe we can continue our current
level of operations with the cash we have on hand without
additional financing through 2023. Absent sufficient additional
financing, we may be unable to remain a going concern.
Risks
Related to Our Intellectual Property and Data Security and
Privacy
Our vaccine research and development efforts are to a large extent
dependent upon our intellectual property and biologicals materials
license with the Licensors.
An
important element of our intellectual property portfolio are our
License Agreements. Pursuant to the NIH Patent License and
Biological Materials License Agreement, we hold a nonexclusive,
worldwide license to certain specified patent rights (including
patent applications, provisional patent applications and PCT patent
applications) and biological materials relating to the use of
prefusion coronavirus spike proteins for the purpose of developing
and commercializing a vaccine product candidate for SARS-CoV-2.
This intellectual property and biological materials license are
essential to our operations and our ability to research and develop
our NT-CoV2-1 vaccine product candidate. The terms of the license
agreement will terminate upon the earlier of (a) twenty (20) years
from the first commercial sale where no licensed patent rights
exist or have ceased to exist or (b) the expiration of the last to
expire of any licensed patent rights. Additionally, we must use
reasonable commercial efforts to develop, manufacture, and
commercialize our vaccine product candidate, to manufacture our
vaccine product candidate substantially within the United States
and provide the United States public with reasonable access to our
vaccine, if approved for commercialization by the FDA. If we breach
the terms of the license agreement, including any failure to make
minimum royalty payments required thereunder or failure to reach
certain developmental milestones, using best efforts to introduce a
licensed product or practice a licensed process in certain
territories by certain dates, the NIAID has the right to terminate
the license.
If we
were to lose or otherwise be unable to maintain the License
Agreements on acceptable terms, or find that it is necessary or
appropriate to secure new licenses from other third parties, it
would halt our ability to continue to develop our NT-CoV2-1 vaccine
product candidate, which would have an immediate material adverse
effect on our business, operating results and financial condition.
Thus, our inability to retain the rights and technologies
identified by the licenses, or those that we may in the future
identify, could have a material adverse impact on our ability to
complete the development of our vaccine product candidate. No
assurance can be given that we will be successful in licensing any
additional rights or technologies from the Licensors or others. If
we fail to retain the License Agreements or if we fail to obtain
additional rights and licenses necessary to further the development
and commercialization of our vaccine product candidate, our planned
development for our vaccine product candidate may be materially
impacted and the costs associated with the development may increase
significantly, and we may be entirely unable to complete
development of a SARS-CoV-2 vaccine product candidate.
We may incur additional expenses and obligations in connection with
our License Agreements.
We
must use reasonable commercial efforts to bring to market a vaccine
product candidate covered by our licenses, which means we must
adhere to an existing commercial development plan and existing
performance benchmarks. Additionally, we are obliged to pay to the
Licensors certain minimum annual royalties, certain
benchmark-related royalties and royalties based upon a share of any
net sales of our vaccine product candidate, following regulatory
approval and the first commercial sale. Additionally, among other
obligations, we must provide regular written reports to the
Licensors on the development status of our vaccine product
candidate and pay for our pro rata share of the NIH’s patent
prosecution-related expenses and fees. Moreover, we must use
reasonable commercial efforts to develop, manufacture, and
commercialize the vaccine product candidate, to manufacture the
vaccine product candidate substantially within the United States
and or Canada and provide the United States and Canadian public
with reasonable access to the vaccine, if approved for
commercialization by the FDA and Canadian regulatory agencies. All
of these additional obligations beyond ordinary research and
development and regulatory compliance related to the approval of
our vaccine product candidate may impose delays or greater costs
upon our ability to timely develop our vaccine product
candidate.
Although
our forecasts for expenses and the sufficiency of our capital
resources will take into account the funds available for the
research and development of our vaccine product candidate
development, our actual cash requirements may vary materially from
our current expectations for a number of other factors that may
include, but are not limited to, changes in the focus and direction
of our development programs, competitive and technical advances,
costs associated with the development of our product candidates and
our share of the costs of filing, prosecuting, defending and
enforcing the intellectual property rights covered by the NIH
license. If we exhaust the funds available for the development of
NT-CoV2-1 more quickly than anticipated, regardless of the reason,
and we are unable to obtain additional financing on terms
acceptable to us or at all, we may be unable to meet our
obligations under the License Agreements, which may be terminated,
and we will be unable to proceed with development of our product
candidates on expected timelines and will be forced to prioritize
among them.
The intellectual property covered by our License Agreements
concerns patent applications and provisional applications. We
cannot assure investors that any of the currently pending or future
patent applications will result in granted patents, nor can we
predict how long it will take for such patents to be
granted.
The
intellectual property covered by the License Agreements concerns
certain, specified patent rights (including patent applications,
provisional patent applications and PCT patent applications).
Although the Licensors have agreed to assume responsibility for the
preparation, filing, prosecution and maintenance of all patent
applications covered by the licensed patent rights, we cannot be
certain as to when or if final patents will be issued for those
patent applications covered by the licensed patent rights. However,
the Licensors may not successfully prosecute certain patent
applications, the prosecution of which they control, under which we
are only a licensee and on which our business substantially
depends. Even if patents issue from these applications, the
Licensors may fail to maintain these patents, may decide not to
pursue litigation against third-party infringers, may fail to prove
infringement or may fail to defend against counterclaims of patent
invalidity or unenforceability.
Moreover,
it is possible that the licensed pending patent applications will
not result in granted patents, and even if such pending patent
applications grant as patents, they may not provide a basis for
intellectual property protection of commercially viable vaccine
products or may not provide us with any competitive advantages.
Further, it is possible that, for any of the patents that may be
granted in the future, others will design around the Licensors’
patent rights or identify methods for preventing or treating
SARS-CoV-2 that do not concern the rights covered by our licenses.
Further, we cannot assure investors that other parties will not
challenge any patents granted to the Licensors or that courts or
regulatory agencies will hold Licensors’ patents to be valid or
enforceable. We cannot guarantee investors that, if required to
defend the covered patents, we will be successful in defending
challenges made against the Licensors’ patents and patent
applications. Any successful third-party challenge to the NIH
patents could result in the unenforceability or invalidity of such
patents, or to such patents being interpreted narrowly or otherwise
in a manner adverse to our interests. Our ability to establish or
maintain a technological or competitive advantage over our
competitors may be diminished because of these
uncertainties.
Risks
with respect to the Licensors and our License Agreements may also
arise out of circumstances beyond our control. In spite of our best
efforts, the Licensors may conclude that we have materially
breached the license agreement and may therefore terminate the
agreement, thereby removing our ability to market vaccine product
candidates covered by the agreement. If the License Agreements are
terminated, or if the underlying patents fail to provide the
intended market protection, competitors would have the freedom to
seek regulatory approval of, and to market, products similar or
identical to ours. Moreover, if the License Agreements are
terminated, the Licensors may be able to prevent us from utilizing
the technology covered by the licensed patent rights. This could
have a material adverse effect on our competitive business position
and our financial condition, results of operations and our business
prospects.
We cannot prevent the Licensors or other companies, including our
competitors, from licensing the same intellectual property and
biological materials that we have licensed or from otherwise
duplicating our business model and operations.
Our
License Agreements (except our Inspirevax License) are nonexclusive
licenses and we are not permitted to sublicense the intellectual
property or biological materials covered by the license. Therefore,
we cannot be certain that the Licensors have not previously
licensed, or that the Licensors will not, in the future, license
the intellectual property or biological materials to other
biotechnology companies, including those who intend to develop a
vaccine product candidate for SARS-CoV-2, some or all of the
nonexclusive intellectual property and biological materials
available to us under the License Agreements. Moreover, we do not
currently own any exclusive rights or licenses necessary to fully
develop our NT-CoV2-1 vaccine product candidate, and such rights or
licenses, if in existence, could be held by our competitors or used
by other third parties to otherwise directly compete against us. If
our competitors or others have or acquire exclusive rights or
licenses that they could enforce against us, then we may be
required to alter our products, pay licensing fees or cease
activities. If our products conflict with rights or licenses of
others, third parties could bring legal actions against us or our
collaborators, licensees, suppliers or customers, claiming damages
and seeking to enjoin manufacturing and marketing of the affected
products. If these legal actions are successful, in addition to any
potential liability for damages, we could be required to obtain a
license in order to continue to manufacture or market the affected
products. We may not prevail in any legal action and a required
license under the patent may not be available on acceptable terms
or at all. Accordingly, while we may develop, acquire or license
the additional technologies necessary to the development of our
vaccine candidate we cannot assure you that we will be able to
develop, acquire or license such technologies or that alternatives
will be sufficient to enable development of our NT-CoV2-1 vaccine
product candidate or to prevent others from competing with us and
developing substantially-similar products.
We may be subject to claims challenging the inventorship of our
patents and other intellectual property.
We or
the Licensors may be subject to claims that former employees,
collaborators or other third parties have an interest in the
licensed patents or other intellectual property as an inventor or
co-inventor. For example, we or the Licensors may have inventorship
disputes arise from conflicting obligations of employees,
consultants or others who are involved in developing the
intellectual property covered by the License Agreements or our
product candidates. Litigation may be necessary to defend against
these and other claims challenging inventorship or our license or
the Licensors’ ownership, as applicable, of the licensed patents,
trade secrets or other intellectual property. If we or our
licensors fail in defending any such claims, in addition to paying
monetary damages, we may lose valuable intellectual property
rights, such as our right to use intellectual property that is
important to our NT-CoV2-1 vaccine product candidate. Even if we
are successful in defending against such claims, litigation could
result in substantial costs and be a distraction to management and
other employees. Any of the foregoing could have a material adverse
effect on our business, financial condition, results of operations
and prospects.
Changes in patent law or patent jurisprudence could diminish the
value of patents in general, thereby impairing our ability to
protect our product candidates.
The
United States has recently enacted and is currently implementing
wide-ranging patent reform legislation. Further, recent United
States Supreme Court rulings have either narrowed the scope of
patent protection available in certain circumstances or weakened
the rights of patent owners in certain situations. Moreover, patent
law and protection in foreign countries, particularly developing
countries, may be insufficient or otherwise unclear in its efficacy
to protect our intellectual property. In addition to increasing
uncertainty with regard to our ability to obtain patents in the
future, this combination of events has created uncertainty with
respect to the scope and value of patents, once
obtained.
For
our U.S. patent applications containing a priority claim after
March 16, 2013, there is a greater level of uncertainty in the
patent law. In September 2011, the Leahy-Smith America Invents Act,
also known as the America Invents Act, or AIA, was signed into law.
The AIA includes a number of significant changes to U.S. patent
law, including provisions that affect the way patent applications
will be prosecuted and may also affect patent litigation. The USPTO
is currently developing regulations and procedures to govern the
administration of the AIA, and many of the substantive changes to
patent law associated with the AIA. It is not clear what other, if
any, impact(s) the AIA will have on the operation of our business.
Moreover, the AIA and its implementation could increase the
uncertainties and costs surrounding the prosecution of our patent
applications and the enforcement or defense of our issued patents,
all of which could have an adverse effect on our business. One
important change introduced by the AIA is that, as of March 16,
2013, the United States transitioned to a “first-to-file” system
for deciding which party should be granted a patent when two or
more patent applications are filed by different parties claiming
the same invention. A third party who files a patent application
with the USPTO after such date but prior to us may therefore be
awarded a patent covering an invention of ours even if we were the
first to invent. This “first-inventor-to-file” system will require
us both to remain cognizant, going forward, of the timing between
invention and filing of a patent application.
Among
some of the other changes introduced by the AIA are those that (i)
limit where a patentee may file a patent infringement suit and (ii)
provide opportunities for third parties to challenge any issued
patent in the USPTO. Such changes apply to all of our U.S. patents,
even those issued prior to March 16, 2013. Because of a lower
evidentiary standard in USPTO proceedings, as compared to the
evidentiary standard applied in U.S. federal courts, necessary to
invalidate a patent claim, a third party could potentially present
evidence in a USPTO proceeding sufficient for the USPTO to find a
claim invalid, notwithstanding that the same evidence would be
insufficient to invalidate a claim first presented in a district
court action. Accordingly, a third party may attempt
opportunistically to use USPTO procedures to invalidate our patent
claims.
Depending
on decisions by the United States Congress, the U.S. federal
courts, the USPTO or similar authorities in foreign jurisdictions,
the laws and regulations governing patents could change in
unpredictable ways that may weaken our and our licensors’ abilities
to obtain new patents or to enforce existing patents we and our
licensors or partners may obtain in the future.
If we are unable to protect our trademarks or other intellectual
property from infringement, our business prospects may be
harmed.
We
have applied for trademark protection for trademarks in the United
States, the European Union and China. Although we take steps to
monitor the possible infringement or misuse of our trademarks, it
is possible that third parties may infringe, dilute or otherwise
violate our trademark rights. Any unauthorized use of our
trademarks or other intellectual property rights could harm our
reputation or commercial interests. Moreover, our License
Agreements do not commit to defend any declaratory judgment action
alleging the invalidity of any of the licensed patent rights
covered by the license, nor does the NIAID commit to commence legal
actions against third parties alleged to infringe upon those
licensed patent rights. Our enforcement against third-party
infringers or violators may be unduly expensive and time-consuming,
and any remedy obtained may constitute insufficient redress
relative to the damages we may suffer.
We may not be able to protect our intellectual property rights
throughout the world.
Filing,
prosecuting and defending patents on our product candidates in all
countries throughout the world would be prohibitively expensive.
The requirements for patentability may differ in certain countries,
particularly developing countries. In addition, the laws of some
foreign countries do not protect intellectual property rights to
the same extent as laws in the United States. Consequently, we may
not be able to prevent third parties from practicing our inventions
in all countries outside the United States. Competitors may use our
technologies in jurisdictions where we have not obtained patent
protection to develop their own products and, further, may export
otherwise infringing products to territories where we have patent
protection insufficient to guard against such infringement. These
products may compete with our products, and our patents or other
intellectual property rights may not be effective or sufficient to
prevent them from competing.
The
legal systems of certain countries, particularly certain developing
countries, do not favor the enforcement of patents and other
intellectual property protection, particularly those relating to
pharmaceuticals. In such instances, we may be unable to enjoin or
otherwise prevent infringement of our patents or marketing of
competing products in violation of our proprietary rights,
generally. Proceedings to enforce our patent rights in foreign
jurisdictions could (i) result in substantial costs and divert our
efforts and attention from other aspects of our business, (ii) put
our patents at risk of being invalidated or interpreted narrowly
and our patent applications at risk of not issuing and (iii)
provoke third parties to assert claims against us. We may not
prevail in any lawsuits that we initiate and the damages or other
remedies awarded, if any, may not be commercially meaningful. In
addition, certain countries in Europe and certain developing
countries have compulsory licensing laws under which a patent owner
may be compelled to grant licenses to third parties. In those
countries, we may be unable to seek adequate remedies to address
infringement and/or material diminishment of the value of our
patents, which could limit our potential revenue opportunities in
such jurisdictions. Accordingly, our efforts to establish or
enforce our intellectual property rights around the world may be
inadequate to obtain a significant commercial advantage from our
intellectual property. Finally, our ability to protect and enforce
our intellectual property rights may be adversely affected by
unforeseen changes in foreign intellectual property
laws.
If we fail to comply with our obligations under our intellectual
property license agreements, we could lose our license rights that
are important to our business and development of our product
candidates.
The
License Agreements impose various royalties and other obligations
on us as well as development plans. If we fail to comply with these
obligations, our licensors may have the right to terminate the
license, in which event we may not be able to develop or market the
affected product candidate. The License Agreements may be
terminated in the event of a breach. The loss of such rights could
materially adversely affect our business, financial condition,
operating results and prospects.
If we are sued for infringing intellectual property rights of third
parties, it will be costly and time-consuming and an unfavorable
outcome in that litigation could have a material adverse effect on
our business.
Our
commercial success depends upon our ability to develop,
manufacture, market, and sell our product candidates and use our
proprietary technologies without infringing the proprietary rights
of third parties. We cannot guarantee that marketing and selling
such candidates and using such technologies will not infringe
existing or future patents. Numerous U.S. and foreign issued
patents and pending patent applications owned by third parties
exist in the fields relating to our product candidates. As the
biotechnology and pharmaceutical industries expand and more patents
are issued, the risk increases that others may assert that our
product candidates, technologies or methods of delivery or use
infringe their patent rights. Moreover, it is not always clear to
industry participants, including us, which patents cover various
drugs, biologics, drug delivery systems or their methods of use,
and which of these patents may be valid and enforceable. Thus, due
to the large number of patents issued and patent applications filed
in our fields, third parties may allege they have patent rights
encompassing our product candidates, technologies or
methods.
In
addition, our product candidates or proprietary technologies may
infringe patents owned and/or filed by third parties, or third
parties may allege such infringement. Because (i) some patent
applications in the United States may be maintained in secrecy
until the patents are issued, (ii) patent applications in the
United States and many foreign jurisdictions are typically not
published until 18 months after filing and (iii) publications in
the scientific literature often lag behind actual discoveries, we
cannot be certain that others have not filed patent applications
for technology covered by our own and in-licensed issued patents or
our pending applications. Our competitors may have filed, and may
in the future file, patent applications covering our product
candidates or technology similar to ours. Any such patent
application may have priority over our own and in-licensed patent
applications or patents, which could further require us to obtain
rights to issued patents covering such technologies. If another
party has filed a U.S. patent application on inventions similar to
those owned or in-licensed to us, we or, in the case of in-licensed
technology, the licensor may have to participate, in the United
States, in an interference proceeding to determine priority of
invention.
We
may be exposed to, or threatened with, future litigation by third
parties having patent or other intellectual property rights
alleging that our product candidates or proprietary technologies
infringe such third parties’ intellectual property rights,
including litigation resulting from filing under Paragraph IV of
the Hatch-Waxman Act. Such lawsuits can be costly and could
adversely affect our operating results and divert the attention of
managerial and technical personnel, even if we do not infringe such
patents or the patents asserted against us are later invalidated. A
court may, however, decide that we are infringing the third party’s
patents and order us to cease the activities covered by the
patents. In addition, there is a risk that a court will order us to
pay for such third-party damages for having violated the other
party’s patents.
As a
result of patent infringement claims, or to avoid potential claims,
we may choose or be required to seek licenses from third parties.
These licenses may not be available on commercially acceptable
terms, or at all. Even if we are able to obtain a license, the
license would likely obligate us to pay license fees or royalties
or both, and the rights granted to us might be nonexclusive, which
could result in our competitors gaining access to the same
intellectual property, or such rights might be restrictive and
limit our present and future activities. Ultimately, we or a
licensee could be prevented from commercializing a product, or
forced to cease some aspect of our business operations, if, as a
result of actual or threatened patent infringement claims, we are
unable to enter into licenses on acceptable terms.
In
addition to possible infringement claims against us, we may become
a party to other patent litigation and other proceedings, including
interference, derivation, re-examination or other post-grant
proceedings declared or granted by the USPTO, and similar
proceedings in foreign countries, regarding intellectual property
rights with respect to our current or future products.
There
is a substantial amount of litigation involving patent and other
intellectual property rights in the biotechnology and
pharmaceutical industries, generally. To date, no litigation
asserting infringement claims has ever been brought against us. If
a third-party claims that we infringe its intellectual property
rights, we may face a number of issues, including:
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infringement
and other intellectual property claims which, regardless of merit,
may be expensive and time-consuming to litigate and may divert our
management’s attention from our core business; |
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substantial
damages for infringement, which we may have to pay if a court
decides that the product or technology at issue infringes or
violates the third party’s rights, and if the court finds that the
infringement was willful, we could be ordered to pay treble damages
and the patent owner’s attorneys’ fees; |
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a
court prohibiting us from selling or licensing the product or using
the technology unless the third party licenses its intellectual
property rights to us, which it is not required to do; |
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if a
license is available from a third party, we may have to pay
substantial royalties or upfront fees or grant cross-licenses to
intellectual property rights for our products or technologies;
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redesigning
our products or processes so they do not infringe, which may not be
possible or may require substantial monetary expenditures and
time. |
Some
of our competitors may be able to sustain the costs of complex
patent litigation more effectively than we can because they have
substantially greater resources. In addition, any uncertainties
resulting from the initiation and continuation of any litigation
could harm our ability to raise additional funds or otherwise
adversely affect our business, financial condition, operating
results and prospects.
Because
we rely on certain third-party licensors and partners, and will
continue to do so in the future, if one of our licensors or
partners is sued for infringing a third party’s intellectual
property rights, our business, financial condition, operating
results and prospects could suffer in the same manner as if we were
sued directly. In addition to facing litigation risks, we have
agreed to indemnify certain third-party licensors and partners
against claims of infringement caused by our proprietary
technologies, and we have entered or may enter into cost-sharing
agreements with some our licensors and partners that could require
us to pay some of the costs of patent litigation brought against
those third parties whether or not the alleged infringement is
caused by our proprietary technologies. In certain instances, these
cost-sharing agreements could also require us to assume greater
responsibility for infringement damages than our technology alone
would otherwise suggest.
We may become involved in lawsuits to protect or enforce our
patents or other intellectual property or the patents of our
licensors, which could be expensive and
time-consuming.
Competitors
may infringe upon our intellectual property, including our patent
applications or the patents of our licensors. As a result, we may
be required to file infringement claims to stop third-party
infringement or unauthorized use. Such proceedings and/or
litigation can be expensive – particularly for a company of our
size – and time-consuming. In addition, in an infringement
proceeding, a court may decide that a patent of ours is not valid
or is unenforceable, or may refuse to enjoin the other party from
using the technology at issue on the grounds that our patent claims
do not cover its technology or that the factors necessary to grant
an injunction are not satisfied. An adverse determination in such
case could put one or more of our patents at risk of being
invalidated, interpreted narrowly or amended such that they fail to
cover or otherwise protect our product candidates. Moreover, such
adverse determinations could subject our patent applications to the
risk that they will not issue, or issue with limited and
potentially inadequate scope to cover our product
candidates.
Interference,
derivation or other proceedings brought at the USPTO may be
necessary to determine the priority or patentability of inventions
with respect to our patent applications or those of our licensors
or potential partners. Litigation or USPTO proceedings brought by
us may fail or may be invoked against us by third parties. Even if
we are successful, domestic or foreign litigation, or USPTO or
foreign patent office proceedings may result in substantial costs
and distraction to our management. We may not be able, alone or
with our licensors or potential partners, to prevent
misappropriation of our proprietary rights, particularly in
countries where the laws may not protect such rights as fully as in
the United States.
Furthermore,
because of the substantial amount of discovery required in
connection with intellectual property litigation or other
proceedings, there is a risk that we may, intentionally or
incidentally, disclose some of our confidential results of
hearings, motions or other interim proceedings or developments or
public access to related documents. If investors perceive these
results to be negative, the market price for our common stock could
be significantly harmed.
Our success will depend on our ability to partner or sub-license
our product candidates and their subsequent successful
commercialization.
Our
MU1140 homologs research to identify a product candidate is in
early-stage development and is expected to require partners with
substantial financial resources to continue the development of the
product to commercialization. In addition, the product candidate
has not received regulatory approval in any jurisdiction and it may
never receive approval or, if approvals are obtained, may never be
commercialized successfully. In addition, we do not know whether
any of our clinical trials will be successful or can be completed
within our current expected budget. For our MU1140 homologs and
other antibiotic product candidates, we have performed nonclinical
testing using native MU1140 and expect to continue to pursue the
nonclinical testing of our MU1140 homologs and other antibiotic
product candidates during 2023. We would expect the IND for a
first-in-human clinical trial of a lantibiotic compound to be filed
with the FDA based on our ability to identify a new lead compound
and complete the requisite pre-clinical studies, contingent on
sufficient funding. Even if we are able to partner and conduct
successful clinical trials or the required regulatory approvals are
obtained, we may never be able to generate significant revenues
from our MU1140 homologs or other antibiotic product candidates or
other product candidates. If our MU1140 homologs product candidate
or our other product candidates under the Lantibiotics Program are
unsuccessful, we may be unable to generate sufficient revenues to
sustain and grow our business, and our business, financial
condition and results of operations will be materially adversely
affected.
If our intellectual property rights do not adequately protect our
products or product candidates, or if third parties claim we are
infringing their intellectual property rights, others could compete
against us more directly or we could be subject to significant
litigation. Such results could prevent us from marketing our
products or product candidates and hurt our
profitability.
Our
product and product candidates are protected by patents and patent
applications. Our success depends in part on our ability to obtain
patents or rights to patents, protect trade secrets, operate
without infringing upon the proprietary rights of others, and
prevent others from infringing on our patents, trademarks and other
intellectual property rights. We will be able to protect our
intellectual property from unauthorized use by third parties only
to the extent that it is covered by valid and enforceable patents,
trademarks and licenses. Patent protection generally involves
complex legal and factual questions and, therefore, enforceability
of patent rights cannot be predicted with certainty. Patents, if
issued, may be challenged, invalidated or circumvented. Thus, any
patents that we own or license from others may not provide adequate
protection against competitors. In addition, any future patent
applications may fail to result in patents being issued. Also,
those patents that are issued may not provide us with adequate
proprietary protection or competitive advantages against
competitors with similar product candidates. Moreover, the laws of
certain foreign countries do not protect intellectual property
rights to the same extent as do the laws of the United
States.
In
addition to patents and trademarks, we rely on trade secrets and
proprietary know-how. We seek protection of these rights, in part,
through confidentiality and proprietary information agreements.
These agreements may not provide meaningful protection or adequate
remedies for violation of our rights in the event of unauthorized
use or disclosure of confidential and proprietary information.
Failure to protect our proprietary rights could seriously impair
our competitive position.
In
the event of an infringement or violation, we may face litigation
and may be prevented from pursuing product development or
commercialization. We may receive in the future, notice of claims
of infringement of other parties’ proprietary rights. We may not
have the financial resources to defend against claims of
infringement by other parties or to prosecute third parties for
infringement of our intellectual property. Infringement or other
claims could be asserted or prosecuted against us in the future and
it is possible that past or future assertions or prosecutions could
harm our business.
Our business and operations would suffer in the event of
cybersecurity/information systems risk.
Despite
the implementation of security measures, our internal computer
systems, and those of our manufacturers and other third parties on
which we rely, are vulnerable to damage from computer viruses,
malware, ransomware, unauthorized access, natural disasters, fire,
explosions or large-scale accidents, power outages or surges,
terrorism, successful breaches, employee malfeasance, or human or
technological error, war and telecommunication and electrical
failures. In addition, our systems safeguard important confidential
personal data regarding our subjects. If a disruption event were to
occur and cause interruptions in our operations, it could result in
a material disruption of our drug development programs. For
example, the loss of clinical trial data from completed, ongoing or
planned clinical trials could result in delays in our regulatory
approval efforts and significantly increase our costs to recover or
reproduce the data. To the extent that any disruption or security
breach results in a loss of or damage to our data or applications,
or inappropriate disclosure of confidential or proprietary
information, we could incur liability and the further development
of our product candidates could be delayed.
Security breaches and other disruptions to our information
technology systems or those of the vendors on whom we rely could
compromise our information and expose us to liability, reputational
damage, or other costs.
In
the ordinary course of our business, we and our current and future
strategic partners, vendors, contractors, and consultants collect
and store sensitive data, including intellectual property, our
proprietary business information and data about our clinical
participants, suppliers and business partners and personally
identifiable information. The secure maintenance of this
information is critical to our operations and business strategy.
Some of this information represents an attractive target of
criminal attack by malicious third parties with a wide range of
motives and expertise, including nation-states, organized criminal
groups, “hacktivists,” patient groups, disgruntled current or
former employees and others. Our ongoing operating activities also
depend on functioning information technology systems. Cyberattacks
are of ever-increasing levels of sophistication, and, despite our
security measures, our information technology systems and
infrastructure and those of our vendors and partners are not immune
to such attacks or breaches.
In
2020, several domestic and foreign security agencies announced that
government actors or government-affiliated actors were specifically
targeting organizations engaging in COVID-19 vaccine development
and research. Our development of NT-CoV2-1 may result in greater
risk of cyber attack. Any such attack could result in a material
compromise of our networks, and the information stored there could
be accessed, publicly disclosed, lost, rendered, permanently or
temporarily, inaccessible. Furthermore, we may not promptly
discover a system intrusion. Attacks could have a material impact
on our business, operations or financial results. Any access,
disclosure or other loss of information, whether stored by us or
our partners, or other cyberattack causing disruption to our
business, including ransomware, could result in reputational,
business, and competitive harms, significant costs related to
remediation and strengthening our cyber defenses, legal claims or
proceedings, government investigations, liability including under
laws that protect the privacy of personal information, and
increased insurance premium, all of which could adversely affect
our business. We also may need to pay a ransom if a “ransomware”
infection prevents access or use of our systems and we may face
reputational and other harms in addition to the cost of the ransom
if an attacker steals certain critical data in the course of such
an attack.
We may incur costs of addressing a cybersecurity
incident.
Cybersecurity
incidents have increased in number and severity recently and it is
expected that these trends will continue. Should we be affected by
such an incident, we may incur substantial costs and suffer other
negative consequences, which may include:
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investigation
costs and costs to engage specialized consultants or costs of
ransom demands; |
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remediation
costs, such as liability for stolen assets or information, repairs
of system damage, and incentives to customers or business partners
in an effort to maintain relationships after an attack;
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litigation
and legal risks, including regulatory actions by state and federal
regulators. |
Our business and operations would suffer in the event of failures
in our internal computer systems or those of our
collaborators.
Despite
the implementation of security measures, our internal computer
systems and those of our current and any future partners,
contractors and consultants are vulnerable to damage from computer
viruses, unauthorized access, natural disasters, terrorism, war and
telecommunication and electrical failures. While we have not
experienced any such material system failure, accident or security
breach to date, if such an event were to occur and cause
interruptions in our operations, it could result in a material
disruption of our development programs and our business operations.
For example, the loss of clinical development or manufacturing
records or clinical trial data from completed or future clinical
trials could result in delays in our regulatory approval efforts
and significantly increase our costs to recover or reproduce the
data. To the extent that any disruption or security breach were to
result in a loss of, or damage to, our data or applications, or
inappropriate disclosure of confidential or proprietary
information, we could incur liability and the further development
of our product candidates could be delayed.
Risks
Related to Government Regulations
Our product candidates are subject to substantial government
regulation, including the regulation of nonclinical testing and
clinical trials. If we are unable to obtain regulatory approval for
our product candidates, we will be unable to generate
revenues.
The
production and marketing of products which may be developed from
our NT-CoV2-1 vaccine product candidate, and our MU1140 homologs,
or otherwise and our research and development, nonclinical testing
and clinical trial activities are subject to extensive regulation
and review by numerous governmental authorities. Most of the
product candidates we are developing must undergo rigorous
nonclinical testing and clinical trials and an extensive regulatory
approval process before they can be marketed in the United States
or internationally.
If we
fail to obtain regulatory approval for our product candidates, we
may have to cease further development. Clinical trials on our
product candidates are expected to take several years to fully
complete. The commencement or completion of nonclinical studies or
clinical trials can be delayed or prevented for a number of
reasons, including:
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an
inability to raise sufficient capital to commence, conduct, or
complete pre-clinical testing and clinical trials; |
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insufficient
or inadequate supply or quality of a product candidate or other
materials necessary to conduct our clinical trials; |
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difficulties
in finding a partner with the resources to support large and
expensive clinical development and commercialization
costs; |
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findings
in nonclinical trials; |
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difficulties
obtaining regulatory approval to commence a clinical trial or
complying with conditions imposed by a regulatory authority
regarding the scope or term of a clinical trial; |
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delays
in reaching or failing to reach agreement on acceptable terms with
prospective contract research organizations, or CROs, and trial
sites, the terms of which can be subject to extensive negotiation
and may vary significantly among different CROs and trial
sites; |
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difficulties
obtaining institutional review board, or IRB, approval to conduct a
clinical trial at a prospective site; |
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challenges
recruiting and enrolling patients to participate in clinical trials
for a variety of reasons, including the size and nature of patient
population, proximity of patients to clinical sites, eligibility
criteria for the trial, nature of the trial protocol, the
availability of approved effective treatments for the relevant
condition and competition from other clinical trial programs for
similar indications; |
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limitations
directly caused by, or restrictions imposed in response to, the
COVID-19 pandemic, including our ability to conduct research and
development and clinical trials, to engage or continue to engage
with third-party contractors and suppliers or to comply with
regulatory obligations relating to our business; |
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severe
or unexpected drug or biologic-related side effects experienced by
patients in a clinical trial; and |
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difficulties
retaining patients who have enrolled in a clinical trial but may be
prone to withdraw due to rigors of the trial, lack of efficacy,
side effects, or personal issues, or who are lost to further follow
up. |
Clinical
trials also may be delayed or terminated as a result of ambiguous
or negative interim results. In addition, a clinical trial may be
suspended or terminated by us, the FDA, the IRBs at the sites where
the IRBs are overseeing a trial, or a data safety monitoring board,
or DSMB, overseeing the clinical trial at issue, or other
regulatory authorities due to a number of factors,
including:
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failure
to conduct the clinical trial in accordance with regulatory
requirements or our clinical protocols; |
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inspection
of the clinical trial operations or trial sites by the FDA or other
regulatory authorities; |
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inspection
of manufacturing and drug packaging operations by regulatory
authorities; |
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unforeseen
safety issues or lack of effectiveness; and |
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lack
of adequate funding to continue the clinical trial. |
We
cannot assure you that clinical trials will demonstrate the safety
or effectiveness of any of our product candidates, or will
otherwise satisfy regulatory requirements. Our nonclinical studies
or clinical trials may produce negative or inconclusive results,
there may be inconsistencies between early clinical trial results
and results obtained in later clinical trials, and we may decide,
or regulators may require us, to conduct additional nonclinical
studies or clinical trials. Moreover, nonclinical and clinical data
are often susceptible to varying interpretations and analyses, and
many companies that have believed their product candidates
performed satisfactorily in nonclinical studies and clinical trials
have nonetheless failed to obtain FDA approval for their products.
If we are unable to resolve the FDA’s concerns, we will not be able
to obtain regulatory approval for these product
candidates.
The
pre-marketing approval process can be particularly expensive,
uncertain and lengthy, and a number of products for which FDA or
other governmental regulatory approval has been sought by other
companies have never been approved for marketing. In addition to
testing and approval procedures, extensive regulations also govern
marketing, manufacturing, distribution, labeling, and
record-keeping procedures. If we do not comply with applicable
regulatory requirements, such violations could result in warning
letters, non-approval, suspensions of regulatory approvals or
ongoing clinical trials, civil penalties and criminal fines,
product seizures and recalls, operating restrictions, injunctions,
and criminal prosecution.
We
may encounter such delays and rejection of our product candidates
by the FDA or other regulatory authority may also adversely affect
our business. Such delays or rejection may be encountered due to,
among other reasons, government or regulatory delays, lack of
efficacy during clinical trials, unforeseen safety issues, or
changes in regulatory policy during the period of product
development. More stringent regulatory approval processes in
product clearance and enforcement activities could result in our
experiencing longer approval cycles, more uncertainty, greater
risk, and higher expenses. Even if regulatory approval of a product
is granted, this approval may entail limitations on uses for which
the product may be labeled and promoted. It is possible, for
example, that we may not receive FDA approval to market products
based on our licensed, patented product candidates for different
indications or to market updated products that represent extensions
of our basic product candidates. In addition, we may not receive
FDA approval to export our products based on our licensed, patented
product candidates in the future, and countries to which products
are to be exported may not approve them for import.
From
time to time, legislative or regulatory proposals are introduced
that could alter the review and approval process relating to our
product candidates. It is possible that the applicable regulatory
authority will issue additional regulations further restricting the
sale of our product candidates. Any change in legislation or
regulations that govern the review and approval process relating to
our future product candidates could make it more difficult and
costlier to obtain approval for new products based on our product
candidates, or to produce, market, and distribute such products if
approved.
We may be unable to obtain regulatory approval for our SARS-CoV-2
vaccine product candidate, or other early-stage product candidates
under applicable regulatory requirements. The FDA and foreign
regulatory bodies have substantial discretion in the approval
process, including the ability to delay, limit or deny approval of
product candidates. The delay, limitation or denial of any
regulatory approval would adversely impact commercialization, our
potential to generate revenue, our business and our operating
results.
We
are not permitted to market any of our current product candidates
in the United States until we receive approval of an NDA or BLA
from the FDA. We are also not permitted to market any of our
current product candidates in any foreign countries until we
receive the requisite approval from the applicable regulatory
authorities of such countries. Failure to obtain such regulatory
approvals will delay or prevent us from commercializing any of our
current or future product candidates.
To
gain approval to market a new drug such as a lantibiotic compound,
or a new biological product such as our SARS-CoV-2 vaccine product
candidate or a lantibiotic product candidate, we must provide the
FDA and/or foreign regulatory authorities with, among other things,
extensive pre-clinical and clinical data that adequately
demonstrates the safety and efficacy of the drug in its intended
indication and information to demonstrate the adequacy of the
manufacturing methods to assure the drug’s identity, strength,
quality and purity. The development and approval of new drug
product candidates involves a long, expensive and uncertain
process, and delay or failure can occur at any stage. A number of
companies in the pharmaceutical and biopharmaceutical industries
have suffered significant setbacks in clinical trials, including in
Phase 3 clinical development, even after promising results in
earlier pre-clinical studies or clinical trials. These setbacks
have been caused by, among other things, observations during
clinical trials regarding safety or efficacy, such as previously
unreported adverse events. Success in pre-clinical testing and
early clinical trials does not ensure success in later clinical
trials, and the results of clinical trials by other parties may not
be indicative of the results in trials we may conduct. Further,
different results may be achieved depending upon whether the “per
protocol”, or PP, analysis is used to report data results or
whether the “modified intent-to-treat,” or MITT, approach is used.
Accordingly, regardless of the outcome of any Phase 2 trials, any
Phase 3 trials we may conduct may not be successful.
The
FDA and foreign regulatory bodies have substantial discretion in
the drug approval process, including the ability to delay, limit or
deny approval of product candidates for many reasons. The FDA or
the applicable foreign regulatory body may:
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disagree
with the design or implementation of one or more clinical
trials; |
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decline
to deem a product candidate safe and effective for its proposed
indication, or deem a product candidate’s safety or other perceived
risks to outweigh its clinical or other benefits; |
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find
the data from pre-clinical studies and clinical trials does not
sufficiently support approval, or the results of clinical trials
may not meet the level of statistical or clinical significance
required for approval; |
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disagree
with our interpretation of data from pre-clinical studies or
clinical trials performed by us or third parties; |
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determine
the data collected from clinical trials are insufficient to support
the submission or approval of an NDA or other applicable regulatory
filing; |
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require
additional pre-clinical studies or clinical trials; |
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identify
deficiencies in the formulation, quality control, labeling or
specifications of our current or future product
candidates; |
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grant
approval contingent on the performance of costly additional
post-approval clinical trials; |
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approve
our current or any future product candidates for a more limited
indication or a narrower patient population than we originally
requested or with strong warnings that may affect
marketability; |
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decline
to approve the labeling that we believe is necessary or desirable
for the successful commercialization of our product
candidates; |
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require
a Risk Evaluation and Mitigation Strategy, or REMS, with monitoring
requirements or distribution limitations. For example, it is
possible that the FDA could require distribution controls in the
approval, if any, of our product candidates to prevent inadvertent
exposure to pregnant women; |
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decline
to approve of the manufacturing processes, controls or facilities
of third-party manufacturers or testing labs with whom we contract;
or |
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change
its approval policies or adopt new regulations in a manner
rendering our clinical data or regulatory filings insufficient for
approval. |
Any
delay, limitation or denial of any regulatory approval would
adversely impact commercialization, our potential to generate
revenue, our business and our operating results.
Delays or difficulties in the enrollment of patients in clinical
trials may result in additional costs and delays in our ability to
generate significant revenues, and may delay or prevent our receipt
of any regulatory approvals necessary to commercialize our planned
and future products.
We
may not be able to initiate or continue, or complete in a timely
fashion clinical trials for NT-CoV2-1 or our other product
candidates if we are unable to locate and enroll a sufficient
number of eligible patients to participate in these trials as
required by the FDA or similar regulatory authorities outside the
United States. Many companies are currently or will soon be
researching, developing and testing therapeutic and vaccine product
candidates specifically for or with potential application to
SARS-CoV-2 or COVID-19, which may reduce our ability to conduct
clinical trials for our SARS-CoV-2 vaccine product candidate. For
example, even if we are able to identify potential patients or
eligibility criteria for a NT-CoV2-1 clinical trial, patients who
are otherwise eligible for such clinical trials may instead enroll
in the clinical trials of our competitors’ SARS-CoV-2 product
candidates or opt not to enroll due to other competitive vaccines
being administered by competitors based upon emergency use
authorization.
Patient
enrollment is affected by other factors including:
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the
severity of the disease under investigation; |
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the
eligibility criteria for the study in question; |
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the
perceived risks and benefits of the product candidate under
study; |
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the
efforts to facilitate timely enrollment in clinical
trials; |
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the
patient referral practices of physicians; |
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the
ability to monitor patients adequately during and after treatment;
and |
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the
proximity and availability of clinical trial sites for prospective
patients. |
Our
inability to enroll a sufficient number of patients for our
clinical trials would result in significant delays, could require
us to abandon one or more clinical trials altogether and could
delay or prevent our receipt of necessary regulatory approvals.
Enrollment delays in our clinical trials may result in increased
development costs for our product candidates, which would cause the
value of our company to decline and impede our ability to obtain
additional financing.
Any product candidates that we commercialize will be subject to
ongoing and continued regulatory review.
Even
after we achieve U.S. regulatory approval for a product candidate,
if any, we will be subject to continued regulatory review and
compliance obligations. For example, the FDA may impose significant
restrictions on the approved indicated uses for which our product
candidates may be marketed or on the conditions of approval. A
product candidate’s approval may contain requirements for
potentially costly post-approval studies and surveillance,
including Phase 4 clinical trials or a REMS to monitor the safety
and efficacy of the product. We will also be subject to ongoing FDA
obligations and continued regulatory review with respect to, among
other things, the manufacturing, processing, labeling, packaging,
distribution, adverse event reporting, storage, advertising,
promotion and recordkeeping for our product candidates. These
requirements include submissions of safety and other post-marketing
information and reports, registration, continued compliance with
the FDA’s good clinical practice, or GCP, requirements and good
laboratory practice requirements, which are regulations and
guidelines the FDA would apply to all of our product candidates in
clinical and pre-clinical development, along with any clinical
trials that we conduct post-approval, and continued compliance with
the FDA’s cGMP requirements pursuant to which manufacturing
facilities are subject to continual review and periodic inspections
by the FDA. To the extent that a product candidate is approved for
sale in other countries, we may be subject to similar restrictions
and requirements imposed by laws and government regulators in those
countries.
If
we, our product candidates or the manufacturing facilities for our
product candidates fail to comply with applicable regulatory
requirements, a regulatory agency may:
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impose
restrictions on the marketing or manufacturing of the product,
suspend or withdraw product approvals or revoke necessary
licenses; |
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issue
warning letters, show cause notices or untitled letters describing
alleged violations, which may be publicly available; |
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mandate
modifications to promotional materials or require us to provide
corrective information to healthcare practitioners; |
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require
us to enter into a consent decree, which can include imposition of
various fines, reimbursements for inspection costs, required due
dates for specific actions and penalties for noncompliance;
commence criminal investigations and prosecutions; |
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impose
injunctions; |
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impose
other civil or criminal penalties; |
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suspend
any ongoing clinical trials; |
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delay
or refuse to approve pending applications or supplements to
approved applications filed by us; |
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refuse
to permit drugs or active ingredients to be imported or exported to
or from the United States; |
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suspend
or impose restrictions on operations, including costly new
manufacturing requirements; or |
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seize
or detain products or require us to initiate a product
recall. |
The
regulations, policies or guidance of the FDA and other applicable
government agencies may change and new or additional statutes or
government regulations may prevent or delay regulatory approval of
our product candidates or further restrict or regulate
post-approval activities. We cannot predict the likelihood, nature
or extent of adverse government regulation that may arise from
future legislation or administrative action, either in the United
States or abroad. If we are not able to achieve and maintain
regulatory compliance, we may not be permitted to market our
product candidates, which would materially and adversely affect our
ability to generate revenue and achieve or maintain
profitability.
Our product candidates may cause serious or undesirable side
effects or possess other unexpected properties that could delay or
prevent their regulatory approval, limit the commercial profile of
approved labeling or result in post-approval regulatory
action.
Unforeseen
side effects from any of our product candidates could arise either
during clinical development or, if approved, after marketing such
product. Undesirable side effects caused by product candidates
could cause us or regulatory authorities to interrupt, modify,
delay or halt clinical trials and could result in a more
restrictive label or the delay or denial of regulatory approval by
the FDA or comparable foreign authorities. Results of clinical
trials could reveal a high and unacceptable severity and prevalence
of side effects. In such an event, trials could be suspended or
terminated and the FDA or comparable foreign regulatory authorities
could order us to cease further development of or deny approval of
product candidates for any or all targeted indications. The
drug-related side effects could affect patient recruitment or the
ability of enrolled patients to complete the trial or result in
product liability claims. Any of these occurrences may harm our
business, financial condition, operating results and
prospects.
Additionally,
if we or others identify undesirable side effects, or other
previously unknown problems, caused by our product candidates after
obtaining U.S. or foreign regulatory approval or other products
with the same or related active ingredients, a number of
potentially negative consequences could result,
including:
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regulatory
authorities may withdraw their approval of the product; |
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regulatory
authorities may require a recall of the product or we may
voluntarily recall a product; |
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regulatory
authorities may require the addition of warnings or
contraindications in the product labeling, narrowing of the
indication in the product label or issuance of field alerts to
physicians and pharmacies; |
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we
may be required to create a medication guide outlining the risks of
such side effects for distribution to patients or institute a
REMS; |
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we
may be subject to limitations as to how we promote the
product; |
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we
may be required to change the way the product is administered or
modify the product in some other way; |
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the
FDA or applicable foreign regulatory authority may require
additional clinical trials or costly post-marketing testing and
surveillance to monitor the safety or efficacy of the
product; |
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sales
of the product may decrease significantly; |
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we
could be sued and held liable for harm caused to patients;
and |
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our
brand and reputation may suffer. |
Any
of the above events could prevent us from achieving or maintaining
market acceptance of the affected product candidate and could
substantially increase the costs of commercializing our product
candidates.
If any of our product candidates are approved for marketing and we
are found to have improperly promoted off-label uses, or if
physicians misuse our products or use our products off-label, we
may become subject to prohibitions on the sale or marketing of our
products, product liability claims and significant fines, penalties
and sanctions, and our brand and reputation could be
harmed.
The
FDA and other regulatory agencies strictly regulate the marketing
and promotional claims that are made about drug products. In
particular, a product may not be promoted for uses or indications
that are not approved by the FDA or such other regulatory agencies
as reflected in the product’s approved labeling. If we are found to
have promoted off-label uses of any of our product candidates, we
may receive a warning or untitled letters and become subject to
significant liability, which would materially harm our business.
Both federal and state governments have levied large civil and
criminal fines against companies for alleged improper promotion and
have enjoined several companies from engaging in off-label
promotion. If we become the target of such an investigation or
prosecution based on our marketing and promotional practices, we
could face similar sanctions, which would materially harm our
business. In addition, management’s attention could be diverted
from our business operations, significant legal expenses could be
incurred and our brand and reputation could be damaged. The FDA has
also requested that companies enter into consent decrees or
permanent injunctions under which specified promotional conduct is
changed or curtailed. If we are deemed by the FDA to have engaged
in the promotion of our products for off-label use, we could be
subject to FDA regulatory or enforcement actions, including the
issuance of an untitled letter, a warning letter, injunction,
seizure, civil fine or criminal penalties. It is also possible that
other federal, state or foreign enforcement authorities might take
action if they determine our business activities constitute
promotion of an off-label use, which could result in significant
penalties, including criminal, civil or administrative penalties,
damages, fines, disgorgement, exclusion from participation in
government healthcare programs and the curtailment or restructuring
of our operations.
We
cannot, however, prevent a physician from using our product
candidates in ways that fall outside the scope of the approved
indications, as he or she may deem appropriate in his or her
medical judgment. Physicians may also misuse our product candidates
or use improper techniques, which may lead to adverse results, side
effects or injury and, potentially, subsequent product liability
claims. Furthermore, the use of our product candidates for
indications other than those cleared by the FDA and/or other
regulatory agencies may not effectively treat such conditions,
which could harm our brand and reputation among both physicians and
patients.
We may also be subject to healthcare laws, regulation and
enforcement and our failure to comply with those laws could
adversely affect our business, operations and financial
condition.
Certain
federal and state healthcare laws and regulations pertaining to
fraud and abuse and patients’ rights are and will be applicable to
our business. We are subject to regulation by both the federal
government and the states in which we conduct our business. The
laws and regulations that may affect our ability to operate
include:
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the
federal healthcare program anti-kickback statute, which prohibits,
among other things, any person or entity from knowingly and
willfully offering, soliciting, receiving or providing any
remuneration (including any kickback, bribe or rebate), directly or
indirectly, overtly or covertly, in cash or in kind, to induce
either the referral of an individual or in return for the purchase,
lease, or order of any good, facility item or service, for which
payment may be made, in whole or in part, under federal healthcare
programs such as the Medicare and Medicaid programs; |
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federal
civil and criminal false claims laws and civil monetary penalty
laws, including, for example, the United States False Claims Act,
which impose criminal and civil penalties, including civil
whistleblower or qui tam actions, against individuals or entities
for, among other things, knowingly presenting, or causing to be
presented, to the federal government, including the Medicare and
Medicaid programs, claims for payment that are false or fraudulent
or making a false statement to avoid, decrease or conceal an
obligation to pay money to the federal government; |
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the
federal Health Insurance Portability and Accountability Act of
1996, as amended by the Health Information Technology for Economic
and Clinical Health Act, or HIPAA, which prohibits knowingly and
willfully executing, or attempting to execute, a scheme to defraud
any healthcare benefit program or obtain, by means of false or
fraudulent pretenses, representations or promises, any of the money
or property owned by, or under the custody or control of, any
healthcare benefit program, regardless of the payor (i.e., public
or private), knowingly and willfully embezzling or stealing from a
health care benefit program, willfully obstructing a criminal
investigation of a health care offense and knowingly and willfully
falsifying, concealing or covering up by any trick or device a
material fact or making any materially false statements in
connection with the delivery of, or payment for, healthcare
benefits, items or services relating to healthcare
matters; |
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HIPAA
and related implementing regulations, which impose obligations on
covered entities, including healthcare providers, health plans, and
healthcare clearinghouses, as well as their respective business
associates that create, receive, maintain or transmit individually
identifiable health information for or on behalf of a covered
entity, with respect to safeguarding the privacy, security and
transmission of individually identifiable health
information; |
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the
federal physician sunshine requirements under the Patient
Protection and Affordable Care Act, or ACA, which require
manufacturers of drugs, devices, biologics and medical supplies to
report annually to the Centers for Medicare & Medicaid Services
information related to payments and other transfers of value
provided to physicians and teaching hospitals, and ownership and
investment interests held by physicians and their immediate family
members, with such information published on a searchable website on
an annual basis; and |
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state
law equivalents of each of the above federal laws, such as
anti-kickback and false claims laws, which may apply to items or
services reimbursed by any third-party payor, including commercial
insurers; state laws that require pharmaceutical companies to
comply with the pharmaceutical industry’s voluntary compliance
guidelines and the applicable compliance guidance promulgated by
the federal government, or otherwise restrict payments that may be
provided to healthcare providers and other potential referral
sources; state laws that require drug manufacturers to report
information related to payments and other transfers of value to
healthcare providers or marketing expenditures; and state laws
governing the privacy and security of health information in certain
circumstances, many of which differ from each other in significant
ways and may not have the same effect, thus complicating compliance
efforts. |
Because
of the breadth of these laws and the narrowness of the statutory
exceptions and safe harbors available, it is possible that some of
our business activities could be subject to challenge under one or
more of such laws. In addition, recent health care reform
legislation has strengthened these laws. For example, the recently
enacted ACA, among other things, amended the intent requirement of
the federal anti-kickback statute and certain criminal healthcare
fraud statutes. A person or entity no longer needs to have actual
knowledge of the statute or specific intent to violate it. In
addition, the ACA provides that the government may assert that a
claim including items or services resulting from a violation of the
federal anti-kickback statute constitutes a false or fraudulent
claim for purposes of the federal civil False Claims
Act.
Achieving
and sustaining compliance with these laws may prove costly. In
addition, any action against us for violation of these laws, even
if we successfully defend against it, could cause us to incur
significant legal expenses and divert our management’s attention
from the operation of our business. If our operations are found to
be in violation of any of the laws described above or any other
governmental laws or regulations that apply to us, we may be
subject to penalties, including administrative, civil and criminal
penalties, damages, fines, disgorgement, the exclusion from
participation in federal and state healthcare programs, individual
imprisonment or the curtailment or restructuring of our operations,
any of which could materially and adversely affect our ability to
operate our business and our financial results.
Our employees, independent contractors, principal investigators,
consultants, vendors and CROs may engage in misconduct or other
improper activities, including noncompliance with regulatory
standards and requirements.
We
are exposed to the risk that our employees, independent
contractors, principal investigators, consultants, vendors and CROs
may engage in fraudulent or other illegal activity. Misconduct by
these persons could include intentional, reckless or negligent
conduct or unauthorized activity that violates laws or regulations,
including those laws requiring the reporting of true, complete and
accurate information to the FDA or foreign regulatory authorities;
manufacturing standards; federal, state and foreign healthcare
fraud and abuse laws and data privacy; or laws that require the
true, complete and accurate reporting of financial information or
data. In particular, sales, marketing and other business
arrangements in the healthcare industry are subject to extensive
laws intended to prevent fraud, kickbacks, self-dealing and other
abusive practices. These laws may restrict or prohibit a wide range
of business activities, including research, manufacturing,
distribution, pricing, discounting, marketing and promotion, sales
commission, customer incentive programs and other business
arrangements. Activities subject to these laws also involve the
improper use of information obtained in the course of clinical
trials, or illegal misappropriation of drug product, which could
result in regulatory sanctions or other actions or lawsuits
stemming from a failure to comply with such laws or regulations,
and serious harm to our reputation. In addition, federal
procurement laws impose substantial penalties for misconduct in
connection with government contracts and require certain
contractors to maintain a code of business ethics and conduct. If
any such actions are instituted against us, we may have to
terminate employees or others involved and the impact of such
termination can result in our experiencing delays and additional
costs associated with replacing the services being provided. If we
are not successful in defending ourselves or asserting our rights,
those actions could have a significant impact on our business,
including the imposition of civil, criminal and administrative
penalties, damages, monetary fines, possible exclusion from
participation in Medicare, Medicaid and other federal healthcare
programs, FDA debarment, contractual damages, reputational harm,
diminished profits and future earnings, and curtailment of our
operations, any of which could adversely affect our ability to
operate our business and our operating results.
Even if our current product candidates or any future product
candidates obtain regulatory approval, they may fail to achieve the
broad degree of health care payers, physician and patient adoption
and use necessary for commercial success.
The
commercial success of any of our current or future product
candidates, if approved, will depend significantly on the broad
adoption and use of the resulting product by health care payers,
physicians and patients for approved indications, and may not be
commercially successful. The degree and rate of physician and
patient adoption of our current or future product candidates, if
approved, will depend on a number of factors, including:
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the
clinical indications for which the product is approved and patient
demand for approved products that treat those
indications; |
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the
effectiveness of our product as compared to other available
therapies; |
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the
availability of coverage and adequate reimbursement from managed
care plans and other healthcare payors for any of our product
candidates that may be approved; |
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the
cost of treatment with our product candidates in relation to
alternative treatments and willingness to pay for the product, if
approved, on the part of patients; |
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acceptance
by physicians, major operators of clinics and patients of the
product as a safe and effective treatment; |
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physician
and patient willingness to adopt a new therapy over other available
therapies to treat approved indications; |
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overcoming
any biases physicians or patients may have toward particular
therapies for the treatment of approved indications; |
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proper
training and administration of our product candidates by physicians
and medical staff; |
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patient
satisfaction with the results and administration of our product
candidates and overall treatment experience; |
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the
willingness of patients to pay for certain of our product
candidates relative to other discretionary items, especially during
economically challenging times; |
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the
revenue and profitability that our product candidate may offer a
physician as compared to alternative therapies; |
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the
prevalence and severity of side effects; |
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limitations
or warnings contained in the FDA-approved labeling for our product
candidates; |
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any
FDA requirement to undertake a REMS; |
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the
effectiveness of our sales, marketing and distribution
efforts; |
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adverse
publicity about our product candidates or favorable publicity about
competitive products; and |
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potential
product liability claims. |
If
any of our current or future product candidates are approved for
use but fail to achieve the broad degree of physician and patient
adoption necessary for commercial success, our operating results
and financial condition will be adversely affected, which may
delay, prevent or limit our ability to generate revenue and
continue our operations.
If we are unable to achieve and maintain coverage and adequate
levels of reimbursement for any of our product candidates for which
we receive regulatory approval, or any future products we may seek
to commercialize, their commercial success may be severely
hindered.
As to
any of our product candidates that become available by prescription
only, our success will depend on the availability of coverage and
adequate reimbursement for our product from third-party payors.
Patients who are prescribed medicine for the treatment of their
conditions generally rely on third-party payors to reimburse all or
part of the costs associated with their prescription drugs. The
availability of coverage and adequate reimbursement from
governmental healthcare programs, such as Medicare and Medicaid,
and private third-party payors is critical to new product
acceptance. Coverage decisions may depend upon clinical and
economic standards that disfavor new drug products when more
established or lower cost therapeutic alternatives are already
available or subsequently become available. If any of our product
candidates fail to demonstrate attractive efficacy profiles, they
may not qualify for coverage and reimbursement. Even if we obtain
coverage for a given product, the resulting reimbursement payment
rates might not be adequate or may require co-payments that
patients find unacceptably high. Patients are unlikely to use our
prescription-only products unless coverage is provided and
reimbursement is adequate to cover a significant portion of the
cost of our products.
In
addition, the market for certain of our product candidates will
depend significantly on access to third-party payors’ drug
formularies, or lists of medications for which third-party payors
provide coverage and reimbursement. The industry competition to be
included in such formularies often leads to downward pricing
pressures on pharmaceutical companies. Also, third-party payors may
refuse to include a particular branded drug in their formularies or
otherwise restrict patient access to a branded drug when a less
costly generic equivalent or another alternative is
available.
Moreover,
third-party payors, whether foreign or domestic, or governmental or
commercial, are developing increasingly sophisticated methods of
controlling healthcare costs. In addition, in the United States,
although private third-party payors tend to follow Medicare, no
uniform policy of coverage and reimbursement for drug products
exists among third-party payors. Therefore, coverage and
reimbursement for drug products can differ significantly from payor
to payor. As a result, the coverage determination process is often
a time-consuming and costly process that will require us to provide
scientific and clinical support for the use of our product
candidates to each payor separately, with no assurance that
coverage and adequate reimbursement will be obtained.
Further,
we believe that future coverage and reimbursement will likely be
subject to increased restrictions in both the United States and in
international markets. Third-party coverage and reimbursement for
any of our product candidates for which we may receive regulatory
approval may not be available or adequate in either the United
States or international markets, which could harm our business,
financial condition, operating results and prospects.
If our products do not receive favorable third-party reimbursement,
or if new restrictive legislation is adopted, market acceptance of
our products may be limited and we may not generate significant
revenues.
Our
ability to commercialize our products will depend in part on the
extent to which appropriate reimbursement levels for the cost of
our proposed formulations and products and related treatments are
obtained by governmental authorities, private health insurers and
other organizations, such as Health Maintenance Organizations, or
HMOs. Reimbursement from third parties depends greatly on our
ability to present data which demonstrate positive outcomes and
reduced utilization of other products or services as well as cost
data which show that treatment costs using the new product are
equal to or less than what is currently covered for other products.
If our products do not receive favorable third-party reimbursement
and patients are unwilling or unable to pay for our products
out-of-pocket, it could limit our revenues and harm our
business.
The
continuing efforts of government and insurance companies, health
maintenance organizations and other payers of healthcare costs to
contain or reduce costs of health care may affect our future
revenues and profitability, and the future revenues and
profitability of our potential customers, suppliers and
collaborative partners and the availability of capital. For
example, in certain foreign markets, pricing or profitability of
prescription pharmaceuticals is subject to government control. In
the United States, recent federal and state government initiatives
have been directed at lowering the total cost of health care. In
March 2010, President Obama signed into law the Patient Protection
and Affordable Care Act, a sweeping law intended to broaden access
to health insurance, reduce or constrain the growth of healthcare
spending, enhance remedies against fraud and abuse, add new
transparency requirements for healthcare and health insurance
industries, impose new taxes and fees on the health industry and
impose additional health policy reforms. Federal and state
legislatures will likely continue to focus on health care reform,
controlling the cost of prescription pharmaceuticals and on the
reform of the Medicare and Medicaid systems. While we cannot
predict whether any such legislative or regulatory proposals will
be adopted, the announcement or adoption of such proposals could
materially harm our business, financial condition and results of
operations.
Risks
Related to Coronavirus Disease (COVID-19)
Our business has been, and may in the future be, adversely affected
by outbreaks of epidemic, pandemic or other contagious diseases,
including the COVID-19 pandemic.
Our
business operations expose us to risks associated with public
health crises, epidemics and pandemics. An epidemic or pandemic
disease outbreak, including the ongoing spread of COVID-19, could
cause significant disruption to our business operations or the
operations of our third-party manufacturers and CROs upon whom we
rely, as well as to our clinical trials, including as a result of
significant restrictions or bans on travel into and within the
countries in which our manufacturers produce our product candidates
or where we conduct our pre-clinical testing or our future clinical
trials. Such disruption could impede, delay, limit or prevent our
employees and CROs from continuing research and development
activities, the production, delivery or release of our product
candidates to our clinical trial sites, as well as clinical trial
investigators, patients or other critical staff from traveling to
or otherwise continuing to participate in our clinical trials, and
delay data collection and analysis and other related activities,
any of which could impede, delay, limit or prevent completion of
our ongoing pre-clinical testing or our future clinical trials
pre-clinical or commencement of new clinical trials, and ultimately
lead to the delay or denial of regulatory approval of our product
candidates, which would seriously harm our operations and financial
condition and increase our costs and expenses.
The
COVID-19 outbreak could also potentially affect the business of the
FDA, EMA or other health authorities, which could result in delays
in meetings related to planned or completed clinical trials and
ultimately of reviews and approvals of our product candidates. The
COVID-19 outbreak and mitigation measures also have had and may
continue to have an adverse impact on global economic conditions
which could have an adverse effect on our business and financial
condition, including impairing our ability to raise capital when
needed. The extent to which the spread of COVID-19 impacts our
results will depend on future developments that are highly
uncertain and cannot be predicted, including new information that
may emerge concerning the severity of the virus and the actions to
contain its impact. The severity of the coronavirus disease could
also make access to our existing supply chain difficult or
impossible and could materially impact our business. Any one or a
combination of the aforementioned events could have an adverse
effect on our business.
In
addition, during a global health crisis, one or more government
entities could take actions (such as via the Defense Production Act
in the U.S.) that diminish our rights or economic opportunities
with respect to our products. Our third-party service providers
could be impacted by government-imposed restrictions on services
they might otherwise offer. Any such action could cause us to
experience delays in the development, production, distribution or
export of our products and development candidates and increased
expenses.
Our ability to conduct clinical trials may be impeded, delayed,
limited or prevented entirely due to the spread of COVID-19, the
imposition of government restrictions and the concurrent
disruptions to ordinary business activities
globally.
As
the U.S. and foreign governments and nongovernmental organizations
continue to respond to the spread of COVID-19, our ability to
conduct clinical trials may be impeded, delayed, limited or
prevented entirely by a number of factors, including, but not
limited to, the following:
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delays
or difficulties in enrolling patients in our clinical
trials; |
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delays
or difficulties in clinical site initiation, including difficulties
in recruiting clinical site investigators and clinical site
staff; |
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diversion
of healthcare resources away from the conduct of clinical trials,
including the diversion of hospitals serving as our clinical trial
sites and hospital staff supporting the conduct of our clinical
trials; |
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interruption
of key clinical trial activities, such as clinical trial site
monitoring, due to limitations on travel imposed or recommended by
federal or state governments, employers and others; |
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limitations
in employee resources that would otherwise be focused on the
conduct of our clinical trials, including because of sickness of
employees or their families or the desire of employees to avoid
contact with large groups of people; |
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delays
in receiving approval from local regulatory authorities to initiate
our planned clinical trials; |
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delays
in clinical sites receiving the supplies and materials needed to
conduct our clinical trials; |
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interruption
in global shipping that may affect the transport of clinical trial
materials; |
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changes
in local regulations as part of a response to the COVID-19, which
may require us to change the ways in which our clinical trials are
conducted, which may result in unexpected costs, or to discontinue
the clinical trials altogether; |
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delays
in necessary interactions with local regulators, ethics committees
and other important agencies and contractors due to limitations in
employee resources or forced furlough of government employees;
and |
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refusal
of the FDA to accept data from clinical trials in affected
geographies outside the United States. |
As
the spread of COVID-19 continues, the extent to which COVID- may
impact our business and clinical trials will depend on future
developments, which are highly uncertain and cannot be predicted
with confidence, such as the ultimate geographic spread and density
of the