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AEterna Zentaris Inc.

aezs · TSX Healthcare
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FY2021 Annual Report · AEterna Zentaris Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 20-F

☐☐  Registration Statement Pursuant to Section 12(b) or 12(g) of The Securities Exchange Act of 1934

OR

X Annual Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934 for the fiscal year ended December 31, 2021

☐☐  Transition Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934

OR

OR

☐☐  Shell Company Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934

Commission file number 001-38064

AETERNA ZENTARIS INC.
(Exact Name of Registrant as Specified in its Charter)

Not Applicable
(Translation of Registrant’s Name into English)

Canada
(Jurisdiction of Incorporation)

c/o Norton Rose Fulbright Canada, LLP, 222 Bay Street, Suite 3000, PO Box 53, Toronto ON M5K 1E7
(Address of Principal Executive Offices)

Klaus Paulini
Telephone: +49-69-426020
E-mail: KPaulini@aezsinc.com
Weismüllerstr. 50
Frankfurt am Main, Germany
D-60314
(Name, Telephone, E-mail and Address of Company Contact Person)

Securities registered or to be registered pursuant to Section 12(b) of the Act:

Title of Each Class
Common Shares

Name of Each Exchange on Which Registered
NASDAQ Capital Market
Toronto Stock Exchange

Securities registered or to be registered pursuant to Section 12(g) of the Act: NONE

Securities for which there is a reporting obligation pursuant to Section 15(d) of the ACT: NONE

Indicate the number of outstanding shares of each of the issuer’s classes of capital or common stock as at the close of the period covered by the annual report: 121,397,007
Common Shares as at December 31, 2021.

Indicate by check mark whether the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No : X

If this report is an annual or transition report, indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Securities Exchange Act of
1934. Yes ☐ No X

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 X No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted and posted 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 and post such files). Yes X No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or an emerging growth company. See definitions of "accelerated
filer,” "large accelerated filer,” and "emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer ☐ Accelerated filer ☐ Non-accelerated filer X Emerging growth company ☐

If an emerging growth company that prepares its financial statements in accordance with U.S. GAAP, 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.

† The term "new or revised financial accounting standard” refers to any update issued by the Financial Accounting Standards Board to its Accounting Standards Codification
after April 5, 2012.

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 which basis of accounting the registrant has used to prepare the financial statements included in this filing:

US GAAP ☐ International Financial Reporting Standards as issued by the Other ☐

International Accounting Standards Board X

If "other” has been checked in response to the previous question, indicate by check mark which financial statement item the registrant has elected to follow. Item 17 ☐ Item 18 ☐

If this is an annual report, indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No X

Basis of Presentation

General

Except where the context otherwise requires, all references in this Annual Report on Form 20-F to the "Company”, "Aeterna Zentaris”, "Aeterna”, "we”, "us”, "our” or similar
words or phrases are to Aeterna Zentaris Inc. and its subsidiaries, taken together. In this Annual Report on Form 20-F, references to "$” and "U.S.$” are to United States (" U.S.”)
dollars, references to "CAN$” are to Canadian dollars and references to "EUR” and "€” are to euros, and references to "£” are to British Pounds. Unless otherwise indicated, all
information contained in this Annual Report on Form 20-F are presented as of December 31, 2021.

This Annual  Report  on  Form  20-F  also  contains  certain  information  regarding  products  or  product  candidates  that  may  potentially  compete  with  our  products  and  product
candidates, and such information has been primarily derived from information made publicly available by the companies developing such potentially competing products and
product candidates and has not been independently verified by Aeterna Zentaris.

Special Note on Forward-Looking Statements

This Annual Report on Form 20-F and the documents incorporated herein by reference contain "forward-looking statements” made pursuant to the safe-harbor provision of the
U.S.  Private  Securities  Litigation  Reform Act  of  1995,  which  reflect  our  current  expectations  regarding  future  events. All  statements  other  than  statements  of  historical  facts
included in or incorporated by reference into this Annual Report on Form 20-F, under the caption "Key Information—Risk Factors” filed with the relevant Canadian securities
regulatory authorities in lieu of an annual information form and with the U.S. Securities and Exchange Commission ("SEC”) that address activities, events or developments that we
expect,  believe  or  anticipate  will  or  may  occur  in  the  future  are  forward-looking  statements.  Our  forward-looking  statements  may  relate  to  the  Company’s  future  outlook  and
anticipated  events  or  results,  and  may  include  statements  regarding  the  financial  position,  business  strategy,  growth  strategy,  budgets,  operations,  financial  results,  taxes,
dividends, plans and objectives of the Company. Particularly, statements regarding future results, performance, achievements, prospects or opportunities of the Company are
forward-looking statements.  In some cases, forward-looking statements can be identified by the use of forward-looking terminology such as "plans”, "expects” or "does not
expect”, "is expected”, "budget”, "scheduled”, "estimates”, "forecasts”, "intends”, "anticipates” or "does not anticipate” or "believes”, or variations of such words and phrases or
state that certain actions, events or results "may”, "could”, "would”, "might”, "will” or "will be taken”, "occur” or "be achieved”.or the negative of these words or other words and
terms of similar meaning.

2

Certain forward-looking statements contained herein about prospective results of operations, financial position or cash flows may constitute a financial outlook. Such statements
are based on assumptions about future events, are given as at the date hereof and are based on economic conditions, proposed courses of action and management’s assessment
of the relevant information currently available. Management of the Company has approved the financial outlook as of the date hereof. Readers are cautioned that such financial
outlook information contained herein should not be used for purposes other than for which it is disclosed herein.

Forward-looking statements are based on the opinions and estimates of the Company as of the date of this Annual Report, and they are subject to known and unknown risks,
uncertainties, assumptions and other factors that may cause the actual results, level of activity, performance or achievements to be materially different from those expressed or
implied by such forward-looking statements, including but not limited to the factors described in "Risk Factors” and those relating to: Aeterna’s expectations with respect to the
DETECT-trial (including regarding the enrollment of subjects in the DETECT-trial, the application of the macimorelin growth hormone stimulation tests and the completion of the
DETECT-trial); Aeterna’s expectations regarding conducting pre-clinical research to identify and characterize an AIM Biologicals-based development candidate for the treatment
of NMOSD as well as Parkinson’s disease, and developing a manufacturing process for selected candidates; Aeterna’s expectations regarding conducting assessments in relevant
Parkinson’s disease models; The University of Queensland undertaking a subsequent investigator initiated clinical trial evaluating macimorelin as a potential therapeutic for the
treatment of ALS and Aeterna formulating a pre-clinical development plan for same; the commencement of Aeterna’s formal pre-clinical development of AEZS-150 in preparation
for a potential IND filing for conducting the first in-human clinical study of AEZS-150; Aeterna’s plans to perform challenge experiments, select a development candidate, start
clinical development and establish a manufacturing process for the orally active COVID-19 (SARS-CoV-2) and Chlamydia live-attenuated bacterial vaccine.

Forward-looking statements involve known and unknown risks and uncertainties, and other factors which may cause the actual results, performance or achievements stated herein
to be materially different from any future results, performance or achievements expressed or implied by the forward-looking information.  Such risks and uncertainties include,
among others, our reliance on the success of the pediatric clinical trial in the European Union and U.S. for Macrilen™ (macimorelin); the commencement of the DETECT-trial may be
delayed or we may not obtain regulatory approval to initiate that study; we may be unable to enroll the expected number of subjects in the DETECT-trial and the result of the
DETECT-trial may not support receipt of regulatory approval in CGHD; the coronavirus vaccine platform technology (and any vaccine candidates using that technology) licensed
from  the  University  of  Wuerzburg  has  never  been  tested  in  humans  and  so  further  pre-clinical  or  clinical  studies  of  that  technology  and  any  vaccine  developed  using  that
technology may not be effective as a vaccine against COVID-19 (SARS-CoV-2) or any other coronavirus disease; the timeline to develop a vaccine may be longer than expected;
such technology or vaccines may not be capable of being used orally, may not have the same characteristics as vaccines previously approved using the Salmonella Typhi Ty21a
carrier strain; results from ongoing or planned pre-clinical studies of macimorelin by the  University of  Queensland or for our other products under development may not be
successful or may not support advancing the product to human clinical trials; our ability to raise capital and obtain financing to continue our currently planned operations; our
now heavy dependence on the success of Macrilen™ (macimorelin) and related out-licensing arrangements and the continued availability of funds and resources to successfully
commercialize the product, including our heavy reliance on the success of the license agreement and the amended license agreement (collectively the Novo Amended License
Agreement); the global instability due to the global pandemic of COVID-19, and its unknown potential effect on our planned operations; our ability to enter into out-licensing,
development, manufacturing, marketing and distribution agreements with other pharmaceutical companies and keep such agreements in effect; and our ability to continue to list
our common shares on the NASDAQ Capital Market ("NASDAQ”) or the Toronto Stock Exchange ("TSX”).

These risk factors are not intended to represent a complete list of the risk factors that could affect the Company. These factors and assumptions, however, should be considered
carefully. More detailed information about these and other factors is included under "Risk Factors” in this Annual Report on Form 20-F and in other documents incorporated herein
by reference.

However, we advise you to review any further disclosures we make on related subjects in our reports on Form 6-K filed or furnished to the SEC and in our other public disclosure

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
filed under our profile on SEDAR at www.sedar.com.

Although the Company has attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there
may be other factors that cause results not to be as anticipated, estimated or intended. Many of these factors are beyond our control. There can be no assurance that such
statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements, particularly in light of the ongoing and
developing COVID-19 pandemic and its impact on the global economy and its uncertain impact on the Company’s business. Accordingly, readers should not place undue reliance
on forward-looking statements. The Company does not undertake to update any forward-looking statements contained herein, except as required by applicable securities laws.
New  factors  emerge  from  time  to  time,  and  it  is  not  possible  for  the  Company  to  predict  all  of  these  factors,  or  to  assess  in  advance  the  impact  of  each  such  factor  on  the
Company’s  business  or  the  extent  to  which  any  factor,  or  combination  of  factors,  may  cause  actual  results  to  differ  materially  from  those  contained  in  any  forward-looking
statement.

3

TABLE OF CONTENTS

GENERAL INFORMATION

PART I
Item 1.

Item 2.

Item 3.

Item 4.

Item 4A.
Item 5.

Item 6.

Item 7.

Item 8.

Item 9.

Identity of Directors, Senior Management and Advisers
A. Directors and senior management
B. Advisers
C. Auditors
Offer Statistics and Expected Timetable
A. Offer statistics
B. Method and expected timetable
Key Information
A. [Reserved]
B. Capitalization and indebtedness
C. Reasons for the offer and use of proceeds
D. Risk factors
Information on the Company
A. History and development of the Company
B. Business overview
C. Organizational structure
D. Property, plants and equipment
Unresolved Staff Comments
Operating and Financial Review and Prospects
A. Operating results
B. Liquidity, cash flows and capital resources
C. Research and development, patents and licenses, etc.
D. Trend information
E. Critical Accounting Estimates
Directors, Senior Management and Employees
A. Directors and senior management
B. Compensation
C. Board practices
D. Employees
E. Share ownership
Major Shareholders and Related Party Transactions
A. Major shareholders
B. Related party transactions
C. Interests of experts and counsel
Financial Information
A. Consolidated statements and other financial information
B. Significant changes
The Offer and Listing
A. Offer and listing details
B. Plan of distribution
C. Markets
D. Selling shareholders
E. Dilution
F. Expenses of the issue

Item 10.

Item 11.
Item 12.

Additional Information
A. Share capital
B. Memorandum and articles of association
C. Material contracts
D. Exchange controls
E. Taxation
F. Dividends and paying agents
G. Statement by experts
H. Documents on display
I. Subsidiary information
Quantitative and Qualitative Disclosures About Market Risk
Description of Securities Other than Equity Securities
A. Debt securities

4

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Responsibility

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119
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179

B. Warrants and rights
C. Other securities
D. American depositary shares

PART II

Defaults, Dividend Arrearages and Delinquencies
Item 13.
Material Modifications to the Rights of Security Holders and Use of Proceeds
Item 14.
Controls and Procedures
Item 15.
Audit Committee Financial Expert
Item 16A.
Code of Ethics
Item 16B.
Principal Accountant Fees and Services
Item 16C.
Exemptions from the Listing Standards for Audit Committees
Item 16D.
Purchases of Equity Securities by the Issuer and Affiliated Purchasers
Item 16E.
Change in Registrant’s Certifying Accountant
Item 16F.
Item 16G.
Corporate Governance
Item 16H. Mine Safety Disclosure
Item 16I

Disclosure Regarding Foreign Jurisdictions That Prevent Inspections

PART III
Item 17.
Item 18.
Item 19.

Financial Statements
Financial Statements
Exhibits

5

PART I

Item 1.

Identity of Directors, Senior Management and Advisers

A.

Directors and senior management

Not applicable.

B.

Advisers

Not applicable.

C.

Auditors

Not applicable.

Item 2.

Offer Statistics and Expected Timetable

A.

Offer statistics

Not applicable.

B.

Method and expected timetable

Not applicable.

Item 3.

Key Information

A.

B.

(Reserved)

Capitalization and indebtedness

Not applicable.

C.

Reasons for the offer and use of proceeds

Not applicable.

D.

Risk factors

An investment in our securities involves a high degree of risk. You should carefully consider the risks described below, together with all of the other information included in
this Annual Report, before making an investment decision. If any of the following risks actually occur, our business, prospects, financial condition or results of operations
could be materially, adversely affected by any of these risks. Additional risks not presently known to us or that we currently deem immaterial may also impair our business
operations. The trading price of our securities could decline due to any of these risks, and you may lose all or part of your investment. This Annual Report also contains
forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in these forward-looking statements as a
result of certain factors, including the risks mentioned below. Forward-looking statements included in this Annual Report are based on information available to us on the date
hereof, and all forward-looking statements in the documents incorporated by reference are based on information available to us as of the date of each such document. We
disavow and are under no obligation to update or alter such forward-looking statements whether as a result of new information, future events or otherwise, other than as
required by applicable securities legislation.

6

Risks Relating to Us and Our Business

Our Common Shares may be delisted from the NASDAQ or the TSX, which could affect their market price and liquidity. If our Common Shares were to be delisted, investors

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
may have difficulty in disposing their Common Shares.

Our Common Shares are currently listed on both the NASDAQ and the TSX under the symbol "AEZS”. We must meet continuing listing requirements to maintain the listing of our
Common Shares on the NASDAQ and the TSX. For continued listing, the NASDAQ requires, among other things, that listed securities maintain a minimum closing bid price of not
less than $1.00 per share. On July 28, 2021, we received a letter from the Listing Qualifications Staff of the NASDAQ (the "Staff”), notifying us that for the last 30 consecutive
business days prior to the date of the letter, the closing bid price of our common shares was below $1.00 per share and, therefore, we did not meet the requirement for continued
listing on Nasdaq as required by Nasdaq Listing Rule 5550(a)(2) (the "Bid Price Rule”). In accordance with Nasdaq Listing Rule 5810(c)(3)(A), we were granted a grace period of
180 calendar days, through January 24, 2022, and on January 26, 2022, we were granted a subsequent 180 calendar day extension, through July 26, 2022, to evidence compliance
with the Bid Price Rule. If at any time before July 26, 2022, the bid price for the Company’s common shares closes at or above US$1.00 per share for a minimum of 10 consecutive
business days (and generally not more than 20 consecutive business days, in NASDAQ’s discretion), it is expected that NASDAQ would provide formal notice that the Company
has regained compliance with the bid price requirement. The Company may choose to implement a reverse stock split before July 26, 2022 in order to regain compliance. In the
event the Company does not evidence compliance with the minimum bid price requirement during the 180-day grace period, it is expected that Nasdaq would notify the Company
that its shares are subject to delisting. At such time, the Company may appeal such determination to a Nasdaq Hearings Panel (the "Panel”) and it is expected that the Company’s
securities would continue to be listed and available to trade on Nasdaq at least pending the completion of the appeal process. There can be no assurance that any such appeal
would be successful or that the Company would be able to evidence compliance with the terms of any extension that may be granted by the Panel. The NASDAQ notification letter
does not impact the Company’s compliance or listing status on the Toronto Stock Exchange.

On July 27, 2020, we received a letter from the Staff notifying us that for the last thirty (30) consecutive business days prior to the date of the letter, the closing bid price of our
Common Shares was below $1.00 per share and, therefore, we did not meet the requirement for continued listing on the NASDAQ as required the Bid Price Rule. In accordance with
NASDAQ Listing Rule 5810(c)(3)(A), we were granted a grace period of one hundred and eighty (180) calendar days, through January 25, 2021, and on January 26, 2021, we were
granted a subsequent 180 calendar day extension, through July 26, 2021, to evidence compliance with the Bid Price Rule. On March 22, 2021, the Company received confirmation
that it had regained compliance with the Bid Price Rule and NASDAQ advised us that this matter was then closed.

In addition to the minimum bid price requirement, the continued listing rules of the NASDAQ require us to meet at least one of the following listing standards: (i) stockholders’
equity of at least $2.5 million, (ii) market value of listed securities (calculated by multiplying the daily closing bid price of our securities by our total outstanding securities) of at
least $35 million or (iii) net income from continuing operations (in the latest fiscal year or in two of the last three fiscal years) of at least $500,000.

It is possible that we may be a passive foreign investment company, which could result in adverse tax consequences to U.S. investors.

Adverse U.S. federal income tax rules apply to "U.S. Holders” who directly or indirectly hold stock of a passive foreign investment company ("PFIC”). We would be classified as a
PFIC for U.S. federal income tax purposes for a taxable year if (i) at least 75% of our gross income is "passive income” or (ii) at least 50% of the average value of our assets,
including goodwill (based on annual quarterly average), is attributable to assets which produce passive income or are held for the production of passive income.

The determination of whether we are, or will be, a PFIC for a taxable year depends, in part, on the application of complex U.S. federal income tax rules, which are subject to various
interpretations. Although the matter is not free from doubt, we believe that we were not a PFIC during our 2020 taxable year and will not likely be a PFIC during our 2021 taxable
year. Because PFIC status is based on our income, assets and activities for the entire taxable year, and our market capitalization, it is not possible to determine whether we will be
characterized as a PFIC for the 2021 taxable year until after the close of the taxable year. The tests for determining PFIC status are subject to a number of uncertainties. These tests
are applied annually, and it is difficult to accurately predict future income, assets and activities relevant to this determination. In addition, because the market price of our Common
Shares is likely to fluctuate, the market price may affect the determination of whether we will be considered a PFIC. There can be no assurance that we will not be considered a PFIC
for any taxable year (including our 2021 taxable year).

7

If we are a PFIC for any taxable year during which a U.S. Holder holds Common Shares, we generally would continue to be treated as a PFIC with respect to that U.S. Holder for all
succeeding years during which the U.S. Holder holds such Common Shares, even if we ceased to meet the threshold requirements for PFIC status. Accordingly, no assurance can
be given that we will not constitute a PFIC in the current (or any future) tax year or that the Internal Revenue Service (the "IRS”) will not challenge any determination made by us
concerning our PFIC status. PFIC characterization could result in adverse U.S. federal income tax consequences to U.S. Holders. In particular, absent certain elections, a U.S.
Holder would generally be subject to U.S. federal income tax at ordinary income tax rates, plus a possible interest charge, in respect of a gain derived from a disposition of our
Common Shares, as well as certain distributions by us. If we are treated as a PFIC for any taxable year, a U.S. Holder may be able to make an election to "mark-to-market” Common
Shares each taxable year and recognize ordinary income pursuant to such election based upon increases in the value of the Common Shares.

In addition, U.S. Holders may mitigate the adverse tax consequences of the PFIC rules by making a "qualified electing fund” ("QEF”) election; however, there can be no assurance
that we will satisfy the record keeping requirements applicable to a QEF or that we will provide the information regarding our income that would be necessary for a U.S. Holder to
make a QEF election.

If the Company is a PFIC, U.S. Holders will generally be required to file an annual information return with the IRS (on IRS Form 8621 Information Return by a Shareholder of a
Passive Foreign Investment Company or Qualified Electing Fund, which PFIC shareholders will be required to file with their U.S. federal income tax or information returns) relating
to their ownership of Common Shares. This filing requirement is in addition to any pre-existing reporting requirements that apply to a U.S. Holder’s interest in a PFIC (which this
requirement does not affect).

Our net operating losses may be limited for U.S. federal income tax purposes under Section 382 of the Internal Revenue Code.

If a corporation with net operating losses ("NOLs”) undergoes an "ownership change” within the meaning of Section 382 of the United States Internal Revenue Code of 1986, as
amended (the "Code”), then such corporation’s use of such "pre-change” NOLs to offset income incurred following such ownership change may be limited. Such limitation also
may apply to certain losses or deductions that are "built-in” (i.e., attributable to periods prior to the ownership change, but not yet taken into account for tax purposes) as of the
date of the ownership change that are subsequently recognized. An ownership change generally occurs when there is either (i) a shift in ownership involving one or more "5%
shareholders,” or (ii) an "equity structure shift” and, as a result, the percentage of stock of the corporation owned by one or more 5% shareholders (based on value) has increased
by more than 50 percentage points over the lowest percentage of stock of the corporation owned by such shareholders during the "testing period” (generally the 3 years preceding
the testing date).  In general, if such change occurs, the corporation’s ability to utilize its  NOL carry-forwards and certain other tax attributes would be subject to an annual
limitation, as described below. The unused portion of any such NOL carry-forwards or tax attributes each year is carried forward, subject to the same limitation in future years. The
impact  of  an  ownership  change  on  state  NOL  carry  forwards  may  vary  from  state  to  state.  Due  to  previous  ownership  changes,  or  if  we  undergo  an  ownership  change  in
connection with or after this offering, our ability to use our NOLs could be limited by Section 382 of the Code. Future changes to our stock ownership, some of which are outside of
our control, could result in an ownership change under Section 382 of the Code. Recent legislation added several limitations to the ability to claim deductions for NOLs in future
years, particularly for tax years beginning after December 31, 2020, including a deduction limit equal to 80% of taxable income and a restriction on NOL carryback deductions. For
these reasons, we may not be able to use a material portion of the NOLs, even if we attain profitability.

Prevention of Transactions Involving a Change of Control of the Company

8

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Effective May 8, 2019, the shareholders re-approved our Rights Plan that provides the Board and the Company’s shareholders with additional time to assess any unsolicited take-
over bid for the Company and, where appropriate, to pursue other alternatives for maximizing shareholder value. Under the Rights Plan, one right has been issued for each currently
issued Common Share, and one right will be issued with each additional Common Share that may be issued from time to time. The Rights Plan may have a significant anti-takeover
effect. The Rights Plan has the potential to significantly dilute the ownership interests of an acquiror of our shares, and therefore may have the effect of delaying, deterring or
preventing a change in control of the Company.

The economic effects of a pandemic, epidemic or outbreak of an infectious disease could adversely affect our operations or the market price of our Common Shares.

Public health crises such as pandemics, epidemics or similar outbreaks could adversely impact our operations or the market price of our Common Shares. Specifically, the global
pandemic declared regarding the novel strain of coronavirus ("COVID-19”) in 2020 and 2021 that adversely impacted global markets is abating, but currently ongoing. The extent
to which the COVID-19 impacts our operations or market price of our Common Shares will depend on future developments, which are highly uncertain and cannot be predicted with
confidence, either internationally or within the U.S., Canada or Germany, including the duration of the outbreak, new information that may emerge concerning the severity of the
COVID-19, and the actions to contain the virus or treat its impact, among others. COVID-19, however, has already resulted in significant volatility in the world and the national
trading markets.

The spread of COVID-19 may impact our operations, including the potential interruption of our clinical trial activities and our supply chain. For example, the rise in the Omicron
variant in the COVID-19 pandemic has caused delays in site initiation and patient enrollment in our Phase 3 DETECT clinical trial for diagnostic use in childhood-onset growth
hormone deficiency. As well, sales activities for Macrilen™ in the US by Novo Nordisk may be impacted due to delays of diagnostic activities on adult growth hormone deficiency
("AGHD”) in the U.S. In addition, the COVID-19 pandemic may also cause some patients to be unwilling to enroll in our trials or be unable to comply with clinical trial protocols if
quarantines impede patient movement or interrupt healthcare services, which would delay our ability to conduct clinical trials or release clinical trial results on a timely basis and
could delay our ability to obtain regulatory approval and commercialize our product candidates. The spread of an infectious disease, including COVID-19, may also result in the
inability of our suppliers to deliver components or raw materials on a timely basis or at all. In addition, hospitals may reduce staffing and reduce or postpone certain treatments in
response to the spread of an infectious disease.  Such events may result in a period of business disruption and, in reduced operations, doctors or medical providers may be
unwilling to participate in our clinical trials, any of which could materially affect our business, financial condition or results of operations. The significant spread of COVID-19
within the U.S., Canada or Germany resulted in a widespread health crisis and has had adverse effect on the national economies generally, the markets that we serve, our operations
and the market price of our Common Shares.

Investments in biopharmaceutical companies are generally considered to be speculative in nature.

The  prospects  for  companies  operating  in  the  biopharmaceutical  industry  are  uncertain,  given  the  very  nature  of  the  industry,  in  which  companies  often  experience  lengthy
development time, extensive capital requirements, rapid technological developments and a high degree of competition based primarily on scientific and technological factors. These
factors include the availability to obtain patent and other protection for technology and products, the ability to commercialize technological developments and the ability to obtain
government approval for testing, manufacturing and marketing. Accordingly, investments in biopharmaceutical companies should be considered to be speculative assets.
.

9

If we are unable to successfully commercialize or out-license Macrilen™ (macimorelin), or if we experience significant delays in doing so, our business would be materially
harmed, and the future and viability of the Company could be imperiled.

Our lead product, Macrilen™ (macimorelin), is the first and only U.S. Food and Drug Administration and European Commission approved oral test indicated for the diagnosis of
patients with AGHD and we currently do not have any other products. We are focused on opportunistically utilizing our network with universities in Europe and the U.S., which
we believe will provide vital access to innovative development candidates in different indications, with a focus on rare or orphan indications and potential for pediatric use. To
date, we have signed agreements to establish this growing pipeline across a number of indications, including neuromyelitis optica spectrum disorder ("NMOSD”) and Parkinson’s
disease  ("PD”),  primary  hypoparathyroidism  and  amyotrophic  lateral  sclerosis  ("ALS”,  or  Lou  Gehrig’s  disease). Additionally,  we  are  developing  oral  prophylactic  bacterial
vaccines against each form of SARS-CoV-2, the virus that causes COVID-19, and chlamydia.

We are a party to license agreements to carry out development, manufacturing, registration and commercialization of Macrilen™ (macimorelin) in the U.S., Canada, the European
Economic Area, the United Kingdom, and the Republic of Korea. We are party to a distribution agreement for the commercialization of Macrilen™ (macimorelin) in Israel and the
Palestinian Authority, Turkey and some non-European Union Balkan countries. We continue to explore licensing and distribution opportunities worldwide.

The commercial success of Macrilen™ (macimorelin) depends on several factors, including, but not limited to, the following:

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receipt of approvals from foreign regulatory authorities;

successfully negotiating pricing and reimbursement in key markets in the EU for Macrilen™ (macimorelin);

successfully contracting with qualified third-party suppliers to manufacture Macrilen™ (macimorelin);

developing appropriate distribution and marketing infrastructure and arrangements for our product;

launching and growing commercial sales of the product;

out-licensing Macrilen™ (macimorelin) to third parties; and

acceptance of the product in the medical community, among patients and with third-party payers.

If we are unable to successfully achieve any of these factors, our business, financial condition and results of operations may be materially, adversely affected.

Our revenues and expenses may fluctuate significantly, and any failure to meet financial expectations may disappoint securities analysts or investors and result in a decline
in the price or the value of our Common Shares or other securities.

We have a history of operating losses. Our revenues and expenses have fluctuated in the past and may continue to do so in the future. These fluctuations could cause our share
price of Common Shares or the value of our other securities to decline. Some of the factors that could cause our revenues and expenses to fluctuate include, but are not limited to,
the following:

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the timing and willingness of any current or future collaborators to invest the resources necessary to commercialize Macrilen™ (macimorelin);

not obtaining necessary regulatory approvals from the United States Food & Drug Administration ("FDA”), the  European Medicines Agency ("EMA”), the
European  Commission ("EC”) or other agencies that may delay or prevent us from obtaining approval of a pediatric indication for Macrilen™ (macimorelin),
which may affect the share price of our Common Shares;

10

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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the timing of regulatory submissions and approvals;

the nature and timing of licensing fee revenues;

the outcome of future litigation;

foreign currency fluctuations;

the effects of the recent outbreak of COVID-19, including the effects of intensified efforts to contain the spread of the virus, which has, to date, included, among
other things, quarantines and travel restrictions;

the timing of the achievement and the receipt of milestone payments from current or future licensing partners; and

failure to enter into new or the expiration or termination of current agreements with suppliers who manufacture Macrilen™ (macimorelin).

Due  to  fluctuations  in  our  revenues  and  expenses,  we  believe  that  period-to-period  comparisons  of  our  results  of  operations  are  not  necessarily  indicative  of  our  future
performance. It is possible that in some future periods, our revenues and expenses will be above or below the expectations of securities analysts or investors. In this case, the
share price of our Common Shares and the value of our other securities could fluctuate significantly or decline.

If we are unable to successfully complete the pediatric clinical trial program for Macrilen™ (macimorelin), or if such clinical trial takes longer to complete than we project,
our ability to execute any related business strategy will be adversely affected.

If we experience delays in identifying and contracting with sites and/or in-patient enrollment in our pediatric clinical trial program for  Macrilen™ (macimorelin), we may incur
additional costs and delays in our development programs, and may not be able to complete our clinical trials on a cost-effective or timely basis. In addition, conducting multi-
national studies adds another level of complexity and risk as we are subject to events affecting countries other than the U.S. and Canada. Moreover, negative or inconclusive
results from the clinical trials we conduct or adverse medical events could cause us to have to repeat or terminate the clinical trials. Furthermore, children have different metabolic
issues than adults. Accordingly, we may not be able to complete the pediatric clinical trial within an acceptable time-frame, if at all. If we or our Contract Research Organizations
("CRO”) have difficulty enrolling a sufficient number of patients to conduct our clinical trials as planned, we may need to delay or terminate ongoing clinical trials.

Clinical trials are subject to continuing oversight by governmental regulatory authorities and institutional review boards and must, among other requirements:

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meet the requirements of these authorities from multiple countries and jurisdictions and their related statutes, regulations and guidance;

meet the requirements for informed consent;

meet the requirements for institutional review boards; and

meet the requirements for good clinical practices.

We are currently dependent on certain strategic relationships with third parties for the development, manufacturing and licensing of Macrilen™ (macimorelin) and we may
enter into future collaborations for the development, manufacturing and licensing of Macrilen™ (macimorelin).

Our arrangements with third parties may not provide us with the benefits we expect and may expose us to a number of risks.

Currently, we are dependent on various partners to commercialize macimorelin in the U.S. and Canada, the U.K. and EU and the Republic of Korea. Most of our potential revenue
consists of contingent payments, including milestones and royalties on the sale of Macrilen™ (macimorelin). The milestone and royalty revenue that we may receive under this
collaboration will depend upon these parties’ ability to successfully introduce, market and sell Macrilen™ (macimorelin). If they do not devote sufficient time and resources to their
respective collaboration arrangements with us, we may not realize the potential commercial benefits of the arrangement, and our results of operations may be materially, adversely
affected.

11

Our reliance on these relationships and other potential third parties poses a number of risks. We may not realize the contemplated benefits of such agreements nor can we be
certain that any of these parties will fulfill their obligations in a manner which maximizes our revenue. These arrangements may also require us to transfer certain material rights to
third  parties.  These  agreements  create  certain  additional  risks.  The  occurrence  of  any  of  the  following  or  other  events  may  delay  or  impair  commercialization  of  Macrilen™
(macimorelin):

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in certain circumstances, third parties may assign their rights and obligations under these agreements to other third parties without our consent or approval;

the third parties may cease to conduct business for financial or other reasons;

we may not be able to renew such agreements;

t h e third  parties  may  not  properly  maintain  or  defend  certain  intellectual  property  rights  that  may  be  important  to  the  commercialization of  Macrilen™
(macimorelin);

the third parties may encounter conflicts of interest, changes in business strategy or other issues which could adversely affect their willingness or ability to fulfill
their obligations to us (for example, pharmaceutical companies historically have re-evaluated their priorities following mergers and consolidations, which have
been common in this industry);

delays in, or failures to achieve, scale-up to commercial quantities, or changes to current raw material suppliers or product manufacturers (whether the change is
attributable to us or the supplier or manufacturer) could delay clinical studies, regulatory submissions and commercialization of Macrilen™ (macimorelin); and

disputes may  arise  between  us  and  the  third  parties  that  could  result  in  the  delay  or  termination  of  the  manufacturing  or  commercialization of  Macrilen™
(macimorelin), resulting in litigation or arbitration that could be time-consuming and expensive, or causing the third parties to act in their own self-interest and not
in our interest or those of our shareholders.

In addition, the third parties can terminate our agreements with them for a number of reasons based on the terms of the individual agreements that we have entered into with them.
If one or more of these agreements were to be terminated, we would be required to devote additional resources to manufacturing and commercializing Macrilen™ (macimorelin).

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We may be unsuccessful in consummating further out-licensing arrangements for MacrilenTM (macimorelin) on favorable terms and conditions, or we may be significantly
delayed in doing so.

As part of our product development and commercialization strategy, we are evaluating out-licensing opportunities for Macrilen™ (macimorelin) in addition to existing License
Agreements signed with Novo Nordisk, Consilient Health and NK MEDITECH Ltd. by the end of 2021. If we elect to collaborate with third parties in respect of macimorelin, we may
not be able to negotiate a collaborative arrangement for macimorelin on favorable terms and conditions, if at all. Should any partner fail to successfully commercialize macimorelin,
our business, financial condition and results of operations may be adversely affected.

We have initiated significant early-stage pre-clinical programs

Over  the  course  of  2021,  we  in-licensed  six  new  pre-clinical  development  programs,  four  potential  therapeutics  and  two  potential  vaccines,  all  of  which  were  added  to  our
development  pipeline  based  on  their  potential  to  represent  significant  individual  market  opportunities.  These  pre-clinical  development  programs  are  at  an  early  stage  of
development and none of these potential products has obtained regulatory approval for commercial use and sale in any country and, as such, no revenues have resulted from
product  sales.  Significant  additional  investment  will  be  necessary  to  complete  the  development  of  any  of  our  product  candidates.  Pre-clinical  and  clinical  trial  work  must  be
completed before our potential products could be ready for use within the markets that we have identified. We may fail to develop any products, obtain regulatory approvals, enter
clinical trials or commercialize any products. We do not know whether any of our potential product development efforts will prove to be effective, meet applicable regulatory
standards, obtain the requisite regulatory approvals, be capable of being manufactured at a reasonable cost or be accepted in the marketplace. We also do not know whether sales,
license fees or related royalties will allow us to recoup any investment we make in the commercialization of our products. The product candidates we are currently developing are
not expected to be commercially viable for at least the next several years and we may encounter unforeseen difficulties or delays in commercializing our product candidates. In
addition, our potential products may not be effective or may cause undesirable side effects.

12

Our product candidates require significant funding to reach regulatory approval assuming positive clinical results. Such funding for our product candidates may be difficult, or
impossible to raise in the public or private markets or through partnerships. If funding or partnerships are not readily attainable, the development of our product candidates may be
significantly delayed or stopped altogether. The announcement of a delay or discontinuation of development would likely have a negative impact on our share price.

We may require significant additional financing, and we may not have access to sufficient capital.

We may require significant additional capital to fund our commercialization efforts and may require additional capital to pursue planned clinical trials and regulatory approvals.
Although  we  have  capital  from  the  License Agreement,  we  do  not  anticipate  generating  significant  revenues  from  operations  in  the  near  future  other  than  from  the  License
Agreement. Moreover, we currently have no committed sources of capital.

We may attempt to raise additional funds through public or private financings, collaborations with other pharmaceutical companies or from other sources, including, without
limitation, through at-the-market offerings and issuances of securities. Additional funding may not be available on terms that are acceptable to us. If adequate funding is not
available to us on reasonable terms, we may need to delay, reduce or eliminate our product development programs or obtain funds on terms less favorable than we would otherwise
accept. To the extent that additional capital is raised through the sale of equity securities or securities convertible into or exchangeable or exercisable for equity securities, the
issuance of those securities would result in dilution to our shareholders. Moreover, the incurrence of debt financing or the issuance of dividend-paying preferred shares, could
result in a substantial portion of our future operating cash flow, if any, being dedicated to the payment of principal and interest on such indebtedness or the payment of dividends
on such preferred shares and could impose restrictions on our operations and on our ability to make certain expenditures and/or to incur additional indebtedness, which could
render us more vulnerable to competitive pressures and economic downturns.

Our future capital requirements are substantial and may increase beyond our current expectations depending on many factors, including, but not limited to, the following:

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the duration of changes to and results of our clinical trials for any future products going forward;

unexpected delays or developments in seeking regulatory approvals;

the time and cost involved in preparing, filing, prosecuting, maintaining and enforcing patent claims;

unexpected developments encountered in implementing our business development and commercialization strategies;

the potential addition of commercialized products to our portfolio;

the outcome of future litigation; and

further arrangements, if any, with collaborators.

In addition, global economic and market conditions, as well as future developments in the credit and capital markets, may make it even more difficult for us to raise additional
financing in the future.

13

We are and will be subject to stringent ongoing government regulation for our products and our product candidates, even if we obtain regulatory approvals for the latter.

The manufacturing, marketing and sale of  Macrilen™ (macimorelin) and our product candidates are and will be subject to strict and ongoing regulation, even with marketing
approval by the FDA and the EC for Macrilen™ (macimorelin). Compliance with such regulation will be expensive and consume substantial financial and management resources.
For example, the EC approval for macimorelin was conditioned on our agreement to conduct post-marketing follow-up studies to monitor the safety or efficacy of the product. In
addition, as clinical experience with a drug expands after approval because the drug is used by a greater number and more diverse group of patients than during clinical trials, side
effects or other problems may be observed after approval that were not observed or anticipated during pre-approval clinical trials. In such a case, a regulatory authority could
restrict the indications for which the product may be sold or revoke the product’s regulatory approval.

We and our contract manufacturers will be required to comply with applicable current Good Manufacturing Practice (" GMP”) regulations for the manufacture of our current or
future products and other regulations. These regulations include requirements relating to quality assurance, as well as the corresponding maintenance of rigorous records and
documentation. Manufacturing facilities must be approved before we can use them in the commercial manufacturing of a product and are subject to subsequent periodic inspection
by regulatory authorities. In addition, material changes in the methods of manufacturing or changes in the suppliers of raw materials are subject to further regulatory review and
approval.

If we, or if any future marketing collaborators or contract manufacturers, fail to comply with applicable regulatory requirements, we may be subject to sanctions including fines,
product  recalls  or  seizures  and  related  publicity  requirements,  injunctions,  total  or  partial  suspension  of  production,  civil  penalties,  suspension  or  withdrawals  of  previously

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
granted  regulatory  approvals,  warning  or  untitled  letters,  refusal  to  approve  pending  applications  for  marketing  approval  of  new  products  or  of  supplements  to  approved
applications, complete withdrawal of a marketing application, exclusion from government healthcare programs, import or export bans or restrictions, and/or criminal prosecution and
penalties. Any of these penalties could delay or prevent the promotion, marketing or sale of a product.

Even with marketing approval for MacrilenTM (macimorelin), such product approval could be subject to restrictions or withdrawals. Regulatory requirements are subject to
change.

On December 20, 2017, the FDA granted marketing approval in the U.S. for Macrilen™ (macimorelin) to be used in the diagnosis of patients with AGHD, and on January 16, 2019,
the  EC  granted  marketing  approval  in  Europe  for  macimorelin  for  the  diagnosis  of AGHD.  Regulatory  authorities  generally  approve  products  for  specified  indications.  If  an
approval is for a limited indication, this limitation reduces the size of the potential market for that product. Product approvals, once granted, are subject to continual review and
periodic inspections by regulatory authorities. Our operations and practices are subject to regulation and scrutiny by the U.S. government, as well as governments of any other
countries in which we do business or conduct activities. Later discovery of previously unknown problems or safety issues and/or failure to comply with domestic or foreign laws,
knowingly or unknowingly, can result in various adverse consequences, including, among other things, a possible delay in the approval or refusal to approve a product, warning
or untitled letters, fines, injunctions, civil penalties, recalls or seizures of products and related publicity requirements, total or partial suspension of production, import or export
bans or restrictions, refusal of the government to renew marketing applications, complete withdrawal of a marketing application, criminal prosecution and penalties, suspension or
withdrawals  of  previously  granted  regulatory  approvals,  withdrawal  of  an  approved  product  from  the  market  and/or  exclusion  from  government  healthcare  programs.  Such
regulatory enforcement could have a direct and negative impact on the product for which approval is granted, but also could have a negative impact on the approval of any
pending applications for marketing approval of new drugs or supplements to approved applications.

Because we operate in a highly regulated industry, regulatory authorities could take enforcement action against us in connection with our licensees’ or collaborators’ businesses
or marketing activities for various reasons.

14

From time to time, new legislation is passed into law that could significantly change the statutory provisions governing the approval, manufacturing and marketing of products
regulated  by  the  FDA,  the  EC  and  other  health  authorities.  In  addition,  regulations  and  guidance  are  often  revised  or  reinterpreted  by  health  agencies  in  ways  that  may
significantly affect our business. It is impossible to predict whether further legislative changes will be enacted, or whether regulations, guidance, or interpretations will change, and
what the impact of such changes, if any, may be.

Healthcare reform measures could hinder or prevent the commercial success of a product and adversely affect our business.

The business prospects and financial condition of pharmaceutical and biotechnology companies are affected by the efforts of governmental and third-party payers to contain or
reduce the costs of healthcare. The U.S. government and other governments have shown significant interest in pursuing healthcare reform and reducing healthcare costs. Any
government-adopted reform measures could cause significant pressure on the pricing of healthcare products and services, including Macrilen™ (macimorelin), both in the U.S. and
internationally,  as  well  as  the  amount  of  reimbursement  available  from  governmental  agencies  and  other  third-party  payers.  If  reimbursement  for  Macrilen™  (macimorelin)  is
substantially less than we expect, our revenue prospects could be materially and adversely impacted.

In the  U.S. and in other jurisdictions there have been, and we expect that there will continue to be, a number of legislative and regulatory  proposals  aimed  at  changing  the
healthcare system, such as proposals relating to the pricing of healthcare products and services in the U.S. or internationally, the reimportation of drugs into the U.S. from other
countries (where they are then sold at a lower price), and the amount of reimbursement available from governmental agencies or other third-party payers. Furthermore, the pricing
of pharmaceutical products, in general, and specialty drugs, in particular, has been a topic of concern in the U.S. Congress, where hearings on the topic have been held, and has
been a topic of speeches given by political figures, including the President of the U.S. Additionally, in the U.S., individual states have also passed legislation and proposed bills
that are aimed at drug pricing transparency, which will likely impact drug pricing. There can be no assurance as to how this scrutiny on pricing of pharmaceutical products will
impact future pricing of Macrilen™ (macimorelin).

The Patient Protection and Affordable Care Act and the Healthcare and Education Affordability Reconciliation Act of 2010 (collectively, the " ACA”) has had far-reaching
consequences for most healthcare companies, including specialty biopharmaceutical companies like us. The future of the ACA is, however, uncertain as there have been executive,
judicial and congressional challenges to certain aspects of the ACA. In June 2021, the United States Supreme Court dismissed a challenge to the ACA on the grounds the plaintiffs
did  not  have  standing  to  attack  as  unconstitutional  the ACA’s  minimum  essential  coverage  provision  because  they  had  not  shown  they  had  suffered  damages  from  the
defendants’ conduct in enforcing the ACA.” Change the last sentence to: "It is unclear how other such litigation and the healthcare reform efforts of the Biden administration will
impact the ACA and our business. It is unclear how the Supreme Court ruling, other such litigation and the healthcare reform efforts of the Biden administration will impact the
ACA and our business.

In addition, the Food and Drug Administration Amendments Act of 2007 gives the FDA enhanced post-market authority, including the authority to require post-marketing studies
and clinical trials, labeling changes based on new safety information, and compliance with risk evaluations and mitigation strategies approved by the FDA. The FDA’s exercise of
this authority may result in delays or increased costs during the period of product development, clinical trials and regulatory review and approval, which may also increase costs
related to complying with new post-approval regulatory requirements, and increase potential FDA restrictions on the sale or distribution of approved products.

If we or our licensees market products or interact with health care practitioners in a manner that violates healthcare fraud or abuse laws, we or our licensees may be subject
to civil or criminal penalties, including exclusion from participation in government healthcare programs.

As a pharmaceutical company, even though we do not provide healthcare services or receive payments directly from or bill directly to Medicare, Medicaid or other national or
third-party payers for our current product, U.S. federal and state healthcare laws and regulations, as well as certain EU regulatory and government agencies, pertaining to fraud or
abuse are and will be applicable to our business. We, and our licensees, are subject to healthcare fraud and abuse regulation by EU regulatory and government agencies in the
countries where we may seek marketing access, and the U.S. federal government and the states in which we conduct our business.

15

The laws that may affect us or affect our licensee’s ability to operate include the federal healthcare program anti-kickback statute, which prohibits, among other things, knowingly
and willfully offering, paying, soliciting, or receiving remuneration to induce, or in return for, the purchase, lease or order, or arrangement for the purchase, lease or order of any
healthcare item or service reimbursable under Medicare, Medicaid or other federally financed healthcare programs. This statute applies to arrangements between pharmaceutical
manufacturers and prescribers, purchasers and formulary managers. Although there are a number of statutory exceptions and regulatory safe harbors protecting certain common
activities, the exceptions and safe harbors are drawn narrowly, and practices that involve remuneration intended to induce prescribing, purchases or recommendations may be
subject to scrutiny if they do not qualify for an exception or a safe harbor.

Federal false claims laws prohibit any person from knowingly presenting, or causing to be presented, a false claim for payment to the federal government, or knowingly making, or
causing to be made, a false statement to get a false claim paid. Pharmaceutical companies have been prosecuted under these laws for a variety of alleged promotional and marketing
activities, such as providing free product to customers with the expectation that the customers would bill federal programs for the product, reporting to pricing services inflated
average wholesale prices that were then used by federal programs to set reimbursement rates, engaging in off-label promotion that caused claims to be submitted to Medicaid for
non-covered off-label uses, and submitting inflated best price information to the Medicaid Drug Rebate Program.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Health  Insurance  Portability and  Accountability  Act of 1996 also created prohibitions against healthcare fraud and false statements relating to healthcare matters.  The
healthcare fraud statute prohibits knowingly and willfully executing a scheme to defraud any healthcare benefit program, including private payers. The false statements statute
immediately noted above prohibits knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement in
connection with the delivery of or payment for healthcare benefits, items or services.

In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians. The ACA, through the Physician Payment Sunshine Act of
2010, imposed new requirements on manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s
Health  Insurance  Program (with certain exceptions) to report annually to the  Centers for  Medicare and  Medicaid  Services ("CMS”), information related to payments or other
"transfers of value” made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors) and teaching hospitals, and applicable manufacturers and
group purchasing organizations to report annually to CMS ownership and investment interests held by physicians (as defined above) and their immediate family members and
payments or other "transfers of value” to such physician owners and their immediate family members. Manufacturers are required to report such data to the government by the
90th calendar day of each year.

The majority of states also have statutes or regulations similar to these federal laws, which apply to items and services reimbursed under Medicaid and other state programs, or, in
several states, apply regardless of the payer. In addition, some states have laws that require pharmaceutical companies to adopt comprehensive compliance programs. For example,
under California law, pharmaceutical companies must comply with both the April 2003 Office of Inspector General Compliance Program Guidance for Pharmaceutical Manufacturers
and  the  PhRMA  Code  on  Interactions  with  Healthcare  Professionals,  as  amended.  Certain  states  also  mandate  the  tracking  and  reporting  of  gifts,  compensation,  and  other
remuneration paid by us to physicians and other healthcare providers.

Although compliance programs can mitigate the risk of investigation and prosecution for violations of these laws, the risks cannot be entirely eliminated. Any action against us or
our licensees for violation of these laws, even if we successfully defend against it, could cause us to incur significant legal expenses, cause reputational harm and divert our
management’s attention from the operation of our business. Moreover, achieving and sustaining compliance with EU government and regulatory agencies and applicable U.S.
federal and state laws may prove costly.

Because of the breadth of these laws and the narrowness of the safe harbors, it is possible that some of our business activities could be subject to challenge under one or more of
such laws. The ACA also made several important changes to the federal anti-kickback statute, false claims laws and healthcare fraud statute by weakening the intent requirement
under the anti-kickback and healthcare fraud statutes that may make it easier for the government or whistleblowers to charge such fraud and abuse violations. A person or entity
no longer needs to have actual knowledge of this 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 false claims statutes. In addition, the ACA
increases  penalties  for  fraud  and  abuse  violations.  If  our  past,  present  or  future  operations  are  found  to  be  in  violation  of  any  of  the  laws  described  above  or  other  similar
governmental  regulations  to  which  we  are  subject,  we  may  be  subject  to  significant  civil,  criminal  and  administrative  penalties,  damages,  fines,  imprisonment,  exclusion  from
government funded healthcare programs, such as Medicare and Medicaid, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to
operate our business and negatively impact our financial results.

16

If Macrilen™ (macimorelin) does not gain market acceptance, we may be unable to generate significant revenues.

Market acceptance of Macrilen™ (macimorelin) depends on a number of factors, including, but not limited to, the following:

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demonstration of clinical efficacy and safety;

the prevalence and severity of any adverse side effects;

limitations or warnings contained in the product’s approved labeling;

availability of alternative treatments or tests for the indications we target;

the advantages and disadvantages of Macrilen™ (macimorelin) relative to current or alternative treatments and tests;

the classification and description of MacrilenTM (macimorelin) in relevant guidelines;

the availability of acceptable pricing and adequate third-party reimbursement; and

the effectiveness of marketing and distribution methods for Macrilen™ (macimorelin).

If Macrilen™ (macimorelin) does not gain market acceptance among physicians, patients, healthcare payers and others in the medical community, who may not accept or utilize
Macrilen™ (macimorelin), our ability to generate significant revenues from Macrilen™ (macimorelin) would be limited, and our financial condition could be materially, adversely
affected. In addition, if we fail to further penetrate our core markets and existing geographic markets or to successfully expand our business into new markets, the growth in sales of
Macrilen™ (macimorelin), along with our operating results, could be negatively impacted.

Our ability to further penetrate our core markets and existing geographic markets in which we compete or to successfully expand our business into additional countries in Europe,
Asia or elsewhere is subject to numerous factors, many of which are beyond our control. Macrilen™ (macimorelin), if successfully commercialized, may compete with a number of
drugs,  therapies,  products  and  tests  currently  manufactured  and  marketed  by  major  pharmaceutical  and  other  biotechnology  companies.  Macrilen™  (macimorelin)  may  also
compete with new products currently under development by others or with products which may be less expensive than Macrilen™ (macimorelin). There can be no assurance that
our efforts to increase market penetration in our core markets and existing geographic markets will be successful. Our failure to do so could have an adverse effect on our operating
results and would likely cause a drop in the share price of our Common Shares.

We may expend our limited resources to pursue a particular product or indication and fail to capitalize on other products or indications for which there may be a greater
likelihood of success.

We are currently focusing our efforts on Macrilen™ (macimorelin) for specific indications and for the six pre-clinical programs announced in 2021. As a result, we may forego or
delay  pursuit  of  opportunities  for  other  potential  indications  for  Macrilen™  (macimorelin),  which  there  may  be  a  greater  likelihood  of  success  or  may  prove  to  have  greater
commercial potential. Research programs to identify new product candidates or pursue alternative indications for Macrilen™ (macimorelin) require substantial technical, financial
and human resources. These activities – if pursued – may initially show promise in identifying potential product candidates or indications, yet fail to yield product candidates or
indications for further clinical development.

We may not achieve our projected development goals in the time-frames we announce and expect.

We may set goals and make public statements regarding the timing of the accomplishment of objectives material to our success, such as the commencement, enrollment and
anticipated completion of clinical trials, anticipated regulatory submission and approval dates and time of product launch. The actual timing of these events can vary dramatically

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
due to factors such as delays or failures in any clinical trials, the uncertainties inherent in the regulatory approval process and delays in achieving manufacturing or marketing
arrangements sufficient to commercialize any of our products or product candidates. There can be no assurance that we will make regulatory submissions or receive regulatory
approvals as planned or that we will be able to adhere to our schedule for launching of Macrilen™ (macimorelin) or any of our future product candidates. If we fail to achieve one
or more of these milestones as planned, the share price of our Common Shares may decline.

17

If we fail to obtain acceptable prices or adequate reimbursement for Macrilen™ (macimorelin), our ability to generate revenues will be diminished.

Our ability or that of our licensee(s) to successfully commercialize Macrilen™ (macimorelin) will depend significantly on our or their ability to obtain acceptable prices and the
availability of reimbursement to the patient from third-party payers, such as governmental and private insurance plans. These third-party payers frequently require companies to
provide  predetermined  discounts  from  list  prices,  and  they  are  increasingly  challenging  the  prices  charged  for  pharmaceuticals  and  other  medical  products.  Macrilen™
(macimorelin) may not be considered cost-effective, and reimbursement to the patient may not be available or sufficient to allow us or our licensee(s) to sell our products on a
competitive basis. It may not be possible to negotiate favorable reimbursement rates for Macrilen™ (macimorelin). Adverse pricing and reimbursement conditions would also likely
diminish our ability to induce third parties to in-license Macrilen™ (macimorelin).

In addition, the continuing efforts of third-party payers to contain or reduce the costs of healthcare through various means may limit our commercial opportunity and reduce any
associated revenue and profits. We expect that proposals to implement similar government controls will continue. The pricing of pharmaceutical products, in general, and specialty
drugs, in particular, has been a topic of concern in the U.S. Congress, where hearings on the topic have been held, and has been a topic of speeches given by political figures,
including the  President of the  U.S.  Specifically, there have been several recent  U.S.  Congressional inquiries and proposed bills designed to, among other things, bring more
transparency to drug pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for drugs.
Furthermore, there is drug pricing reform taking place at the state level in the U.S. that will impact how pharmaceutical companies can market and sell drug products and at what
price. Additionally, third-party payers are increasingly challenging the price, examining the medical necessity, and reviewing the cost-effectiveness of medical drug products and
medical services, in addition to questioning their safety and efficacy. There can be no assurance as to how this scrutiny on pricing of pharmaceutical products will impact future
pricing of a product or orphan drugs or pharmaceutical products generally. In addition, increasing emphasis on managed care will continue to put pressure on the pricing of
pharmaceutical and biopharmaceutical products. Cost control initiatives could decrease the price that we or any current or potential collaborators could receive a product and
could adversely affect our profitability.  In addition, in the  U.S.,  Canada and many other countries, pricing and/or profitability of some or all prescription pharmaceuticals and
biopharmaceuticals are subject to government control.

If  we  or  our  licensee(s)  fail  to  obtain  acceptable  prices  or  an  adequate  level  of  reimbursement  for  Macrilen™  (macimorelin),  the  sales  of  Macrilen™  (macimorelin)  would  be
adversely affected or there may be no commercially viable market for Macrilen™ (macimorelin).

Competition in our targeted markets is intense, and development by other companies could render Macrilen™ (macimorelin), or any of our future products, non-competitive.

The  biopharmaceutical  field  is  highly  competitive.  New  products  developed  by  other  companies  in  the  industry  could  render  Macrilen™  (macimorelin)  or  any  of  our  future
products uncompetitive or significantly less competitive. Competitors are developing and testing products and technologies that would compete with Macrilen™ (macimorelin) or
any of our future products. Some of these competitive products may be more effective or have an entirely different approach or means of accomplishing the desired effect than
Macrilen™  (macimorelin)  or  any  of  our  future  products.  We  expect  competition  from  pharmaceutical  and  biopharmaceutical  companies  and  academic  research  institutions  to
continue to increase over time. Many of our competitors and potential competitors have substantially greater product development capabilities and financial, scientific, marketing
and human resources than we do.

18

We may not obtain adequate protection for Macrilen™ (macimorelin) through our intellectual property.

We  rely  heavily  on  our  proprietary  information  in  developing  and  manufacturing  Macrilen™  (macimorelin).  Our  success  depends,  in  large  part,  on  our  ability  to  protect  our
competitive position through patents, trade secrets, trademarks and other intellectual property rights. We have filed and are pursuing applications for patents and trademarks in
many  countries.  Pending  patent  applications  may  not  result  in  the  issuance  of  patents,  and  we  may  not  be  able  to  obtain  additional  issued  patents  relating  to  Macrilen™
(macimorelin).

The laws of some countries do not protect intellectual property rights to the same extent as the laws of the U.S. and Canada. Many companies have encountered significant
problems in protecting and defending such rights in foreign jurisdictions. Many countries, including certain countries in Europe, have compulsory licensing laws under which a
patent owner may be compelled to grant licenses to third parties.  In addition, many countries limit the enforceability of patents against government agencies or government
contractors.  In these countries, the patent owner may have limited remedies, which could materially diminish the value of the patent.  Moreover, the legal systems of certain
countries, particularly certain developing countries, do not favor the aggressive enforcement of patent and other intellectual property protection, which makes it difficult to stop
and prevent infringement.

Our patents may be challenged, narrowed, invalidated, held to be unenforceable or circumvented, which could limit our ability to stop competitors from marketing similar products
or limit the length of term of patent protection we may have for Macrilen™ (macimorelin). Changes in either patent laws or in interpretations of patent laws in the U.S. and other
countries may diminish the value of our intellectual property or narrow the scope of our patent protection for Macrilen™ (macimorelin). The patents issued or to be issued to us for
Macrilen™ (macimorelin) may not provide us with any competitive advantage or protect us against competitors with similar technology. In addition, it is possible that third parties
with products that are very similar to ours will circumvent our patents by means of alternate designs or processes. We may have to rely on method-of-use, methods of manufacture
and/or new-formulation protection for our compounds in development, and any resulting products, which may not confer the same protection as claims to compounds per se.

In addition, our patents may be challenged by third parties in patent litigation, which is becoming widespread in the biopharmaceutical industry. There may be prior art of which we
are not aware that may affect the validity or enforceability of a patent claim. There may also be prior art of which we are aware, but which we do not believe affects the validity or
enforceability of a claim, which may, nonetheless, ultimately be found to affect the validity or enforceability of a claim. No assurance can be given that our patents would, if
challenged, be held by a court to be valid or enforceable, or that a competitor’s technology or product would be found by a court to infringe our patents. Our granted patents could
also be challenged and revoked in U.S. post-grant proceedings as well as in opposition or nullity proceedings in certain countries outside the U.S. In addition, we may be required
to disclaim part of the term of certain patents. The costs of these proceedings could be substantial, and it is possible that our efforts could be unsuccessful, resulting in a loss of
our U.S. patent position.

We also rely on trade secrets and proprietary know-how to protect our intellectual property. If we are unable to protect the confidentiality of our proprietary information and know-
how, the value of our technology and products could be adversely affected.  We seek to protect our unpatented proprietary information in part by requiring our employees,
consultants, outside scientific collaborators, and sponsored researchers and other advisors to enter into confidentiality agreements. These agreements provide that all confidential
information developed or made known to the individual during the course of the individual’s relationship with us is to be kept confidential and not disclosed to third parties except
in specific circumstances. In the case of our employees, the agreements provide that all of the technology that is conceived by the individual during the course of employment is
our  exclusive  property.  These  agreements  may  not  provide  meaningful  protection  or  adequate  remedies  in  the  event  of  unauthorized  use  or  disclosure  of  our  proprietary
information. In addition, it is possible that third parties could independently develop proprietary information and techniques substantially similar to ours or otherwise gain access
to our trade secrets. If we are unable to protect the confidentiality of our proprietary information and know-how, competitors may be able to use this information to develop

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
products that compete with our products and technologies, which could adversely impact our business.

We currently have the right to use certain patents and technologies under license agreements with third parties. Our failure to comply with the requirements of one or more of our
license agreements could result in the termination of such agreements, which could cause us to terminate the related development program and cause a complete loss of our
investment in that program or given market. Inventions claimed in certain in-licensed patents may have been made with funding from the U.S. government and may be subject to
the rights of the U.S. government, and we may be subject to additional requirements in the event we seek to commercialize or manufacture product candidates incorporating such
in-licensed technology.

19

As a result of the foregoing factors, we may not be able to rely on our intellectual property to protect Macrilen™ (macimorelin) in the marketplace.

We may infringe the intellectual property rights of others.

Our commercial success depends significantly on our ability to operate without infringing the patents and other intellectual property rights of third parties. There could be issued
patents of which we are not aware that our products or methods may be found to infringe, or patents of which we are aware and believe we do not infringe, but which we may
ultimately be found to infringe. Moreover, patent applications and their underlying discoveries are in some cases maintained in secrecy until patents are issued. Because patents
can take many years to issue, there may be currently pending applications of which we are unaware that may later result in issued patents that our products or technologies are
found to infringe. Moreover, there may be published pending applications that do not currently include a claim covering our products or technologies, but, which nonetheless,
provide support for a later drafted claim that, if issued, our products or technologies could be found to infringe.

If we infringe or are alleged to infringe intellectual property rights of third parties, it will adversely affect our business. Third parties may own or control these patents or patent
applications in the U.S. and abroad. These third parties could bring claims against us or our collaborators that would cause us to incur substantial expenses and, if successful
against us, could cause us to pay substantial damages. Further, if a patent infringement suit were brought against us or our collaborators, we or they could be forced to stop or
delay research, development, manufacturing or sales of the product or product candidate that is the subject of the suit.

The biopharmaceutical industry has produced a proliferation of patents, and it is not always clear to industry participants, including us, which patents cover various types of
products. The coverage of patents is subject to interpretation by the courts, and the interpretation is not always uniform. In the event of infringement or violation of another
party’s patent or other intellectual property rights, we may not be able to enter into licensing arrangements or make other arrangements at a reasonable cost. Any inability to secure
licenses or alternative technology could result in delays in the introduction of our products or lead to prohibition of the manufacture or sale of products by us or our partners and
collaborators.

Patent litigation is costly and time consuming and may subject us to liabilities.

If we become involved in any patent litigation, interference, opposition, re-examination or other administrative proceedings, we will likely incur substantial expenses in connection
therewith, and the efforts of our technical and management personnel will be significantly diverted. In addition, an adverse determination in litigation could subject us to significant
liabilities.

We may not obtain trademark registrations for our current or future products.

We have filed applications for trademark registrations, including Macrilen™ (macimorelin), in various jurisdictions, including the U.S. We may file applications for other possible
trademarks for macimorelin. No assurance can be given that any of our trademarks will be registered elsewhere, or that the use of any registered or unregistered trademarks will
confer a competitive advantage in the marketplace.

We rely on third parties to conduct, supervise and monitor our clinical trials, and those third parties may not perform satisfactorily.

We rely on third parties such as CROs, medical institutions and clinical investigators to enroll qualified patients and to conduct, supervise and monitor our clinical trials. Our
reliance on these third parties for clinical development activities reduces our control over these activities. Our reliance on these third parties, however, does not relieve us of our
regulatory responsibilities, including ensuring that our clinical trials are conducted in accordance with GCP guidelines and the investigational plan and protocols contained in an
IND application to the FDA, or a comparable foreign regulatory submission. Furthermore, these third parties may also have relationships with other entities, some of which may be
our competitors. In addition, they may not complete activities on schedule, or may not conduct our preclinical studies or clinical trials in accordance with regulatory requirements
or our trial design. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, our efforts to obtain regulatory approvals for, and to
commercialize, our products may be delayed or prevented.

20

We  are  dependent  on,  and  rely  upon,  third  parties  to  perform  various  functions  related  to  our  business,  including,  but  not  limited  to,  development  of  some  of  our  product
candidates. Our reliance on these relationships poses a number of risks.

Any difficulties or delays in the commencement or completion, or termination or suspension, of our ongoing or planned clinical trials could result in increased costs to us,
delay or limit our ability to generate revenue and adversely affect our commercial prospects.

Before we can initiate clinical trials for our product candidates, we must submit the results of preclinical studies to the FDA or comparable foreign regulatory authorities along with
other information, including information about product candidate chemistry, manufacturing and controls and our proposed clinical trial protocol, as part of an  IND or similar
regulatory filing required for authorization to proceed with clinical development.  The  FDA or comparable foreign regulatory authorities  may  require  us  to  conduct  additional
preclinical studies for any product candidate before it allows us to initiate clinical trials under any IND or similar regulatory filing, which may lead to delays and increase the costs
of our preclinical development programs. Any such delays in the commencement or completion of the DETECT-trial evaluating macimorelin for the diagnosis of CGHD, or any other
product candidate, could significantly affect our product development costs.

Further, conducting clinical trials in foreign countries, as in our ongoing DETECT-trial, presents additional risks that may delay completion of our clinical trials. These risks include
the  failure  of  enrolled  patients  in  foreign  countries  to  adhere  to  clinical  protocol  as  a  result  of  differences  in  healthcare  services  or  cultural  customs,  managing  additional
administrative burdens associated with foreign regulatory schemes, as well as political and economic risks, including war, relevant to such foreign countries. For example, we have
engaged a CRO to conduct the DETECT-trial outside the United States, including in Russia and Ukraine and clinical trial sites in those countries are being halted due to the conflict
in Ukraine. To date, no patients have been enrolled in these clinical trials. Russia’s invasion of Ukraine in February 2022 may impact our ability to conduct certain of our trials in the
region. This could hinder the completion of our clinical trials and/or analyses of clinical results, which could materially harm our business.

We  are  conducting  our  DETECT-trial  of  macimorelin  globally  and  may  conduct  future  clinical  trials  outside  the  United  States.  However,  the  FDA  and  other  foreign
equivalents may not accept data from such trials, in which case our development plans will be delayed, which could materially harm our business.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In particular, we have engaged a CRO to conduct our DETECT-trial outside of the United States, including in Russia and Ukraine. As a result of Russia’s invasion of Ukraine in
February 2022, clinical trial sites in  Ukraine and the surrounding region are being halted.Furthermore, the  United  States and its  European allies have imposed significant new
sanctions against Russia, including regional embargoes, full blocking sanctions, and other restrictions targeting major Russian financial institutions. Our ability to conduct clinical
trials in Russia, parts of Ukraine and elsewhere in the region may become restricted under applicable sanctions laws, which would require us to identify alternative trial sites, which
may increase our development costs and delay the clinical development of our product candidates. All of the foregoing could impede the execution of our clinical development
plans, which could materially harm our business.

In carrying out our operations, we are dependent on a stable and consistent supply of ingredients and raw materials.

There can be no assurance that we, our contract manufacturers or our licensees, will be able, in the future, to continue to purchase products from our current suppliers or any other
supplier on terms that are favorable or similar to current terms or at all. An interruption in the availability of certain raw materials or ingredients, or significant increases in the prices
we pay for them, could have a material adverse effect on our business, financial condition, liquidity and operating results.

The failure to perform satisfactorily by third parties upon which we expect to rely to manufacture and supply products may lead to supply shortfalls.

We rely on third parties to manufacture and supply Macrilen™ (macimorelin). We also have or may have certain supply obligations  vis-à-vis our existing and potential licensees,
who are or will be responsible for the marketing of  Macrilen™ (macimorelin).  To be successful,  Macrilen™ (macimorelin) has to be manufactured in commercial quantities in
compliance with quality controls and regulatory requirements. Even though it is our objective to minimize such risk by introducing alternative suppliers to ensure a constant
supply  at  all  times,  there  are  a  limited  number  of  contract  manufacturers  or  suppliers  that  are  capable  of  manufacturing  Macrilen™  (macimorelin)  or  the  materials  used  in  its
manufacture.  If we are unable to do so ourselves or to arrange for third-party manufacturing or supply of  Macrilen™ (macimorelin) or materials, or to do so on commercially
reasonable terms, we may not be able to commercialize Macrilen™ (macimorelin) through our licensees. Reliance on third-party manufacturers entails risks to which we would not
be subject if we manufactured products ourselves, including reliance on the third party for regulatory compliance, the possibility of breach of the manufacturing agreement by the
third party because of factors beyond our control, and the possibility of termination or non-renewal of the agreement by the third party, based on its own business priorities, at a
time that is costly or inconvenient for us.

We are subject to intense competition for our skilled personnel, and the loss of key personnel or the inability to attract additional personnel could impair our ability to
conduct our operations.

We  are  highly  dependent  on  our  management  and  our  clinical,  regulatory  and  scientific  staff,  the  loss  of  whose  services  might  adversely  impact  our  ability  to  achieve  our
objectives.  Recruiting  and  retaining  qualified  management  and  clinical,  scientific  and  regulatory  personnel  is  critical  to  our  success.  Reductions  in  our  staffing  levels  have
eliminated redundancies in key capabilities and skill sets among our full-time staff, and required us to rely more heavily on outside consultants and third parties. We have been
unable to increase the compensation of our associates to the extent required to remain fully competitive for their services, which increased our employee retention risk.  The
competition for qualified personnel in the biopharmaceutical field is intense, and if we are not able to continue to retain qualified personnel and/or maintain positive relationships
with our outside consultants, we may not be able to achieve our strategic and operational objectives.

We may be subject to litigation in the future.

We may, from time to time, be a party to litigation in the normal course of business. Monitoring and defending against legal actions, whether meritorious, is time-consuming for our
management and detracts from our ability to fully focus our internal resources on our business activities.  In addition, legal fees and costs incurred in connection with such
activities may be significant and we could, in the future, be subject to judgments or enter into settlements of claims for significant monetary damages. A decision adverse to our
interests could result in the payment of substantial damages and could have a material adverse effect on our cash flow, results of operations and financial position.

21

With respect to any litigation, our insurance may not reimburse us, or may not be sufficient to reimburse us, for the expenses or losses we may suffer in contesting and concluding
such lawsuit. Substantial litigation costs, including the substantial self-insured retention that we are required to satisfy before any insurance applies to a claim, unreimbursed legal
fees or an adverse result in any litigation may adversely impact our business, operating results or financial condition.

We are subject to the risk of product liability claims, for which we may not have or may not be able to obtain adequate insurance coverage.

The sale and use of Macrilen™ (macimorelin) will involve the risk of product liability claims and associated adverse publicity. Product liability claims might be made against us
directly by patients, healthcare providers or pharmaceutical companies, or others selling, buying or using our products. We attempt to manage our liability risks by means of
insurance. We maintain insurance covering our liability for our preclinical and clinical studies as well as products liability insurance. However, we may not have or be able to obtain
or maintain sufficient and affordable insurance coverage, including coverage for potentially very significant legal expenses, and without sufficient coverage any claim brought
against us could have a materially adverse effect on our business, financial condition or results of operations.

We are a holding company, and claims of creditors of our subsidiaries will generally have priority as to the assets of such subsidiaries over our claims and those of our
creditors and shareholders. In addition, our principal operating subsidiary, AEZS Germany, may become subject to insolvency proceedings if it is illiquid or "over-indebted”
in accordance with German law.

Aeterna Zentaris is a holding company and a substantial portion of our non-cash assets is the share capital of our subsidiaries. AEZS Germany, our principal operating subsidiary,
based in  Frankfurt,  Germany, holds most of our intellectual property rights.  Because Aeterna  Zentaris is a holding company, our obligations to our creditors are structurally
subordinated to all existing and future liabilities of our subsidiaries, which may incur additional or other liabilities and/or obligations. As a result, our rights and the rights of our
creditors to participate in any distribution of the assets of any subsidiary in the event that such subsidiary were to be liquidated or reorganized or in the event of any bankruptcy
or insolvency proceeding relating to or involving such subsidiary, and, therefore, the rights of the holders of our securities to participate in those assets, are subject to the prior
claims of such subsidiary’s creditors. To the extent that we may be a creditor with recognized claims against any such subsidiary, our claims would still be subject to the prior
claims of our subsidiary’s creditors to the extent that they are secured or senior to those held by us.

Holders of our securities are not creditors of our subsidiaries. Claims to the assets of our subsidiaries will derive from our own ownership interest in those operating subsidiaries.
Claims of our subsidiaries’ creditors will generally have priority as to the assets of such subsidiaries over our own ownership interest claims and, therefore, will have priority over
the holders of our securities.  Our subsidiaries’ creditors may from time to time include general creditors, trade creditors, employees, secured creditors, taxing authorities and
creditors  holding  guarantees.  Accordingly,  in  the  event  of  any  foreclosure,  dissolution,  winding-up,  liquidation  or  reorganization,  or  a  bankruptcy,  insolvency  or  creditor
protection proceeding relating to us or our property, or any subsidiary, there can be no assurance as to the value, if any, that would be available to holders of our securities. In
addition, any distributions to us by our subsidiaries could be subject to monetary transfer restrictions in the jurisdictions in which our subsidiaries operate.

German  law,  which  governs  our  principal  operating  subsidiary AEZS  Germany,  imposes  an  obligation  on  the  managing  director(s)  of AEZS  Germany  to  institute  insolvency
proceedings  of  that  subsidiary  if  the  managing  director(s)  concludes  that AEZS  Germany  is  insolvent  because  it  is  either  illiquid  or  "over-indebted”  in  accordance  with  the
provisions of German law.

22

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
It may be difficult for U.S. investors to obtain and enforce judgments against us because of our Canadian incorporation and German presence.

We are a company existing under the laws of Canada. A number of our directors and officers are residents of Canada or otherwise reside outside the U.S., and all or a substantial
portion of their assets, and a substantial portion of our assets, are located outside the U.S. Consequently, although we have appointed an agent for service of process in the U.S.,
it may be difficult for investors in the U.S. to bring an action against such directors or officers or to enforce against those persons or us a judgment obtained in a U.S. court
predicated upon the civil liability provisions of federal securities laws or other laws of the U.S. Investors should not assume that foreign courts (i) would enforce judgments of U.S.
courts obtained in actions against us or such directors, officers or experts predicated upon the civil liability provisions of the U.S. federal securities laws or the securities or "blue
sky” laws of any state within the U.S. or (ii) would enforce, in original actions, liabilities against us or such directors, officers or experts predicated upon the U.S. federal securities
laws or any such state securities or "blue sky” laws.

We are subject to various internal control reporting requirements under applicable Canadian securities laws and the Sarbanes-Oxley Act in the U.S. We can provide no
assurance that we will, at all times in the future, be able to report that our internal controls over financial reporting are effective.

As a public company, we are required to comply with  Section 404 of the  U.S. Sarbanes-Oxley  Act of 2002 ("Section 404”)  and  National  Instrument  52-109  - Certification  of
Disclosure in Issuers’ Annual and Interim Filings of the Canadian securities administrators. In any given year, we cannot be certain as to the time of completion of our internal
control evaluation, testing and remediation actions or of their impact on our operations. Upon completion of this process, we may identify control deficiencies of varying degrees
of severity under applicable SEC and Public Company Accounting Oversight Board (U.S.) rules and regulations. As a public company, we are required to report, among other
things, control deficiencies that constitute material weaknesses or changes in internal controls that, or that are reasonably likely to, materially affect internal controls over financial
reporting. A "material weakness” is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a
material misstatement of our annual or interim consolidated financial statements will not be prevented or detected on a timely basis. If we fail to comply with the requirements of
Section 404 or similar Canadian requirements, or if we report a material weakness, we might be subject to regulatory sanction and investors may lose confidence in our consolidated
financial statements, which may be inaccurate if we fail to remedy such material weakness.

We have identified a material weakness in our internal control over financial reporting as of December 31, 2021. If we fail to fully remediate this weakness and maintain
proper and effective internal controls, our ability to produce accurate and timely consolidated financial statements could be impaired, which could harm our operating
results and our ability to operate our business or investors’ views of us and could have a material adverse effect on the price of our common stock.

Management assessed the effectiveness of our internal control over financial reporting as of December 31, 2021, and based on our assessment using criteria established in Internal
Control — Integrated Framework: 2013, issued by the Committee of Sponsoring Organizations of the Treadway Commission, management concluded that our internal control
over financial reporting was not effective as of December 31, 2021. Management identified a control deficiency that constitutes a material weakness. The material weakness resulted
from  a  failure  in  the  design  and  implementation  of  review  controls  over  the  accounting  for  under  license  and  collaboration  agreements  under  IFRS  and  the  related  revenue
recognition. This resulted in a restatement of our previously issued condensed interim consolidated financial statements as at and for the quarters and year-to-date periods ended
March 31, 2021, June 30, 2021 and September 30, 2021, with respect to revenue recognition on one agreement.

We have developed and commenced implementation of a remediation plan for this material weakness. While we intend to remediate this material weakness, we have not completed
the implementation of this plan, and we can give no assurance that our current and planned implementation will remediate this deficiency in our internal control or that additional
material weaknesses or significant deficiencies in our internal control over financial reporting will not be identified in the future. Our failure to implement and maintain effective
internal control over financial reporting could result in errors in our consolidated financial statements that could result in a restatement of our consolidated financial statements and
cause us to fail to meet our reporting obligations. If we cannot in the future favorably assess the effectiveness of our internal control over financial reporting, investor confidence
in the reliability of our financial reports may be adversely affected, which could have a material adverse effect on the trading price of our common stock.

We are subject to a broad range of environmental laws and regulations and may be subject to environmental remediation obligations under such safety and related laws and
regulations. The impact of these obligations and the Company’s ability to respond effectively to them may have a material adverse effect on our business, financial condition,
cash flows and results of operations and could cause the market value of our Common Shares to decline.

We are subject to a broad range of federal, state, provincial and local environmental laws and regulations in the U.S., Canada and Germany concerning the environment, safety
matters, regulation of chemicals and product safety in the countries where we manufacture and sell our products or otherwise operate our business. These requirements include,
among other matters, regulation of the handling, manufacture, transportation, storage, use and disposal of materials, including the discharge of pollutants, hazardous substances
and waste into the environment. In the normal course of our business, such substances and waste may be released into the environment, which could cause environmental or
property damage or personal injuries, and which could subject us to remediation obligations regarding contaminated soil and groundwater, potential liability for damage claims or
to social or reputational harm and other similar adverse impacts. Under certain laws, we may be required to remediate contamination at certain of our properties regardless of
whether the contamination was caused by us or by previous occupants of the property, or by others and at third-party sites where we send waste.

In recent years, the operations of all companies have become subject to increasingly stringent legislation and regulation related to environmental protection. Such legislation and
regulations are complex and constantly changing. Future events, such as changes in existing laws or regulations or the enforcement thereof, or the discovery of contamination at
our facilities may, among other things, require us to install additional controls for certain of our emission sources, undertake changes in our manufacturing processes, remediate
soil or groundwater contamination at facilities where such cleanup is not currently required, or to take action to address social expectations or concerns arising from or relating to
such changes and our response to such changes. The cost of such additional compliance or remediation obligations or responding to such social expectations or concerns may be
significant and could have a material adverse effect on our business, financial condition, cash flows and results of operations and could cause the market value of our Common
Shares and/or debt securities to decline.

23

We may incur losses associated with foreign currency fluctuations.

Our operations are, in many instances, conducted in currencies other than our functional currency or the functional currencies of our subsidiaries. Fluctuations in the value of
currencies could cause us to incur currency exchange losses. We do not currently employ a hedging strategy against exchange rate risk. We cannot assert with any assurance that
we will not suffer losses as a result of unfavorable fluctuations in the exchange rates between the U.S. dollar, the euro, the Canadian dollar and other currencies.

Legislative actions, new accounting pronouncements and higher insurance costs may adversely impact our future financial position or results of operations.

Changes in financial accounting standards or implementation of accounting standards may cause adverse, unexpected revenue or expense fluctuations and affect our financial
position or results of operations. New pronouncements and varying interpretations of pronouncements have occurred with greater frequency and are expected to occur in the
future, and we may make or be required to make changes in our accounting policies in the future. Compliance with changing regulations of corporate governance and public
disclosure, notably with respect to internal controls over financial reporting, may result in additional expenses. Changing laws, regulations and standards relating to corporate
governance and public disclosure are creating uncertainty for companies such as ours, and insurance costs are increasing as a result of this uncertainty.

Data security breaches may disrupt our operations and adversely affect our operating results.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our network security and data recovery measures and those of third parties with which we contract, may not be adequate to protect against computer viruses, cyber-attacks,
breaches, and similar disruptions from unauthorized tampering with our computer systems. The misappropriation, theft, sabotage or any other type of security breach with respect
to any of our proprietary and confidential information that is electronically stored, including research or clinical data, could cause interruptions in our operations, could result in a
material  disruption  of  our  clinical  activities  and  business  operations  and  could  expose  us  to  third-party  legal  claims.  Furthermore,  we  could  be  required  to  make  substantial
expenditures of resources to remedy the cause of cyber-attacks or break-ins. This disruption could have a material adverse impact on our business, operating results and financial
condition. Additionally, any break-in or trespass of our facilities that results in the misappropriation, theft, sabotage or any other type of security breach with respect to our
proprietary and confidential information, including research or clinical data, or that results in damage to our research and development equipment and assets could have a material
adverse impact on our business, operating results and financial condition.

Our business processes personal information, both in connection with clinical activities and our employees. The use of this information is critical to our operations and innovation,
including  the  development  of  our  products,  as  well  as  management  of  our  employees.  New  and  evolving  regulations,  such  as  the  European  Union  General  Data  Protection
Regulation, could bring increased scrutiny of our data management in the future. Any cyber-attacks or other failure to protect critical and sensitive systems and information could
damage our reputation, prompt litigation or lead to regulatory sanctions, all of which could materially affect our financial condition and results of operation.

Risks Relating to our Common Shares

Our share price is volatile, which may result from factors outside of our control.

Our valuation and share price since the beginning of trading after our initial listings, first in  Canada and then in the  U.S., have had no meaningful relationship to current or
historical financial results, asset values, book value or many other criteria based on conventional measures of the value of shares.

Between January 1, 2021 and December 31, 2021, the closing price of our Common Shares ranged from $0.36 to $3.34 per share on the NASDAQ and from C$0.64 to C$4.25 per share
on the TSX. As of March 24, 2022, the price of our Common Shares on the NASDAQ was $0.375 and C$0.47 on the TSX. Our share price may be affected by developments directly
affecting our business and by developments out of our control or unrelated to us. The stock market generally, and the biopharmaceutical sector in particular, are vulnerable to
abrupt changes in investor sentiment. Prices of shares and trading volume of companies in the biopharmaceutical industry can swing dramatically in ways unrelated to, or that bear
a  disproportionate  relationship  to,  operating  performance.  Our  share  price  and  trading  volume  may  fluctuate  based  on  a  number  of  factors  including,  but  not  limited  to,  the
following:

24

● developments regarding current or future third-party suppliers and licensee(s);

● clinical trial and regulatory developments regarding Macrilen™ (macimorelin);

● delays in our anticipated clinical trial development or commercialization timelines;

● announcements by us regarding technological, regulatory or other matters;

● arrivals or departures of key personnel;

● governmental or regulatory action affecting our product candidates and our competitors’ products in the U.S., Canada and other countries;

● developments or disputes concerning patent or proprietary rights;

● actual or anticipated fluctuations in our revenues or expenses;

● general market conditions and fluctuations for the emerging growth and biopharmaceutical market sectors; and

● economic conditions in the U.S. or abroad, including the instability due to COVID-19.

Our listing on both the NASDAQ and the TSX may increase price volatility due to various factors, including different ability to buy or sell our Common Shares, different market
conditions in different capital markets, and different trading volumes. In addition, low trading volume may increase the price volatility of our Common Shares. A thin trading market
could cause the share price of our Common Shares to fluctuate significantly more than the stock market as a whole.

We do not intend to pay dividends in the near future.

To date, we have not declared or paid any dividends on our Common Shares. As a result, the return on an investment in our Common Shares, or any of our other securities, will
depend upon any future appreciation in value. There is no guarantee that our Common Shares or any of our other securities will appreciate in value or even maintain the price at
which shareholders have purchased them.

Future issuances of securities and hedging activities may depress the trading price of our Common Shares.

Any additional or future issuance of securities or convertible securities, including the issuance of securities upon the exercise of stock options and upon the exercise of warrants
or other convertible securities or securities pursuant to which Common Shares are issuable, could dilute the interests of our existing shareholders, and could substantially decrease
the trading share price of our Common Shares.

We may issue equity securities in the future for a number of reasons, including to finance our operations and business strategy, to satisfy our obligations upon the exercise of
options or warrants, or for other reasons. Our stock option plans generally permit us to have outstanding, at any given time, stock options that are exercisable for a maximum
number of Common Shares equal to 11.4% of all then issued and outstanding Common Shares.

In addition, the share price of our Common Shares could also be affected by possible sales of securities by investors who view other investment vehicles as more attractive means
of equity participation in us and by hedging or arbitrage trading activity that may develop involving our securities. This hedging or arbitrage could, in turn, affect the trading share
price of our Common Shares.

25

In the event we were to lose our foreign private issuer status as of June 30 of a given financial year, we would be required to comply with the Securities Exchange Act of 1934
domestic reporting regime, which could cause us to incur additional legal, accounting and other expenses.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In order to maintain our current status as a foreign private issuer, either (1) a majority of our Common Shares must not be either directly or indirectly owned of record by residents
of the U.S. or (2) (a) a majority of our executive officers and of our directors must not be U.S. citizens or residents, (b) more than 50 percent of our assets cannot be located in the
U.S. and (c) our business must be administered principally outside the U.S.

In 2021, our management conducted its annual assessment of the various facts and circumstances underlying the determination of our status as a foreign private issuer and, based
on the foregoing, our management has determined that, as of the date of such determination and as of June 30, 2021, we continued to be a foreign private issuer.

There can be no assurance, however, that we will remain a foreign private issuer either in 2022 or in future financial years.

If we were to lose our foreign private issuer status as of June 30 of any given financial year, we would be required to comply with the Securities Exchange Act of 1934 reporting and
other requirements applicable to U.S. domestic issuers, which are more detailed and extensive than the requirements for foreign private issuers. We may also be required to make
changes in our corporate governance practices in accordance with various SEC rules and the NASDAQ listing standards. The regulatory and compliance costs to us of complying
with the reporting requirements applicable to a U.S. domestic issuer under U.S. securities laws may be higher than the cost we have historically incurred as a foreign private issuer.
As  a  result,  we  would  expect  that  a  potential  loss  of  foreign  private  issuer  status  at  some  future  point  in  time  could  increase  our  legal,  financial  reporting  and  accounting
compliance costs, and it is difficult at this time to estimate by how much our legal, financial reporting and accounting compliance costs may increase in such eventuality.

Our articles of incorporation contain "blank check” preferred share provisions, which could delay or impede an acquisition of our company.

Our  articles  of  incorporation,  as  amended,  authorize  the  issuance  of  an  unlimited  number  of  "blank  check”  preferred  shares,  which  could  be  issued  by  our  Board  without
shareholder  approval  and  which  may  contain  liquidation,  dividend  and  other  rights  equivalent  or  superior  to  our  Common  Shares.  In  addition,  we  have  implemented  in  our
constating documents an advance notice procedure for shareholder approvals to be brought before an annual meeting of our shareholders, including proposed nominations of
persons for election to our Board. These provisions, among others, whether alone or together, could delay or impede hostile takeovers and changes in control or changes in our
management. Any provision of our constating documents that has the effect of delaying or deterring a change in control could limit the opportunity for our shareholders to receive
a premium for their Common Shares and could also affect the price that some investors are willing to pay for our Common Shares.

Our business could be negatively affected as a result of the actions of activist shareholders.

Proxy  contests  have  been  waged  against  many  companies  in  the  biopharmaceutical  industry  over  the  last  few  years.  If  faced  with  a  proxy  contest,  we  may  not  be  able  to
successfully respond to the contest, which would be disruptive to our business. Even if we are successful, our business could be adversely affected by a proxy contest because:

●

●

●

responding to proxy contests and other actions by activist shareholders may be costly and time-consuming, and may disrupt our operations and divert  the
attention of management and our employees;

perceived uncertainties as to the potential outcome of any proxy contest may result in our inability to consummate potential acquisitions, collaborations or in-
licensing opportunities and may make it more difficult to attract and retain qualified personnel and business partners; and

if individuals that have a specific agenda different from that of our management, or other members of our board of directors are elected to our Board as a result of
any  proxy  contest,  such  an  election  may  adversely  affect  our  ability  to  effectively  and  timely  implement our  strategic  plan  and  to  create  value  for  our
shareholders.

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Item 4.

Information on the Company

A.

History and development of the Company

Aeterna Zentaris Inc. was incorporated on September 12, 1990 under the Canada Business Corporations Act (the "CBCA”) and continues to be governed by the CBCA. Our
registered address is located at 222 Bay St., Suite 3000, Toronto, Ontario, Canada M5K 1E7 c/o Norton Rose Fulbright Canada LLP and we operate another office located at 315
Sigma Drive, Summerville, South Carolina 29486; our telephone number is (843) 900-3223 and our website is www.zentaris.com.

In May 2004, we changed our name to Aeterna Zentaris Inc. and on November 17, 2015, we completed 100-to-1 Share Consolidation (reverse stock split). Our Common Shares
commenced trading on a consolidated and adjusted basis on both the NASDAQ and the TSX on November 20, 2015.

We currently have three wholly-owned direct and indirect subsidiaries: Aeterna Zentaris GmbH ("AEZS Germany”), based in Frankfurt am Main, Germany and incorporated under
the laws of Germany; Zentaris IVF GmbH, a direct wholly-owned subsidiary of AEZS Germany based in Frankfurt am Main, Germany and incorporated under the laws of Germany;
and Aeterna Zentaris, Inc., an entity incorporated in the State of Delaware with an office in the Charleston, South Carolina area in the U.S.

Our Common Shares are listed for trading on both the NASDAQ and the TSX under the trading symbol "AEZS”.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our agent for service of process and SEC matters in the U.S. is our wholly-owned subsidiary, Aeterna Zentaris, Inc., located at 315 Sigma Drive, Summerville, South Carolina 29486.

Recent Developments

For a complete description of our recent corporate and pipeline developments, refer to "Item 5. - Operating and Financial Review and Prospects - Key Developments”.

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B.

Business overview

Aeterna  Zentaris  is  a  specialty  biopharmaceutical  company  commercializing  and  developing  therapeutics  and  diagnostic  tests.  The  Company’s  lead  product,  Macrilen™
(macimorelin),  is  the  first  and  only  U.S.  Food  and  Drug Administration  and  European  Commission  approved  oral  test  indicated  for  the  diagnosis  of  patients  with AGHD.
Macimorelin  is  currently  marketed  in  the  U.S.  under  the  tradename  Macrilen™  through  the  license  agreement  and  the  amended  license  agreement  (collectively  the  "Novo
Amendment”) with Novo Nordisk Healthcare AG ("Novo Nordisk” or "Novo”) under which Aeterna Zentaris receives royalties on net sales. According to a commercialization and
supply agreement, MegaPharm Ltd. is seeking regulatory approval and plans to subsequently commercialize macimorelin in Israel and the Palestinian Authority. Additionally, upon
receipt  of  pricing  and  reimbursement  approvals, Aeterna  Zentaris  expects  that  macimorelin  will  be  marketed  in  Europe  and  the  United  Kingdom  as  GHRYVELIN™  through  a
recently established license agreement with Consilient Health Ltd. ("Consilient Health”) under which Aeterna Zentaris will receive regulatory milestone payments related to agreed-
upon pricing and reimbursement parameters; net sales milestone payments; and royalties, ranging from 10%-20% of net sales, subject to reduction in certain cases, or sublicense
income  recorded  by  Consilient  Health.  The  Company  is  also  leveraging  the  clinical  success  and  compelling  safety  profile  of  macimorelin  to  develop  it  for  the  diagnosis  of
childhood-onset  growth  hormone  deficiency  ("CGHD”),  an  area  of  significant  unmet  need.  The  Company  is  actively  pursuing  business  development  opportunities  for  the
commercialization of macimorelin in Asia and the rest of the world. We entered into license and supply agreements with NK Meditech Ltd. ("NK”), a subsidiary of PharmBio Korea,
effective  November  30,  2021,  and  a  distribution  and  commercialization  agreement  with  ER  Kim  Pharmaceuticals  Bulgaria  Food  ("ER-Kim”),  effective  February  1,  2022.  The
agreements with NK are related to the development and commercialization of macimorelin for the diagnosis of AGHD and CGHD in the Republic of Korea, while the agreement with
ER-Kim is related to the commercialization of macimorelin for the diagnosis of growth hormone deficiency in children and adults in Turkey and some non-European Union Balkan
countries.

The Company is dedicated to the development of therapeutic assets and has recently taken steps to establish a pre-clinical pipeline to potentially address unmet medical needs
across a number of indications with a focus on rare or orphan indications and with the potential for pediatric use. To date, we have signed agreements to establish this growing
pipeline across a number of indications, including neuromyelitis optica spectrum disorder (NMOSD),  Parkinson’s disease (PD), primary hypoparathyroidism and amyotrophic
lateral sclerosis (ALS, Lou Gehrig’s disease). Additionally, the Company is developing oral prophylactic bacterial vaccines against each of SARS-CoV-2, the virus that causes
COVID-19, and Chlamydia Trachomatis.

Macrilen™ (macimorelin)

Macrilen™ (macimorelin) is a novel orally available peptidomimetic ghrelin receptor agonist that stimulates the secretion of growth hormone by binding to the ghrelin receptor
(GHSR-1a) and has potential uses in both endocrinology and oncology indications. Macrilen™ (macimorelin) was granted orphan-drug designation by the FDA for use in the
diagnosis of growth hormone deficiency ("GHD”).

Competitors for Macrilen™ (macimorelin) as a product for the diagnosis of AGHD are principally the diagnostic tests currently performed by endocrinologists, although none of
these tests are approved by the FDA for this purpose. The most commonly used diagnostic tests for GHD are:

●

●

●

The Insulin Tolerance Test ("ITT”), which has historically been considered the gold standard for the evaluation of AGHD because of its high sensitivity and
specificity. However, the ITT is inconvenient to both patients and physicians, administered  intravenously ("IV”), and contra-indicated in certain patients, such
as  patients  with  coronary  heart  disease  or seizure  disorder,  because  it  requires  the  patient  to  experience  hypoglycemia  to  obtain  an  accurate  result.  Some
physicians will not induce full hypoglycemia, intentionally compromising accuracy to increase safety and comfort for the patient. Furthermore, administration of
the ITT includes additional costs associated with the patient being closely monitored by a physician for the two- to four-hour duration of the test, and the test
must be administered in a setting where emergency equipment is available and where the patient can be quickly hospitalized. The ITT is not used for patients
with co-morbidities, such as cardiovascular disease, seizure disorder or a history of brain cancer, or for patients who are elderly and frail, due to safety concerns.

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The Glucagon Stimulation Test ("GST”) is considered relatively safe by endocrinologists. The mechanism of action for this test is unclear. Also, this test takes
up to three to four hours. It produces side effects in up to one-third of the patients with the most common being nausea during and after the test. This test is
administered intramuscularly ("IM”).

The growth hormone releasing hormone-arginine stimulation test ("GHRH + ARG”) is an easier test to perform in an office setting and has a good safety profile,
but is considered to be costly to administer compared to the ITT and the GST. GHRH + ARG has been proposed to be the best alternative to ITT, but GHRH +
ARG is no longer available in the U.S. This test is administered through an IV.

Oral administration of Macrilen™ (macimorelin) offers convenience and simplicity over the current GHD tests used, all of which require either IV or IM administration. Additionally,
Macrilen™ (macimorelin) may demonstrate a more favorable safety profile than existing diagnostic tests, some of which may be inappropriate for certain patient populations (e.g.
patients with diabetes mellitus or coronary heart disease) and have demonstrated a variety of side effects, which Macrilen™ (macimorelin) has not thus far. These factors may be
limiting  the  use  of  GHD  testing  and  may  potentially  enable  Macrilen™  (macimorelin)  to  become  the  product  of  choice  in  evaluating  AGHD.  We  believe  that  Macrilen™
(macimorelin) is well-positioned to displace the ITT as the preferred means by endocrinologists of evaluating AGHD for the following reasons:

●

●

●

●

●

●

it is safer and more convenient than the ITT because it does not require the patient to become hypoglycemic;

Macrilen™ (macimorelin) is administered orally, while the ITT requires an intravenous injection of insulin;

Macrilen™ (macimorelin) is a more robust test than the ITT leading to evaluable test results;

Macrilen™ (macimorelin) results are highly reproducible;

the evaluation of AGHD using Macrilen™ (macimorelin) is less time-consuming and labor-intensive than the ITT; and

the evaluation can be conducted in the physician’s office rather than in a hospital-like setting.

We believe that approximately 15,000 – 20,000 AGHD tests will be conducted annually, in the U.S., after full market introduction of Macrilen™ (macimorelin). In addition, based on
published information from the U.S. Centers for Disease Control and Prevention, different scientific publications, Huron, TVG and Navigant Research, we estimate that the total
potential U.S. market for AGHD evaluation is in the range of 28,000 to 43,000 tests per year, excluding the evaluation of patients who have suffered a traumatic brain injury (" TBI”).

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In patients with a TBI, GHD is frequent and may contribute to cognitive sequelae and reduction in quality of life. GHD may develop in approximately 10% to 35% of TBI victims
according to published study results. These data support a large upside potential for GHD testing.
Macimorelin Development History

The following is a summary of the history of our development of Macrilen™ (macimorelin):

2017 - present

●On January 4, 2017, we announced that, based on an analysis of top-line data, the confirmatory Phase 3 clinical trial of Macrilen™ (macimorelin) failed to achieve one of its co-
primary endpoints. Under the study protocol, the evaluation of AGHD with Macrilen™ (macimorelin) would be considered successful, if the lower bound of the two-sided 95%
confidence interval for the primary efficacy variables was 75% or higher for "percent negative agreement” with the ITT, and 70% or higher for the "percent positive agreement”
with  the  ITT.  While  the  estimated  percent  negative  agreement  met  the  success  criteria,  the  estimated  percent  positive agreement  did  not  reach  the  criteria  for  a  successful
outcome.  Therefore,  the  results  did  not  meet  the  pre-defined  equivalence  criteria which  required  success  for  both  the  percent  negative  agreement  and  the  percent  positive
agreement.

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●On February 13, 2017, we announced that, after reviewing the raw data on which the top-line data were based, we had concluded that Macrilen™ (macimorelin) had demonstrated
performance supportive of achieving FDA registration and that we intended to pursue registration. The announcement set forth the facts on which our conclusion was based.
The Company met with the FDA at the end of March 2017 to discuss this position.

●On March 7, 2017, we announced that the Pediatric Committee ("PDCO”) EMA agreed to the Company’s Pediatric Investigation Plan ("PIP”) for Macrilen™ (macimorelin) and
agreed  that  the  Company  may  defer  conducting  the  PIP  until  after  it files  a  Marketing Authorization Application  ("MAA”)  seeking  marketing  authorization  for  the  use  of
Macrilen™ (macimorelin) for the evaluation of AGHD.

●On July 18, 2017, we were provided a Prescription Drug User Fee Amendment date of December 30, 2017 by the FDA.

●On November 27, 2017, the EMA accepted our MAA submission for Macrilen™ (macimorelin).

●On December 20, 2017, the FDA approved the market authorization for Macrilen™ (macimorelin), to be used in the diagnosis of patients with AGHD.

●On January 16, 2018, the Company, through AEZS Germany, entered into a License Agreement to carry out development, manufacturing, registration,  regulatory and supply

chain services for the commercialization of Macrilen™ (macimorelin) in the U.S. and Canada as further described below.

●In the  August  2018, Volume  103,  Issue  8 edition o f The Journal  of  Clinical  Endocrinology  and  Metabolism,  the  pivotal  Phase  3  data  from  the Macrilen™  (macimorelin)

confirmatory trial was published by Jose M. Garcia, MD, PhD, et al., titled ‘Macimorelin as a Diagnostic Test for Adult GH Deficiency’.

●On November  19,  2018,  we announced the  Committee for  Medicinal  Products for Human Use ("CHMP”) of the EMA adopted a positive opinion recommending  a  marketing

authorization for macimorelin.

●On January 16, 2019, we announced that the EC granted marketing authorization for macimorelin.

●On December 18, 2019, we announced that the American Association of Clinical Endocrinologists ("AACE”) and the American  College of Endocrinology ("ACE”) published new
"Guidelines  for  Management  of  Growth  Hormone  Deficiency  in  Adults and  Patients  Transitioning  from  Pediatric  to Adult  Care”  ("Guidelines”).  Theses AACE/ACE  2019
Guidelines identify macimorelin as a "shorter and simpler alternative” compared to the traditionally available GHST.

Macrilen™ (macimorelin) Clinical Program

On January 28, 2020, we announced the successful completion of patient recruitment for the first pediatric study of macimorelin as a growth hormone stimulation test for the
evaluation of GHD in children. This study, AEZS-130-P01 (" Study P01”), was the first of two studies as agreed with the EMA in our Pediatric Investigation Plan (the "PIP”) for
macimorelin as a GHD diagnostic. Macimorelin, a ghrelin agonist, is an orally active small molecule that stimulates the secretion of growth hormone from the pituitary gland into the
circulatory system. The goal of Study P01 was to establish a dose that can both be safely administered to pediatric patients and cause a clear rise in growth hormone concentration
in subjects ultimately diagnosed as not having GHD. The recommended dose derived from Study P01 will be evaluated in the pivotal second study, Study P02, on diagnostic
efficacy and safety. Study P01 was an international, multicenter study, which was conducted in Hungary, Poland, Ukraine, Serbia, Belarus and Russia. Study P01 was an open label,
group comparison, dose escalation trial designed to investigate the safety, tolerability, and pharmacokinetic/pharmacodynamic (" PK/PD”) of macimorelin acetate after ascending
single oral doses of macimorelin at 0.25, 0.5, and 1.0 milligram per kilogram body weight in pediatric patients from two to less than 18 years of age with suspected CGHD. We
enrolled a total of 24 pediatric patients across the three cohorts of the study. Per study protocol, all enrolled patients completed four study visits after successful completion of the
screening period. At Visit 1 and Visit 3, a provocative growth hormone stimulation test was conducted according to the study sites’ local practices. At Visit 2, the macimorelin test
was performed, and following the oral administration of the macimorelin solution, blood samples were taken at predefined times for PK/PD assessment. Visit 4 was a safety follow-
up visit at study end.

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The final study results from Study P01 were published in the second quarter of 2020 indicating positive safety and tolerability data for use of macimorelin in CGHD, as well as
PK/PD data observed in a range as expected from the adult studies.

On April 7, 2020 the Company announced the decision of the EMA to accept our modification request of our PIP as originally approved in March 2017, which covered the conduct
of two pediatric studies and defined relevant key elements in the outline of these studies. We believe this EMA decision supports the development of one globally harmonized
study protocol for test validation, specifically Study P02, which we expect to be accepted both in Europe and the U.S.

In late 2020, Aeterna entered into the start-up phase for the clinical safety and efficacy study, AEZS-130-P02 ("Study P02” or ""DETECT-trial”), evaluating macimorelin for the
diagnosis of CGHD. The DETECT-trial is an open-label, single dose, multicenter and multinational study expected to enroll approximately 100 subjects worldwide, with at least 40
pre-pubertal and 40 pubertal subjects, and a minimum of 25 subjects expected to be enrolled in the U.S. The study design is expected to be suitable to support a claim for potential
stand-alone testing, if successful. In addition, under the Novo Amendment, Novo and Aeterna agreed that the percentage of DETECT-trial clinical trial costs that Novo is required
to reimburse to Aeterna was adjusted from 70% to 100% of costs up to $11 million (€9 million), and includes reimbursement of Aeterna’s budgeted internal labor costs. Any
additional external jointly approved DETECT-trial costs incurred over $11 million (€9 million) will be shared equally between Novo and Aeterna. On April 22, 2021, the U.S. FDA
Investigational New Drug Application associated with this clinical trial became active, see: https://clinicaltrials.gov/ct2/show/NCT04786873 and on May 13, 2021, we announced
the opening of the first clinical site in the U.S. On January 26, 2022, the Company announced that it had experienced unavoidable delays in site initiation and patient enrollment due
to  rise  of  the  Omicron  variant  in  the  COVID-19  pandemic.  Further  delays  may  be  experienced  as  a  result  of  the  invasion  into  Ukraine  by  Russia  which  may  cause  volatility,
disruption and instability in general economic conditions and international relations.

 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
Macimorelin Pre-clinical Program

On January 13, 2021, we entered into a material transfer agreement with Queensland University to provide macimorelin for the conduct of preclinical and clinical studies evaluating
macimorelin as a therapeutic for the treatment of amyotrophic lateral sclerosis ("ALS” and commonly known as Lou Gehrig’s disease). Queensland University researchers have
filed funding applications to dedicated organizations in Australia to finance parts of the abbreviated preclinical development program and to conduct a subsequent investigator-
initiated clinical trial to evaluate the safety, tolerability and efficacy of macimorelin as a potential new treatment option for ALS patients. The Company expects to continue work
with Queensland University to conduct proof-of-concept studies with macimorelin in disease specific animal models, assess alternative formulations and formalize a preclinical
development  plan.  The  Company  plans  to  evaluate  the  development  of  additional  alternative  formulations  or  administration  routes  with  the  goal  of  ensuring  sufficient
bioavailability and expects to provide updates on its progress as results become available.

Macimorelin Commercialization Program

On  June 25, 2020, we announced that we entered into an exclusive distribution and related quality agreement with  MegaPharm  Ltd., a leading  Israel-based biopharmaceutical
company, for the commercialization in Israel and in the Palestinian Authority of macimorelin, to be used in the diagnosis of patients with AGHD and in clinical development for the
diagnosis of CGHD.

Under the terms of the agreement, MegaPharm Ltd. will be responsible for obtaining registration to market macimorelin in Israel and the Palestinian Authority, while the Company
will be responsible for manufacturing, product supply, quality assurance and control, regulatory support, and maintenance of the relevant intellectual property.  In  June 2021,
MegaPharm Ltd. filed an application to the Ministry of Health of Israel for regulatory approval of macimorelin in Israel.

31

On November 16, 2020, the Company announced that it had entered into the Novo Amendment related to the development and commercialization of macimorelin. Novo is currently
marketing macimorelin in the U.S. under the tradename Macrilen™ for the diagnosis of AGHD. Aeterna, in collaboration with Novo, is currently developing the expanded use of
macimorelin for the diagnosis of CGHD, an area of significant unmet need.

Pursuant to the Novo Amendment, the Company agreed to grant to Novo additional rights with respect to ownership of the Aeterna Patent Rights and Trademarks, as defined, and
to  amend  certain  responsibilities  between Aeterna  and  Novo  with  respect  to  the  ongoing  development  initiatives  for  the  use  of  Macrilen™  as  a  diagnostic  in  the  pediatric
indication (the "Pediatric Indication”). Additionally, the Novo Amendment: reflected the existence of a supply agreement; established total consideration to be provided by Novo
as reimbursements for costs incurred in connection with the development activities related to the Pediatric Indication; provided for a non-refundable upfront payment of $6.1
million (€5.0 million) to be made by Novo to the Company; and modified future payment obligations, including a reduction of royalty rates and a waiver by the Company with
respect to the $5 million pediatric milestone from the original agreement with Novo.

Per the Novo Amendment, total consideration to be payable by Novo to the Company as reimbursement for Pediatric Indication development-related costs was established at
approximately $11 million (€9 million) plus 50% of any excess over this amount, limited specifically to clinical trial expenses, which were estimated to total $11.7 million (€9.9 million)
(the "Pediatric Development Consideration”). The Pediatric Development Consideration was derived from development forecasts that were approved by both the Company and
Novo.

As for the reduction in royalties, the Company agreed to reduce the Net Sales Royalties from 15% to 8.5% for annual net sales of Macrilen™ up to $40 million and to establish a
royalty of 15% for annual net sales of Macrilen™ over $40 million.

On December 7, 2020, the Company entered into an exclusive licensing agreement with Consilient Health Limited ("CH”) for the commercialization of macimorelin as GHRYVELIN™
in the European Economic Area and the United Kingdom (the "CH License Agreement”).

Under the terms of the CH License Agreement, CH agreed to make a non-refundable, non-creditable upfront payment to the Company of $1.2 million (€1.0 million), which the
Company  received  in  January  2021.  The  Company  also  is  eligible  to  receive  additional  consideration,  including:  regulatory  milestones  related  to  agreed-upon  pricing  and
reimbursement parameters; net sales milestones; and royalties, ranging from 10%-20% of net sales of macmorelin, subject to reduction in certain cases, or sublicense income
recorded by CH.

Also on December 7, 2020, the Company and CH entered into an exclusive supply agreement, pursuant to which the Company agreed to provide the Licensed Product to CH, with
such  Licensed  Product  to  be  manufactured  by  third-party  manufacturers  for  a  period  of  ten  years,  subject  to  renewal  (the  "CH  Supply Agreement”).  In  December  2021,  the
Department of Health and Social Care in the United Kingdom approved a list price which triggered a $226 (€0.2 million) pricing milestone payment from CH to the Company.

We  entered  into  license  and  supply  agreements  with  NK  Meditech  Ltd.  (" NK”),  a  subsidiary  of  PharmBio  Korea,  effective  November  30,  2021,  and  a  distribution  and
commercialization agreement with ER Kim Pharmaceuticals Bulgaria Food ("ER-Kim”), effective February 1, 2022. The agreements with NK are related to the development and
commercialization  of  macimorelin  for  the  diagnosis  of AGHD  and  CGHD  in  the  Republic  of  Korea,  while  the  agreement  with  ER-Kim  is  related  to  the  commercialization  of
macimorelin for the diagnosis of growth hormone deficiency in children and adults in Turkey and some non-European Union Balkan countries.

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Pipeline Expansion Opportunities

Bacterial  Vaccine  Platform:  Orally  active,  live-attenuated  bacterial  vaccine  platform  with  potential  application  against  viruses  and  bacteria,  such  as  coronaviruses  and
chlamydia bacteria

On  February  2,  2021,  the  Company  announced  that  it  had  entered  into  an  exclusive  option  agreement  to  evaluate  a  preclinical  potential  COVID-19  vaccine  developed  at  the
University of Wuerzburg. On March 14, 2021, the Company exercised the option to enter into a license agreement with the University. Pursuant to the terms of the University
License Agreement, the  Company has been granted an exclusive, world-wide, license to certain patent applications and know-how owned by the  University to research and
develop, manufacture, and sell a potential COVID-19 vaccine using the University’s bacterial vaccine platform technology. The Company has paid an up-front payment under the
University License Agreement and will conduct milestones payments upon achievement of certain development, regulatory, and sales milestones, as well as a percentage of any
sub-licensing revenue received by the Company as well as royalty payments on net sales of the licensed vaccine products (including for by the Company or its sub-licensees).
Pursuant to the University License Agreement, the University granted the Company an exclusive option for the exclusive use of the Licensed Rights in an undisclosed field. In
September 2021, the Company exercised this option and disclosed the field to be chlamydia. Additionally, the Company has entered into the Research Agreement under which the
Company has engaged the University on a fee-for-service basis to conduct supplementary research activities and preclinical development studies on the potential vaccines.

The vaccine technology developed at the University is based on the active live-attenuated bacterial typhoid fever vaccine Salmonella Typhi Ty21a with an excellent safety profile,
as a carrier strain. Our vaccines have the potential to be administered orally, induce mucosal immunity, induce a response to more than one antigen, and be stored and distributed
at 2 to 8°C. We believe that, if there is sufficient data to advance into human clinical trials, the development program for these vaccines is expected to be abbreviated, as clinical
safety data and manufacturing technology is already available for the underlying vaccine strain.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Coronavirus outbreak began in the end of 2019 and in early 2022 was reaching its fourth infection peak worldwide with vaccinated people getting infected and with booster
vaccinations being needed. As of January 12, 2022, there were three vaccines approved in US, and five in EU. At that time, over 9.5 billion doses had been administered, 59% of the
world population had received at least one dose, and 35 million doses were being administered every day. The competition is large with 11 vaccines currently being in clinical
studies only in Europe. Our COVID-19 vaccine candidate is unique in stimulating the mucosal immune system giving the potential to eliminate the virus when it enters the body,
before an infection can occur, and drastically reducing the risk of vaccinated people getting infected and spreading the virus. In addition, the oral application and its storage
stability greatly facilitates distribution and administration. Our next development steps include evaluating the administration route, dose and immunization scheme; initiating in-
vivo  immunology  experiments  with  antigen  variant  candidates  in  relevant  mice  models;  conducting  virus  challenge  experiments  in  immunized  transgenic  animals;  starting  the
manufacturing process assessment / development; and conducting pre-clinical safety and toxicology assessments.

Chlamydia trachomatis is a sexually transmitted bacterium infecting over 130 million subjects annually. In US, the prevalence 2.4 million per year, the incidence is 4 million per year,
and the associated yearly health cost $691 million. The disease can spread to the reproductive tract eventually inducing infertility, miscarriage, or ectopic pregnancy, which is a life-
threatening condition. Additionally, ocular infections can lead to inclusion conjunctivitis or trachoma, which is the primary source of visual impairment or infectious blindness.
While diagnosed infections can be treated with antibiotics, three quarters of all infections are asymptomatic and currently no vaccine exists to protect against chlamydia. The
potential strengths of our Chlamydia vaccine candidate are the mucosal immunity, oral administration, good stability, and inexpensive production. Our next development steps
include designing and preparing candidate vaccine strains; evaluating administration route, dose and immunization scheme; and initiating in-vivo immunology experiments with
candidate strains in relevant mouse models.

Delayed Clearance Parathyroid Hormone ("DC-PTH”) Fusion Polypeptides: Potential treatment for chronic hypoparathyroidism

On March 11, 2021, the Company entered into an exclusive license agreement with The University of Sheffield, United Kingdom, for the intellectual property relating to parathyroid
hormone  ("PTH”)  fusion  polypeptides  covering  the  field  of  human  use,  which  will  initially  be  studied  by  Aeterna  for  the  potential  therapeutic  treatment  of  chronic
hypoparathyroidism  ("HypoPT”).  Under  the  terms  of  the  exclusive  patent  and  know-how  license  agreement  entered  into  with  the  University  of  Sheffield, Aeterna  obtained
worldwide rights to develop, manufacture and commercialize PTH fusion polypeptides covered by the licensed patent applications for all human uses for an up-front cash payment,
and milestone payments to be paid upon the achievement of certain development, regulatory and sales milestones, as well as low single digit royalty payments on net sales of
those products and certain fees payable in connection with sublicensing. Aeterna will be responsible for the further development, manufacturing, approval, and commercialization
of the licensed products. Aeterna has also engaged the University of Sheffield under a research contract to conduct certain research activities to be funded by Aeterna, the results
of which will be included within the scope of the license granted to Aeterna.

33

The researchers at the University of Sheffield have developed a method to increase the serum clearance time of peptides, which the Company is applying to the development of a
treatment for HypoPT. HypoPT is an orphan disease where the PTH level is abnormally low or absent, with a prevalence per 100 000 of 37 in US, 22 in Denmark, 9.4 in Norway, and
5.3  to  27  in  Italy.  Standard  treatment  is  calcium  and  vitamin  D  supplementation.  The  only  approved  hormone  replacement  therapy,  Natpar/Natpara,  is  sold  by  Takedo
Pharmaceuticals. It is approved when standard treatment is insufficient and is administered by daily subcutaneous injections. Longer-acting PTH formulations are expected to give
a more natural PTH level and a better treatment and quality of life for patients with HypoPT. Three competitors working on long-acting PTH formulations have their products in
clinical trials. Ascendis Pharma develops TransCon PTH for daily injections and currently perform phase III trials. Amolyt Pharma develops their PTH hybrid AZP-3601 for daily
injections and completed phase I trials in October 2021. Extend Biosciences develops their candidate EXT608 for weekly injections and foresee phase I trials starting in Q4 2021.
Entera Bio has an orally administered PTH variant EB612 tested in a phase II study completed in 2015 and is currently evaluating further formulations for their next clinical trials. In
consultation with The University of Sheffield, Aeterna has selected AEZS-150 as the lead candidate in its DC-PTH program. AEZS-150 is developed to provide a weekly treatment
option of chronic hypoparathyroidism in adults. The delayed clearance time of AEZS-150 is achieved by transposing a principle successfully demonstrated by the University of
Sheffield for the human growth hormone.

AIM Biologicals: Targeted, highly specific autoimmunity modifying therapeutics for the potential treatment of neuromyelitis optica spectrum disorder and Parkinson’s disease

In  January  2021,  Aeterna  entered  into  an  exclusive  patent  license  and  research  agreement  with  the  University  of  Wuerzburg,  Germany,  for  worldwide  rights  to  develop,
manufacture, and commercialize AIM Biologicals for the potential treatment of neuromyelitis optica spectrum disorder (" NMOSD”). Additionally, the Company has engaged Prof.
Dr.  Joerg  Wischhusen  from  the  University  Hospital  in  Wuerzburg  as  well  as  neuro-immunologist  Dr.  Michael  Levy  from  the  Massachusetts  General  Hospital  in  Boston  as
consultants  for  scientific  support  and  advice  in  the  field  of  inflammatory  CNS  disorders,  autoimmune  diseases  of  the  nervous  system,  and  NMOSD.  In  September  2021,  the
Company entered into an additional exclusive license with the University of Wuerzburg for early pre-clinical development towards the potential treatment of Parkinson’s disease
("PD”).

AIM Biologicals is based on a natural process during pregnancy, which induces immunogenic tolerance of the maternal immune system to the partially foreign fetal antigens. Fetal
proteins are processed and presented on certain immunosuppressive MHC class I molecules to induce this tolerance. In an autoimmune disease is the immune system misdirected
and targets the body’s own protein. With AIM Biologicals, we aim to restore the tolerance against such proteins to treat autoimmune diseases.

NMOSD is an autoimmune disease targeting the protein aquaporin 4 ("AQP4”), primarily found in optic nerves and the spinal cord. The disease leading to blindness and paralysis
has a prevalence of 0.7-10 in 100 000, more common in persons with Asian or African compared to European ancestors, and 9 times more prevalent among women compared to men.
NMOSD progresses in often life-threatening relapses, which are aggressively treated with high-dose steroids and plasmapheresis.

Until 2019, there was no FDA approved medication so the prevention of relapses and disease progression were treated by off-label use of immunosuppressive medication such as
rituximab,  azathioprine  and  mycophenolate  mofetil.  More  recently  three  monoclonal  antibodies  were  approved;  soliris  inhibiting  cleavage  of  complement  protein  C5,  uplizna
depleting B lymphocytes through binding to C19, and enspryng blocking interleukin-6-mediated inflammatory cascades. Additionally, ultomiris, a long-acting variant of soliris, is
currently in phase III trials for NMOSD.

34

In addition, other immunosuppressive medications are in clinical trials for this disease. In 2016, TG Therapeutics announced the development of the antibody ublituximab (TG-1101)
for the treatment of NMOSD, although it currently is in phase III trials for relapsing multiple sclerosis. Lundbeck is also investigating related indications and is performing phase I
trials with Lu AG06466. And finally, Aquaporumab has demonstrated its ability to block the interaction between the autoimmune antibody and AQP4 in preclinical studies.

With AIM Biologicals, we have the potential to specifically suppress the autoimmune response against aquaporin-4 and thereby treating NMOSD without suppressing the immune
defense against pathogens in general.

Parkinson’s disease is a neurological disease commonly associated with motoric problems with a slow and fast progression form. It is the second most common neurodegenerative
disease affecting 10 million people worldwide. In US, there are almost 1 million people living with PD and this is predicted to increase to 1.2 million by 2030. In addition, 60 000
people are diagnosed with PD each year, with the direct and indirect costs estimated at over $50 billion per year. The hallmark of PD is the neuronal inclusion of mainly α-synuclein
protein  (αSyn)  associated  with  the  death  of  dopamine-producing  cells.  Dopaminergic  medication  is  the  mainstay  treatment  of  PD  symptoms,  but  currently  there  is  no
pharmacological therapy to prevent or delay disease progression leading to alternate treatments, such as deep brain stimulation with short electric bursts, being investigated for
the treatment of symptoms.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
A survey of clinical trials under development for PD include: Anavex Life Sciences which is testing their Sigma-1 receptor agonist blarcamesine in related indications in phase I to
III  and  are  planning  phase  II  trials  to  treat  PD;  stem-cell  therapies  are  investigated  for  the  regeneration  of  damaged  neurons  by  several  groups,  and  International  Stem  Cell
Corporation  currently  performing  a  phase  I  trial.  Since  αSyn  aggregation  has  a  crucial  part  in  the  propagation  of  PD  between  cells,  Prothena  Biosciences  and  Roche  are
investigating their αSyn antibody Prasinemuzab in phase II clinical trials, while AFFiRiS have completed phase I studies with their candidate PD01 stimulating the immune system
to produce such antibodies. With AIM Biologicals we want to induce tolerance for αSyn to stop or slow down the progression of this degenerative disease.

Macimorelin Therapeutic: Ghrelin agonist in development for the treatment of amyotrophic lateral sclerosis (Lou Gehrig’s disease)

In January 2021, the Company entered into a material transfer agreement with the University of Queensland, Australia, to provide macimorelin for the conduct of pre-clinical and
subsequent clinical studies, evaluating macimorelin as a potential therapeutic for the treatment of amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). The University of
Queensland researchers have filed for supportive grants to conduct such clinical studies. AEZS and the  University are currently in the final steps of negotiating a research
agreement.

ALS is a rare progressive neurological disease primarily affecting the neurons controlling voluntary movement, leading to the disability to control movements such as walking,
talking, and chewing. Most people with ALS die from respiratory failure, usually between 3-5 years after diagnosis. ALS has a prevalence per 100 000 persons and an incidence per
100,000 person-years of 6.22 and 2.31 in Europe, 5.20 and 2.35 in North America, 3.41 and 1.25 in Latin America, 3.01 and 0.93 in Asian countries excluding Japan, and 7.96 and 1.76
in Japan, respectively.

Currently there is no cure for ALS and no effective treatment to halt or reverse the progression of the disease. Riluzole was the first treatment for ALS, it was approved by FDA in
1995, reduces the amount of the neurotransmitter glutamate, is taken orally, and increases life expectance with 2-3 months. Edaravone is available in Japan since 2016 and in US
since 2018, but not marketed in EMA. It is an intravenous mediation aimed at reducing the progression of ALS with 30% for a specific patient group. The developer Mitsubishi
Tanabe Pharma has recently presented promising 24 weeks results for their oral formulation of edaravone (MT-1186) in a 48-weeks phase III trial. These are the two only FDA
approved treatments of ALS, but various additional drug and non-drug therapies are used to relieve symptoms and improve quality of life.

35

There is a great need of further treatment options of ALS and many candidates with various modes of action are being investigated. Advanced clinical phase treatments include
antisense  medicine  targeting  different  proteins  investigated  by  Ionis  in  phase  III,  Ionis/Biogen  in  phase  III  and  II,  and  Wave  Life  Sciences/Takeda  in  phase  I/II.  Biohaven
Pharmaceuticas is investigating verdiperstat, an orally administered irreversible myeloperoxidase inhibitor, in phase II/III trial. Brainstorm Cell Therapeutics have a cell therapy in
phase III trials, where they are collecting autologous mesenchymal stem cells from the patient, inducing them to secrete growth factors, and injecting them into the cerebrospinal
fluid where they slow down disease progression. Cytokinetics has phase III trials for reldesemtiv, a fast skeletal muscle troponin activator, expected to lead to increased muscle
contractility. The gene therapy, engensis (WM202), from Helixmith induces expression of the hepatocyte growth factor, which may stimulate nerve regeneration and is currently in
phase II trials for ALS and in phase I to III for further indications. Masitinib is a tyrosine kinase inhibitor being investigated by AB Science which demonstrated 27% decreased
disease progression in a phase IIB/III trial, and is currently in a phase III confirmatory trial. Zilucoplan is an investigational macrocyclic peptide inhibitor of complement component
5 from UCB currently in phase III trials. Clene Nanomedicine has demonstrated the potential of their orally administered gold nanocrystals CNM-Au8 to reverse neuronal damage,
improve energy production, decrease reactive oxygen species, through the execution of its phase III trials which are expected to be completed in the second half of 2022. Another
potential cure is under development by researchers at the Northwestern University in USA, NU-9 demonstrated in mouse models potential to decrease misfolding of superoxide
dismutase and regeneration of upper motor neurons.

Ghrelin is a hormone with wide-ranging biological actions, most known for stimulating growth hormone release, which is demonstrating emerging evidence as therapeutic for ALS.
Macimorelin (AEZS-130) is our small molecule ghrelin agonist approved for clinical tests of growth hormone deficiency. As a ghrelin agonist AEZS-130 has the potential as a
treatment for ALS, which is evaluated in this research collaboration.

Geographic Areas

A description of the principal geographic areas in which we compete, including a geographical and categorical breakdown of our revenues in the past three years, is presented in
note 25 (Segment information) to our consolidated financial statements included in this Annual Report on Form 20-F at Item 17.

Seasonality

As a specialty biopharmaceutical company, the Company does not consider any of its products or services to be seasonal.

Raw Materials

Raw  materials  and  supplies  are  generally  available  in  quantities  adequate  to  meet  the  needs  of  our  business.  We  will  be  dependent  on  third-party  manufacturers  for  the
pharmaceutical products that we or our licensees will market. An interruption in the availability of certain raw materials or ingredients, or significant increases in the prices paid by
us for them, could have a material adverse effect on our business, financial condition, liquidity and operating results.

Regulation of Drug Development

Generally. Governmental authorities in the U.S., Canada, Europe, and other countries extensively regulate the preclinical and clinical testing, manufacturing, labeling, storage,
record keeping, advertising, promotion, export, marketing, and distribution, among other things, of pharmaceuticals. Under the laws of the U.S., the countries of the EU, and other
countries, we are subject to obligations to ensure that our clinical trials are conducted in accordance with Good Clinical Practice ("GCP”) guidelines and the investigational plan
and protocols contained in an Investigational New Drug ("IND”) application, or comparable foreign regulatory submission. Set forth below is a brief summary of the material
governmental regulations affecting us in the major markets in which we intend to market our products and/or promote products that we acquire or in-license or to which we obtain
promotional rights.

36

The United States. In the U.S., the FDA’s Center for Drug Evaluation and Research (" CDER”) under the Federal Food, Drug and Cosmetic Act of 1938, as amended (the " FDCA”),
the Public Health Service Act and other federal statutes and regulations, subjects pharmaceutical products to rigorous review. In order to market and sell a new drug product in the
U.S., we must first test it and send CDER evidence from these tests to prove that the drug is safe and effective for its intended use. In most cases, these tests include extensive
preclinical, clinical, and laboratory tests. A team of  CDER physicians, statisticians, chemists, pharmacologists, and other scientists review the company’s data and proposed
labeling. If this independent and unbiased review establishes that a drug’s health benefits outweigh its known risks, the drug is approved for sale. CDER does not test the drug
itself, but it does conduct limited research in the areas of drug quality, safety, and effectiveness standards. Before approving a new drug or marketing application, the FDA may
conduct pre-approval inspections of the developer of the drug (the "sponsor”), its  CRO and/or its clinical trial sites to ensure that clinical, safety, quality control, and other
regulated  activities  are  compliant  with  GCP,  or  Good  Laboratory  Practices  (" GLP”),  for  specific  non-clinical  toxicology  studies.  The  manufacturing  process,  which  must  be
compliant with GMP, and the manufacturing facilities used to produce a product are also subject to ongoing inspection by the FDA. The FDA may also require confirmatory trials,
post-marketing testing, and/or extra surveillance to monitor the effects of approved products, or place conditions on any approvals that could restrict the commercial applications
of  a  product.  Once  approved,  the  labeling,  advertising,  promotion,  marketing,  and  distribution  of  a  drug  or  biologic  product  must  be  in  compliance  with  FDA  regulatory
requirements.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The first stage required for ultimate FDA approval of a new biologic or drug involves completion of preclinical studies whereby a sponsor must test new drugs on animals for
toxicity. Multiple species are used to gather basic information on the safety and efficacy of the compound being investigated and/or researched. The FDA regulates preclinical
studies under a series of regulations called the current GLP regulations as well as regulatory requirements found in Part 21 subchapter D of the Code of Federal Regulations. If the
sponsor violates these regulations, the FDA may require that the sponsor replicates those studies or can subject the sponsor to enforcement actions or penalties as described
further below. The sponsor then submits to the FDA an IND application based on the results from the initial testing that include the drug’s composition and manufacturing, along
with a plan for testing the drug on humans. The FDA reviews the IND to ensure that the proposed studies (clinical trials) do not place human subjects at unreasonable risk of harm.
FDA also verifies that there are adequate informed consent and human subject protections in place.

After a sponsor submits an IND application, it must wait thirty (30) days before starting a clinical trial to allow the FDA time to review the prospective study. If the FDA finds a
problem, it can order a clinical hold to delay an investigation, or interrupt a clinical trial if problems occur during the study. After the IND application is in effect, a sponsor may
commence human clinical trials. The sponsor typically conducts human clinical trials in three sequential phases, but the phases may overlap. In Phase 1 trials, the sponsor tests the
product in a small number of patients or healthy volunteers (typically 20-80 healthy volunteers), primarily for safety at one or more doses. The goal in this phase is to determine
what the drug’s most frequent side effects are and, often, how the drug is metabolized and excreted. Phase 2 studies begin if Phase 1 studies do not reveal unacceptable toxicity. In
Phase 2, in addition to safety, the sponsor evaluates the efficacy of the product in a patient population somewhat larger than Phase 1 trials. The number of subjects in Phase 2
studies typically ranges from a few dozen to about 300. This phase aims to obtain preliminary data on whether a drug works in people who have a certain disease or condition. At
the end of Phase 2, the FDA and sponsor try to come to an agreement on how large-scale studies in Phase 3 should be done.

Phase 3 studies begin if evidence of effectiveness is shown in Phase 2. Phase 3 trials typically involve additional testing for safety and clinical efficacy in an expanded population
(approx.  300-3,000  volunteers  who  have  the  disease  or  condition)  at  geographically  dispersed  test  sites.  The  sponsor  must  submit  to  the  FDA  a  clinical  plan,  or  "protocol”,
accompanied  by  the  approval  of  the  institutions  participating  in  the  trials,  prior  to  commencement  of  each  clinical  trial.  The  FDA  may  order  the  temporary  or  permanent
discontinuation of a clinical trial at any time.

In the case of product candidates for cancer, the initial human testing may be done in patients with the disease rather than in healthy volunteers. Because these patients are
already afflicted with the target disease, such studies may provide results traditionally obtained in Phase 2 studies. Accordingly, these studies are often referred to as "Phase 1/2”
studies as they combine two phases. Even if patients participate in initial human testing and a Phase 1/2 study is carried out, the sponsor is still responsible for obtaining all the
data usually obtained in both Phase 1 and Phase 2 studies.

The sponsor must submit to the FDA the results of the preclinical and clinical testing, together with, among other things, detailed information on the manufacture and composition
of the product, in the form of a New Drug Application (an " NDA”) or, in the case of a biologic, a Biologics License Applications (a " BLA”). In a process that can take a year or
more, the FDA reviews this application and, when and if it decides that adequate data are available to show that the new compound is both safe and effective for a particular
indication and that other applicable requirements have been met, approves the drug or biologic for marketing. The amount of time taken for this approval process is a function of a
number of variables, including the quality of the submission and studies presented and the potential contribution that the compound will make in improving the treatment of the
disease in question.

37

FDA  provides incentives, such as orphan drug designation or pediatric exclusivity. Orphan-drug designation is granted by the FDA Office of Orphan Drug Products to novel
drugs or biologics that are intended for the safe and effective treatment, diagnosis or prevention of rare diseases or disorders that affect fewer than 200,000 people in the U.S., or
that affect more than 200,000 people but are not expected to recover the costs of developing and marketing a treatment drug. The designation provides the sponsor with a seven-
year  period  of  U.S.  marketing  exclusivity  if  the  drug  is  the  first  of  its  type  approved  for  the  specified  indication,  or  if  it  demonstrates  superior  safety,  efficacy,  or  a  major
contribution to patient care versus another drug of its type that was previously granted the designation for the same indication. We have been granted orphan drug designations
for Macrilen™ (macimorelin) for the evaluation of GHD.

Under the Drug Price Competition and Patent Term Restoration Act of 1984 (the " Hatch-Waxman Act”), newly approved drugs and indications may benefit from a statutory period
of non-patent data exclusivity. The Hatch-Waxman Act provides five-year data exclusivity to the first applicant to gain approval of an NDA for a new chemical entity (" NCE”),
meaning that the FDA has not previously approved any other drug containing the same active pharmaceutical ingredient, or active moiety. Although protection under the Hatch-
Waxman Act will not prevent the submission or approval of another full  NDA, such an  NDA applicant would be required to conduct its own preclinical and adequate, well-
controlled clinical trials to demonstrate safety and effectiveness.

The Hatch-Waxman Act also provides three years of data exclusivity for the approval of new and supplemental NDAs, including Section 505(b)(2) applications, for, among other
things, new indications, dosage forms, routes of administration, or strengths of an existing drug, or for a new use, if new clinical investigations that were conducted or sponsored
by the sponsor are determined by the FDA to be essential to the approval of the application. This exclusivity, which is sometimes referred to as clinical investigation exclusivity,
would not prevent the approval of another application if the sponsor has conducted its own adequate, well-controlled clinical trials demonstrating safety and efficacy, nor would it
prevent approval of a generic product that did not incorporate the exclusivity-protected changes of the approved drug product.

The labeling, advertising, promotion, marketing, and distribution of a drug or biologic product must be in compliance with FDA regulatory requirements. Failure to comply with
applicable requirements can lead to the FDA demanding that production and shipment cease and, in some cases, that the manufacturer recall products, or to enforcement actions
that can include seizures, injunctions, and criminal prosecution. These failures can also lead to FDA withdrawal of approval to market a product. As long as the requirements are
fulfilled and the fees are paid to FDA the product can stay on the market, there is no renewal procedure.

Canada. In Canada, the Therapeutic Products Directorate of Health Canada is the Canadian federal authority that regulates pharmaceutical drugs and medical devices for human
use. Prior to being given market authorization, a sponsor must present substantive scientific evidence of a product’s safety, efficacy, and quality as required by the Food and
Drugs Act and other legislation and regulations. The requirements for the development and sale of pharmaceutical drugs in Canada are substantially similar to those in the U.S.,
which are described above.

The  European  Union. Medicines can be authorized in the  EU by using either the centralized authorization procedure (CP), or national authorization procedures.  The  EU has
implemented a centralized procedure coordinated by the EMA for the approval of human medicines, which results in a single marketing authorization issued by the EC that is valid
across the EU, as well as Iceland, Liechtenstein, and Norway. The centralized procedure is mandatory for human medicinal products containing a new active substance for the
treatment of HIV/AIDS, cancer, diabetes, neurodegenerative diseases, autoimmune diseases, other immune dysfunctions, viral diseases, or that are designated as orphan medicinal
products. In addition, the CP is required for product types derived, for example, from biotechnological processes or genetic engineering. For medicines that do not fall within these
categories, an applicant has the option of submitting an application for a centralized marketing authorization to the  EMA, as long as the medicine concerned is a significant
therapeutic, scientific or technical innovation, or if its authorization would be in the interest of public health.

38

There are two national routes to authorize medicinal products in several EU countries, which are available for investigational drug products that fall outside the scope of the
centralized procedure and result in a national marketing authorization:

●

Decentralized procedure. Using the decentralized procedure, a sponsor may apply for simultaneous authorization in more than one EU country of medicinal products that

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
have  not  yet  been  authorized  in  any  EU  country  and  that  do  not  fall  within  the  mandatory  scope  of  the centralized  procedure.  After  mutual  approval  national
authorizations  will  be  granted  separately  by  each  member  state  involved. Mutual recognition  procedure. In  the  mutual  recognition  procedure,  a  medicine  is  first
authorized in one EU Member State, in accordance with the national procedures of that country. Following this, further marketing authorizations can be sought from other
EU countries in a procedure whereby the countries concerned agree to recognize the validity of the original, national marketing authorization.

●

National procedure. If approval is sought independently in only one country, the application for marketing authorization is addressed directly to the competent authority
of the member state.

Similar to the U.S., the EMA provides incentives for the development of orphan drugs or for pediatrics. Orphan designation is granted for diseases affecting less than 5 in 10,000
people in the EU. With the designation, the sponsor benefits from prolonged market exclusivity (10 years) and fee reductions.

The pediatric regulation grants pediatric development with a six-month extension of the supplementary protection certificate.

The EU marketing authorization is valid for five years and is renewable upon application by the MAH. After the renewal the approval is permanently valid.

Regulation of Commercial Operations

The marketing, promotional, and pricing practices of human pharmaceutical manufacturers, as well as the manner in which manufacturers interact with purchasers and prescribers,
are subject to various U.S. federal and state laws, including the federal anti-kickback statute and the False Claims Act, and state laws governing kickbacks, false claims, unfair trade
practices, and consumer protection, and to similar laws in other countries. In the U.S., these laws are administered by, among others, the Department of Justice (" DOJ”), the Office
of Inspector General of the Department of Health and Human Services, the Federal Trade Commission, the Office of Personnel Management, and state attorneys general. Over the
past several years, the FDA, the DOJ and many other agencies have increased their enforcement activities with respect to pharmaceutical companies and increased the inter-
agency coordination of enforcement activities.

In the U. S., biopharmaceutical and medical device manufacturers are required to record any transfers of value made to licensed physicians and teaching hospitals and to disclose
such data to the Department of Health and Human Services ("HHS”). In addition to civil penalties for failure to report transfers of value to physicians or teaching hospitals, there
will be criminal penalties if a manufacturer intentionally makes false statements or excludes information in such reports. The payment data across biopharmaceutical and medical
device companies is posted by the HHS on a publicly available website. Increased access to such data by fraud and abuse investigators, industry critics and media will draw
attention to our collaborations with reported entities and will importantly provide opportunities to underscore the critical nature of our collaborations for developing new medicines
and exchanging scientific information. This national payment transparency effort coupled with industry commitment to uphold voluntary codes of conduct (such as the PhRMA
Code on  Interactions with  Healthcare  Professionals and  PhRMA  Guiding  Principles  Direct to  Consumer Advertisements About  Prescription  Medicines) and rigorous internal
training and compliance efforts will complement existing laws and regulations to help ensure ethical collaboration and truthful product communications.

The Canadian Association of Research-Based Pharmaceutical Companies (" Rx & D”) has adopted "Guidelines for Transparency in Stakeholder Funding” that require member
companies to regularly disclose, by means of websites and annual reports, a list of all stakeholders to which they provide direct funding. The term "stakeholder” is defined in Rx &
D’s Code of Ethical Practices to include "Health Care Professionals”. In the EU, the disclosure code of transfers of value to healthcare professionals and organizations adopted by
the European Federation of Pharmaceutical Industries and Associations (" EFPIA”) requires all members of EFPIA to disclose transfers of value to healthcare professionals and
healthcare organizations beginning in 2016, covering the relevant transfers in 2015. Each member company will be required to document and disclose: (i) the names of healthcare
professionals and associations that have received payments or other transfers of value and (ii) the amounts or value transferred, and the type of relationship.

39

For more information about the regulatory risks associated with our business operations, see "Item 3D. Risk Factors”.

Intellectual Property - Patents

We seek to protect our compounds, manufacturing processes, compositions and methods of medical use for our lead drugs and drug candidates through a combination of patents,
trade secrets and know-how. Our patent portfolio consists of approximately six owned and in-licensed patent families (issued, granted or pending in the U.S., Europe and other
jurisdictions).  The  patent  positions  of  companies  in  the  biotechnology  and  pharmaceutical  industries  are  highly  uncertain  and  involve  complex  legal  and  factual  questions.
Therefore, we cannot predict the breadth of claims, if any, that may be allowed under any of our patent applications, or the enforceability of any of our allowed patents. See "Item
3.D. Risk Factors - We may not obtain adequate protection for our products through our intellectual property.”

Patents extend for varying periods according to the date of patent filing or grant and the legal term of patents in the various countries where patent protection is obtained. The
actual protection afforded by a patent, which can vary from country to country, depends on the type of patent, the scope of its coverage and the availability of legal remedies in
the country. In the U.S., the patent term of a patent that covers an FDA-approved drug may also be eligible for patent term extension, which permits patent term restoration as
compensation for the patent term lost during the FDA regulatory review process. The Hatch-Waxman Act permits a patent term extension of up to five years beyond the expiration
of the patent, in which the patentee may file an application for yearly interim extensions within five years if the patent will expire and the FDA has not yet approved the NDA. The
length of the patent term extension is related to the length of time the drug is under regulatory review. Patent extension cannot extend the remaining term of a patent beyond a total
of 14 years from the date of product approval and only one patent applicable to an approved drug may be extended.

Similar provisions are available in Europe and other foreign jurisdictions to extend the term of a patent that covers an approved drug. In these jurisdictions, however, no interim
extensions exist and the marketing approval must be granted before the patent expires. In the future, we expect to apply for patent term extensions on patents covering those
products, outside the U.S. While we anticipate that any such applications for patent term extensions will likely be granted, we cannot predict the precise length of time for which
such patent terms would be extended in the U.S., Europe or other jurisdictions. If we are not able to secure patent term extensions on patents covering our products for meaningful
periods of additional time, we may not achieve or sustain profitability, which would adversely affect our business.

In addition to patent protection, our products may benefit from the market-exclusivity provisions contained in the orphan-drug regulations or the pediatric-exclusivity provisions or
other provisions of the FDA Act, such as a NCE exclusivity or new formulation exclusivity. Orphan drug regulations provide incentives to pharmaceutical and biotechnology
companies to develop and manufacture drugs for the treatment of rare diseases, currently defined as diseases that exist in fewer than 200,000 individuals in the U.S., or diseases
that affect more than 200,000 individuals in the U.S. but that the sponsor does not realistically anticipate will generate a net profit. Under these provisions, a manufacturer of a
designated orphan drug can seek tax benefits, and the holder of the first FDA approval of a designated orphan product will be granted a seven-year period of marketing exclusivity
for such FDA-approved orphan product. In the U.S., the FDA has the authority to grant additional data protection for approved drugs where the sponsor conducts specified
testing in pediatric or adolescent populations. If granted, this pediatric exclusivity provides an additional six months which are added to the term of data protection as well as to the
term of any relevant patents, to the extent these protections have not already expired. We may also seek to utilize market exclusivities in other territories, such as in the EU. There
can be no assurance that any of our drug candidates will obtain such orphan drug designation, pediatric exclusivity, a NCE exclusivity or any other market exclusivity in the U.S.,
the  EU or any other territory, or that we will be the first to receive the regulatory approval in a given country or territory for such drugs so as to be eligible for any market
exclusivity protection.

40

Macrilen™ (macimorelin):

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We hold the worldwide rights to macimorelin pursuant to an exclusive license agreement with the French Centre National de la Recherche Scientifique (CNRS), as licensor, and
AEZS Germany, as licensee. The obligation to pay royalties on net sales to CNRS expired in 2021. Macrilen™ is the approved trademark for macimorelin as licensed under the
License Agreement for commercialization in the U.S. and Canada.

The following patents and patent applications relate to macimorelin:

●

●

●

U.S. patent  8,192,719  covers  a  method  of  assessing  pituitary-related  GHD  in  a  human  or  animal  subject  comprising  an  oral  administration of  the  compound
macimorelin and determination of the level of growth hormone in the sample and assessing whether the level of growth hormone in the sample is indicative of GHD.
This patent expires in October 2027.

European patent 1 984 744 covers a method of assessing pituitary-related GHD by oral administration of macimorelin. This patent expires in February 2027.

Japanese patent 4 852 728 covers a method of assessing pituitary-related GHD by oral administration of macimorelin. This patent expires in February 2027.

An invention has been made by inventors of AEZS Germany to use a macimorelin containing composition for the assessment of GHD in adults.

●

●

A related U.S. provisional patent applications Serial No. 62/607,866 was filed on December 19, 2017 and Serial No. 62/609,059 was filed on December 21, 2017. Both are
identical and are directed to a method of assessing GHD comprising oral administration of a macimorelin containing composition and collecting one or two post-
administration samples.

The non-provisional U.S. application 15/993,507 was filed on May 30, 2018 drawing the priority of both provisional applications. The related U.S. patent 10,288,629
was granted on May 14, 2019, and will expire on May 30, 2038.A Patent Cooperation Treaty ("PCT”) PCT/EP/2018/085622 application was filed December 18, 2018
drawing the priority of both provisional U.S. applications. In addition to the method of assessing GHD comprising oral administration of a macimorelin containing
composition  and  collecting  one  or  two  post-administration samples,  the  PCT  application  also  covers  a  similar  method  of  assessing  GHD  using  three  post-
administration  samples.  On  February  24, 2022,  following  examination  of  European  patent  application  18827044.1,  a  European  patent  with  the  title  "Method  of
assessing growth hormone deficiency comprising oral administration of a macimorelin containing composition and collecting one or two post-administration samples”
has been granted. The patent will be published in European Patent Bulletin on March 23, 2022. The European patent covers the use of macimorelin according to the
label approved by EC to diagnose GHD in adults. The European patent will be validated in 41 European countries.

An invention has been made by inventors of AEZS Germany to use a macimorelin containing composition for the assessment of GHD in children. The invention is directed to
a method comprises providing at least one blood sample, taken from a subject within a range from about 15 to about 100 minutes following an administration of an sufficient
amount of macimorelin to induce growth hormone secretion, measuring the growth hormone level of each blood sample and compare the level with a single threshold value to
carry out the diagnosis GHD. The method of the invention is a stand-alone test.

●

●

●

A related U.S. provisional application Serial No. 63/054,889 was filed July 22, 2020 for the use of macimorelin in assessing growth hormone deficiency in children.

A non-provisional U.S. application named "Use of macimorelin in assessing growth hormone deficiency in children” with docket number 17/375,709 was filed on July
14, 2021, drawing the priority of the provisional application.

An international PCT application with docket number PCT/EP2020/070691 was filed on July 22, 2020. Based on the PCT application several national applications have
been filed in due time.

41

Patent applications related to the pipeline expansion opportunities and covered by the individual Patent and License Agreements between AEZS Germany and licensors.

Development of a COVID-19 vaccine based on a modified Salmonella Typhi Ty21a bacterial strain

●

Our licensor the University of Wuerzburg has filed a priority patent application at European Patent Office on August 14, 2020, named "Salmonella vaccine for the
treatment  of  coronavirus”.  The  patent  application  with  docket  number  EP20  191142.7  provides a live-attenuated bacterium of the genus  Salmonella comprising a
recombinant  plasmid  encoding  a  fusion  protein,  wherein  the  fusion protein  comprises  a  coronavirus  antigen,  and  an  adjuvant  peptide.  An  international  PCT
application with docket number PCT/EP2021/072624, and a national U.S. application with docket number 17/402,014 was filed August 13, 2021.

Delayed Clearance Parathyroid Hormone (DC-PTH) Fusion Polypeptide for the treatment of hypoparathyroidism in adults

●

A priority patent application with docket number GB 1706781.0 has been filed by our licensor The University of Sheffield on April 27, 2017. The patent application
provides  long-acting  parathyroid  hormone  like  fusion  polypeptides  comprising  a  receptor  polypeptide and  its  use  in  the  treatment  of  hypoparathyroidism  and
osteoporosis. An international PCT application named "Parathyroid Hormone Fusion Polypeptide” with docket number PCT/GB2018/051120 was filed April 27, 2018.
A national U.S. application with docket number 16/608,611 has been filed on October 25, 2019 and was published as US 2020/0164033A1 on May 28, 2020.

AIM Biologicals: Targeted, highly specific autoimmunity modifying therapeutics

●

Our licensor the University of Wuerzburg has filed a priority patent application with docket number EP 17172444.6 on May 23, 2017. The invention relates to targeted
immunomodulatory  effects  of  defined  peptides  in  combination  with  proteins  comprising  one  or  more  domains of  a  non-classical  MHC  class  1b  molecules  or  in
combination with molecules that interfere with the interaction of MHC class 1b molecules and their receptors. An international PCT application named "Combinations
of MHC class 1b molecules and peptides for targeted therapeutic immunomodulation” with docket number PCT/EP2018/063100 has been filed on May 18, 2018. The
application was published as WO 2018/215340 A1 on November 29, 2018. A national U.S. application with docket number 16/615,188 has been filed on November 20,
2019 and was published as US 2020/0157175A1 on May 21, 2020.

C.

Organizational structure

Our corporate structure, the jurisdiction of incorporation of our direct and indirect subsidiaries and the percentage of shares that we held in those subsidiaries as at December 31,
2021 is depicted in the chart set forth under the caption "Item 4.A. History and development of the Company”.

D.

Property, plant and equipment

Our registered address is located in Toronto, Canada. Our largest office is located in Frankfurt, Germany and we have an additional office in Summerville, South Carolina. We do
not own any real property. Effective August 25, 2021, the Company and its landlord mutually agreed to a one year extension to its existing building lease agreement for its German
subsidiary, continuing such terms until March 31, 2023.

42

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table sets forth information with respect to our main facilities as at December 31, 2021.

Location

315 Sigma Drive, Summerville SC 29486
Weismüllerstr. 50
D-60314
Frankfurt-am-Main, Germany

Use of space

  Occupied for administration
  Occupied for management, R&D, business development and

administration

We believe that our current facilities are adequate to meet our ongoing needs.

Square Footage

168 
30,343 

Type of interest
Leasehold
Leasehold

Item 4A

Unresolved Staff Comments

Not required.

Item 5.

Operating and Financial Review and Prospects

Key Developments

Financing activities

During  the  year  ended  December  31,  2021,  certain  warrant  holders  exercised  outstanding  warrants  to  purchase  35,111,187  of  our  common  shares  for  gross  proceeds  of
approximately $20.1 million (such exercises, the "2021 Warrant Exercises”).

On February 19, 2021, the Company completed a bought deal public offering of 20,509,746 common shares at $1.45 per common share, resulting in aggregate gross proceeds of
$29.7 million, less underwriting discounts, commissions and offering expenses of $2.8 million (the "February 2021 Financing”). The Company also granted to the underwriter and
placement agent (the "Underwriter”), a 30-day over-allotment option to purchase up to 3,076,461 additional common shares at a price of $1.45 per common share (the "Underwriter
Option”). In connection with the February 2021 Financing, the Company issued warrants to purchase 1,435,682 common shares to the Underwriter, with each warrant bearing an
exercise price of $1.8125 (the "February 2021 Placement Agent Warrants”). The February 2021 Placement Agent Warrants expire on February 17, 2026.

On February 22, 2021, the Underwriter exercised the Underwriter Option and received 3,076,461 common shares in exchange for gross proceeds to the Company of $4.5 million.
Upon exercise of the Underwriter Option, the Underwriter also received an additional 215,352 February 2021 Placement Agent Warrants.

Aggregate gross proceeds received in connection with the February 2021 Financing totaled $34.2 million, less cash transaction costs of $3.2 million and non-cash transaction
costs, which represent the issue-date fair value of the February 2021 Placement Agent Warrants, of $1.9 million.

The Company expects to use the net proceeds from the February 2021 Financing for general corporate purposes, including, to advance, the investigation of further therapeutic
uses of Macrilen™ (macimorelin), to expand pipeline development activities, to further expand commercial activities associated with macimorelin in available territories and to fund
a potential pediatric clinical trial in the E.U. and U.S. for macimorelin.

43

Macimorelin Clinical Program

On January 28, 2020, we announced the successful completion of patient recruitment for the first pediatric study of macimorelin as a growth hormone stimulation test for the
evaluation of GHD in children. This study, AEZS-130-P01 (" Study P01”), was the first of two studies as agreed with the EMA in our Pediatric Investigation Plan (the "PIP”) for
macimorelin as a GHD diagnostic. Macimorelin, a ghrelin agonist, is an orally active small molecule that stimulates the secretion of growth hormone from the pituitary gland into the
circulatory system. The goal of Study P01 was to establish a dose that can both be safely administered to pediatric patients and cause a clear rise in growth hormone concentration
in subjects ultimately diagnosed as not having GHD. The recommended dose derived from Study P01 will be evaluated in the pivotal second study, Study P02, on diagnostic
efficacy and safety. Study P01 was an international, multicenter study, which was conducted in Hungary, Poland, Ukraine, Serbia, Belarus and Russia. Study P01 was an open label,
group comparison, dose escalation trial designed to investigate the safety, tolerability, and pharmacokinetic/pharmacodynamic (" PK/PD”) of macimorelin acetate after ascending
single oral doses of macimorelin at 0.25, 0.5, and 1.0 milligram per kilogram body weight in pediatric patients from two to less than 18 years of age with suspected CGHD. We
enrolled a total of 24 pediatric patients across the three cohorts of the study. Per study protocol, all enrolled patients completed four study visits after successful completion of the
screening period. At Visit 1 and Visit 3, a provocative growth hormone stimulation test was conducted according to the study sites’ local practices. At Visit 2, the macimorelin test
was performed, and following the oral administration of the macimorelin solution, blood samples were taken at predefined times for PK/PD assessment. Visit 4 was a safety follow-
up visit at study end.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The final study results from Study P01 were published in the second quarter of 2020 indicating positive safety and tolerability data for use of macimorelin in CGHD, as well as
PK/PD data observed in a range as expected from the adult studies.

On April 7, 2020, the Company announced the decision of the EMA to accept our modification request of our PIP as originally approved in March 2017, which covered the conduct
of two pediatric studies and defined relevant key elements in the outline of these studies. We believe this EMA decision supports the development of one globally harmonized
study protocol for test validation, specifically Study P02, which we expect to be accepted both in Europe and the U.S.

44

In late 2020, Aeterna entered into the start-up phase for the clinical safety and efficacy study, AEZS-130-P02 (" Study P02” or "DETECT-trial”), evaluating macimorelin for the
diagnosis of CGHD.The DETECT-trial is an open-label, single dose, multicenter and multinational study expected to enroll approximately 100 subjects worldwide, with at least 40
pre-pubertal and 40 pubertal subjects, and a minimum of 25 subjects expected to be enrolled in the U.S. The study design is expected to be suitable to support a claim for potential
stand-alone testing, if successful. In addition, under the Novo Amendment, Novo and Aeterna agreed that the percentage of DETECT-trial clinical trial costs that Novo is required
to reimburse to Aeterna was adjusted from 70% to 100% of costs up to $11 million (€9 million), and includes reimbursement of Aeterna’s budgeted internal labor costs. Any
additional external jointly approved DETECT-trial costs incurred over $11million (€9 million) will be shared equally between Novo and Aeterna. On April 22, 2021, the U.S. FDA
Investigational New Drug Application associated with this clinical trial became active, see: https://clinicaltrials.gov/ct2/show/NCT04786873 and on May 13, 2021, we announced
the opening of the first clinical site in the U.S. On January 26, 2022, the Company announced that it had experienced unavoidable delays in site initiation and patient enrollment due
to rise of the Omicron variant in the COVID-19 pandemic. Our team is diligently working to get more clinical sites up and running with the goal of building momentum and bringing
this study across the finish line while navigating as best as possible through this challenge. However, we have engaged a CRO to conduct the DETECT-trial outside the United
States, including in Russia and Ukraine and clinical trial sites in those countries are being halted due to the conflict in Ukraine. To date, no patients have been enrolled in these
clinical trials. Russia’s invasion of Ukraine in February 2022 may also impact our ability to conduct certain of our trials in the region. This could hinder the completion of our clinical
trials and/or analyses of clinical results, which could materially harm our business.

Macimorelin Pre-clinical Program

On January 13, 2021, we entered into a material transfer agreement with Queensland University to provide macimorelin for the conduct of preclinical and clinical studies evaluating
macimorelin as a therapeutic for the treatment of amyotrophic lateral sclerosis ("ALS” and commonly known as Lou Gehrig’s disease). Queensland University researchers have
filed funding applications to dedicated organizations in Australia to finance parts of the abbreviated preclinical development program and to conduct a subsequent investigator-
initiated clinical trial to evaluate the safety, tolerability and efficacy of macimorelin as a potential new treatment option for ALS patients. The Company expects to continue work
with Queensland University to conduct proof-of-concept studies with macimorelin in disease specific animal models, assess alternative formulations and formalize a preclinical
development  plan.  The  Company  plans  to  evaluate  the  development  of  additional  alternative  formulations  or  administration  routes  with  the  goal  of  ensuring  sufficient
bioavailability and expects to provide updates on its progress as results become available.

Macimorelin Commercialization Program

On  June 25, 2020, we announced that we entered into an exclusive distribution and related quality agreement with  MegaPharm  Ltd., a leading  Israel-based biopharmaceutical
company, for the commercialization in Israel and in the Palestinian Authority of macimorelin, to be used in the diagnosis of patients with AGHD and in clinical development for the
diagnosis of CGHD.

Under the terms of the agreement, MegaPharm Ltd. will be responsible for obtaining registration to market macimorelin in Israel and the Palestinian Authority, while the Company
will be responsible for manufacturing, product supply, quality assurance and control, regulatory support, and maintenance of the relevant intellectual property.  In  June 2021,
MegaPharm Ltd. filed an application to the Ministry of Health of Israel for regulatory approval of macimorelin in Israel.

On November 16, 2020, the Company announced that it had entered into the Novo Amendment related to the development and commercialization of macimorelin. Novo is currently
marketing macimorelin in the U.S. under the tradename Macrilen™ for the diagnosis of AGHD. Aeterna, in collaboration with Novo, is currently developing the expanded use of
macimorelin for the diagnosis of CGHD, an area of significant unmet need.

Pursuant to the Novo Amendment, the Company agreed to grant to Novo additional rights with respect to ownership of the Aeterna Patent Rights and Trademarks, as defined, and
to  amend  certain  responsibilities  between Aeterna  and  Novo  with  respect  to  the  ongoing  development  initiatives  for  the  use  of  Macrilen™  as  a  diagnostic  in  the  pediatric
indication (the "Pediatric Indication”). Additionally, the Novo Amendment: reflected the existence of a supply agreement; established total consideration to be provided by Novo
as reimbursements for costs incurred in connection with the development activities related to the Pediatric Indication; provided for a non-refundable upfront payment of $6.1
million (€5.0 million) to be made by Novo to the Company; and modified future payment obligations, including a reduction of royalty rates and a waiver by the Company with
respect to the $5 million pediatric milestone from the original agreement with Novo.

45

Per the Novo Amendment, total consideration to be payable by Novo to the Company as reimbursement for Pediatric Indication development-related costs was established at
approximately $11.1 million (€9 million) plus 50% of any excess over this amount, limited specifically to clinical trial expenses, which were estimated to total $11.7 million (€9.9
million) (the "Pediatric Development Consideration”). The Pediatric Development Consideration was derived from development forecasts that were approved by both the Company
and Novo.

As for the reduction in royalties, the Company agreed to reduce the Net Sales Royalties from 15% to 8.5% for annual net sales of Macrilen™ up to $40 million and to establish a
royalty of 15% for annual net sales of Macrilen™ over $40 million.

On December 7, 2020, the Company entered into an exclusive licensing agreement with Consilient Health Limited ("CH”) for the commercialization of macimorelin (the "Licensed
Product”) in the European Economic Area and the United Kingdom (the "CH License Agreement”).

Under the terms of the CH License Agreement, CH agreed to make a non-refundable, non-creditable upfront payment to the Company of $1.2 million (€1.0 million), which the
Company  received  in  January  2021.  The  Company  also  is  eligible  to  receive  additional  consideration,  including  regulatory  milestones  related  to  agreed-upon  pricing  and
reimbursement parameters; net sales milestones; and royalties, ranging from 10%-20% of net sales of macimorelin, subject to reduction in certain cases, or sublicense income
recorded by CH.

Also on December 7, 2020, the Company and CH entered into an exclusive supply agreement, pursuant to which the Company agreed to provide the Licensed Product to CH, with
such  Licensed  Product  to  be  manufactured  by  third-party  manufacturers  for  a  period  of  ten  years,  subject  to  renewal  (the  "CH  Supply Agreement”).  In  December  2021,  the
Department of Health and Social Care in the United Kingdom approved a list price which triggered a $226 (€0.2 million) pricing milestone payment from CH to the Company.

We  entered  into  license  and  supply  agreements  with  NK  Meditech  Ltd.  (" NK”),  a  subsidiary  of  PharmBio  Korea,  effective  November  30,  2021,  and  a  distribution  and
commercialization agreement with ER Kim Pharmaceuticals Bulgaria Food ("ER-Kim”), effective February 1, 2022. The agreements with NK are related to the development and
commercialization  of  macimorelin  for  the  diagnosis  of AGHD  and  CGHD  in  the  Republic  of  Korea,  while  the  agreement  with  ER-Kim  is  related  to  the  commercialization  of

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
macimorelin for the diagnosis of growth hormone deficiency in children and adults in Turkey and some non-European Union Balkan countries.

46

Pipeline Expansion Opportunities

Bacterial  Vaccine  Platform:  Orally  active,  live-attenuated  bacterial  vaccine  platform  with  potential  application  against  viruses  and  bacteria,  such  as  coronaviruses  and
chlamydia bacteria

On  February  2,  2021,  the  Company  announced  that  it  had  entered  into  an  exclusive  option  agreement  to  evaluate  a  preclinical  potential  COVID-19  vaccine  developed  at  the
University of Wuerzburg. On March 14, 2021, the Company exercised the option to enter into a license agreement with the University. Pursuant to the terms of the University
License Agreement, the  Company has been granted an exclusive, world-wide, license to certain patent applications and know-how owned by the  University to research and
develop, manufacture, and sell a potential COVID-19 vaccine using the University’s bacterial vaccine platform technology. The Company has paid an up-front payment under the
University License Agreement and will conduct milestones payments upon achievement of certain development, regulatory, and sales milestones, as well as a percentage of any
sub-licensing revenue received by the Company as well as royalty payments on net sales of the licensed vaccine products (including for by the Company or its sub-licensees).
Pursuant to the University License Agreement, the University granted the Company an exclusive option for the exclusive use of the Licensed Rights in an undisclosed field. In
September 2021, the Company exercised this option and disclosed the field to be chlamydia. Additionally, the Company has entered into the Research Agreement under which the
Company has engaged the University on a fee-for-service basis to conduct supplementary research activities and preclinical development studies on the potential vaccines.

The vaccine technology developed at the University is based on the active live-attenuated bacterial typhoid fever vaccine Salmonella Typhi Ty21a with an excellent safety profile,
as a carrier strain. Our vaccines have the potential to be administered orally, induce the mucosal immune system, induce a response to more than one antigen, and be stored and
distributed at 2 to 8°C. We believe that, if there is sufficient data to advance into human clinical trials, the development program for these vaccines is expected to be abbreviated, as
clinical safety data and manufacturing technology is already available for the underlying vaccine strain.

47

The Coronavirus outbreak began in the end of 2019 and in early 2022 was reaching its fourth infection peak worldwide with vaccinated people getting infected and with booster
vaccinations being needed. As of January 12, 2022, there were three vaccines approved in US, and five in EU. At that time, over 9.5 billion doses had been administered, 59% of the
world population had received at least one dose, and 35 million doses were being administered every day. The competition is large with 11 vaccines currently being in clinical
studies only in Europe. Our COVID-19 vaccine candidate is unique in stimulating the mucosal immune system giving the potential to eliminate the virus when it enters the body,
before an infection can occur, and drastically reducing the risk of vaccinated people getting infected and spreading the virus. In addition, the oral application and its storage
stability greatly facilitates distribution and administration. Our next development steps include evaluating the administration route, dose and immunization scheme; initiating in-
vivo  immunology  experiments  with  antigen  variant  candidates  in  relevant  mice  models;  conducting  virus  challenge  experiments  in  immunized  transgenic  animals;  starting  the
manufacturing process assessment / development; and conducting pre-clinical safety and toxicology assessments.

Chlamydia trachomatis is a sexually transmitted bacterium infecting over 130 million subjects annually. In US, the prevalence 2.4 million per year, the incidence is 4 million per year,
and the associated yearly health cost $691 million. The disease can spread to the reproductive tract eventually inducing infertility, miscarriage, or ectopic pregnancy, which is a life-
threatening condition. Additionally, ocular infections can lead to inclusion conjunctivitis or trachoma, which is the primary source of visual impairment or infectious blindness.
While diagnosed infections can be treated with antibiotics, three quarters of all infections are asymptomatic and currently no vaccine exists to protect against chlamydia. The
potential strengths of our chlamydia vaccine candidate are the mucosal immunity, oral administration, good stability, and inexpensive production. Our next development steps
include designing and preparing candidate vaccine strains; evaluating administration route, dose and immunization scheme; and initiating in-vivo immunology experiments with
candidate strains in relevant mouse models.

On March 10, 2022, the Company announced the expansion of its research program with the University of Wuerzburg to include the development of human 3D intestinal tissue
models to study infection biology in the gut, the site of Salmonella primary action.

Delayed Clearance Parathyroid Hormone ("DC-PTH”) Fusion Polypeptides: Potential treatment for chronic hypoparathyroidism

On March 11, 2021, the Company entered into an exclusive license agreement with The University of Sheffield, United Kingdom, for the intellectual property relating to parathyroid
hormone  ("PTH”)  fusion  polypeptides  covering  the  field  of  human  use,  which  will  initially  be  studied  by  Aeterna  for  the  potential  therapeutic  treatment  of  chronic
hypoparathyroidism  ("HypoPT”).  Under  the  terms  of  the  exclusive  patent  and  know-how  license  agreement  entered  into  with  the  University  of  Sheffield, Aeterna  obtained
worldwide rights to develop, manufacture and commercialize PTH fusion polypeptides covered by the licensed patent applications for all human uses for an up-front cash payment,
and milestone payments to be paid upon the achievement of certain development, regulatory and sales milestones, as well as low single digit royalty payments on net sales of
those products and certain fees payable in connection with sublicensing. Aeterna will be responsible for the further development, manufacturing, approval, and commercialization
of the licensed products. Aeterna has also engaged the University of Sheffield under a research contract to conduct certain research activities to be funded by Aeterna, the results
of which will be included within the scope of the license granted to Aeterna.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The researchers at the University of Sheffield have developed a method to increase the serum clearance time of peptides, which the Company is applying to the development of a
treatment for HypoPT. HypoPT is an orphan disease where the PTH level is abnormally low or absent, with a prevalence per 100 000 of 37 in US, 22 in Denmark, 9.4 in Norway, and
5.3 to 27 in Italy.  Standard treatment is calcium and vitamin  D supplementation.  In consultation with  The  University of  Sheffield, Aeterna has selected AEZS-150 as the lead
candidate in its DC-PTH program. AEZS-150 is being developed to provide a weekly treatment option of chronic hypoparathyroidism in adults and our next steps include working
with The University of Sheffield to conduct in depth characterization of development candidate (in-vitro and in-vivo); developing the manufacturing process; and formalizing the
pre-clinical development of AEZS-150 in preparation for a potential IND filing for conducting the first in-human clinical study.

48

AIM Biologicals: Targeted, highly specific autoimmunity modifying therapeutics for the potential treatment of neuromyelitis optica spectrum disorder and Parkinson’s disease

In  January  2021,  Aeterna  entered  into  an  exclusive  patent  license  and  research  agreement  with  the  University  of  Wuerzburg,  Germany,  for  worldwide  rights  to  develop,
manufacture, and commercialize AIM Biologicals for the potential treatment of NMOSD. Additionally, the Company has engaged Prof. Dr. Joerg Wischhusen from the University
Hospital in Wuerzburg as well as neuro-immunologist Dr. Michael Levy from the Massachusetts General Hospital in Boston as consultants for scientific support and advice in the
field of inflammatory CNS disorders, autoimmune diseases of the nervous system, and NMOSD. In September 2021, the Company entered into an additional exclusive license with
the University of Wuerzburg for early pre-clinical development towards the potential treatment of Parkinson’s disease.

AIM Biologicals is based on a natural process during pregnancy, which induces immunogenic tolerance of the maternal immune system to the partially foreign fetal antigens. Fetal
proteins are processed and presented on certain immunosuppressive major histocompatibility complex class I molecules to induce this tolerance. In an autoimmune disease is the
immune system misdirected and targets the body’s own protein. With AIM Biologicals, we aim to restore the tolerance against such proteins to treat autoimmune diseases.

NMOSD is an autoimmune disease targeting the protein aquaporin 4, primarily found in optic nerves and the spinal cord. The disease leading to blindness and paralysis has a
prevalence of 0.7-10 in 100,000, more common in persons with Asian or African compared to European ancestors, and nine times more prevalent among women compared to men.
NMOSD progresses in often life-threatening relapses, which are aggressively treated with high-dose steroids and plasmapheresis. Our pre-clinical plans include conducting in-
vitro and in-vivo assessments to select an AIM Biologicals-based development candidate; and manufacturing process development for the selected candidate.

Parkinson’s disease is a neurological disease commonly associated with motoric problems with a slow and fast progression form. It is the second most common neurodegenerative
disease affecting 10 million people worldwide. The hallmark of PD is the neuronal inclusion of mainly α-synuclein protein (αSyn) associated with the death of dopamine-producing
cells. Dopaminergic medication is the mainstay treatment of PD symptoms, but currently there is no pharmacological therapy to prevent or delay disease progression leading to
alternate treatments, such as deep brain stimulation with short electric bursts, being investigated for the treatment of symptoms.  For the development of AIM  Biologicals as
potential PD therapeutics, Aeterna plans to utilize, among others, an innovative animal model on neurodegeneration by α-synuclein-specific T cells in AAV-A53T-α-synuclein
Parkinson’s disease mice, which has recently been published by University of Wuerzburg researchers. Our next steps include designing and producing antigen-specific AIM
Biologics molecules for the potential treatment of Parkinson’s disease; and conducting in-vitro and in-vivo assessments in relevant Parkinson’s disease models.

Macimorelin Therapeutic: Ghrelin agonist in development for the treatment of amyotrophic lateral sclerosis (Lou Gehrig’s disease)

In January 2021, the Company entered into a material transfer agreement with the University of Queensland, Australia, to provide macimorelin for the conduct of pre-clinical and
subsequent clinical studies, evaluating macimorelin as a potential therapeutic for the treatment of ALS. The University of Queensland researchers have filed for supportive grants
to conduct such clinical studies. AEZS and the University are currently in the final steps of negotiating a research agreement.

ALS is a rare progressive neurological disease primarily affecting the neurons controlling voluntary movement, leading to the disability to control movements such as walking,
talking, and chewing. Most people with ALS die from respiratory failure, usually between 3-5 years after diagnosis. Currently there is no cure for ALS and no effective treatment to
halt  or  reverse  the  progression  of  the  disease.  Ghrelin  is  a  hormone  with  wide-ranging  biological  actions,  most  known  for  stimulating  growth  hormone  release,  which  is
demonstrating  emerging  evidence  as  therapeutic  for ALS. As  a  ghrelin  agonist,  macimorelin  has  the  potential  as  a  treatment  for ALS,  which  is  evaluated  in  this  research
collaboration.  Our  next  steps  include  working  with  the  University  of  Queensland  to  conduct  proof-of-concept  studies  with  macimorelin  in  disease-specific  animal  models,
assessing alternative formulations and formalizing a pre-clinical development plan.

49

Changes in personnel and advisors

On May 3, 2021, the Company announced the addition of Michael Teifel, Ph.D. as Senior Vice President, Non-Clinical Development and Chief Scientific Officer to drive forward our
pre-clinical research initiatives. In the second quarter of 2021, Prof. Dr. Joerg Wischhusen (Wuerzburg University) and Dr. Michael Levy, MD, PhD were engaged by the Company
as a scientific consultant to support the development of the AIM Biologicals in NMOSD. Dr. Thomas Rudel (Wuerzburg University) was engaged by the Company in September
2021 as a scientific consultant to support development of the salmonella-based vaccine platform for coronavirus and chlamydia vaccines. Effective January 24, 2022, Mr. Giuliano
La Fratta joined the Company as the Senior Vice President, Chief Financial Officer, replacing Ms. Leslie Auld.

Nasdaq Letters

On July 28, 2021, we received a letter from the Listing Qualifications Staff of the Nasdaq, notifying us that during the 30 consecutive business days prior to the date of the letter,
the closing bid price of our common shares was below $1.00 per share and, therefore, we did not meet the requirement for continued listing on Nasdaq as required by Nasdaq
Listing Rule 5550(a)(2) (the "Bid Price Rule”). In accordance with Nasdaq Listing Rule 5810(c)(3)(A), we were granted a grace period of 180 calendar days, through January 24, 2022.
On January 26, 2022, we announced that the Listing Qualifications Staff of the Nasdaq had notified the Company that it has been granted an additional 180 calendar day period,
through July 26, 2022, to comply with the US$1.00 minimum bid price requirement for continued listing on the Nasdaq. If at any time before July 26, 2022, the bid price for the
Company’s common shares closes at or above US$1.00 per share for a minimum of 10 consecutive business days (and generally not more than 20 consecutive business days, in
Nasdaq’s discretion), it is expected that Nasdaq would provide formal notice that the Company has regained compliance with the bid price requirement. The Company may choose
to implement a reverse stock split before July 26, 2022 in order to regain compliance. In the event the Company does not provide, during the 180-day grace period, evidence to
demonstrate compliance with Bid Price Rule, it is expected that Nasdaq would notify the Company that its shares are subject to delisting. At such time, the Company may appeal
such determination to a Nasdaq Hearings Panel (the "Panel”) and it is expected that the Company’s securities would continue to be listed and available to trade on Nasdaq at least
pending the completion of the appeal process. There can be no assurance that any such appeal would be successful or that the Company would be able to comply with the terms
of any extension that may be granted by the Panel. There is no assurance that we will regain compliance with the Bid Price Rule in the future, and therefore there can be no
assurance that our common shares will remain listed on Nasdaq. The aforementioned notification from the Nasdaq does not impact the Company’s listing status on the TSX.

As of the date of this Annual Report on Form 20-F, the Company’s closing bid price was below $1.00. See "Item 3.D. Risk factors—Our Common Shares may be delisted from the
NASDAQ or the TSX, which could affect their market price and liquidity. If our Common Shares were to be delisted, investors may have difficulty in disposing their Common
Shares.”

Settlement of Class-Action Lawsuit

On March 9, 2020, the Company settled the previously disclosed class-action lawsuit against it pending in the U.S. District Court for the District of New Jersey. This settlement was

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
approved by the U.S. District Court for the District of New Jersey on June 3, 2021. The settlement payment was funded entirely by the Company’s insurers. As no appeals were
filed within the 30-day appeal period, this matter is fully and finally settled.

Extension of German building lease

Effective August 25, 2021, the Company and its landlord mutually agreed to a one year extension to its existing building lease agreement for its German subsidiary, continuing such
terms until March 31, 2023.

Exposure to Epidemic or Pandemic Outbreak

Coronavirus, or COVID-19, a contagious disease that was characterized by the World Health Organization as a pandemic in early 2020, continues to affect the global community.
The significant spread of COVID-19 resulted in a widespread health crisis and has had adverse effects on national economies generally, on the markets that we serve, on our
operations and on the market price of our Common Shares.

50

The spread of COVID-19 may continue to impact our operations, including the potential interruption of our clinical trial activities and of our supply chain. For example, the rise in
the Omicron variant in the COVID-19 pandemic has caused delays in site initiation and patient enrollment in our Phase 3 DETECT clinical trial for diagnostic use in childhood-onset
growth hormone deficiency. Additionally, sales activities for Macrilen™ in the US may be impacted due to delays of diagnostic activities on AGHD in the US. Further, the COVID-
19 pandemic may also cause some patients to be unwilling to enroll in our trials or be unable to comply with clinical trial protocols if quarantines impede patient movement or
interrupt healthcare services, which would delay our ability to conduct clinical trials or release clinical trial results on a timely basis and could delay our ability to obtain regulatory
approval  and  commercialize  our  product  candidates.  The  spread  of  an  infectious  disease,  including  COVID-19,  may  also  result  in  the  inability  of  our  suppliers  to  deliver
components or raw materials on a timely basis or at all. In addition, hospitals may reduce staffing and reduce or postpone certain treatments in response to the spread of an
infectious disease. Such events may result in a period of business disruption and, in reduced operations, doctors or medical providers may be unwilling to participate in our clinical
trials, any of which could materially affect our business, financial condition or results of operations.

Given this rapidly evolving situation, the duration, scope and impact on our business operations, clinical studies and financial results cannot at this time be fully determined or
quantified. Aeterna Zentaris has developed protocols and procedures should they be required to deal with any potential epidemics and pandemics and has implemented these
protocols and procedures to address the current COVID-19 pandemic. Despite appropriate steps being taken to mitigate such risks, there can be no assurance that existing policies
and procedures will ensure that the Company’s operations will not be adversely affected. The COVID-19 pandemic has resulted in a widespread health crisis that has adversely
affected the economies and financial markets of many regions and countries. There can be no assurance that a disruption in financial markets, regional economies and the world
economy would not negatively affect Aeterna Zentaris’ access to capital or its financial performance.

Uncertain factors, including the duration of the outbreak, the severity of the disease and the actions to contain or treat its impact, could impair our operations including, among
other things, employee mobility and productivity, availability of our facilities, conduct of our clinical trials and the availability and the productivity of third-party product and
service suppliers. Please see the Risk Factor entitled "The economic effects of a pandemic, epidemic or outbreak of an infectious disease could adversely affect our operations or
the market price of our Common Shares”.

Russia/Ukraine Conflict

Conducting clinical trials in foreign countries, as in our ongoing DETECT-trial, presents additional risks that may delay completion of our clinical trials. These risks include the
failure of enrolled patients in foreign countries to adhere to clinical protocol as a result of differences in healthcare services or cultural customs, managing additional administrative
burdens associated with foreign regulatory schemes, as well as political and economic risks, including war, relevant to such foreign countries. For example, we have engaged a
CRO to conduct the DETECT-trial outside the United States, including in Russia and Ukraine and clinical trial sites in those countries are being halted due to the conflict in
Ukraine. To date, no patients have been enrolled in these clinical trials. Russia’s invasion of Ukraine in February 2022 may impact our ability to conduct certain of our trials in the
region. This could hinder the completion of our clinical trials and/or analyses of clinical results, which could materially harm our business.

In particular, we have engaged a CRO to conduct our DETECT-trial outside of the United States, including in Russia and Ukraine. As a result of Russia’s invasion of Ukraine in
February 2022, clinical trial sites in Ukraine and the surrounding region are being halted. Furthermore, the United States and its European allies have imposed significant new
sanctions against Russia, including regional embargoes, full blocking sanctions, and other restrictions targeting major Russian financial institutions. Our ability to conduct clinical
trials in Russia, parts of Ukraine and elsewhere in the region may become restricted under applicable sanctions laws, which would require us to identify alternative trial sites, which
may increase our development costs and delay the clinical development of our product candidates. All of the foregoing could impede the execution of our clinical development
plans, which could materially harm our business.

51

A. Operating Results

Consolidated Statements of Comprehensive Loss Information

(in thousands, except share and per share data)

Revenues
License fees
Development services
Product sales
Royalty income
Supply chain
Total revenues
Operating expenses
Cost of sales
Research and development expenses
General and administrative expenses
Selling expenses
Restructuring costs
Gain on modification of building lease
Impairment of right of use asset
(Reversal) impairment of other asset
Total operating expenses

Three months ended December 31,

2021
$

2020
$

2021
$

Years ended December 31,
2020
$

2019
$

361   
528   
—   
21   
46   
956   

18   
1,863   
1,779   
427   
—   
—   
—   
—   
4,087   

856   
—   
1,354   
20   
136   
2,366   

1,410   
626   
1,314   
404   
—   
—   
—   
(139)  
3,615   

1,670   
3,337   
—   
68   
185   
5,260   

90   
6,574   
5,916   
1,351   
—   
—   
—   
—   
13,931   

911   
—   
2,370   
67   
304   
3,652   

2,317   
1,506   
4,759   
1,134   
—   
(219)  
—   
(139)  
9,358   

74 
— 
129 
45 
284 
532 

410 
1,837 
6,615 
1,214 
507 
— 
22 
169 
10,774 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Loss from operations
Gain due to changes in foreign currency exchange rates
Change in fair value of warrant liability
Other finance costs
Net finance income
Loss before income taxes
Income tax (expense) recovery
Net loss
Other comprehensive loss
Foreign currency translation adjustments
Actuarial (loss) gain on defined benefit plans
Comprehensive loss
Net loss per share (basic)
Net loss per share (diluted)

(3,131)  
257   
—   
—   
257   
(2,874)  
(20)  
(2,894)  

(93)  
(3,725)  
(6,712)  
(0.02)  
(0.02)  

(1,249)  
335   
—   
(2)  
333   
(916)  
(395)  
(1,311)  

(657)  
15   
(1,953)  
(0.02)  
(0.02)  

(8,671)  
215   
—   
(21)  
194   
(8,477)  
109   
(8,368)  

367   
(3,592)  
(11,593)  
(0.07)  
(0.07)  

(5,706)  
572   
1,147   
(736)  
983   
(4,723)  
(395)  
(5,118)  

(1,139)  
(650)  
(6,907)  
(0.12)  
(0.12)  

(10,242)
87 
4,518 
(593)
4,012 
(6,230)
188 
(6,042)

83 
(1,068)
(7,027)
(0.35)
(0.35)

Our operating and financial review and prospects should be read in conjunction with our consolidated financial statements, accompanying notes and other information appearing
in this Annual Report.

2021 compared with 2020

Fourth Quarter

Revenues

Our total revenue for the three-month period ended December 31, 2021 was $1.0 million as compared with $2.4 million for the same period in 2020, representing a decrease of $1.4
million, primarily due to $1.4 million decline in product sales of macimorelin to its licensees (as no product sales were generated in 2021), $0.5 million decline in license fees offset by
$0.5 million increase in development services (as further discussed below).

In the fourth quarter of 2021, the Company restated its previously reported condensed consolidated interim financial statements for the three-month period ended March 31, 2021
and the three-month and six-month periods ended June 30, 2021 and three-month and nine-month periods ended September 30, 2021 with respect to the recognition of revenue for
the Novo Amendment, signed in November 2020. During the fourth quarter of 2021, management reassessed the classification of the development activities associated with the
DETECT-trial and concluded that subsequent to the Novo Amendment the parties no longer shared joint control of these activities and, as such, these development activities no
longer met the definition of a joint operation, as defined in IFRS 11. Therefore, pursuant to the guidance in IFRS 15, the Company reclassified the charges to Novo, from research
and development expenses to development services revenue, in the related periods. In addition, the license fees related to the pediatric indication were adjusted to reflect the
revised pattern of recognition as the performance obligation for the development services has now been combined with the pediatric license.  In addition, the accounting for
prepaid expenses and other assets and deferred revenues related to the DETECT-trial expenses incurred were restated.

52

The impacts of these restatements are as follows (amounts in thousands, except for basic and diluted loss per share):

Consolidated interim statement of loss and comprehensive loss for the three-
month period ended March 31, 2021
License fees
Development service revenues
Research and development expenses

Net loss
Total comprehensive loss
Basic and diluted loss per share

Consolidated interim statement of financial position as of March 31, 2021

Prepaid expenses and other current assets
Current portion of deferred revenues
Deficit

Consolidated interim statement of loss and comprehensive loss for the three-
month period ended June 30, 2021
License fees
Development service revenues
Research and development expenses

Net loss
Total comprehensive loss
Basic and diluted loss per share

Consolidated interim statement of loss and comprehensive loss for the six-
month period ended June 30, 2021
License fees
Development service revenues
Research and development expenses
Net loss
Total comprehensive loss
Basic and diluted loss per share

Consolidated interim statement of financial position as of June 30, 2021

Prepaid expenses and other current assets
Current portion of deferred revenues
Deficit

Previously reported    

$

Effect of restatement
$

Amended
$

537   
—   
363   
(1,445)  
(16)  
(0.02)  

3,050   
2,101   
(323,222)  

(13)  
1,095   
1,095   
(13)  
(13)  
—   

543   
556   
(13)  

524 
1,095 
1,458 
(1,458)
(29)
(0.02)

3,593 
2,657 
(323,235)

Previously reported    

$

Effect of restatement
$

Amended
$

537   
—   
738   
(2,039)  
(3,133)  
(0.02)  

1,074   
—   
1,101   
(3,484)  
(3,149)  
(0.03)  

3,308   
2,125   
(326,229)  

(45)  
1,030   
1,030   
(45)  
(45)  
—   

(58)  
2,125   
2,125   
(58)  
(58)  
—   

1,067   
1,111   
(58)  

492 
1,030 
1,768 
(2,084)
(3,178)
(0.02)

1,016 
2,125 
3,226 
(3,542)
(3,207)
(0.03)

4,375 
3,236 
(326,287)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
Consolidated interim statement of loss and comprehensive loss for the three-
month period ended September 30, 2021
License fees
Development service revenues
Research and development expenses

Net loss
Total comprehensive loss
Basic and diluted loss per share

Consolidated interim statement of loss and comprehensive loss for the nine-
month period ended September 30, 2021
License fees
Development service revenues
Research and development expenses
Net loss
Total comprehensive loss
Basic and diluted loss per share

Consolidated  interim statement  of  financial  position  as  of  September  30,
2021

Prepaid expenses and other current assets
Current portion of deferred revenues
Deficit

53

Previously reported    

$

Effect of restatement
$

Amended
$

527   
—   
801   
(1,698)  
(1,440)  
(0.01)  

1,601   
—   
1,902   
(5,182)  
(4,589)  
(0.05)  

3,431   
2,075   
(327,708)  

(234)  
684   
684   
(234)  
(234)  
(0.01)  

(292)  
2,809   
2,809   
(292)  
(292)  
—   

600   
943   
(292)  

293 
684 
1,485 
(1,932)
(1,674)
(0.02)

1,309 
2,809 
4,711 
(5,474)
(4,881)
(0.05)

4,031 
3,018 
(328,000)

These restatements did not impact the Company’s cash and cash equivalent amounts and reported amounts of operating, investing and financing activities within the consolidated
interim statements of cash flows for the three-month period ended March 31, 2021 and the three-month and six-month periods ended June 30, 2021 and three-month and nine-month
periods ended September 30, 2021. Nor did these restatements have any impact on 2020 results. No amended financial statements will be filed.

Operating expenses

Our total operating expenses for the three-month period ended December 31, 2021 were $4.1 million as compared with $3.6 million for the same period in 2020, representing an
increase of $0.5 million.  This increase arose primarily from a $1.3 million increase in research and development expenses, a $0.5 million increase in general and administrative
expenses and $0.1 million in costs incurred in 2020 and not incurred in 2021 (comprised of $0.1 million in reversal of impairment of other asset), offset by a decline of $1.4 million in
cost of sales, as discussed below.

54

Research and development expenses

The following table summarizes our research and development expenses incurred during the periods indicated (amounts in thousands, except percentages):

Macrilen™ (macimorelin) pediatric trial direct research and development
expenses (DETECT-trial)
AEZS-130 direct research and development expenses
DC-PTH direct research and development expenses
Parkinsons direct research and development expenses
Covid-19 direct research and development expenses
NMOSD direct research and development expenses
Chlamydia direct research and development expenses
Additional programs’ direct research and development expenses

Total direct research and development expenses

Employee-related expenses
Facilities, depreciation, and other expenses

Total

$

$

QUARTER ENDED
DECEMBER 31,

2021

2020

$ CHANGE

%  CHANGE

526   
143   
63   
171   
137   
106   
108   
249   
1,503   
335   
25   
1,863   

$

$

(32)  
—   
—   
—   
—   
—   
—   
333   
301   
226   
99   
626   

$

$

558   
143   
63   
171   
137   
106   
108   
(84)  
1,202   
109   
(74)  
1,237   

1,743.8%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
(25.2)%
399.3%
48.2%
(74.7)%
197.6%

Research and development expenses increased $1.2 million for the quarter ended December 31, 2021 compared to the quarter ended December 31, 2020 primarily due to $1.2 million
increase in direct research and development expenses. Direct research and development expenses include expenses incurred under arrangements with third parties, such as a
contract research organization for the DETECT-trial, contract manufacturers, and consultants. The $1.2 million increase in total direct research and development expenses for the
quarter ended December 31, 2021 was primarily due to a $0.6 million increase in costs for the DETECT-trial and a $0.6 million increase in the initiation of our new pre-clinical projects
with universities. During the fourth quarter of 2021, management reassessed the classification of the charges to Novo for development activities associated with the DETECT-trial
and reclassified them from direct research and development expenses to development services revenue, as discussed in further detail above in "Revenues” in the Results from
operations  section  of  this  MD&A.  In  2020,  the  Company  accounted  for  employee  charges  to  Novo  for  the  DETECT-trial  relating  as  a  reduction  in  the  direct  research  and
development costs, while the gross employee costs remained in the ‘Employee-related expenses’ in the analysis above. This classification led to the negative direct expenses for
the DETECT-trial

In the fourth quarter of 2021, the Company was actively recruiting patients for the DETECT-trial. This is in contrast to 2020, when we were primarily focused on the completion of
our pediatric Study P01 for macimorelin which established the dose that is being used in the DETECT-trial. In addition to the DETECT-trial, the Company was actively working with
its university research partners on the named pre-clinical programs, which primarily began in the first quarter of 2021. Of note, the Parkinsons’ project became active in the fourth
quarter of 2021 after being in-licensed in the third quarter of 2021.

Employee-related expenses have increased in 2021 by $0.1 million for the quarter ended December 31, 2021 as compared to the quarter ended December 31, 2020 primarily from the
impact of the addition of Dr. Michael Teifel as our Chief Scientific Officer in May 2021 and of our Head of Quality Control and CMC-Regulatory in March 2021, to better support

 
 
 
 
 
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
our new pre-clinical initiatives.

Facilities, depreciation, and other expenses have declined by $0.1 million for the quarter ended December 31, 2021 as compared to the quarter ended December 31, 2020 primarily
from the impact of lease negotiations for its German subsidiary initiated in 2020. Effective March 31, 2020, the Company modified its existing building lease agreement with its
landlord, significantly reducing its leased space and leasing costs, and ultimately leading to the extension of its lease term to March 31, 2023.

General and administrative expenses

General and administrative expenses increased by $0.5 million for the quarter ended December 31, 2021 compared to the quarter ended December 31, 2020, due to increased directors
and officers’ insurance coverage of $0.2 million, for recruiting costs pertaining to the Chief Financial Officer role of $0.1 million, and increased salary and bonus costs of $0.1
million.

55

Cost of sales

Cost of sales decreased by $1.3 million in the fourth quarter of 2021 as compared with the same quarter in 2020, as there were no purchases of macimorelin by any licensee in 2021
as compared to the sale of one batch of Macrilen™ in the fourth quarter of 2020 to Novo.

Net Loss

For the three-month period ended December 31, 2021, we reported a consolidated net loss of $2.9 million, or $0.02 loss per common share (basic and diluted), as compared with a
consolidated net loss of $1.3 million, or $0.02 loss per common share (basic and diluted) for the three-month period ended December 31, 2020. The $1.6 million increase in net loss is
primarily from a $0.5 million increase in total operating expenses and a $1.4 million decrease in revenues, partially offset by a $0.4 million reduction in income tax expense, as
discussed above.

Fiscal Year-End

Revenues

Our total revenue for the twelve-month period ended December 31, 2021 was $5.3 million as compared with $3.7 million for the same period in 2020, representing an increase of $1.6
million, primarily due to $3.3 million increase in development services with Novo and $0.8 million increase in license fees related to the partial recognition of the €5 million up front
payment received from Novo in 2020 offset by a $2.4 million decline in product sales (as no product sales were generated in 2021).

Operating expenses

Our total operating expenses for the twelve-month period ended December 31, 2021 was $13.9 million as compared with $9.4 million for the same period in 2020, representing an
increase  of  $4.5  million.  This  increase  arises  primarily  from  a  $5.1  million  increase  in  research  and  development  expenses,  $1.1  million  increase  in  general  and  administration
expenses, $0.3 million in increase in selling expenses and $0.3 million in costs incurred in 2020 and not incurred in 2021 (comprised of $0.2 million in gain on modification of building
lease and $0.1 million in reversal of impairment of other asset), offset by a $2.2 million decrease in cost of sales, as discussed below.

Research and development expenses

The following table summarizes our research and development expenses incurred during the periods indicated (amounts in thousands, except percentages):

Macrilen™ (macimorelin) pediatric trial direct research and development
expenses (DETECT-trial)
AEZS-130 direct research and development expenses
DC-PTH direct research and development expenses
Parkinson’s direct research and development expenses
Covid-19 direct research and development expenses
NMOSD direct research and development expenses
Chlamydia direct research and development expenses
Additional programs’ direct research and development expenses

Total direct research and development expenses

Employee-related expenses
Facilities, depreciation, and other expenses

Total

$

$

YEAR ENDED
DECEMBER 31,

2021

2020

$ CHANGE

%  CHANGE

3,244   
230   
154   
171   
712   
453   
146   
486   
5,596   
839   
139   
6,574   

$

$

56

184   
—   
—   
—   
—   
—   
—   
475   
659   
653   
194   
1,506   

$

$

3,060   
230   
154   
171   
712   
453   
146   
11   
4,937   
186   
(55)  
5,068   

1,663.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
2.3%
749.2%
28.5%
(28.4)%
336.5%

Research and development expenses increased $5.1 million for the year ended December 31, 2021 as compared to the year ended December 31, 2020 primarily due to $4.9 million
increase in direct research and development expenses. Direct research and development expenses include expenses incurred under arrangements with third parties, such as a
contract research organization for the DETECT-trial, contract manufacturers, and consultants. The $4.9 million increase in total direct research and development expenses for the
year ended December 31, 2021 was primarily due to a $3.1 million increase in costs for the DETECT-trial and a $1.8 million increase in the initiation of our new pre-clinical projects
with universities for named projects. In the second quarter of 2021, the DETECT-trial became active and we announced the opening of the first clinical site in the U.S. During the
fourth quarter of 2021, management reassessed the classification of the charges to Novo for development activities associated with the DETECT-trial and reclassified them from
direct research and development expenses to development services revenue, as discussed in further detail above in "Revenues” in the 2021 compared with 2020 for the Fourth
Quarter from this section of this Annual Report.

Employee-related expenses have increased in 2021 by $0.2 million as compared to the year ended December 31, 2020 primarily from the addition of two senior members of our
research and development team earlier in 2021.

Facilities, depreciation, and other expenses have declined in 2021 by $0.1 million as compared to the year ended December 31, 2020, primarily from the impact of lease negotiations
for its German subsidiary which were completed early in 2020 and resulted in the negotiated reduction in leased space for its German subsidiary.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
General and administrative expenses

General and administrative expenses increased by $1.1 million for the year ended December 31, 2021 compared to the year ended December 31, 2020, primarily from higher share
based compensation of $0.2 million, higher spending on media and communication of $0.2 million, increased directors and officers’ insurance coverage of $0.2 million, higher
professional fees of $0.2 million, increased higher public company costs of $0.2 million from holding our annual shareholders meeting in May 2021, subsequent to our issuance of
common shares in the February 2021 Financing and the 2021 Warrant Exercises, in addition to recruiting costs for the Chief Financial Officer role of $0.1 million.

Cost of sales

Cost of sales decreased by $2.2 million during the year ended December 31, 2021 as compared to the same period in 2020, as there were no purchases of macimorelin by any
licensee in 2021 as compared to the sale of two batches of Macrilen™ to Novo in 2020.

Net finance income

Our net finance income for the twelve-month period ended December 31, 2021 was $0.2 million as compared with $1.0 million for the same period in 2020, representing a decrease of
$0.8 million. This is primarily due to a $1.1 million change in fair value of warrant liability, a $0.4 million decline in gain due to change in foreign currency, offset by a $0.7 million
decline in other finance costs.  During the prior year, the  Company registered the common shares underlying certain warrants which allowed the  Company to reclassify such
warrants from liability to shareholders’ equity in the consolidated statements of financial position. As such the change in fair value of such warrants liabilities was classified as a
finance cost in the consolidated statements of loss in 2020; there was no such change in fair value in 2021.

57

Net Loss

For the twelve-month period ended December 31, 2021, we reported a consolidated net loss of $8.4 million, or $0.07 loss per common share (basic and diluted), as compared with a
consolidated net loss of $5.1 million, or $0.12 loss per common share (basic and diluted), for the year ended December 31, 2020. The $3.3 million increase in net loss is primarily from
a $4.5 million increase in operating expenses and a $0.8 million decline in net finance income, partially offset by an increase of $1.6 million in total revenues and a change in income
tax recovery of $0.5 million, as previously discussed.

2020 compared with 2019

Fourth Quarter

Revenues

Our total revenue for the three-month period ended December 31, 2020 was $2.4 million as compared with $0.02 million for the same period in 2019, representing an increase of $2.4
million. The 2020 revenue was comprised of $1.4 million in product sales (2019 - $nil), $0.9 million in licensing revenue (2019 - $0.02 million), $0.02 million in royalty revenue (2019 -
$0.2 million) and $0.1 million in supply chain revenue (2019 – ($0.02) million).

On November 16, 2020, the Company announced that it had entered into the Amendment of its existing License Agreement and received an upfront payment of €5 million ($6.1
million) in December 2020. Management determined that the remaining performance obligation under the contract which provides the customer with a license of a future FDA
approved pediatric indication is a distinct performance obligation before and after the modification. Accordingly, the  Company accounted for the modification to the  License
Agreement as an adjustment to the existing License Agreement with Novo, on a prospective basis. The portion of the changes in the transaction price that was attributable to the
change in future royalty rate was allocated to both the adult and pediatric indications. Based on the change in future royalty rates, the Company determined that $0.6 million of the
additional upfront payment should be allocated to the Adult Indication. Accordingly, the Company recognized $0.6 million related to the adult indication in revenues for the year
ended December 31, 2020 and has deferred $5.6 million to be recognized over time until the expected FDA approval date of June 2023.

Operating expenses

Our total operating expense for the three-month period ended December 31, 2020 was $3.6 million as compared with $1.8 million for the same period in 2019, representing an increase
of $1.8 million. This increase arises primarily from a $1.1 million increase in cost of sales, $0.4 million increase in research and development costs, $0.4 million increase in selling
expenses  and  $0.5  million  in  costs  incurred  in  the  fourth  quarter  of  2019  and  not  incurred  in  the  fourth  quarter  of  2020  (comprised  of  $0.3  million  in  restructuring  costs  and
approximately $0.2 million in impairment of right of use asset), offset by a decline of $0.4 million in general and administrative expenses and a reversal of $0.1 million of write off of
other asset.

In  the  fourth  quarter  of  2020,  cost  of  sales  increased  from  the  sale  of  a  batch  of  macimorelin  to  Novo  Nordisk.  The  increase  in  research  and  development  costs  reflect  the
Company’s  initial  pipeline  expansion  activities  in  2020  as  compared  to  close  out  activities  for  Study  P01  in  2019.  The  impact  of  our  June  2019  restructuring  in  our  German
subsidiary, namely for payroll and share based compensation costs, was a key influence in the declines in general and administrative expenses.

Net finance costs

Our net finance income for the three-month period ended December 31, 2020 was $0.3 million as compared with $0.6 million for the same period in 2019, representing a decrease of
$0.3 million. This is primarily due to a $0.5 million lower gain in the change in fair value of warrant liability offset by $0.3 million from changes in currency exchange rates. By
December 31, 2020, the Company had registered all of the common shares underlying all of its issued and outstanding warrants.

58

Net loss

For the three-month period ended December 31, 2020, we reported a consolidated net loss of $1.3 million, or $0.02 loss per common share (basic), as compared with a consolidated
net loss of $1.0 million, or $0.05 loss per common share for the three-month period ended December 31, 2019. The $0.3 million increase in net results is primarily from an increase in
total operating expenses of $1.8 million, an increase in net finance costs of $0.2 million, a change of tax expenses of $0.6 million partially offset by an increase in revenues of $2.3
million in operating expenses.
Fiscal Year-End

Revenues

Our total revenue for the twelve-month period ended December 31, 2020 was $3.7 million as compared with $0.5 million for the same period in 2019, representing an increase of $3.2
million. The 2020 revenue was comprised of $2.4 million in product sales (2019 – $0.1 million), $0.9 million in licensing revenue (2019 - $0.07 million), $0.3 million in supply chain
(2019 - $0.3 million) and $0.07 million in royalty income (2019 - $0.05 million).

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
On November 16, 2020, the Company announced that it had entered into the Amendment of its existing License Agreement and received an upfront payment of €5 million ($6.1
million) in December 2020. Management determined that the remaining performance obligation under the contract which provides the customer with a license of a future FDA
approved pediatric indication is a distinct performance obligation before and after the modification. Accordingly, the  Company accounted for the modification to the  License
Agreement as an adjustment to the existing License Agreement with Novo , on a prospective basis. The portion of the changes in the transaction price that was attributable to the
change in future royalty rate was allocated to both the adult and pediatric indications. Based on the change in future royalty rates, the Company determined that $0.6 million of the
additional upfront payment should be allocated to the Adult Indication. Accordingly, the Company recognized $0.6 million related to the adult indication in revenues for the year
ended December 31, 2020 and has deferred $5.6 million to be recognized over time until the expected FDA approval date of June 2023.

Operating expenses

Our total operating expense for the twelve-month period ended December 31, 2020 was $9.4 million as compared with $10.8 million for the same period in 2019, representing a
decrease of $1.4 million. This decline arises primarily from a $1.9 million reduction in general and administration expenses, a decrease of $0.5 million in restructuring costs, a $0.3
million reduction in research and development costs, a $0.3 million reversal in write off of other asset, a $0.2 million gain on modification of building lease and $0.1 million reduction
in selling costs, offset by an increase of $1.9 million in cost of sales.  This decline in operating expenses is in-line with the expected impact of our cost control initiatives as
previously implemented and the impact of the 2019 restructuring at our German subsidiary.

Net finance income

Our net finance income for the year ended December 31, 2018 was $1.2 million, as compared to $2.8 million for the same period in 2017, representing a decrease of $1.6 million. The
decline in net finance income is primarily due to the change in fair value of our warrant liability. Such change in fair value results from the periodic "mark-to-market” revaluation via
the application of pricing models to our outstanding share purchase warrants. The closing price of our Common Shares, which, on the NASDAQ, fluctuated from $1.19 to $3.87
during the twelve-month period ended December 31, 2018, compared to $2.67 to $2.70 during the same period in 2017, also had a direct impact on the change in fair value of warrant
liability.

Net Loss

For the twelve-month period ended December 31, 2020, we reported a consolidated net loss of $5.1 million, or $0.12 loss per common share, as compared with a consolidated net
loss of $6.0 million, or $0.35 loss per common share (basic), for the twelve-month period ended December 31, 2019. The $0.9 million improvement in net results is primarily from an
increase in total revenues of $3.1 million and a reduction of operating expenses of $1.4 million partially offset by a $3.0 million decline in net finance income and an increase in
income tax expense of $0.6 million.

Selected quarterly financial data

(in thousands, except for per share data)

Revenues
Net loss
Net loss per share (basic and diluted)(2)

59

December 31, 2021    

$

956   
(2,894)  
(0.02)  

Three months ended

September 30,
2021(1)
$

June 30, 2021(1)
$

1,052   
(1,932)  
(0.02)  

1,584   
(2,084)  
(0.02)  

    March 31, 2021(1)  

$

1,668 
(1,458)
(0.02)

(in thousands, except for per share data)

Revenues
Net (loss) income
Net (loss) income per share (basic and diluted)(2)

Three months ended

December 31, 2020    

$

September 30, 2020    
$

June 31, 2020
$

March 31, 2020  

$

2,366   
(1,311)  
(0.02)  

128   
(1,136)  
(0.02)  

68   
(3,450)  
(0.15)  

1,090 
779 
0.04 

(1) The restatements are discussed above under "Revenues” in the Results from operations section of this 20-F comparing 2021 with 2020 for the Fourth Quarter (which had no impact on 2020). The
interim financial statements for the periods ended March 31, 2021, June 30, 2021 and September 30, 2021 have not been refiled but the comparatives will be corrected when the interim financial
statements for the periods ended March 31, 2022, June 30, 2022 and September 30, 2022 are filed. These restatements did not have any impact on 2020 results.

(2) Net loss per share is based on the weighted average number of shares outstanding during each reporting period, which may differ on a quarter-to-quarter basis. As such, the sum of the quarterly net

loss per share amounts may not equal full-year net loss per share.

Historical quarterly results of operations and net (loss) income cannot be taken as reflective of recurring revenue or expenditure patterns of predictable trends, largely given the
non-recurring  nature  of  certain  components  of  our  historical  revenues,  due  most  notably  to  unpredictable  quarterly  variations  in  net  finance  income,  which  are  impacted  by
periodic "mark-to-market” revaluations of our warrant liability and of foreign exchange gains and losses.

Condensed Consolidated Statement of Financial Position Information

(in thousands)

Cash and cash equivalents
Trade and other receivables and other current assets
Inventory
Restricted cash equivalents
Property, plant and equipment
Right of use assets
Other non-current assets

Total assets

Payables and accrued liabilities and income taxes payable
Current portion of provisions
Current portion of deferred revenues
Lease liabilities
Warrant liability
Non-financial non-current liabilities (*)

As of
December 31, 2021
$

As of
December 31, 2020
$

As of
December 31, 2019
$

65,300   
5,447   
73   
335   
42   
150   
8,755   
80,102   
2,787   
34   
4,815   
161   
—   
19,319   

24,271   
3,322   
21   
338   
22   
157   
8,874   
37,005   
2,322   
92   
2,193   
184   
—   
19,003   

7,838 
1,869 
1,203 
364 
35 
582 
8,090 
19,981 
3,596 
418 
991 
903 
2,225 
14,281 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total liabilities
Shareholders’ equity (deficiency)
Total liabilities and shareholders’ equity (deficiency)

27,116   
52,986   
80,102   

23,794   
13,211   
37,005   

22,444 
(2,463)
19,981 

(*) Comprised mainly of employee future benefits, provisions, deferred gain and non-current portion of deferred revenues.

60

Outstanding Share Data

As  at  March  25,  2022,  we  had  121,397,007  common  shares  issued  and  outstanding,  as  well  as  1,086,368  stock  options,  423,000  deferred  share  units  and  11,441,213  warrants
outstanding representing a total of 11,441,213 equivalent common shares.

Recent Accounting Pronouncements

The IASB continues to issue new and revised IFRS. A listing of the recent accounting pronouncements promulgated by the IASB and not yet adopted by the Company is included
in note 4 to the Company’s December 31, 2021 consolidated financial statements which are included in Item 17 of this Annual Report on Form 20-F.

B.

Liquidity, Cash Flows and Capital Resources

Since inception, the Company has incurred significant expenses in its efforts to develop and co-promote products. Our current business focus is to: investigate further therapeutic
uses of Macrilen™, expand pipeline development activities, further expand the commercialization of macimorelin in available territories and fund our 50% share of the DETECT-trial
costs which exceed €9 million. Consequently, the Company has incurred operating losses and has generated negative cash flow from operations historically and in each of the last
several years except for the year ended December 31, 2018 when the Company earned revenue from the sale of a license for the adult indication of Macrilen™ (macimorelin) in the
U.S. and Canada. The Company expects to incur significant expenses and operating losses for the foreseeable future as it advances its product candidates through preclinical and
clinical development, seeks regulatory approval and pursues commercialization of any approved product candidates. We expect that our research and development costs will
increase in connection with our planned research and development activities.

As of December 31, 2021, the Company had cash and cash equivalents of $65.3 million and an accumulated deficit of $334.6 million. The Company also had a net loss of $8.4 million
and negative cash flows from operations of $8.6 million for the year ended December 31, 2021. We believe that our existing cash on hand will be sufficient to fund our anticipated
operating  and  capital  expenditure  requirements  through  2023.  We  have  based  this  estimate  on  assumptions  that  may  prove  to  be  wrong,  and  we  could  exhaust  our  capital
resources sooner than we expect. We may also require additional capital to pursue in-licenses or acquisitions of other product candidates.

Registered and Private Offerings

On March 28, 2017, we commenced a new at-the-market ("ATM”) offering pursuant to the existing ATM Sales Agreement, dated April 1, 2016, under which we were able, at our
discretion, from time to time, to sell up to a maximum of 3 million common shares through ATM issuances on the NASDAQ, up to an aggregate amount of $9.0 million (the " March
2017 ATM Program”). The common shares were to be sold at market prices prevailing at the time of the sale of the common shares and, as a result, sale prices varied.

61

Between March 28, 2017 and April 18, 2017, we issued a total of 597,994 common shares under the March 2017 ATM Program at an average issuance price of $2.97 per share for
aggregate gross proceeds of $1.8 million less cash transaction costs of $55,000 and previously deferred financing costs of $65,000.

On April  27,  2017,  we  entered  into  a  new ATM  Sales Agreement  (the  " New ATM  Sales Agreement ”),  and  filed  with  the  SEC  a  prospectus  supplement  (the  "Prospectus
Supplement”) related to sales and distributions of up to a maximum of 2,240,000 common shares through ATM issuances on the NASDAQ, up to an aggregate amount of $6.9
million under the New ATM Sales Agreement. The common shares will be sold at market prices prevailing at the time of the sale of the common shares and, as a result, prices may
vary. The New ATM Sales Agreement and the Prospectus Supplement superseded and replaced the March 2017 ATM Program, which itself had superseded and replaced the April
2016 ATM  Program.  The  Prospectus  Supplement  supplements  the  base  prospectus  included  in  our  Shelf  Registration  Statement  on  Form  F-3,  as  amended  (the  " 2017  Shelf
Registration Statement”), which was declared effective by the SEC on April 27, 2017. Between May 30, 2017 and December 31, 2017, we issued 1.8 million common shares at an
average issuance price of $2.08 per share under the New ATM Sales Agreement.

On  September  20,  2019,  we  entered  into  a  securities  purchase  agreement  (the  "2019  Securities  Purchase Agreement”)  with  institutional  investors  in  the  U.S.  to  purchase
approximately $5.0 million of our Common Shares for $1.50 per share in a registered direct offering and warrants to purchase Common Shares in a concurrent private placement. The
gross proceeds from the offering were approximately $5.0 million before deducting the placement agent’s fees and other estimated offering expenses. Under the terms of the 2019
Securities Purchase Agreement, we sold 3,325,000 Common Shares. In a concurrent private placement, we issued unregistered warrants to purchase up to approximately 3,325,000
Common Shares. The warrants are exercisable six months following the date of issuance and have an exercise price of $1.65. The warrants will expire five years from the date of
issuance.  The  Common  Shares described above (but not the warrants or the  Common  Shares underlying the warrants) were offered by us pursuant to a "shelf” registration
statement on Form F-3, as amended (the "2019 Shelf Registration Statement”), which was declared effective by the SEC on August 15, 2019.

On February 21, 2020, the Company completed a registered direct offering for 3,478,261 common shares, at a purchase price of $1.29375 per share, priced at-the-market. Additionally,
the Company issued to the investors in the offering unregistered warrants to purchase up to an aggregate of 2,608,696 common shares in a concurrent private placement. The
warrants have an exercise price of $1.20 per common share, are exercisable immediately and will expire five and one-half years following the date of issuance. The net cash proceeds
to the Company from the offering totaled $3.9 million. The Company issued 243,478 warrants to the placement agent with an exercise price of $1.61719 per common share, which are
exercisable immediately and will expire five years following the date of issuance. Collectively, this financing is referred to as the "February 2020 Financing”.

Effective June 16, 2020, the Company registered under the Securities Act of 1933 the 2,608,696 investor warrants and 243,478 placement agent warrants issued on February 21, 2020
and the 3,325,000 investor warrants issued on September 20, 2019.

On July 7, 2020, the Company completed a public offering of 26,666,666 units at a price to the public of $0.45 per unit, for gross proceeds of $12 million, before deducting placement
agent fees and other offering expenses payable by the Company, in the amount of $1.4 million. Each unit contained one common share (or common share equivalent in lieu thereof)
and one investor share purchase warrant to purchase one common share. In total, 26,666,666 common shares, 26,666,666 investor share purchase warrants with an exercise price of
$0.45 per share expiring July 7, 2025 and 1,866,667 placement agent warrants with an exercise price of $0.5625 per share expiring July 1, 2025 were issued. The net cash proceeds to
the Company from the offering totaled $10.6 million. Collectively, this financing is referred to as the "July 2020 Financing”.

On August 5, 2020, the Company entered into a securities purchase agreement with several institutional investors in the U.S. providing for the sale and issuance of 12,427,876
common shares at a purchase price of $0.56325 per common share in a registered direct offering priced at-the-market under Nasdaq rules. The offering resulted in gross proceeds of
$7 million. Concurrently, the Company issued to the purchasers unregistered warrants to purchase up to an aggregate of 9,320,907 common shares. The warrants are exercisable for

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
a period of five and one-half years, exercisable immediately following the issuance date and have an exercise price of $0.47 per common share. In addition, the Company issued
unregistered warrants to the placement agent to purchase up to an aggregate of 869,952 common shares, with an exercise price of $0.7040625 per share and an expiration date of
August 3, 2025. The net cash proceeds to the Company from the offering totaled $6.3 million. Effective September 14, 2020, the Company registered the common shares underlying
the 9,320,907 investor warrants and 869,952 placement agent warrants issued on August 3, 2020 by way of a registration statement which removed the cashless exercise option for
registered warrants. Collectively, this financing is referred to as the "August 2020 Financing”.

62

During the period between January 1, 2021 and December 31, 2021, holders have exercised certain of our outstanding warrants to purchase 35,111,187 of our common shares for
gross proceeds of approximately $20.1 million (such exercises, the "Warrant Exercises”).

On February 19, 2021, the Company closed a public offering of 20,509,746 common shares at a price to the public of $1.45 per common share, for gross proceeds of $29.7 million,
before deducting underwriting discounts, commissions and offering expenses payable by the Company, in the amount of $2.8 million. Aeterna also granted the underwriter a 30-
day  overallotment  option  (the  "Underwriter  Option”)  to  purchase  up  to  3,076,461  additional  common  shares  at  the  public  offering  price,  less  underwriting  discounts  and
commissions, and 1,435,682 warrants with an exercise price of $1.8125 and expiring on February 17, 2026. The net cash proceeds to the Company from the offering totaled $26.9
million. On February 22, 2021, the underwriter exercised the Underwriter Option in full and received 3,076,461 common shares for gross proceeds to the Company of $4.5 million. In
connection with the public offering and the exercise of the Underwriter Option, the Company paid commissions and other expenses of $0.4 million and issued 215,352 warrants
priced at $1.8125 and expiring on February 17, 2026. Aggregate gross proceeds received in connection with the February 2021 Financing totaled $34.2 million, less cash transaction
costs of $3.2 million and non-cash transaction costs, which represent the issue-date fair value of the February 2021 Placement Agent Warrants, of $1.9 million. Collectively, this
financing is referred to as the "February 2021 Financing”.

The variations in our liquidity by activity are explained below.

(in thousands) 

Cash and cash equivalents - Beginning of period
Cash flows from operating activities:
Net cash (used in) operating activities

Cash flows from financing activities:
Net proceeds from issuance of common shares and issuance
of common shares and warrants
Proceeds from exercise of warrants, stock options and deferred
share units
Proceeds on deferred gain
Payments on lease liability

Cash flows from investing activities:
Net cash (used in) provided by investing activities

Effect of exchange rate changes on cash and cash equivalents  
Cash and cash equivalents - End of period

Operating Activities

2021 compared to 2020

Three months ended
December 31,

2021
$

2020
$

2021
$

Years ended
December 31,
2020
$

68,002   

(2,413)  
(2,413)  

—   

45   
98   
(32)  
111   

(124)   
(124)   

(276)   
65,300   

63

21,746   

2,518   
2,518   

—   

—   
—   
(17)   
(17)   

—   
—   

24   
24,271   

24,271   

(8,581)  
(8,581)  

30,979   

20,087   
98   
(127)  
51,037   

(658)   
(658)   

(769)   
65,300   

7,838   

(4,129)  
(4,129)  

20,733   

—   
—   
(265)  
20,468   

56   
56   

38   
24,271   

2019
$

14,512 

(10,725)
(10,725)

4,193 

314 
— 
(614)
3,893 

50 
50 

108 
7,838 

Cash used by operating activities totaled $8.6 million for the twelve months ended December 31, 2021, as compared to $4.1 million used by operating activities in the same period in
2020.  This  $4.5  million  increase  in  spending  in  operating  activities  is  attributed  primarily  to  $1.9  million  spending  on  the  pre-clinical  development  programs,  four  potential
therapeutics and two potential vaccines initiated in 2021 in addition to $2.4 million decrease in product sales.

2020 compared to 2019

Cash used by operating activities totaled $4.1 million for the twelve months ended December 31, 2020, as compared to $10.7 million used by operating activities in the same period
in 2019. This $6.6 million improvement in operating activities is attributed primarily to the receipt of the non-refundable payment of $6.1 million (€5 million) from Novo Nordisk and
the impact of the June 2019 restructuring in Germany, primarily impacting payroll and share-based compensation costs.

Financing Activities

2021 compared to 2020

Cash provided by financing activities totaled $51.0 million for the twelve months ended December 31, 2021, as compared with cash provided by financing activities of $20.5 million
in the same period in 2020. In February 2021, the Company completed a financing which provided $31.0 million in net funding (2020 – the Company completed three financings for
$20.7 million in net funding). Throughout 2021, holders exercised 35.1 million warrants resulting in proceeds to the Company of $20.1 million.

2020 compared to 2019

Cash provided by financing activities totaled $20.5 million for the twelve months ended December 31, 2020, as compared with cash provided by financing activities of $3.9 million in
the same period in 2019. On February 21, 2020, the Company completed the February 2020 Financing with net cash proceeds of $3.9 million. In 2020, the Company also completed
the July 2020 Financing with net proceeds of $10.6 million and the August 2020 Financing with net proceeds of $6.3 million (2019 – completed the September 2019 financing for $4.2
million).

Investing Activities

 
 
 
 
 
 
 
   
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2021 compared to 2020

Cash used in investing activities totaled $0.7 million for the twelve months ended December 31, 2021, as compared with cash provided by investing activities of $0.1 million in the
same period in 2020. The $0.6 million year-over-year increase is attributable entirely to the five pre-clinical development programs discussed above, for which we made payments to
the University of Wuerzburg for $0.5 million and to the University of Sheffield for $0.1 million.

2020 compared to 2019

Cash flows from investing activities totaled $0.1 million for the year ended December 31, 2020, as compared with $0.1 million for the same period in 2019 reflecting change being
made in our restricted cash balances.

64

Critical Accounting Policies, Estimates and Judgments

Our consolidated financial statements as of December 31, 2021 and December 31, 2020 and for the years ended December 31, 2021, 2020 and 2019 have been prepared in accordance
with IFRS as issued by the IASB.

The  preparation  of  consolidated  financial  statements  in  accordance  with  IFRS  requires  management  to  make  judgments,  estimates  and  assumptions  that  affect  the  reported
amounts of our assets, liabilities, revenues, expenses and related disclosures.  Judgments, estimates and assumptions are based on historical experience, expectations, current
trends and other factors that management believes to be relevant when our consolidated financial statements are prepared.

Management reviews, on a regular basis, the Company’s accounting policies, assumptions, estimates and judgments in order to ensure that the consolidated financial statements
are presented fairly and in accordance with IFRS. Revisions to accounting estimates are recognized in the period in which the estimates are revised and in any future periods
affected. Further details can be found in note 3 in the consolidated financial statement as of December 31, 2021 and December 31, 2020 and for the years ended December 31, 2021,
2020 and 2019.  Our most significant accounting estimates and assumptions that the  Company has made in the preparation of the consolidated financial statements including
accounting  for  a  contract  modification,  license  and  collaboration  arrangement  with  multiple  elements,  impairment  of  goodwill,  employee  future  benefits  and  research  and
development accrual.

Capital Disclosures

The Company’s objective in managing capital, consisting of shareholders’ equity (deficiency), with cash and cash equivalents and restricted cash equivalents being its primary
components, is to ensure sufficient liquidity to fund R&D costs, selling expenses, G&A expenses and working capital requirements. Over the past several years, the Company has
raised capital via public and private equity offerings and issuances as its primary source of liquidity. The capital management objective of the Company remains the same as that in
previous periods. The policy on dividends is to retain cash to keep funds available to finance the activities required to advance the Company’s product development portfolio and
to pursue appropriate commercial opportunities as they may arise.

The Company is not subject to any capital requirements imposed by any regulators or by any other external source.

Material Cash Requirements

Contractual obligations and commitments as of December 31, 2021

Less than 1 year
1 – 3 years
4 – 5 years
More than 5 years
Total

Service and
manufacturing
$

R&D
contracts
$

TOTAL
$

1,085   
6   
-   
-   
1,091   

2,252   
1,049   
-   
-   
3,301   

3,337 
1,055 
- 
- 
4,392 

During 2021, the Company executed various agreements including in-licensing and similar arrangements with development partners. Such agreements may require the
Company to make payments on achievement of stages of development, launch or revenue milestones, although the Company generally has the right to terminate these
agreements at no penalty.

Based on the closing exchange rates at December 31, 2021, the Company expects to pay $3.3 million, including $3.1 million (€2.8 million), and $0.2 million (£0.1 million), in
R&D contracts and up to $8.9 million, including $7.4 million (€6.5 million) and $1.5 million (£1.2 million), in R&D milestone payments and up to $32.9 million, including $31.3
million (€27.6 million) and $1.6 million (£1.3 million), in revenue related milestone payments. The table below contains all potential R&D and revenue-related milestone
payments that the Company may be required to make under such agreements:

(in thousands)

Less than 1 year
1 – 3 years
4 – 5 years
More than 5 years
Total

Future potential R&D
milestone payments

Future potential revenue
milestone
payments

TOTAL

$   
28   
113   
927   
7,869   
8,937   

$   
-   
-   
-   
32,942   
32,942   

$ 
28 
113 
927 
40,811 
41,879 

The future payments that are disclosed represent contract payments and are not discounted and are not risk-adjusted. The development of any pharmaceutical product candidates
is a complex and risky process that may fail at any stage in the development process due to a number of factors. The timing of the payments is based on the Company’s current
best estimate of achievement of the relevant milestone.

C.

Research and development, patents and licenses, etc.

For a description of our R&D policies for the last three years, see "Item 4.B. Business Overview” and "Key Developments” at the beginning of this Item 5. Over the past three
years, our research and development activities have encompassed the 2018 initiation of pediatric indication P01 study for MacrilenTM (macimorelin) for which Novo paid 70% of
the costs, the 2021 initiation of the PCT study for MacrilenTM (macimorelin) for which Novo is paying 100% of the initial €9 million of the trial costs and 50% of any excess costs, in
addition to our pipeline activities which consist of pre-clinical work.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
D.

Trend Information

Aeterna is currently conducting its pivotal Phase 3 safety and efficacy study AEZS-130-P02 (the " DETECT-trial”) evaluating macimorelin for the diagnosis of CGHD. Children and
adolescents from two to less than 18 years of age with suspected growth hormone deficiency are to be included. The study is expected to include approximately 100 subjects in
Europe and North America, with at least 40 subjects in pre-pubertal and 40 subjects in pubertal status. Macimorelin growth hormone stimulation test (" GHST”) will be performed
twice for repeatability data and two standard  GHSTs will be used as controls: arginine (IV) and clonidine (orally).  On April 22, 2021, the  U.S.  FDA  Investigational  New  Drug
Application associated with this clinical trial became active.  The first clinical sites in the  U.S. and in  Europe are open for patient recruitment.  In  Europe, national clinical trial
approval procedures and site initiation activities are ongoing. At this point in time, we are closely monitoring delays in site activation and enrollment due to the ongoing COVID-19
pandemic, to mitigate potential impact on estimated trial completion dates.

65

The Company continues to advance its ongoing business development discussions to secure commercialization partners for macimorelin in additional markets. In addition to its
previously established agreements, Aeterna recently entered into a license agreement with NK Meditech Ltd., for the development and commercialization of macimorelin in the
Republic of Korea, and a distribution agreement with Er-Kim Pharmaceuticals Bulgaria EOOD for the commercialization of macimorelin in Turkey and some Balkan countries.

For the development of AIM Biologicals as potential PD therapeutics, Aeterna plans to utilize, among others, an innovative animal model on neurodegeneration by α-synuclein-
specific T cells in AAV-A53T-α-synuclein Parkinson’s disease mice, which has recently been published by University of Wuerzburg researchers.

Next Steps – NMOSD

● Conduct in-vitro and in-vivo assessments to select an AIM Biologicals-based development candidate.
● Manufacturing process development for selected candidate.

Next Steps – Parkinson’s Disease

● Design and produce antigen-specific AIM Biologics molecules for the potential treatment of Parkinson’s disease.
● Conduct in-vitro and in-vivo assessments in relevant Parkinson’s disease models.

In consultation with the University of Sheffield, Aeterna has selected AEZS-150 as the lead candidate in its DC-PTH program. AEZS-150 is being developed with the goal of
providing a potential new treatment option of primary hypoparathyroidism in adults.

Next Steps DC-PTH

● Work with the University of Sheffield to conduct in depth characterization of development candidate (in-vitro and in-vivo).
● Develop manufacturing process.
● Formalize pre-clinical development of AEZS-150 in preparation for a potential IND filing for conducting the first in-human clinical study

Apart from already available pre-clinical and clinical data on macimorelin for the development as a diagnostic, Aeterna may utilize the established supply chain to support this
development. Alternative formulations are currently also under development, as a further option in addition to the existing oral solution already approved for the diagnostic use in
adult growth hormone deficiency (AGHD).

Next Steps – Macimorelin as a Potential Therapeutic (ALS)

● Work with the University of Queensland to conduct proof-of-concept studies with macimorelin in disease-specific animal models.
● Assess alternative formulations.
● Formalize pre-clinical development plan

During 2021, the Company entered into a Research Agreement with the University of Wuerzburg on a fee-for-service basis to conduct supplementary research activities and pre-
clinical development studies on the potential vaccines, the results of which are covered within the scope of the license agreements. Additionally, Prof. Dr. Thomas Rudel of the
University of Wuerzburg was engaged by the Company in September 2021 as a scientific consultant to support development of the salmonella-based vaccine platform for the
coronavirus and Chlamydia vaccines.

66

Next Steps – Coronavirus Vaccine

● Evaluate administration route, dose and immunization scheme.
● In-vivo immunology experiments with antigen variant candidates in relevant mice models.
● Conduct virus challenge experiments in immunized transgenic animals.
● Start manufacturing process assessment / development.
● Conduct pre-clinical safety and toxicology assessment.

Next Steps – Chlamydia Vaccine

● Design and prepare candidate vaccine strains.
● Evaluate administration route, dose and immunization scheme.
● In-vivo immunology experiments with candidate strains in relevant mouse models.

Financial Risk Factors and Other Instruments

The nature and extent of our exposure to risks arising from financial instruments, including credit risk, liquidity risk and market risk (share price risk) and how we manage those risks
are described in note 24 to the Company’s annual audited consolidated financial statements as of December 31, 2021 and 2020 and for the years ended December 31, 2021, 2020 and
2019.

The consolidated financial statements filed as part of this Annual Report on Form 20-F are presented under "Item 17. – Financial Statements”.

E.

Critical Accounting Estimates

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
See Item 5.B above "Liquidity, Cash Flows and Capital Resources – Critical Accounting Policies, Estimates and Judgments”.

67

Item 6. Directors, Senior Management and Employees

A.

Directors and senior management

The following table sets forth information about our directors and our senior corporate officers as at December 31, 2021:

Name and Place of Residence

Position with Aeterna Zentaris

Ammer, Nicola
Hessen, Germany
Auld, Leslie
Ontario, Canada
Edwards, Peter G.
Ohio, United States
Egbert, Carolyn
Texas, United States
Gagnon, Gilles
Quebec, Canada
Gerlach, Matthias
Hessen, Germany
Grau, Guenther
Hessen, Germany
Guenther, Eckhard
Hessen, Germany
Paulini, Klaus
Hessen, Germany
Turpin, Dennis(1)
Quebec, Canada
Teifel, Michael
Hessen, Germany

Senior Vice President Clinical Development, Chief Medical Officer

Senior Vice President, Chief Financial Officer

  Director

  Director, Chair of the Board

  Director

Senior Vice President Manufacturing and Supply Chain

  Vice President Finance

Senior Vice President Business Development & Alliance Management; Managing
Director AEZS Germany

President, Chief Executive Officer, Director; Managing Director AEZS Germany

  Director

Senior Vice President Non-Clinical Development, Chief Scientific Officer

(1)

Mr. Turpin joined the Board on May 5, 2021.

68

The following is a brief biography of each of our directors and executive officers.

Nicola Ammer was appointed as our Senior Vice President, Clinical Development and as Chief Medical Officer in January 2021. She serves as one of our executive officers. Dr.
Ammer, who is based in the Frankfurt, Germany office of AEZS Germany, began her career in the pharmaceutical medicine environment in the CRO business in 2002 and gained
experience in all aspects of clinical research & development  in  various  positions  with  increasing  responsibility,  including  a  Director  of  Clinical  Operations.  She  joined AEZS
Germany in March 2015 as Clinical Program Director and took over the role of the Head of Clinical Development in January 2016. She possesses numerous skills in the area of
pharmaceutical medicine and contributed significantly to the successful completion of the macimorelin clinical development program in the adult indication. Dr. Ammer obtained
the license to practice medicine in 1995 after completion of her academic studies at the University of Essen. She was awarded a doctorate diploma in medicine by the University of
Münster in 2004 and a Master of Science in Pharmaceutical Medicine by the University Duisburg-Essen in 2009.

Leslie Auld was appointed as our Senior Vice President, Chief Financial Officer in September 2018. She has over twenty-five years of accounting, finance and pharmaceutical
industry  experience,  with  increasingly  senior  roles  at  Helix  BioPharma  Corp.,  Luminex  Diagnostics  (formerly  TM  BioScience  Corp.),  Attwell  Capital  Inc.  (formerly  Fralex
Therapeutics) and GeneNews Limited. Ms. Auld was most recently the Chief Financial Officer and Treasurer of GeneNews Limited from 2010 to 2018. A Chartered Professional
Accountant,  Ms. Auld  graduated  with  an  Honors  Bachelor  of  Science  degree  in  Pharmacology  &  Toxicology  from  the  Western  University  and  has  a  Master  of  Business
Administration degree from the University of Toronto and began her career at PricewaterhouseCoopers.

Peter G. Edwards joined the Board on May 15, 2020 and is a member of the Audit Committee and of the Nominating, Governance and Compensation Committee. Mr. Edwards is
currently General Counsel of Aziyo Biologics. Mr. Edwards served as the Executive Vice President and General Counsel of Celanese Corporation from January 2017 to January
2019. Mr. Edwards previously was Executive Vice President and General Counsel of Baxalta Incorporated, the biopharmaceutical spin-off from Baxter, from June 2015 until its merger
with Shire plc in July 2016. Before that, he was Senior Vice President and General Counsel of the global specialty pharmaceuticals company Mallinckrodt plc from July 2013 to June
2015 and served as its Vice President and General Counsel from May 2010 to its spin-off from Covidien plc in June of 2013. He previously served as Executive Vice President and
General Counsel for Solvay Pharmaceuticals in Brussels, Belgium from June 2007 until April 2010 and as its Senior Vice President and General Counsel in the US from October 2005
to June 2007. Prior to that, he held in-house positions of increasing responsibility within Mettler-Toledo, Inc. and Eli Lilly and Company. Mr. Edwards began his career in 1990 as
an associate in the Kansas City, Missouri office of Shook, Hardy & Bacon L.L.P. Mr. Edwards received his J.D., cum laude, from Brigham Young University.

Carolyn Egbert has served as a director on our Board since August 2012 and as Chair of our Board since May 2016. She is also a member of the Nominating, Governance and
Compensation  Committee. After  enjoying  the  private  practice  of  law  as  a  defense  litigator  in  Michigan  and  Washington,  D.C.,  she  joined  Solvay America,  Inc.  (" Solvay”)  (a
chemical and pharmaceutical company) in  Houston,  Texas.  Over the course of a twenty-year career with  Solvay, she held the positions of  Vice  President,  Human  Resources,
President of Solvay Management Services, Global Head of Human Resources and Senior Executive Vice President of Global Ethics and Compliance. During her tenure with Solvay,
she served as a director on the board of directors of seven subsidiary companies and as Chair of one subsidiary board. After retiring in 2010, she established Creative Solutions for
Executives, a consulting business providing expertise in corporate governance, ethics and compliance, organizational development, executive compensation and strategic human
resources.  She  holds  a  Bachelor  of  Sciences  degree  in  Biological  Sciences  from  George  Washington  University,  Washington  D.C.  and  a  Juris  Doctor  degree  from  Seattle
University,  Seattle,  Washington.  She  also  was  a  Ph.D.  candidate  in  Pharmacology  at  both  Georgetown  University  Medical  School  at  Washington,  D.C.  and  Northwestern
University Medical School at Chicago, Illinois. She remains an active member of both the Michigan State Bar and the District of Columbia Bar, Washington, D.C.

69

Gilles  Gagnon joined the Board on January 1, 2020 and is a member of the Audit Committee and of the Nominating, Governance and Compensation Committee. Mr. Gagnon is

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
currently the President and Chief Executive Officer of Ceapro Inc., a biotechnology company. Prior to that, he was President and CEO of Aeterna Zentaris Inc. During the past 35
years,  Mr.  Gagnon  has  worked  at  several  management  levels  within  the  field  of  health,  especially  in  the  hospital  environment  and  pharmaceutical  industry.  Mr.  Gagnon  has
participated  in  several  international  committees  and  strategic  advisory  boards.  He  served  nine  years  on  the  board  of  directors  of  Canada’s  Research  Based  Pharmaceutical
Companies (Rx&D—now  Innovative  Medicine  Canada) where he represented members from the biopharmaceutical sector and pioneered the  Rx&D’s  Canadian  Bio partnering
initiative. He is currently a member of the CEO Council of Innovative Medicine Canada. He is a certified corporate Director having completed the Directors Education Program at
the Rotman School of Management at the University of Toronto, and he has served on several boards of both private and publicly listed companies in the biopharmaceutical
sector.

Matthias Gerlach was appointed as our Vice President, Manufacturing Operations in June 2014 and as Vice President, Manufacturing and Supply Chain in January 2018. He serves
as one of our executive officers. From December 2011 through May 2014, he was our Vice President, Medicinal Chemistry. Dr. Gerlach, who is based in the Frankfurt office of AEZS
Germany,  began  his  career  in  the  pharmaceutical  industry  in  1997.  He  joined  our  Company  in  January  2001,  assuming  roles  of  increasing  responsibility  in  areas  of  medicinal
chemistry  and  preclinical  development  through  product  commercialization  during  his  career.  He  possesses  numerous  scientific  and  business  skills  and  has  a  long  record  of
successful  innovation,  drug  development  and  management,  and  contributed  significantly  to  the  successful  U.S.-commercialization  of  macimorelin  in  the  adult  indication.  Dr.
Gerlach obtained a diploma in Chemistry from the Johann Wolfgang Goethe University in Frankfurt in 1994 and was awarded his doctorate diploma in synthetic organic chemistry
by the Johann Wolfgang Goethe University in 1997.

Guenther Grau was appointed as our Vice President, Finance in February 2018. Mr. Grau has been part of the Company since 2000. He began his career in the pharmaceutical
industry at ASTA Medica AG, a predecessor of our Company, in 1995, assuming roles of increasing responsibility in areas of internal and external accounting during his career.
Mr. Grau obtained a diploma in Business Administration from the Philipps-University, Marburg, in 1991.

Eckhard Guenther was appointed as Managing Director of Aeterna Zentaris GmbH in January 2020 and Senior Vice President of Business Development & Alliance Management
in 2021. Dr. Guenther brings more than 25 years in the pharmaceutical industry, with profound knowledge and expertise in drug discovery and development in various indication
areas  like  oncology  and  endocrinology. Additionally,  over  the  course  of  his  career,  he  has  gained  extensive  experience  across  research  coordination,  project  management,
intellectual properties and business development. After receiving his Ph.D. in organic chemistry from the Martin-Luther University of Halle-Wittenberg (Germany), he started his
industrial career at Fahlberg-List Magdeburg in 1985. In 1990 he joined ASTA Medica AG in Frankfurt where he worked in the department of Medicinal Chemistry. During his time
at ASTA Medica, Dr. Guenther was significantly involved in the preparation and execution for the spin-off of the biotechnology company Zentaris from ASTA Medica. After the
founding  of Aeterna  Zentaris  in  2002  he  was  appointed  to  Vice  President  of  Drug  Discovery  and  Preclinical  Research.  In  2008  he  was  promoted  to  Vice  President Alliance
Management & Intellectual Property and in 2014 he became Vice President of Business Development at Aeterna Zentaris. Dr. Guenther was responsible for the initiation and
execution of several research and development and licensing deals with midsize and large international pharmaceutical companies, like Consilient Health, MegaPharm Ltd., Schering
Pharma, Solvay, Yakult Honsha, Hikma Pharmaceuticals and Sinopharm A-Think. Dr. Guenther is based in Frankfurt, Germany.

Dr.  Klaus  Paulini was  appointed  President  and  Chief  Executive  Officer  of  the  Company  in  October  2019  and  also  serves  as  a  director  on  our  Board.  Dr.  Paulini  is  based  in
Frankfurt, Germany at our subsidiary AEZS Germany, where he was appointed Managing Director in July 2019 and as Vice President Quality and Regulatory in February 2018. Dr.
Paulini began his career in the pharmaceutical industry at ASTA Medica AG in 1997. He had an active role when Zentaris was formed and spun out of ASTA Medica and served in
various roles with increasing responsibility at the company ever since, including project responsibility for Cetrotide®. As Head of Quality Assurance from 2010 and 2019, Dr.
Paulini successfully managed many of our clinical development projects – including Macrilen™/Macimorelin – in the research and development phase as group leader medicinal
chemistry. With his extensive experience and knowledge, he provided successful oversight and valuable input for our pharmaceutical and clinical development programs, ensuring
successful and compliant outcomes, ultimately leading to regulatory approvals by the U.S. FDA and the EMA. Dr. Paulini obtained his PhD (Dr. Ing.) in chemistry at the Technical
University Darmstadt (Germany) in 1993 and specialized in medicinal chemistry/drug discovery during subsequent postdoctoral fellowships at Strathclyde University (Glasgow,
Scotland) and J.W. Goethe University (Frankfurt, Germany) before joining ASTA Medica AG.

70

Dennis  Turpin  is  a  seasoned  professional  executive  and  chartered  accountant  (CA,  CPA)  with  significant  experience  in  finance  and  capital  markets  transactions,  business
development  and  mergers  and  acquisitions,  over  20  years  of  which  has  been  in  the  biopharmaceutical  industry.  He  is  currently  the  President  and  Chief  Executive  Officer  of
Endoceutics, Inc., a speciality biopharmaceutical company where he was previously the Vice President, Special Projects. Mr. Turpin was previously the Vice President and Chief
Financial Officer of the Quebec Port Authority from February 2016 to June 2018. From 2007 to 2015, Mr. Turpin was the Senior Vice President and Chief Financial Officer of Aeterna
Zentaris  and,  between  2007  and  1996  he  held  various  finance  roles  with Aeterna  Zentaris.  Prior  to  that,  he  was  a  Director  in  the  tax  department  at  Coopers  Lybrand,  now
PricewaterhouseCoopers, from 1988 to 1996 and worked as an auditor from 1985 to 1988. Mr. Turpin earned his Bachelor’s degree in Accounting from Laval University in Québec.
He obtained his license in accounting in 1985 and became a chartered accountant in 1987.

Michael Teifel is a leading industry executive with a career spanning over 20 years in various therapeutic areas, including endocrinology and oncology. He has deep experience in
translating research into clinical development.  Over the course of his career, he has gained particular expertise in the design and implementation of non-clinical development
programs for small molecule drugs, peptides, targeted therapies, and biologics, as well as in the continued non-clinical evaluation of drug candidates for global registration. Dr
Teifel joined Aeterna Zentaris having held various positions in industry with increasing responsibilities in pharmacology, pharmacokinetics, toxicology and translational sciences.
He began his career in industry at Roche Diagnostics in the area of delivery systems / non-viral gene therapy. In 1999, Dr. Teifel joined the biotech start-up, Munich Biotech in
Martinsried, Germany as a co-founder. As head of pharmacology & toxicology, he was responsible for the evaluation and non-clinical development of a novel vascular targeting
technology for the development of anti-tumor diagnostics and therapeutics. In 2004, Dr. Teifel started his first term at Aeterna Zentaris where he held several positions in the field
of preclinical development and translational research. In his capacity he was, among others, responsible for preparation of the non-clinical dossier for registration of macimorelin in
the U.S. and EU in the indication AGHD. In 2019, Dr. Teifel left Aeterna Zentaris to pursue his career in non-clinical research and development at Cleara Biotech in Utrecht, The
Netherlands. As head of translational sciences at Cleara Biotech, he was responsible for translating research on anti-senescent drugs into pre-clinical development in age-related
diseases and late-stage cancer. In May 2021 he re-joined Aeterna Zentaris as Senior Vice-President Non-Clinical Development and Chief Scientific officer. Dr. Teifel holds a degree
in biology and his Ph.D. from the Technical University of Darmstadt, Germany.

There are no family relationships between any of the persons named above and no arrangement with any customers, major shareholders, suppliers or others pursuant to which any
person above was selected as a director or executive officer. Each director holds office until the Company’s next annual general meeting or until a successor is duly elected or
appointed.

B.

Compensation

Our directors and executive officers are generally paid in their home country currency. Unless otherwise indicated, all compensation information included in this document is
presented in U.S. dollars and, to the extent a director or officer has been paid in a currency other than U.S. dollars, the amounts have been converted from such person’s home
country currency to U.S. dollars based on the following annual average exchange rates: for the financial year ended December 31, 2021: €1.000 = U.S.$1.182 and CAN$1.000 =
U.S.$0.797; for the financial year ended December 31, 2020: €1.000 = U.S.$1.140 and CAN$1.000 = U.S.$0.745; for the financial year ended December 31, 2019: €1.000 = U.S.$1.120 and
CAN$1.000 = U.S.$0.754.

Compensation of Outside Directors

The compensation paid to members of our Board who are not our employees (our "Outside Directors”) is designed to (i) attract and retain the most qualified people to serve on
the  Board  and  its  committees,  (ii)  align  the  interests  of  the  Outside  Directors  with  those  of  our  shareholders,  and  (iii)  provide  appropriate  compensation  for  the  risks  and
responsibilities related to being an effective Outside Director. This compensation is recommended to the Board by the Nominating, Governance and Compensation Committee
("NGCC”). The NGCC is currently composed of three Outside Directors, each of whom is independent, namely Ms. Carolyn Egbert (Chair), Mr. Peter G. Edwards and Mr. Gilles

 
 
 
 
 
 
 
 
 
 
 
 
 
Gagnon.

71

The Board has adopted a formal mandate for the NGCC, which is available on our website at www.zentaris.com. The mandate of the NGCC provides that it is responsible for,
among  other  matters,  assisting  the  Board  in  developing  our  approach  to  corporate  governance  issues,  proposing  new  Board  nominees,  overseeing  the  assessment  of  the
effectiveness of the Board and its committees, their respective chairs and individual directors, making recommendations to the Board with respect to directors’ compensation and
generally serving in a leadership role for our corporate governance practices.

Retainers

Our Outside Directors are paid an annual retainer, the amount of which depends on the position held on the Board. Annual retainers are paid on a quarterly basis to our Outside
Directors. Each Outside Director is paid the equivalent value of the payment in his or her home currency, net of any withholdings or deductions required by applicable law.

Type of Compensation

Annual Retainer for the year
2021

Chair of the Board Retainer
Board Member Retainer
Audit Committee Chair Retainer
Audit Committee Member Retainer
NGCC Chair Retainer
NGCC Member Retainer

60,000 
30,000 
20,000 
5,000 
10,000 
3,000 

All Directors are reimbursed for travel and other out-of-pocket expenses incurred in attending Board or committee meetings. Retainers are prorated when an Outside Director joins
the Board during a financial year.

Outstanding Awards

The following table shows all awards outstanding to each Outside Director as at December 31, 2021:

Option-based Awards

Share-based Awards

Number of
Securities
Underlying
Unexercised
Options
(#)

Issuance
Date
(mm-dd-
yyyy)

Option
Exercise
Price
($)

Option
Expiration
Date
(mm-dd-
yyyy)

Value of
Unexercised
In-the-
money
Options(1)
($)

—   
—   

05-10-

2016   

12-06-

2016   

08-15-

2017   
—   
—   

—   
—   
—   
—   

—   
—   

10,000   

7,850   

60,000   
—   
—   

—   
—   
—   
—   

—   
—   

3.48   

3.45   

2.05   
—   
—   

—   
—   
—   
—   

—   
—   

05-09-

2023   

12-06-

2023   

08-15-

2024   
—   
—   

—   
—   
—   
—   

—   
—   

—   

—   

—   
—   
—   

—   
—   
—   
—   

Number
of
Shares
or Units
of
Shares
that have
Not
Vested
(#)
  30,000   
  70,000   

Issuance
Date

(mm-dd-
yyyy)
  05/15/2020   
  05/05/2021   

—   

—   

—   

—   

—   
  05/08/2018   
  05/22/2019   
  05/15/2020   
  05/15/2021   
  05/15/2020   
  05/19/2021   
  05/19/2021   

—   
  23,000   
  30,000   
  30,000   
  70,000   
  30,000   
  70,000   
  70,000   

Market
or
Payout
Value of
Share-
based
Awards
that have
Not
Vested(2)
($)

—   
—   

—   

—   

—   
—   
—   
—   
—   
—   
—   
—   

Market or
payout
value of
vested
share-
based
awards not
paid out or
distributed
($)
10,800 
25,200 

— 

— 

— 
8,280 
10,800 
10,800 
25,200 
10,800 
25,200 
25,200 

Name

Edwards, Peter

Egbert, Carolyn

Gagnon, Gilles

Turpin, Dennis(3)

(1) "Value of unexercised in-the-money options” at financial year-end is calculated based on the difference between the closing prices of the Common Shares on the NASDAQ
on the last trading day of the fiscal year (December 31, 2021) of $0.36 and the exercise price of the options, multiplied by the number of unexercised options.

(2) The Company used the closing price of its Common Shares on the NASDAQ as at the last trading day of the fiscal year (December 31, 2021) of $0.36.

(3) Mr. Dennis Turpin joined the Board on May 5, 2021.

72

See "Summary of the Stock Option Plan” for more details on the Company’s second amended and restated stock option plan adopted by the Board on March 29, 2016 and ratified
by the shareholders on May 10, 2016 ("Stock Option Plan”) and see "Summary of Long-Term Incentive Plan” for more details on the Company’s long-term incentive plan adopted
by the Board on March 27, 2018, and ratified by the shareholders on May 8, 2018 ("Long-Term Incentive Plan”).

Total Compensation of Outside Directors

The table below summarizes the total compensation paid to our Outside Directors during the financial year ended December 31, 2021 (all amounts are in U.S. dollars). Our Outside
Directors are generally paid in their home currency. Mr. Desbiens, Mr. Gagnon and Mr. Turpin were paid in Canadian dollars. Ms. Egbert and Mr. Edwards were paid in U.S. dollars.

Fees

Share-
based

Option-
based

Non-Equity
Incentive Plan

Pension

A l

l Other

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name
Desbiens, Pierre-Yves(3)
Edwards, Peter
Egbert, Carolyn
Gagnon, Gilles
Turpin, Dennis(4)  

earned(1)
($)

Awards(2)
($)

Awards
($)

Compensation
($)

Value
($)

Compensation
($)

Total
($)

25,000   
38,000   
70,000   
38,000   
32,778   

—   
60,753   
60,753   
60,753   
60,753   

—   
—   
—   
—   
—   

—   
—   
—   
—   
—   

—   
—   
—   
—   
—   

—   
—   
—   
—   
—   

25,000 
98,753 
130,753 
98,753 
93,531 

(1) In respect of our financial year ended December 31, 2021, we paid an aggregate amount of $203,778 to all of our Outside Directors for services rendered in their capacity as
directors, excluding reimbursement of out-of-pocket expenses and the value of share-based and option-based awards granted in 2021.
(2) Amounts shown represent the value of the DSUs on the grant date ($0.89). The value of one DSU on the grant date is the closing price of one Common Share on the
NASDAQ on the last trading day preceding the date of grant.
(3) Mr. Pierre-Yves Desbiens served on the Board until May 5, 2021.
(4) Mr. Dennis Turpin joined the Board on May 5, 2021.

73

Compensation of Executive Officers

The following is disclosure of information related to the compensation that we paid to our "Named Executive Officers” during 2021. For the 2021 year, our "Named Executive
Officers” were as follows:

● Dr. Klaus Paulini, who, since October 4, 2019, is serving as President and Chief Executive Officer, as well as Managing Director AEZS Germany since July 2019;

● Ms. Leslie Auld, who, since September 24, 2018, is serving as Senior Vice President, Chief Financial Officer as an independent contractor; and

● Dr. Matthias Gerlach, who serves as Vice President Manufacturing and Supply Chain; Mr. Eckhard Guenther, who serves as Vice President  Business Development & Alliance
Management and Managing Director AEZS Germany; and Ms. Nicola Ammer, who serves as Chief Medical  Officer and Senior Vice President Clinical Development, who were
our three most highly compensated executive officers (other than our current and former Chief Executive Officer and our Chief Financial Officer) employed at the end of 2021.

Compensation Discussion & Analysis

Compensation Philosophy and Objectives

Our Board, through the NGCC, establishes our executive compensation program that is market-based and at a competitive percentile grouping for both total cash and total direct
compensation.  The  NGCC  has  established  a  compensation  program  that  is  designed  to  attract,  motivate  and  retain  high-performing  senior  executives,  encourage  and  reward
superior performance and align the executives’ interests with those of our shareholders by:

● providing the opportunity for an executive to earn compensation that is competitive with the compensation received by executives serving in the same or measurably

similar positions within comparable companies;

● providing the opportunity for executives to participate in equity-based incentive compensation plans;

● aligning executive compensation with our corporate objectives; and

● attracting and retaining highly qualified individuals in key positions.

Compensation Elements

Our executive compensation is targeted at the 50th percentile for small cap biopharmaceutical companies within both the local and national markets and is comprised of both fixed
and variable components. The variable components include equity and non-equity incentive plans. Each compensation component is intended to serve a different function, but all
elements are intended to work in concert to maximize both corporate and individual performance by establishing specific, competitive operational and corporate goals and by
providing financial incentives to employees based on their level of attainment of these goals.

Our current executive compensation program is comprised of the following four basic components: (i) base salary; (ii) an annual bonus linked to both individual and corporate
performance; (iii) equity incentives, including stock options, previously granted under our second amended and restated stock option plan adopted by the Board on March 29,
2016 and ratified by the shareholders of Aeterna Zentaris on May 10, 2016 (the " Stock Option Plan”), and presently granted under the Corporation’s long-term incentive plan
adopted by the Board on March 27, 2018 and ratified by the shareholders of Aeterna Zentaris on May 8, 2018 (the " Long-Term Incentive Plan”), established for the benefit of our
directors, certain executive officers and other participants as may be designated from time to time by either the Board or the NGCC; and (iv) other elements of compensation,
consisting of benefits, perquisites and retirement benefits.

74

Base Salary. Base salaries are intended to provide a steady income to our executive officers regardless of share price. In determining individual base salaries, the NGCC takes into
consideration individual circumstances that may include the scope of an executive’s position, the executive’s relevant competencies or experience and retention risk. The NGCC
also takes into consideration the fulfillment of our corporate objectives, as well as the individual performance of the executive.

Short-Term,  Non-Equity  Incentive  Compensation. Our short-term, non-equity incentive compensation plan sets a target cash bonus for each executive officer, expressed as a
percentage of the executive officer’s base salary. The amount of cash bonus paid to an executive officer depends on the extent to which he or she contributed to the achievement
of the annual performance objectives established by the Board for the year. The annual performance objectives are specific operational, clinical, regulatory, financial, commercial
and  corporate  goals  that  are  intended  to  advance  our  product  pipeline,  to  promote  the  success  of  our  commercial  efforts  and  to  enhance  our  financial  position.  The  annual
performance objectives are set at the end of each financial year as part of the annual review of corporate strategies. The performance objectives are not established for individual
executive officers but rather by functional area(s), many of which are carried out by or fall within the responsibility of our President and Chief Executive Officer, Chief Financial
Officer (or principal financial officer) and our other executive officers, including our Named Executive Officers. The award of a cash bonus requires the approval of both the NGCC
and  the  Board  and  is  based  upon  an  assessment  of  each  individual’s  performance,  as  well  as  our  overall  performance  at  a  corporate  level.  The  determination  of  individual
performance does not involve quantitative measures using a mathematical calculation in which each individual performance objective is given a numerical weight. Instead, the
NGCC’s determination of individual performance is a subjective determination as to whether a particular executive officer substantially achieved the stated objectives or over-
performed or under-performed with respect to corporate objectives that were deemed to be important to our success.

 
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Long-Term Equity Compensation Plan of Executive Officers.  The long-term component of the compensation of our executive officers is based exclusively on the  Long-Term
Incentive Plan, which permits the issuance of a number of equity-based awards based on the contribution of the officers and their responsibilities. The Board adopted a policy
regarding stock option grants in December 2014, which provides that each Named Executive Officer is eligible to receive options to acquire our Common Shares having a value,
based on the Black-Scholes option pricing model, equal to a specified multiple of his or her salary. The specified multiple for the President and Chief Executive Officer is 1.5. The
specified multiple for each other Named Executive Officer is 0.75. To encourage retention and focus management on developing and successfully implementing our continuing
growth strategy, stock options vest over a period of three years, with the first third vesting on the first anniversary of the date of grant. Since the adoption of the Long-Term
Incentive Plan in 2018, we have broadened the types of equity-based awards which we may issue beyond stock options (to include, among other types, restricted stock units
("RSUs”), DSUs and others).

Other Forms of Compensation. Our executive employee benefits program also includes life, medical, dental and disability insurance to the same extent and in the same manner as all
other  employees.  Several  of  our  executive  officers  also  receive  a  car  allowance  as  a  perquisite.  These  benefits  and  perquisites  are  designed  to  be  competitive  overall  with
equivalent positions in comparable North American organizations in the life sciences industry. We also contribute to our North American employees’ retirement plans up to an
annual maximum amount of $19,500 for employees in the United States. The contribution amounts for our United States employees are subject to limitations imposed by the United
States  Internal  Revenue  Service  on  contributions  to  our  most  highly  compensated  employees.  Employees  based  in  Frankfurt;  Germany  also  benefit  from  certain  employer
contributions into the employees’ pension funds. Our executive officers, including the Named Executive Officers, are eligible to participate in such employer-contribution plans to
the same extent and in the same manner as all other employees.

75

Positioning

The NGCC is authorized to engage its own independent consultant to advise it with respect to executive compensation matters. While the NGCC may rely on external information
and advice, all of the decisions with respect to executive compensation are made by the Board upon the recommendation of the NGCC and may reflect factors and considerations
other than, or that may differ from, the information and recommendations provided by any external compensation consultants that may be retained from time to time.

In 2013, the  NGCC retained a compensation consultant to benchmark our executive compensation plan in an effort to determine whether we were achieving our objective of
providing market competitive compensation opportunities. The compensation consultant gathered compensation data from companies that it concluded were of comparable size
and/or stage of development as us and from other companies with which we compete for executive talent and advised the NGCC that our executive compensation should be
generally aligned with the 50th percentile, or the mid-point, of the companies surveyed by the consultant. Furthermore, the consultant advised the NGCC that the total cash target
payment (base salary and, if applicable or awarded in cash, annual bonus) for our executive officers in 2013 generally fell around the 50th percentile of the companies surveyed.
The NGCC did not repeat or update the benchmarking process in 2014 – 2020 because it concluded that doing so would not provide additional meaningful data, considering the
expense  of  the  process.  However,  the  NGCC,  as  a  matter  of  good  governance,  annually  reviews  and  assesses  the  Corporation’s  current  compensation  program  and  makes
appropriate adjustments, if any.

Risk Assessment of Executive Compensation Program

The Board, through the NGCC, oversees the implementation of compensation methods that tie a portion of executive compensation to our short-term and long-term performance
and that of each executive officer and that take into account the advantages and risks associated with such compensation methods. In addition, the Board oversees the creation of
compensation policies that are intended to reward the creation of shareholder value while reflecting a balance between our short-term and long-term performance and that of each
executive officer. The NGCC has considered in general terms the concept of risk as it relates to our executive compensation program.

Base salaries are fixed in amount to provide a steady income to the executive officers regardless of share price and thus do not encourage or reward risk-taking to the detriment of
other important business, operational, commercial or clinical metrics or milestones. The variable compensation elements (annual bonuses and equity-based awards) are designed to
reward  each  of  short-term,  mid-term  and  long-term  performance.  For  short-term  performance,  a  discretionary  annual  bonus  may  be  awarded  based  on  the  timing  and  level  of
attainment of specific operational and corporate goals that the NGCC believes to be challenging yet does not encourage unnecessary or excessive risk-taking. While our bonus
payments are generally based on annual performance, a maximum bonus payment is pre-fixed for each senior executive officer and represents only a portion of each individual’s
overall total compensation opportunities. In exceptional circumstances, a particular executive officer may be awarded a bonus that exceeds his or her maximum pre-fixed or target
bonus amount. Finally, a significant portion of executive compensation is provided in the form of equity-based awards, which is intended to further align the interests of executives
with those of shareholders. The NGCC believes that these awards do not encourage unnecessary or excessive risk-taking since the ultimate value of the awards is tied to our share
price, and in the case of grants under the long-term incentive compensation plan, are generally subject to mid-term and long-term vesting schedules to help ensure that executives
generally have significant value tied to long-term share price performance.

76

The  NGCC believes that the variable compensation elements (annual bonuses and equity-based awards) represent a percentage of  overall  compensation  that  is  sufficient  to
motivate our executive officers to produce superior short-term, mid-term and long-term corporate results, while the fixed compensation element (base salary) is also sufficient to
discourage executive officers from taking unnecessary or excessive risks. The NGCC and the Board also generally have the discretion to adjust annual bonuses and equity-based
awards  based  on  individual  performance  and  any  other  factors  they  may  determine  to  be  appropriate  in  the  circumstances.  Such  factors  may  include,  where  necessary  or
appropriate, the level of risk-taking a particular executive officer may have engaged in during the preceding year.

Based on the foregoing, the NGCC has not identified any specific risks associated with our executive compensation program that are reasonably likely to have a material adverse
effect on us. The NGCC believes that our executive compensation program does not encourage or reward any unnecessary or excessive risk-taking behavior.

Our directors, executive officers and employees are prohibited from purchasing, selling or otherwise trading in derivative securities relating to our Common Shares. Derivative
securities are securities whose value varies in relation to the price of our securities. Examples of derivative securities include warrants to purchase our Common Shares, and put or
call options written on our Common Shares, as well as individually arranged derivative transactions, such as financial instruments, including, for greater certainty, prepaid variable
forward contracts, equity swaps, collars, or units of exchange funds, which are designed to hedge or offset a decrease in market value of our equity securities granted as executive
compensation or directors’ remuneration. Options to acquire our Common Shares and other equity-based awards issued pursuant to the Stock Option Plan or Long-Term Incentive
Plan are not derivative securities for this purpose.

2021 Compensation

Base Salary. The primary element of our compensation program is base salary. Our view is that a competitive base salary is a necessary element for retaining qualified executive
officers. In determining individual base salaries, the NGCC takes into consideration individual circumstances that may include the scope of an executive’s position, the executive’s
relevant competencies or experience and retention risk. The NGCC also takes into consideration the fulfillment of our corporate objectives, as well as the individual performance of
the executive.

Short-Term, Non-Equity Incentive Compensation. The Board, based on the NGCC’s recommendation, adopted the following performance objectives for 2021:

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Goal

  Result

Commercialization of Macrilen™
(macimorelin) in Europe and the rest of the
world

Successfully execute  the  Board-approved  strategy
and implementation plan to pursue commercialization
opportunities  for  macimorelin  for  the  rest of  the
world.

Ensure effective clinical studies are in place to obtain
approval  of  pediatric 
indication  of  Macrilen™
(macimorelin).

Commercialization of Macrilen™
(macimorelin) in United States and Canada

Identify and pursue cost-effective pipeline
development projects to further growth
strategy, including the therapeutic
development potential of Macrilen™
(macimorelin)

In progress. The Company signed a distribution agreement, in June 2020,
with  MegaPharm  Ltd.  for  Israel  and  the  Palestinian  Authority,  with
Consilient  Health  in  December  2020  for  the  United  Kingdom  and  the
European Union, with NK Meditech in December 2021 for South Korea.
The  Company  continues 
in  additional
geographies.
In progress. In November 2020, the Company executed an amendment to
the  License Agreement  with  Novo  whereby  the  Company  will conduct
the pivotal Study P02 as sponsor in partnership with a contract research
organization. Study P02 was initiated in April 2021.

to  explore  opportunities 

During 2021,  we  in-licensed  six  new  preclinical  programs,  four  potential
therapeutics  (NMOSD,  Parkinson’s  Disease,  Hypoparathyroidism and
ALS)  and 
(COVID-19  and  Chlamydia
Trachomatis). The ALS program aims at therapeutic use of macimorelin.

two  potential  vaccines 

Manage costs and control expenses to maximize cash
conservation.

  Ongoing activity in progress.

Improve operations

  Ensure appropriate capitalization of the Company.

The Company raised approximately $31.0 million with a public financing in
February  2021  and  approximately  $20.1  million  through  the  exercise of
warrants.

77

Long-Term Equity Compensation

For the financial year ended December 31, 2021, the Board approved awards of a total of 580,000 stock options at an exercise price of $0.42 to employees of the Corporation on
December 17, 2021 in accordance with the Long-Term Incentive Plan.

Summary of the Stock Option Plan

We established the  Stock  Option  Plan in order to attract and retain directors, officers, employees and suppliers of ongoing services, who will be motivated to work towards
ensuring  our  success.  The  Board  has  full  and  complete  authority  to  interpret  the  Stock  Option  Plan,  to  establish  applicable  rules  and  regulations  and  to  make  all  other
determinations it deems necessary or useful for the administration of the Stock Option Plan, provided that such interpretations, rules, regulations and determinations are consistent
with the rules of all stock exchanges and quotation systems on which our securities are then traded and with all relevant securities legislation.

There were 141,400 options outstanding under the Stock Option Plan representing approximately 0% of all issued and outstanding Common Shares as of December 31, 2021. The
proposed number of Common Shares issuable pursuant to the Long-Term Incentive Plan is fixed at 11.4% of the issued and outstanding Common Shares at any given time less the
number of Common Shares issuable pursuant to stock options granted at such time under the Stock Option Plan. See below for a complete description of the Long-Term Incentive
Plan. As of December 31, 2020, there were 246,619 Common Shares unallocated and available for future grants of options under the Stock Option Plan; however, the Corporation
does not intend on issuing any new stock options under the Stock Option Plan, and instead will issue any future stock options under the Long-Term Incentive Plan.

The burn rate for the Stock Option Plan for the most recently completed fiscal year is set out below:

Year End
December 31, 2021
December 31, 2020
December 31, 2019

Stock Option Plan

Options Granted

Weighted Average
Shares Outstanding

Burn Rate(1)

0   
0   
0   

114,924,497   
41,083,163   
17,494,472   

0%
0%
0%

Notes:

(1)

Annual  burn  rate  is  expressed as a percentage and is calculated by dividing the number of securities granted under the Stock Option Plan by the weighted average
number of securities outstanding for the applicable fiscal year.

78

Under the Stock Option Plan, (i) the number of securities issuable to insiders, at any time, or issued within any one-year period, under all of our security-based compensation
arrangements, cannot exceed 10% of our issued and outstanding securities and (ii) no single person eligible to receive grants under the Stock Option Plan (each a "Participant”)
may hold options to purchase, from time to time, more than 5% of our issued and outstanding Common Shares. In addition: (i) the aggregate fair value of options granted under all
of our security-based compensation arrangements to any one of our Outside Directors entitled to receive a benefit under the Stock Option Plan, within any one-year period, cannot
exceed $100,000 valued on a Black-Scholes basis and as determined by the NGCC; and (ii) the aggregate number of securities issuable to all of our Outside Directors entitled to
receive  a  benefit  under  the  Stock  Option  Plan,  within  any  one-year  period,  under  all  of  our  security-based  compensation  arrangements,  cannot  exceed  1%  of  its  issued  and
outstanding securities.

Options granted under the Stock Option Plan may be exercised at any time within a maximum period of seven or ten years following the date of their grant (the "Outside Expiry
Date”), depending on the date of grant. The Board or the NGCC, as the case may be, designates, at its discretion, the specific Participants to whom stock options are granted under
the Stock Option Plan and determines the number of Common Shares covered by each of such option grants, the grant date, the exercise price of each option, the Outside Expiry
Date and any other matter relating thereto, in each case in accordance with the applicable rules and regulations of the regulatory authorities. The price at which the Common Shares
may be purchased may not be lower than the greater of the closing prices of the Common Shares on the NASDAQ on the last trading day preceding the date of grant of the option.
Options granted under the Stock Option Plan shall vest in equal tranches over a three-year period (one-third each year, starting on the first anniversary of the grant date) or as
otherwise determined by the Board or the NGCC, as the case may be. Participants may not assign their options (nor any interest therein) other than by will or in accordance with
the applicable laws of estates and succession.

Unless the Board or the NGCC decides otherwise, Participants cease to be entitled to exercise their options under the Stock Option Plan: (i) immediately, in the event a Participant
who is an officer or employee resigns or voluntarily leaves his or her employment or his or her employment is terminated with cause and, in the case of a Participant who is a non-
employee director of us or one of our subsidiaries, the date on which such Participant ceases to be a member of the relevant Board; (ii) six months following the date on which
employment is terminated as a result of the death of a Participant who is an officer or employee and, in the case of a Participant who is an Outside Director, six months following the
date on which such Participant ceases to be a member of the Board by reason of death; (iii) 90 days following the date on which a Participant’s employment is terminated for a

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
reason other than those mentioned in (i) or (ii) above including, without limitation, upon the disability, long-term illness, retirement or early retirement of the Participant; and (iv)
where the Participant is a service supplier, 30 days following the date on which such Participant ceases to act as such, for any cause or reason (each, an "Early Expiry Date”).

The Stock Option Plan also provides that, if the expiry date of one or more options (whether an Early Expiry Date or an Outside Expiry Date) occurs during a "blackout period” or
within the seven business days immediately after a blackout period imposed by us, the expiry date will be automatically extended to the date that is seven business days after the
last day of the blackout period. For the purposes of the foregoing, "blackout period” means the period during which trading in our securities is restricted in accordance with our
corporate policies.

79

If (i) we accept an offer to amalgamate, merge or consolidate with any other entity (other than one of our wholly-owned subsidiaries) or to sell or license all or substantially all of
our assets to any other entity (other than one of our wholly-owned subsidiaries); (ii) we sign a support agreement in customary form pursuant to which the Board agrees to
support a takeover bid and recommends that our shareholders tender their Common Shares to such takeover bid; or (iii) holders of more than 50% of our then outstanding Common
Shares tender all of their Common Shares to a takeover bid made to all of the holders of the Common Shares to purchase all of the then issued and outstanding Common Shares,
then, in each case, all of the outstanding options shall, without any further action required to be taken by us, immediately vest. Each Participant shall thereafter be entitled to
exercise all of such options at any time up to and including, but not after the close of business on that date which is ten days following the Closing Date (as defined below). Upon
the expiration of such ten-day period, all rights of the Participant to such options or to the exercise of same (to the extent not already exercised) shall automatically terminate and
have no further force or effect whatsoever. "Closing Date” is defined to mean (x) the closing date of the amalgamation, merger, consolidation, sale or license transaction in the case
of clause (i) above; (y) the first expiry date of the takeover bid on which each of the offeror’s conditions are either satisfied or waived in the case of clause (ii) above; or (z) the date
on which it is publicly announced that holders of greater than 50% of our then outstanding Common Shares have tendered their Common Shares to a takeover bid in the case of
clause (iii) above.

The Stock Option Plan provides that the following amendments may be made to the plan only upon approval of each of the Board and our shareholders as well as receipt of all
required regulatory approvals:

● any amendment to Section 3.2 of the Stock Option Plan (which sets forth the limit on the number of options that may be granted to insiders) that would have the effect of
permitting, without having to obtain shareholder approval on a "disinterested vote” at a duly convened shareholders’ meeting, the grant of any option(s) under the Stock
Option Plan otherwise prohibited by Section3.2;

● any amendment to the number of securities issuable under the Stock Option Plan (except for certain permitted adjustments, such as in the case of stock splits, consolidations
or reclassifications);

● any amendment that would permit any option granted under the Stock Option Plan to be transferable or assignable other than by will or in accordance with the applicable
laws of estates and succession;

● the addition of a cashless exercise feature, payable in cash or securities, which does not provide for a full deduction of the number of underlying securities from the Stock
Option Plan reserve;

● the addition of a deferred or restricted share unit component or any other provision that results in employees receiving securities while no cash consideration is received by
us;

● with respect to any Participant, whether or not such Participant is an "insider” and except in respect of certain permitted adjustments, such as in the case of stock splits,
consolidations or reclassifications:

● any reduction in the exercise price of any option after the option has been granted; or

● any cancellation of an option and the re-grant of that option under different terms;

● any extension to the term of an option beyond its Outside Expiry Date to a Participant who is an "insider” (except for extensions made in the context of a "blackout period”);

● any amendment to the method of determining the exercise price of an option granted pursuant to the Stock Option Plan;

● the addition of any form of financial assistance or any amendment to a financial assistance provision which is more favorable to employees; and

● any amendment to the foregoing amending provisions requiring Board, shareholder and regulatory approvals.

80

The  Stock  Option  Plan  further  provides  that  the  following  amendments  may  be  made  to  the  Stock  Option  Plan  upon  approval  of  the  Board  and  upon  receipt  of  all  required
regulatory approvals, but without shareholder approval:

● amendments of a "housekeeping” or clerical nature or to clarify the provisions of the Stock Option Plan;

● amendments regarding any vesting period of an option;

● amendments regarding the extension of an option beyond an Early Expiry Date in respect of any Participant, or the extension of an option beyond the Outside Expiry Date in
respect of any Participant who is a "non-insider”;

● adjustments to the number of issuable Common Shares underlying, or the exercise price of, outstanding options resulting from a split or a consolidation of the Common
Shares, a reclassification, the payment of a stock dividend, the payment of a special cash or non-cash distribution to our shareholders on a pro rata basis provided such
distribution  is  approved  by  our  shareholders  in  accordance  with  applicable  law,  a  recapitalization,  a  reorganization  or  any  other  event  which  necessitates  an  equitable
adjustment to the outstanding options in proportion with corresponding adjustments made to all outstanding Common Shares;

● discontinuing or terminating the Stock Option Plan; and any other amendment which does not require shareholder approval under the terms of the Stock Option Plan.

Summary of the Long-Term Incentive Plan

The purpose of the Long-Term Incentive Plan is to (i) promote our long-term financial interests and growth by attracting and retaining management and other personnel and key
service providers with the training, experience and ability to enable them to make a substantial contribution to the success of our business; (ii) motivate management personnel by
means of growth-related incentives to achieve long-range goals; and (iii) further the alignment of interests of participants with those of our shareholders through opportunities for

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
increased share ownership in the Corporation.

The NGCC is the administrator of the Long-Term Incentive Plan (the "Administrator”). At any time, the Board may serve as the Administrator of the Long-Term Incentive Plan, in
lieu of, or in addition, to the NGCC. Except as provided otherwise under the Long-Term Incentive Plan, the Administrator has plenary authority to grant awards pursuant to the
terms of the Long-Term Incentive Plan to eligible individuals, determine the types of awards and the number of shares to be covered by the awards, establish the terms and
conditions for awards, including the exercise price and term of awards, and take all other actions necessary or desirable to carry out the purpose and intent of the Long-Term
Incentive Plan.

Participation in the  Long-Term  Incentive  Plan is generally open to all officers, employees and other individuals, including  Outside  Directors.  However, any individual whose
services to the Corporation or any of its subsidiaries are limited to capital-raising transactions, or the promotion and maintenance of a market for the Corporation securities, are
ineligible  to  participate  in  the  Long-Term  Incentive  Plan.  Prospective  officers,  employees  and  other  service  providers  who  have  accepted  offers  to  provide  services  to  the
Corporation may also participate in the Long-Term Incentive Plan.

The  Long-Term  Incentive  Plan  enables  the  grant  of  stock  options,  stock  appreciation  rights  ("SARs”),  stock  awards,  stock  unit  awards,  performance  shares,  cash-based
performance units and other stock-based awards, each of which may be granted separately or in tandem with other awards.

81

The maximum number of Common Shares issuable under the Long-Term Incentive Plan is fixed at 11.4% of the issued and outstanding Common Shares at any given time, less the
number of Common Shares issuable pursuant to stock options granted at such time under the Stock Option Plan. There were 1,367,968 awards outstanding under the Long-Term
Incentive Plan representing approximately 1.1% of all issued and outstanding Common Shares as of December 31, 2021. As of December 31, 2021, there were 12,329,890 Common
Shares unallocated and available for future grants of awards that are settled in Common Shares under the Long-Term Incentive Plan. See above for a complete description of the
Stock Option Plan.

The burn rate for the LTIP for the most recently completed fiscal year is set out below:

Year End
December 31, 2021
December 31, 2020
December 31, 2019

LTIP

Awards Granted

Weighted Average
Shares Outstanding

Burn Rate(1)

860,000   
300,000   
335,000   

114,924,497   
41,083,163   
17,494,472   

0.7%
0.7%
1.9%

Notes:

(1)

Annual burn rate is expressed as a percentage and is calculated by dividing the number of securities granted under the LTIP by the weighted average number of securities
outstanding for the applicable fiscal year.

The number of securities issuable to insiders, at any time, or issued within any one-year period, under all of our security-based compensation arrangements, cannot exceed 10% of
our issued and outstanding securities and no single participant may hold options to purchase, from time to time, more than 5% of our issued and outstanding Common Shares.

The aggregate fair value of options granted under all of our security-based compensation arrangements to any one of our Outside Directors entitled to receive a benefit under the
Long-Term Incentive Plan, within any one-year period, cannot exceed $100,000 valued on a Black-Scholes basis and as determined by the NGCC; and the aggregate number of
securities issuable to all of our Outside Directors entitled to receive a benefit under the Long-Term Incentive Plan, within any one-year period, under all of our security-based
compensation arrangements, cannot exceed 1% of its issued and outstanding securities.

Except as provided below or within an award agreement, each award granted under the Long-Term Incentive Plan (other than a performance unit that cannot be paid in shares) will
be subject to a minimum vesting period or minimum restriction period as follows: (i) each stock option or SAR will be subject to a minimum vesting period of 12 months from the
date of grant, (ii) each award of stock, stock units, performance shares, performance units payable in shares and other stock- based awards ("Full Value Awards”) granted to non-
employee directors will be subject to a minimum restriction period of 12 months from the date of grant, and (iii) each Full Value Award granted to a participant other than a non-
employee director will be subject to a minimum restriction period of 12 months from the date of grant if vesting of or lapse of restrictions on such award is based on the satisfaction
of performance goals and a minimum restriction period of 36 months from the date of grant, applied in either pro rata installments or a single installment, if vesting of or lapse of
restrictions on such award is based solely on the participant’s satisfaction of specified service requirements with us (provided that no such Full Value Awards will vest or have its
restrictions lapse during the first 12 months following the date of grant). If the grant of a performance award is conditioned on satisfaction of performance goals, the performance
period must not be less than 12 months’ duration, but no additional minimum restriction period need apply to such award. The minimum vesting period or minimum restriction
period will not apply in the case of death or disability of a participant or in the event of a change in control. Awards that result in the issuance of an aggregate of up to 5% of the
share pool under the Long-Term Incentive Plan may be granted without regard to such minimum vesting period or minimum restriction period.

82

A SAR is the right to receive a payment equal to the excess of the Fair Market Value (as defined below) of a specified number of shares on the date the SAR is exercised over the
base price per share specified in the award agreement. The base price for each SAR cannot be less than 100% of the Fair Market Value of Common Shares on the grant date and the
term of a SAR cannot be more than 10 years from the grant date, unless required otherwise by applicable law. At the discretion of the Administrator, the payment upon a SAR
exercise may be in cash, shares or a combination of the two. The "Fair Market Value” means the official closing price per Common Share for the regular market session on the day
of determination.

Awards granted under the Long-Term Incentive Plan shall not be subject in any manner to alienation, anticipation, sale, transfer, assignment, pledge, or encumbrance, except as
otherwise determined by the Administrator; provided, however, that this restriction shall not apply to the Common Shares received in connection with an award after the date that
the restrictions on transferability of such shares set forth in the applicable award agreement have lapsed.

Except as provided in the applicable award agreement or otherwise determined by the Administrator, and subject to the minimum vesting period or minimum restriction period
described above, upon termination of service (as defined in the Long-Term Incentive Plan):

● Stock options or stock appreciation rights shall be forfeited, to the extent stock options or stock appreciation rights are not vested and exercisable;

● During the applicable restriction period, restricted stock and any accrued but unpaid dividends that are at that time subject to restrictions shall be forfeited; and

● During the applicable deferral period or portion thereof to which forfeiture conditions apply, or upon failure to satisfy any other conditions precedent to the delivery of
Common Shares or cash to which RSUs, performance shares or performance units relate, all performance shares, performance units and RSUs and any other accrued but
unpaid dividend equivalents with respect to such RSUs that are then subject to deferral or restriction shall be forfeited.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In the event of a change in control (as defined in the Long-Term Incentive Plan) of the Corporation, outstanding awards will terminate upon the effective time of the change in
control unless provision is made for the continuation, assumption or substitution of awards by the surviving or successor entity or its parent. Unless an award agreement says
otherwise, the following will occur with respect to awards that terminate in connection with a change in control of the Corporation:

● stock options and SARs, whether vested or unvested, will become fully exercisable and holders of these awards will be permitted immediately before the change in control to
exercise them;

● restricted stock and RSUs with time-based vesting (i.e., not subject to achievement of performance goals) will become fully vested immediately before the change in control,
and RSUs will be settled as promptly as is practicable in accordance with applicable law; and

● restricted stock, RSUs, performance shares, and performance units that vest based on the achievement of performance goals will become fully vested and earned based on
the target performance level as to the performance goals, such that 100% of the target award is earned as of the date of the change of control; and the RSUs and performance
units will be settled as promptly as is practicable in accordance with applicable law. The Long-Term Incentive Plan will terminate on the earlier of (i) the earliest date as of
which all awards granted under the Long-Term Incentive Plan have been satisfied in full or terminated and no shares approved for issuance under the Long-Term Incentive
Plan remain available to be granted under new awards, or (ii) the tenth anniversary of date the  Long-Term  Incentive  Plan, as amended and restated, is approved by our
shareholders.

83

The Administrator may amend, alter or discontinue the Long-Term Incentive Plan, but no amendment, alteration or discontinuation will be made that would materially impair the
rights of a participant with respect to a previously granted award without his or her consent, except such an amendment made to comply with applicable law or rule of any
securities exchange or market on which our Common Shares are listed or admitted for trading or to prevent adverse tax or accounting consequences to the Corporation or the
participant. In no event, however, will an amendment be made without the approval of our shareholders to the extent such amendment would (i) materially increase the benefits
accruing to participants under the Long-Term Incentive Plan, (ii) increase the number of shares that may be issued under the Long-Term Incentive Plan or to a participant, (iii)
materially expand the eligibility for participation in the Long-Term Incentive Plan, (iv) eliminate or modify the prohibition on repricing of stock options and SARs, (v) lengthen the
maximum term or lower the minimum exercise price or base price permitted for stock options and SARs, (vi) modify the prohibition on the issuance of reload or replenishment
options, (vii) amend the amendment provisions in the Long-Term Incentive Plan, or (viii) amend the Long-Term Incentive Plan to remove or exceed the 10% insider participation
limit.

Outstanding Option-Based Awards and Share-Based Awards

The following table shows all awards outstanding to our Named Executive Officers as of December 31, 2021:

Option-based Awards

Number of
Securities
Underlying
Unexercised
Options(1)
(#)

Option
Exercise
Price
($)

Option
Expiration
Date
(mm/dd/yyyy)    

Value of
Unexercised
In-the-
money
Options(2)
($)

Share-based Awards
Number
of
Shares
or Units
of
shares

Market
or
Payout
Value of
Share-
based
Awards
that
have Not
Vested
($)

that
have Not
Vested
(#)

Issuance

Date    

Market or
payout
value of
vested
share-
based
awards not
paid out or
distributed
($)

2,500     
25,000     
35,000     
35,000     
100,000     
—     
5,000     
15,000     
20,000     
25,000     
50,000     
5,000     
398     
10,000     
25,000     
25,000     
50,000     
10,000     
25,000     
25,000     
50,000     

3.45     
2.15     
1.05     
0.366     
0.42     
—     
4.58     
3.45     
0.87     
0.366     
0.42     
4.58     
3.50     
3.45     
0.87     
0.366     
0.42     
3.45     
0.87     
0.366     
0.42     

12/06/2023     
08/15/2026     
11/11/2026     
12/14/2027     
12/17/2028     
—     
12/21/2022     
12/06/2023     
12/04/2026     
12/14/2027     
12/17/2028     
12/21/2022     
11/08/2023     
12/06/2023     
12/04/2026     
12/14/2027     
12/17/2027     
12/06/2023     
12/04/2026     
12/14/2027     
12/17/2027     

—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     

—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     

—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     

—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     
—     

— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

Issuance
Date
(mm/dd/yyyy) 
  12/06/2016    
  08/15/2019    
  11/11/2019    
  12/14/2020    
  12/17/2021    
—
  12/21/2015    
  12/06/2016    
  12/04/2019    
  12/14/2020    
  12/17/2021    
  12/21/2015    
  11/08/2016    
  12/06/2016    
  12/04/2019    
  12/14/2020    
  12/17/2021    
  12/06/2016    
  12/04/2019    
  12/14/2020    
  12/17/2021    

Paulini, Klaus

Name

Auld, Leslie

Gerlach, Matthias

Guenther, Eckhard

Ammer, Nicola

(1) The number of securities underlying unexercised options represents all awards outstanding at December 31, 2021.
(2) "Value of unexercised in-the-money options” at financial year-end is calculated based on the difference between the closing price of the Common Shares on the NASDAQ
on the last trading day of the fiscal year (December 31, 2021) of $0.36 and the exercise price of the options, multiplied by the number of unexercised options.

There were no share-based awards outstanding to our Named Executive Officers at December 31, 2021.

84

Incentive Plan Awards - Value Vested or Earned During the Year

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
   
   
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table shows the incentive plan awards value vested or earned for each Named Executive Officer for the financial year ended December 31, 2021:

Name

Paulini, Klaus
Auld, Leslie
Gerlach, Matthias
Guenther, Eckhard
Ammer, Nicola

Option-based awards —
Value vested during the
year(1)
($)

Share-based awards —
Value vested during the
year
($)

Non-equity incentive
plan compensation —
Value earned during the
year(2)
($)

—   
—   
—   
—   
—   

—   
—   
—   
—   
—   

162,530 
— 
55,319 
67,021 
53,191 

(1) Represents the aggregate dollar value that would have been realized if the options had been exercised on the vesting date, based on the difference between the closing
price of the Common Shares on the NASDAQ and the exercise price on such vesting date. If closing price of the Common Shares on the NASDAQ on the vesting date
was lower than the exercise price, then $nil was considered realized.

(2) During 2021, each of Dr. Paulini, Dr. Gerlach, Dr. Guenther and Dr. Ammer were paid bonuses granted in 2021 for activities related to 2020  and will be paid in 2022 bonuses

granted in 2020 for activities related to 2021.

Summary Compensation Table

The Summary Compensation Table set forth below shows compensation information for each of the Named Executive Officers for services rendered in all capacities during each of
the financial years ended December 31, 2021, 2020 and 2019. All amounts in the table below are in U.S. dollars. Ms. Auld’s cash payments were made in Canadian dollars. All cash
amounts paid to Dr. Paulini, Dr. Guenther, Dr. Gerlach and Dr. Ammer were made in Euros.

85

SUMMARY COMPENSATION TABLE

  Years

Salary
($) 

Share
based
awards
($) 

 Option
based
awards
($)

Non-equity incentive
plan compensation(1)
Long-
term
incentive
plans
($)

Annual
incentive
plan
($)

Pension
Value
($)(2)

All other
compensation
($) 

Total
compensation
($)

  2021       374,496     
  2020       306,086     
  2019       197,282     
  2021       163,038     
  2020       166,834     
  2019       194,060     

—      35,298      162,530     
9,503      183,580     
—     
22,400     
—      66,781     
—     
—     
—     
—     
—     
—     
—     
—     
—     

  2021       238,737     
  2020       218,966     
  2019       169,438     

—      17,649     
—     
6,788     
—      14,792     

67,021     
85,460     
12,443     

  2021       203,276     
  2020       185,379     
  2019       159,862     

—      17,649     
—     
6,788     
—      11,834     

55,319     
70,810     
22,400     

  2021       182,787     
  2020       154,512     
  2019       139,802     

—      17,649     
6,788     
—     
—      14,792     

53,191     
64,880     
20,608     

—      213,700     
—      292,983     
—      191,572     
—     
—     
—     
—     
—     
—     

—     
5,019     
—      97,937     
—      124,866     

—      16,314     
—      14,827     
—      11,368     

—     
—     
—     

2,400     
2,266     
2,164     

—     
—     
—     
—     
—     
—     

—     
—     
—     

—     
—     
—     

—     
—     
—     

786,024 
792,152 
478,035 
163,038 
166,834 
194,060 

328,426 
409,151 
321,539 

292,558 
277,803 
205,464 

256,027 
228,446 
177,366 

Name and principal position

Paulini, Klaus(3) 
President and Chief Executive
Officer; Managing
Director AEZS Germany
Auld, Leslie
Senior Vice President,
Chief Financial Officer
Guenther, Eckhard 
Senior Vice President Business Development and Alliance
Management; Managing
Director AEZS Germany
Gerlach, Matthias 
Senior Vice
President Manufacturing
and Supply Chain
Ammer, Nicola 
Chief Medical Officer and
Senior Vice President
Clinical Development

(1) Non-equity incentive plan compensation includes cash bonuses. During 2021, each of Dr. Paulini, Dr. Gerlach, Dr. Guenther and Dr. Ammer were paid for bonuses granted
in 2020 for activities related to 2020 and will be paid in 2022 bonuses granted in 2021 for activities related to 2021.

(2) Dr. Paulini and Dr. Guenther participate in the DUPK (as defined below), a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. that was
introduced for employees who began their employment with AEZS Germany (or its predecessors) prior to December 31, 1999. The DUPK includes indirect obligations through
a funded multi-employer contribution plan as well as direct unfunded defined benefit plans obligations.  Dr.  Gerlach participates in  RUK 1 (as defined below), a defined-
contribution  pension  plan  maintained  by  Unterstützungskasse  Degussa  e.V.  Dr. Ammer  participates  in  RUK  2  (as  defined  below),  a  defined-contribution  pension  plan
maintained by Unterstützungskasse Degussa e.V.

(3) Dr. Paulini did not receive any compensation in his role as a managing director of GmbH or as an executive director.

86

The value of option-based awards set out in the table above represents the closing price of the Common Shares on the NASDAQ on the last trading day preceding the date of
grant multiplied by the Black-Scholes factor as at such date and the number of stock options granted on such date. For 2021, the Black-Scholes valuation model values the options
based on the following assumptions: a 5.71-year expected life, 115.80% expected volatility, risk-free annual interest rate of 1.23% per annum and an expected dividend yield of 0%.
See the consolidated financial statements for the Corporation for the years ended December 31, 2019, 2018 and 2017 and for the years ended December 31, 2018, 2017 and 2016 for
the assumptions applied to the Black-Scholes option pricing model in previous years. The Corporation used the Black-Scholes valuation model as it most accurately captured the
fair value of such options. The following table sets forth the value of the option-based awards and the corresponding Black-Scholes factor:

Date of Grant
November 9, 2016
December 6, 2016
December 16, 2016
August 15, 2017

Value of Grant

Black-Scholes Factor  
80.35%
80.57%
80.68%
78.86%

3.50   
3.45   
3.80   
2.05   

  $
  $
  $
  $

 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
     
     
     
 
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
April 2, 2018
June 22, 2018
August 15, 2019
November 11, 2019
December 4, 2019
December 14, 2020
December 17, 2021

  $
  $
  $
  $
  $
  $
  $

1.46   
2.11   
2.15   
1.05   
0.87   
0.366   
0.42   

77.57%
80.86%
79.22%
67.13%
68.01%
74.19%
83.94%

Compensation of the Chief Executive Officer

The compensation of our President and Chief Executive Officer is governed by our executive compensation policy described in the section titled "Compensation of Executive
Officers”, and the President and Chief Executive Officer participates, together with the other Named Executive Officers, in all our incentive plans.

Dr. Paulini’s total earnings during the financial year ended December 31, 2021 was $786,023, including an incentive bonus in the amount of $162,530.

For  the  financial  year  ended  December  31,  2021,  the  Board  approved  an  award  of  100,000  stock  options  at  an  exercise  price  of  $0.42  to  Dr.  Paulini  on  December  17,  2021  in
accordance with the Long-Term Incentive Plan.

See "Long-Term Equity Compensation Plan of Executive Officers - Summary of the Stock Option Plan”, for a complete description of the Stock Option Plan. See "Long-Term Equity
Compensation Plan of Executive Officers - Summary of the Long-Term Incentive Plan”, for a complete description of the Long-Term Incentive Plan.

Pension, retirement or similar benefits

Each of our Named Executive Officers who are employed with AEZS Germany participate in defined-contribution pension plans. The terms of these pension plans are described
below.

87

Degussa Pensionskasse ("DUPK”)

Dr. Paulini and Dr. Guenther participate in the DUPK, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. that was introduced for employees
who began their employment with AEZS Germany (or its predecessors) prior to December 31, 1999. The DUPK includes indirect obligations through a funded multi-employer
contribution plan as well as direct unfunded defined benefit plans obligations.

Under the funded multi-employer contribution portion of the DUPK, the contributions by AEZS Germany and the employee are calculated based on the employee’s total salary
during the prior year. The employee contributes 2% of his or her monthly average salary and AEZS Germany contributes an amount of 1.784 times the employee’s contribution.
The contributions are limited to the social security contribution assessment ceiling. In 2021, the social security contribution assessment ceiling is €7,100 per month. Accordingly,
the employee will contribute at most €142.00 monthly and AEZS Germany will contribute at most €253.33 monthly.

Under the unfunded defined benefit portion of the DUPK, the employee earns additional claims for future pension payments for the part of the employee’s salary that exceeds the
social security contribution assessment ceiling ("Supplementary Pensions”) that are unfunded and are presented as a pensions benefit obligation on the balance sheet of the
Company. The Supplementary Pensions amount to 1.25% annually of a fictional salary peak, which is a percentage of the social security contribution assessment ceiling. Further,
the employee is entitled to annual Christmas benefits ("Christmas Benefits”), which amount to 1.4% of the last pensionable monthly income for each year of service, limited by the
social security contribution assessment ceiling. The employee’s contribution and AEZS Germany’s contribution are transferred monthly to the pension fund, and AEZS Germany’s
contribution is calculated with the salary payments and treated as provision for pension payment. We are liable to the employees for the pension benefits that have been promised
if the private pension provider does not, or cannot, pay the promised pension payments. Employees will receive a pension payment based on the contributions that were made
during their employment, and will also receive the Supplementary Pensions and Christmas Benefits, after they have reached the statutory retirement age, independent of whether
they work with AEZS Germany until such age. All direct pension obligations as well as pension obligations from deferred compensation are included and have been included in the
pensions benefit obligation of the Company.

Rückgedeckte Unterstützungskasse 1 ("RUK 1”)

Dr. Gerlach participates in RUK 1, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Under RUK 1, AEZS Germany contributes 2.4% of Dr.
Gerlach’s monthly gross salary and Dr. Gerlach contributes 2% of his monthly gross salary. The contributions are limited to the social security contribution assessment ceiling.
However, AEZS Germany provides an additional contribution of 18% of his monthly gross salary for the part of his salary that exceeds the social security contribution assessment
ceiling.  In  2021,  the  social  security  contribution  assessment  ceiling  is  €7,100  per  month. Accordingly, AEZS  Germany  will  contribute  at  most  €1,232.40  (which  includes  the
additional  contribution  of  18%)  monthly  and  Dr.  Gerlach  will  contribute  at  most  €142.00  monthly.  Both  contributions  are  calculated  with  the  monthly  salary  accounting  and
transferred to the relief fund monthly. We are liable to Dr. Gerlach for the pension benefits that have been promised if the private pension provider does not, or cannot, pay the
promised pension payments. Dr. Gerlach will receive a pension payment based on the contributions that were made during his employment after he has reached the statutory
retirement age, independent of whether he works with AEZS Germany until such age.

Rückgedeckte Unterstützungskasse 2 ("RUK 2”)

Dr. Ammer participates in RUK 2, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Under RUK 2, AEZS Germany contributes 2.4% of Dr.
Ammer’s monthly gross salary and Dr. Ammer contributes 3% of her monthly gross salary. The contributions are limited to the social security contribution assessment ceiling. In
2021, the social security contribution assessment ceiling is €7,100 per month. Accordingly, AEZS Germany will contribute at most €170.40 monthly and Dr. Ammer will contribute at
most €213.00 monthly. Both contributions are calculated with the monthly salary accounting and transferred to the relief fund monthly. We are liable to Dr. Ammer for the pension
benefits that have been promised if the private pension provider does not, or cannot, pay the promised pension payments. Dr. Ammer will receive a pension payment based on the
contributions that were made during her employment after she has reached the statutory retirement age, independent of whether she works with AEZS Germany until such age.

***

88

The  table  below  includes  the  following  information  about  each  Named  Executive  Officer  participating  in  the  DUPK,  the  Company’s  only  benefit  plan  with  a  defined  benefit
component:

● years of credited service as at December 31, 2021;

● estimated annual benefit accrued, or earned, for service to December 31, 2021 and to the normal retirement age of 65; and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● a reconciliation of the accrued obligation from December 31, 2020 to December 31, 2021.

  Number of years    
credited
service
(#)(1)

Annual benefits 
payable ($)(2)

At year end

At age 65

Opening
present
value of
defined
benefit 
obligation
($)(3)

    Compensatory    

change
($)(4)

Non-
compensatory
change
($)

24     
31     

34,085     
54,219     

104,447     
54,219     

855,633     
899,891     

210,131     
1,450     

31,548     
33,180     

Closing
present
value of
defined

benefit
obligation ($)(3)  
1,097,312 
934,521 

Name

Paulini, Klaus
Guenther, Eckhard

(1) The number of years of credited service as at December 31, 2021 corresponds to the actual years of service with AEZS Germany.

(2) For each Named Executive Officer, the amount of annual benefits payable at December 31, 2021 is the pension the Named Executive Officer would be entitled to starting at
age 65 based on termination of employment at December 31, 2021. For each Named Executive Officer, the annual benefits payable at age 65 is the annual benefits payable at
December 31, 2021 increased to reflect estimated credited service at age 65.

(3) The present value is the estimated value of the pension obligation to the date indicated using the actuarial assumptions and methods that are consistent with those used in
determining pension liabilities as disclosed in the Company’s consolidated financial statements.

(4) Compensatory change represents the change in the pension liability between December 31, 2020 and 2021 for each Named Executive Officer.

(5) The calculations of reported amounts use the same actuarial assumptions and methods that are used for calculating accrued benefit obligations and annual expenses, as
disclosed in the Company’s 2021 and 2020 consolidated financial statements in Note 18, and as prescribed by International Financial Reporting Standards. The methods and
assumptions used to determine estimated amounts will not be identical to the methods and assumptions used by other issuers so, as a result, the figures may not be directly
comparable across issuers. All amounts shown above are based on assumptions and represent contractual entitlements that may change over time.

The table below includes amounts from AEZS Germany’s defined-contribution plans. Any difference between (i) the sum of the Accumulated Value at Start of Year column plus the
Compensatory column and (ii) the Accumulated Value at End of Year column is attributable to the employee’s contributions to the pension plan during the year ended December
31, 2021, as well as changes in the foreign exchange rate, each employee’s contributions being made in Euros.

Name

Paulini, Klaus
Gerlach, Matthias
Guenther, Eckhard
Ammer, Nicola

C.

Board practices

89

Accumulated value at start
of year
($)

Compensatory
($)

Accumulated value at year
end
($)

96,086   
212,972   
116,059   
25,784   

3,569   
16,314   
3,569   
5,400   

105,229 
239,090 
125,895 
32,128 

Our Articles provide that our Board shall be composed of a minimum of five (5) and a maximum of fifteen (15) directors. Directors are elected annually by our shareholders, but the
directors may from time to time appoint one or more directors, provided that the total number of directors so appointed does not exceed one-third of the number of directors elected
at the last annual meeting of shareholders. Each elected director will remain in office until termination of the next annual meeting of the shareholders or until his or her successor is
duly elected or appointed, unless his or her post is vacated earlier. We do not have service agreements with our independent directors.

See Item 6A. for information about the period of service of each of our directors and senior corporate officers.

Standing Committees of the Board of Directors

Our Board has established an Audit Committee and a NGCC.

Audit Committee

The Audit Committee assists the Board in fulfilling its oversight responsibilities. The Audit Committee reviews the financial reporting process, the system of internal control, the
audit process, and our process for monitoring compliance with laws and regulations and with our Code of Ethical Conduct. In performing its duties, the Audit Committee will
maintain effective working relationships with the  Board, management, and the external auditors.  To effectively perform his or her role, each committee member will obtain an
understanding of the detailed responsibilities of committee membership as well as our business, operations and risks.

The function of the Audit Committee is oversight and while it has the responsibilities and powers set forth in its charter (incorporated by reference to Exhibit 11.3 to this Annual
Report on Form 20-F), it is neither the duty of the committee to plan or to conduct audits or to determine that our financial statements are complete, accurate and in accordance with
generally accepted accounting principles, nor to maintain internal controls and procedures.

The current members of the Audit Committee are Dennis Turpin (Chair), Peter G. Edwards, and Gilles Gagnon.

NGCC

The compensation of executive officers of the Corporation and its subsidiaries is recommended to the Board by the NGCC. The NGCC is responsible for, among other matters, (i)
assisting the Board in developing our approach to corporate governance issues, (ii) proposing new Board nominees, (iii) overseeing the assessment of the effectiveness of the
Board and its committees, their respective chairs and individual directors and (iv) making recommendations to the Board with respect to board member nominees and directors’
compensation, as well as serving in a leadership role for our corporate governance practices. It is also responsible for taking all reasonable actions to ensure that appropriate
human resources policies, procedures and systems, e.g., recruitment and retention policies, competency and performance metrics and measurements, training and development
programs, and market-based, competitive compensation and benefits structures, are in place so that we can attract, motivate and retain the quality of personnel required to achieve
our business objectives. The NGCC also assists the Board in discharging its responsibilities relating to the recruitment, retention, development, assessment, compensation and
succession planning for our executive and senior management members.

90

 
 
 
 
 
 
   
   
 
 
   
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Thus, the  NGCC recommends the appointment of senior officers, including the terms and conditions of their appointment and termination, and reviews the evaluation of the
performance of our senior officers, including recommending their compensation and overseeing risk identification and management in relation to executive compensation policies
and practices. The Board, which includes the members of the NGCC, reviews the Chief Executive Officer’s corporate strategy, goals and performance objectives and evaluates and
measures his or her performance and compensation against the achievement of such goals and objectives.

The  NGCC  recognizes  that  the  industry,  regulatory  and  competitive  environment  in  which  we  operate  requires  a  balanced  level  of  risk-taking  to  promote  and  achieve  the
performance expectations of executives of a specialty biopharmaceutical company. The NGCC is of the view that our executive compensation program should not encourage senior
executives to take inappropriate or unreasonable risk. In this regard, the NGCC recommends the implementation of compensation methods that appropriately connect a portion of
senior executive compensation with our short-term and longer-term performance, as well as that of each individual executive officer and that take into account the advantages and
risks associated with such compensation methods. The NGCC is also responsible for establishing compensation policies that are intended to reward the creation of shareholder
value while reflecting a balance between our short-term and longer-term performance and that of each executive officer.

The NGCC is currently composed of Ms. Carolyn Egbert (Chair), Mr. Peter G. Edwards and Mr. Gilles Gagnon, each of whom is independent. The Board believes that the members
of the NGCC collectively have the knowledge, experience and background required to fulfill its mandate:

D.

Employees

As at December 31, 2021, we had a total of 17 active employees, of which 16 are based in Frankfurt, Germany. In addition, there was one employee based in the U.S. and our CFO
was based in Toronto, Canada.

Our current employees are engaged in the following activities: (i) six are engaged in research and development, regulatory affairs and quality assurance; (ii) five are involved in
commercial operations and business development; and (iii) six are involved in various administrative functions, including finance and accounting. We do not employ any sales
representatives. As at December 31, 2020, we had a total of 11 active employees, of which 10 were based in Frankfurt, Germany. In addition, there was one employee based in the
U.S. and our CFO was based in Toronto, Canada.

We have agreements with our employees covering confidentiality, loyalty, non-competition and assignment of all intellectual property rights developed during the employment
period.

E.

Share ownership

The table below sets forth information as of March 15, 2022 provided to us by our current directors and named executive officers concerning their ownership of Common Shares
and stock options of the Company:

Name

No. of Common
Shares owned or
held

Percent(1)

No. of stock options
held(2)

—   
31,920   
—   
—   
—   
—   
55,000   
32,000   
118,920   

—   
*   
—   
—   
—   
—   
*   
—   
*   

110,000   
77,850   
—   
—   
115,000   
115,398   
197,500   
—   
620,350   

No. of currently
exercisable options  
35,001 
77,850 
— 
— 
41,668 
40,399 
54,168 
— 
249,086 

Ammer, Nicola
Egbert, Carolyn
Edwards, Peter G.
Gagnon, Gilles
Gerlach, Matthias
Guenther, Eckhard
Paulini, Klaus
Turpin, Dennis(3)
Total

* Less than 1%

(1) Based on 121,397,007 Common Shares outstanding as at March 25, 2022.
(2) For information regarding option expiration dates and exercise price refer to the tables included under the caption "Outstanding Option-Based Awards and Share-Based

Awards”.

(3) Mr. Turpin joined the Board on May 5, 2021.

91

Item 7.

Major Shareholders and Related Party Transactions

A.

Major shareholders

We are not directly or indirectly owned or controlled by another corporation or by any foreign government. Based on filings with the SEC and the Canadian securities regulatory
authorities, as at March 25, 2022, no individual or entity, other than as set out below, beneficially owned, directly or indirectly, or exercised control or direction over our Common
Shares carrying more than 5% of the voting rights attached to all our Common Shares (to whom we refer as our major shareholders).

Changes in Percentage Ownership by Major Shareholders

We had no major shareholders in 2017. During 2018, J. Goldman & Co., L.P. J., Goldman Capital Management, Inc., and Jay G. Goldman (collectively, "Goldman”) became major
shareholders due to the acquisition of over 5% of our outstanding Common Shares, and as of December 31, 2019, Goldman ceased to be the beneficial owner of more than 5% of
our  Common  Shares,  based  solely  on  a  Schedule  13G  filed  with  the  SEC  on  February  14,  2020.  On  February  18,  2020, Armistice  Capital  Master  Fund,  LTD  became  a  major
shareholder of the Company due to the acquisition of over 5% of our outstanding Common Shares, but as of December 31, 2020 ceased to beneficially own more than 5% of our
Common  Shares,  based  solely  on  a  Schedule  13G  filed  with  the  SEC  on  February  16,  2021.  On  July  1,  2020,  Intracoastal  Capital  LLC  became  a  major  shareholder  due  to  the
acquisition of over 5% of our outstanding Common Shares, but as of December 31, 2021 ceased to beneficially own more than 5% of our Common Shares, based solely on a
Schedule  13G  filed  with  the  SEC  on  February  11,  2022.  On  July  2,  2020,  Lind  Global  Macro  Fund,  LP  became  a  major  shareholder  due  to  the  acquisition  of  over  5%  of  our
outstanding Common Shares, but as of December 31, 2021 ceased to beneficially own more than 5% of our Common Shares, based solely on a Schedule 13G filed with the SEC on
February 11, 2022.

United States Shareholders

Based on a review of the information provide to us by our transfer agent, as at March 21, 2022, there were 14 holders of record of our Common Shares, of which two were registered
with an address in the U.S., holding in the aggregate approximately 99% of our outstanding Common Shares. We believe that the number of beneficial owners of our Common
Shares is substantially greater than the number of record holders, because the overwhelming majority of our Common Shares are held in broker "street names”.

 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
B.

Related party transactions

Other than employment agreements and indemnification agreements with our management, there are no related party transactions.

C.

Interests of experts and counsel

Not required.

Item 8.

Financial Information

A.

Consolidated statements and other financial information

The consolidated financial statements filed as part of this Annual Report on Form 20-F are presented under "Item 17. – Financial Statements”.

92

B.

Significant changes

No significant changes occurred since the date of our annual consolidated financial statements included elsewhere in this Annual Report on Form 20-F.

Item 9.

The Offer and Listing

A.

Offer and listing details

Not applicable, except for Item 9A(4). Our Common Shares are listed on both the NASDAQ and the TSX under the symbol "AEZS”. The following table indicates, for the relevant
periods, the high and low closing prices of our Common Shares on the NASDAQ and on the TSX as of December 31, 2021:

2019
2020
2021

Fourth quarter
Third quarter
Second quarter
First quarter

2020

Fourth quarter
Third quarter
Second quarter
First quarter

2019

Fourth quarter
Third quarter
Second quarter
First quarter

B.

Plan of distribution

Not applicable.

C.

Markets

NASDAQ (US$)

TSX (CAN$)

High

Low

High

Low

5.43   
1.44   
3.34   
0.77   
0.88   
1.14   
3.34   

0.44   
0.55   
1.17   
1.44   

1.08   
2.97   
5.43   
4.65   

0.77   
0.30   
0.36   
0.36   
0.59   
0.83   
0.51   

0.30   
0.34   
0.45   
0.42   

0.77   
1.00   
2.04   
3.03   

7.26   
1.87   
4.25   
0.96   
1.10   
1.42   
4.25   

0.56   
0.73   
1.71   
1.87   

1.45   
3.86   
7.26   
6.25   

1.02 
0.39 
0.64 
0.455 
0.76 
1.02 
0.64 

0.39 
0.46 
0.66 
0.59 

1.02 
1.33 
2.73 
4.12 

Our Common Shares are listed and posted for trading on both the NASDAQ and the TSX under the symbol "AEZS”.

D.

Selling shareholders

Not applicable.

E.

Dilution

Not applicable.

F.

Expenses of the issue

Not applicable.

Item 10.

Additional Information

A.

Share capital

Not required.

93

B.

Memorandum and articles of association

We  are  governed  by  our  restated  articles  of  incorporation  (the  " Restated Articles of  Incorporation”)  under  the  CBCA  and  by  articles  of  amendment  dated  October  2,  2012,

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
November 17, 2015, and May 9, 2019 (together with the Restated Articles of Incorporation, the " Articles”) and by our bylaws, as amended and restated on March 21, 2013 (the
"bylaws”). Our Articles are on file with Corporations Canada under Corporation Number 264271-9. The Articles do not include a stated purpose and do not place any restrictions
on the business that we may carry on.

Inspection Rights of Shareholders

Under the CBCA, shareholders are entitled to be provided with a copy of the list of our registered shareholders. In order to obtain the shareholder list, a shareholder must provide
to us an affidavit including, among other things, a statement that the list will only be used for the purposes permitted by the CBCA. These permitted purposes include an effort to
influence the voting of our shareholders, an offer to acquire our securities and any other matter relating to our affairs. We are entitled to charge a reasonable fee for the provision
of the shareholder list and must deliver that list no more than ten days after receipt of the affidavit described above.

Under the CBCA, shareholders have the right to inspect certain corporate records, including our Articles and bylaws and minutes of meetings and resolutions of the shareholders.
Shareholders have no statutory right to inspect minutes of meetings and resolutions of our directors. Our shareholders have the right to certain financial information respecting us.
In addition to the annual and quarterly financial statements required to be filed under applicable securities laws, we are required by the CBCA to place before every annual meeting
of shareholders our audited comparative annual financial statements. In addition, shareholders have the right to examine the financial statements of each of our subsidiaries and
any other corporate entity whose accounts are consolidated in our financial statements.

Directors

The minimum number of directors we must have is five (5) and the maximum number is fifteen (15). In accordance with the CBCA, at least 25% of our directors must be residents of
Canada. In order to serve as a director, a person must be a natural person at least 18 years of age, of sound mind, not bankrupt, and must not be prohibited by any court from
holding the office of director. None of the Articles, the bylaws and the CBCA impose any mandatory retirement requirements for directors.

The directors are elected by a majority of the votes cast at the annual meeting at which an election of directors is required, to hold office until the election of their successors,
except in the case of resignations or if their offices become vacant by death or otherwise. Subject to the provisions of our bylaws, all directors may, if still qualified to serve as
directors, stand for re-election. The Board is not replaced at staggered intervals but is elected annually.

There is no provision in our bylaws or Articles that requires that a director must be a shareholder.

The directors are entitled to remuneration as shall from time to time be determined by the Board or by a committee to which the Board may delegate the power to do so. Under the
mandate  of  the  NGCC,  such  committee,  comprised  of  at  least  a  majority  of  independent  directors,  is  tasked  with  making  recommendations  to  the  Board  concerning  director
remuneration.

94

The CBCA provides that a director who is a party to, or who is a director or officer of, or has a material interest in, any person who is a party to a material contract or transaction or
proposed material contract or transaction with us must disclose to us the nature and extent of his or her interest at the time and in the manner provided by the CBCA, or request
that same be entered in the minutes of the meetings of the Board, even if such contract, in connection with our normal business activity, does not require the approval of either the
directors or the shareholders. At the request of the president or any director, the director placed in a situation of conflict of interest must leave the meeting while the Board
discusses the matter. The CBCA prohibits such a director from voting on any resolution to approve the contract or transaction unless the contract or transaction:

● relates primarily to his or her remuneration as our director, officer, employee or agent or as a director, officer, employee or agent of an affiliate of us;

● is for indemnity or insurance for director’s liability as permitted by the CBCA; or

● is with our affiliate.

The CBCA provides that the Board may, on our behalf and without authorization of our shareholders:

● borrow money upon our credit;

● issue, reissue, sell or pledge our debt obligations;

● give a guarantee on our behalf to secure performance of an obligation of any person; and

● mortgage, hypothecate, pledge or otherwise create a security interest in all or any of our property, owned or subsequently acquired, to secure any of our obligations.

The shareholders have the ability to restrict such powers through our Articles or bylaws (or through a unanimous shareholder agreement), but no such restrictions are in place.

The CBCA prohibits the giving of a guarantee to any of our shareholders, directors, officers or employees or of an affiliated corporation or to an associate of any such person for
any purpose or to any person for the purpose of or in connection with a purchase of a share issued or to be issued by us or our affiliates, where there are reasonable grounds for
believing that we are or, after giving the guarantee, would be unable to pay our liabilities as they become due, or the realizable value of our assets in the form of assets pledged or
encumbered to secure a guarantee, after giving the guarantee, would be less than the aggregate of our liabilities and stated capital of all classes. These borrowing powers may be
varied by our bylaws or Articles. However, our bylaws and Articles do not contain any restrictions on or variations of these borrowing powers.

Pursuant to the CBCA, our directors manage and administer our business and affairs and exercise all such powers and authority as we are authorized to exercise pursuant to the
CBCA, the Articles and the bylaws. The general duties of our directors and officers under the CBCA are to act honestly and in good faith with a view to our best interests and to
exercise the care, diligence and skill that a reasonably prudent person would exercise in comparable circumstances. Any breach of these duties may lead to liability to us and our
shareholders for breach of fiduciary duty. In addition, a breach of certain provisions of the CBCA, including the improper payment of dividends or the improper purchase or
redemption of shares, will render the directors who authorized such action liable to account to us for any amounts improperly paid or distributed.

95

Our bylaws provide that the Board may, from time to time, appoint from amongst their number committees of the Board, and delegate to any such committee any of the powers of
the Board except those which pursuant to the CBCA a committee of the Board has no authority to exercise. As such, the Board has two standing committees: the Audit Committee
and the Nominating, Governance and Compensation Committee, or the NGCC.

Subject to the limitations provided by the CBCA, our bylaws provide that we shall, to the full extent provided by law, indemnify a director or an officer, a former director or officer
or  a  person  who  acts  or  acted  at  our  request  as  a  director  or  officer  of  a  body  corporate  of  which  we  are  or  were  a  shareholder  or  creditor,  and  his  or  her  heirs  and  legal
representatives, against all costs, losses, charges and expenses, including an amount paid to settle an action or satisfy a judgment, reasonably incurred by him or her in respect of
any civil, criminal or administrative action or proceeding to which he or she is made a party by reason of having been our director or officer or such body corporate, provided: (a)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
he or she acted in good faith in our best interests and (b) in the case of a criminal or an administrative action or proceeding that is enforced by a monetary penalty, he or she had
reasonable grounds to believe that his or her conduct was lawful.

Our directors are authorized to indemnify from time to time any director or other person who has assumed or is about to assume in the normal course of business any liability for us
or for any corporation controlled by us and to secure such director or other person against any loss by the pledge of all or part of our movable or immovable property through the
creation of a hypothec or any other real right in all or part of such property or in any other manner.

We have also agreed to indemnify and save harmless our directors and senior corporate officers as well as the managing directors of our German subsidiary pursuant to various
Director  and  Officer  Indemnification Agreements  against  certain  charges,  damages,  awards,  settlements,  liabilities,  interest,  judgments,  fines,  penalties,  statutory  obligations,
professional  fees  and  retainers  and  other  expenses  of  whatever  nature  or  kind,  provided  that  any  such  costs,  charges,  professional  fees  and  other  expenses  are  reasonable
(collectively, "Expenses”) and from and against all Expenses sustained or incurred by the indemnified party as a result of serving as a director, officer or employee of the Company
(or its subsidiary) in respect of any act, matter, deed or thing whatsoever made, done, committed, permitted, omitted or acquiesced in by the indemnified party as a director, officer
or employee of the Company (or its subsidiary).

Share Capitalization

Our authorized share capital structure consists of an unlimited number of shares of the following classes (all classes are without nominal or par value): Common Shares; and first
preferred  shares  (the  "First  Preferred  Shares”)  and  second  preferred  shares  (the  "Second  Preferred  Shares”  and,  together  with  the  First  Preferred  Shares,  the  "Preferred
Shares”), both issuable in series. As at March 25, 2022, there were approximately 121,397,007 Common Shares outstanding. No Preferred Shares have been issued to date. We have
also issued warrants to acquire Common Shares in connection with certain equity financings.

Common Shares

The holders of the Common Shares are entitled to one vote for each Common Share held by them at all meetings of shareholders, except meetings at which only shareholders of a
specified class of shares are entitled to vote. In addition, the holders are entitled to receive dividends if, as and when declared by our Board on the Common Shares. Finally, the
holders of the Common Shares are entitled to receive our remaining property upon any liquidation, dissolution or winding-up of our affairs, whether voluntary or involuntary.
Shareholders have no liability to further capital calls as all shares issued and outstanding are fully paid and non-assessable.

Preferred Shares

The First and Second Preferred Shares are issuable in series with rights and privileges specific to each class. The holders of Preferred Shares are generally not entitled to receive
notice of or to attend or vote at meetings of shareholders. The holders of First Preferred Shares are entitled to preference and priority to any participation of holders of Second
Preferred Shares, Common Shares or shares of any other class of shares of our share capital ranking junior to the First Preferred Shares with respect to dividends and, in the event
of our liquidation, the distribution of our property upon our dissolution or winding-up, or the distribution of all or part of our assets among the shareholders, to an amount equal to
the value of the consideration paid in respect of such shares outstanding, as credited to our issued and paid-up share capital, on an equal basis, in proportion to the amount of
their respective claims in regard to such shares held by them. The holders of Second Preferred Shares are entitled to preference and priority to any participation of holders of
Common  Shares or shares of any other class of shares of our share capital ranking junior to the  Second  Preferred  Shares with respect to dividends and, in the event of our
liquidation, the distribution of our property upon our dissolution or winding-up, or the distribution of all or part of our assets among the shareholders, to an amount equal to the
value of the consideration paid in respect of such shares outstanding, as credited to our issued and paid-up share capital, on an equal basis, in proportion to the amount of their
respective claims in regard to such shares held by them.

96

Our Board may, from time to time, provide for additional series of Preferred Shares to be created and issued, but the issuance of any Preferred Shares is subject to the general duties
of the directors under the CBCA to act honestly and in good faith with a view to our best interests and to exercise the care, diligence and skill that a reasonably prudent person
would exercise in comparable circumstances.

Warrants

For a description of our Warrants, see note 19 – share capital, warrants and other capital, to the audited consolidated financial statements included in Item 17 of this Annual Report
on Form 20-F.

Shareholder Actions

The CBCA provides that our shareholders may, with leave of a court, bring an action in our name and on our behalf for the purpose of prosecuting, defending or discontinuing an
action on our behalf. In order to grant leave to permit such an action, the CBCA provides that the court must be satisfied that our directors were given adequate notice of the
application, the shareholder is acting in good faith and that it appears to be in our best interests that the action be brought.

Shareholder Rights Plan

The Board of the Company approved an amended and restated shareholder rights plan of the Company on March 29, 2019, which was approved, ratified and confirmed by the
shareholders at the annual and special meeting of shareholders of the  Company on  May 8, 2019 (the "Rights Plan”).  The  Rights  Plan amended and restated the  Company’s
shareholder rights plan originally implemented in 2016 and was implemented to ensure, to the extent possible, that all shareholders of the Company are treated fairly in connection
with any take-over offer or other acquisition of control of the Company.

Objectives and Background of the Rights Plan

The fundamental objectives of the Rights Plan are to provide adequate time for our Board and shareholders to assess an unsolicited take-over bid for us, to provide the Board with
sufficient time to explore and develop alternatives for maximizing shareholder value if a take-over bid is made, and to provide shareholders with an equal opportunity to participate
in a take-over bid.

The Rights Plan encourages a potential acquiror who makes a take-over bid to proceed either by way of a "Permitted Bid”, as described below, which requires a take-over bid to
satisfy certain minimum standards designed to promote fairness, or with the concurrence of our Board. If a take-over bid fails to meet these minimum standards and the Rights Plan
is not waived by the Board, the Rights Plan provides that holders of Common Shares, other than the acquiror, will be able to purchase additional Common Shares at a significant
discount to market, thus exposing the person acquiring Common Shares to substantial dilution of its holdings.

Summary of the Rights Plan

The following is a summary of the principal terms of the Rights Plan, which summary is qualified in its entirety by reference to the terms thereof. Capitalized terms not otherwise
defined in this summary shall have the meaning ascribed to such terms in the Rights Plan. A draft of the Rights Plan is available at the following websites: www.zenataris.com,
www.sedar.com and www.sec.gov.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
For the purposes of this summary and as set out in the Rights Plan, the term "NI 62-104” refers to National Instrument 62-104-Take-Over Bids and Issuer Bids adopted by the
Canadian securities regulatory authorities, as now in effect or as the same may from time to time be amended, re-enacted or replaced and including for greater certainty any
successor instrument thereto.

97

Operation of the Rights Plan

Pursuant to the terms of the Rights Plan, one right was issued in respect of each common share outstanding at 5:01 p.m. on March 29, 2016 (the "Record Time”). In addition, we
will issue one right for each additional Common Share issued after the Record Time and prior to the earlier of the Separation Time (as defined below) and the Expiration Time (as
defined below). The rights have an initial exercise price equal to the Market Price (as defined below) of the Common Shares as determined at the Separation Time, multiplied by five,
subject to certain anti-dilution adjustments (the "Exercise Price”), and they are not exercisable until the Separation Time. Upon the occurrence of a Flip-in Event (as defined
below), each right will entitle the holder thereof, other than an Acquiring Person or any other person whose rights are or become void pursuant to the provisions of the Rights
Plan, to purchase from us, effective at the close of business on the eighth trading day after the Stock Acquisition Date (as defined below), upon payment to us of the Exercise
Price, Common Shares having an aggregate Market Price equal to twice the Exercise Price on the date of consummation or occurrence of such Flip-in Event, subject to certain anti-
dilution adjustments.

Definition of Market Price

Market Price is generally defined in the Rights Plan, on any given day on which a determination must be made, as the volume weighted average trading price of the Common Shares
for the 20 consecutive trading days (i.e. days on which the  TSX or another stock exchange or national securities quotation system on which the  Common  Shares are traded
(including for greater certainty, each of the Nasdaq Global Select Market, the Nasdaq Global Market and the Nasdaq Capital Market) is open for the transaction of business,
subject to certain exceptions), through and including the trading day immediately preceding such date of determination, subject to certain exceptions.

Trading of Rights

Until the Separation Time (or the earlier termination or expiration of the rights), the rights trade together with the Common Shares and are represented by the same share certificates
as the Common Shares or an entry in our securities register in respect of any outstanding Common Shares. From and after the Separation Time and prior to the Expiration Time, the
rights are evidenced by rights certificates and trade separately from the Common Shares. The rights do not carry any of the rights attaching to the Common Shares such as voting
or dividend rights.

Separation Time

The rights will separate from the Common Shares to which they are attached and become exercisable at the time (the "Separation Time”) of the close of business on the eighth
business day after the earliest to occur of:

1.

2.

the first date (the "Stock Acquisition Date”) of a public announcement of facts indicating that a person has become an Acquiring Person; and

the date of the commencement of, or first public announcement of the intention of any person (other than us or any of our subsidiaries) to commence a take-over bid or a share
exchange bid for more than 20% of our outstanding Common Shares other than a Permitted Bid or a Competing Permitted Bid (as defined below), so long as such take-over bid
continues to satisfy the requirements of a Permitted Bid or a Competing Permitted Bid, as the case may be.

The Separation Time can also be such later time as may from time to time be determined by the Board, provided that if any such take-over bid expires, or is canceled, terminated or
otherwise withdrawn prior to the Separation Time, without securities deposited thereunder being taken up and paid for, it shall be deemed never to have been made and if the
Board determines to waive the application of the Rights Plan to a particular Flip-in Event, the Separation Time in respect of such Flip-in Event shall be deemed never to have
occurred.

From and after the Separation Time and prior to the Expiration Time, each right entitles the holder thereof to purchase one Common Share upon payment of the Exercise Price to us.

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Flip-in Event

The acquisition by a person (an "Acquiring Person”), including others acting jointly or in concert with such person, of more than 20% of the outstanding Common Shares, other
than by way of a Permitted Bid, a Competing Permitted Bid or in certain other limited circumstances described in the Rights Plan, is referred to as a "Flip-in Event”.

In the event that, prior to the Expiration Time, a Flip-in Event that has not been waived occurs (see "Waiver and Redemption” below), each right (other than those held by or
deemed to be held by the Acquiring Person) will thereafter entitle the holder thereof, effective as at the close of business on the eighth trading day after the Stock Acquisition
Date, to purchase from us, upon payment of the Exercise Price and otherwise exercising such right in accordance with the terms of the Rights Plan, that number of Common Shares
having an aggregate Market Price on the date of consummation or occurrence of the Flip-in Event equal to twice the Exercise Price, for an amount in cash equal to the Exercise Price
(subject to certain anti-dilution adjustments described in the Rights Plan).

A bidder may enter into Permitted Lock-up Agreements with our shareholders (" Locked-up Persons”) who are not affiliates or associates of the bidder and who are not, other than
by virtue of entering into such agreement, acting jointly or in concert with the bidder, whereby such shareholders agree to tender their Common Shares to the take-over bid (the
"Lock-up Bid”) without the bidder being deemed to beneficially own the Common Shares deposited pursuant to the Lock-up Bid. Any such agreement must include a provision
that  permits  the  Locked-up  Person  to  withdraw  the  Common  Shares  to  tender  to  another  take-over  bid  or  to  support  another  transaction  that  will  either  provide  greater
consideration to the shareholder than the Lock-up Bid or provide for a right to sell a greater number of shares than the Lock-up Bid contemplates (provided that the Permitted
Lock-up Agreement may require that such greater number exceed the number of shares under the Locked-up Bid by a specified percentage not to exceed 7%).

A  Permitted  Lock-up Agreement may require that the consideration under the other transaction exceed the consideration under the  Lock-up  Bid by a specified amount.  The
specified amount may not be greater than 7%. For greater certainty, a Permitted Lock-up Agreement may contain a right of first refusal or require a period of delay (or other similar
limitation) to give a bidder an opportunity to match a higher price in another transaction as long as the limitation does not preclude the exercise by the Locked-up Person of the
right to withdraw the Common Shares during the period of the other take-over bid or transaction.

The Rights Plan requires that any Permitted Lock-up Agreement be made available to us and the public. The definition of Permitted Lock-up Agreement also provides that under a
Permitted Lock-up Agreement, no "break up” fees, "topping” fees, penalties, expenses or other amounts that exceed in aggregate the greater of (i) 2.5% of the price or value of the
aggregate consideration payable under the Lock-up Bid, and (ii) 50% of the amount by which the price or value of the consideration received by a Locked-up Person under another
take-over bid or transaction exceeds what such Locked-up Person would have received under the Lock-up Bid, can be payable by such Locked-up Person if the Locked-up Person
fails to deposit or tender Common Shares to the Lock-up Bid or withdraws Common Shares previously tendered thereto in order to deposit such Common Shares to another take-
over bid or support another transaction.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Permitted Bid Requirements

The requirements of a Permitted Bid include the following:

1.

2.

3.

4.

5.

6.

the take-over bid must be made by means of a take-over bid circular;

the take-over bid must be made to all holders of Common Shares wherever resident, on identical terms and conditions, other than the bidder;

the take-over bid must not permit Common Shares tendered pursuant to the bid to be taken up or paid for:

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a)

b)

prior to the close of business on a date that is not less than 105 days following the date of the relevant take-over bid or such shorter minimum period that a take-over bid
(that is not exempt from any of the requirements of Division 5 (Bid Mechanics of NI 62-104)) must remain open for deposits of securities thereunder, in the applicable
circumstances at such time, pursuant to NI 62-104;

then only if at the close of business on the date Common Shares (and/or "Convertible Securities”, as defined in the Rights Plan) are first taken up or paid for under such
take-over bid, outstanding Common Shares and Convertible Securities held by shareholders other than any other Acquiring Person, the bidder, the bidder’s affiliates or
associates, persons acting jointly or in concert with the bidder and any employee benefit plan, deferred profit-sharing plan, stock participation plan or trust for the benefit
of our employees or the employees of any of our subsidiaries, unless the beneficiaries of such plan or trust direct the manner in which the Common Shares are to be voted
or direct whether the Common Shares are to be tendered to a take-over bid (collectively, "Independent Shareholders”) that represent more than 50% of the aggregate of (I)
then outstanding Common Shares and (II) Common Shares issuable upon the exercise of Convertible Securities, have been deposited or tendered pursuant to the take-
over bid and not withdrawn;

the take-over  bid  must  allow  Common  Shares  and/or  Convertible  Securities  to  be  deposited  or  tendered  pursuant  to  such  take-over  bid, unless  such  take-over  bid  is
withdrawn, at any time prior to the close of business on the date Common Shares and/or Convertible Securities are first taken up or paid for under the take-over bid;

the take-over bid must allow Common Shares and/or Convertible Securities to be withdrawn until taken up and paid for; and

in the event the requirement set forth in clause 3.b) above is satisfied, the bidder must make a public announcement of that fact and the take-over bid must remain open for
deposits and tenders of Common Shares for not less than ten days from the date of such public announcement.

A Permitted Bid need not be a bid for all outstanding Common Shares not held by the bidder, i.e., a Permitted Bid may be a partial bid. The Rights Plan also allows a competing
Permitted Bid (a "Competing Permitted Bid”) to be made while a Permitted Bid is in existence. A Competing Permitted Bid must satisfy all the requirements of a Permitted Bid other
than the requirement set out in clause 3.a) above and must not permit Common Shares tendered or deposited pursuant to the bid to be taken up or paid for prior to the close of
business on the last day of the minimum initial deposit period that such take-over bid must remain open for deposits of securities thereunder pursuant to NI 62-104 after the date of
the take-over bid constituting the Competing Permitted Bid; provided, however, that a take-over bid that has qualified as a Competing Permitted Bid shall cease to be a Competing
Permitted Bid at any time and as soon as such time as when such take-over bid ceases to meet any or all of the foregoing provisions of the definition of "Competing Permitted Bid”
and any acquisition of Common Shares and/or Convertible Securities made pursuant to such take-over bid that qualified as a Competing Permitted Bid, including any acquisition of
Common Shares and/or Convertible Securities made before such take-over bid ceased to be a Competing Permitted Bid, will not be a "Permitted Bid Acquisition” (as defined in the
Rights Plan).

Waiver and Redemption

The Board may, prior to the occurrence of a Flip-in Event, waive the dilutive effects of the Rights Plan in respect of, among other things, a particular Flip-in Event resulting from a
take-over bid made by way of a take-over bid circular to all holders of our Common Shares. In such an event, such waiver shall also be deemed to be a waiver in respect of any
other Flip-in Event occurring under a take-over bid made by way of a take-over bid circular to all holders of Common Shares prior to the expiry of the first mentioned take-over bid.

The  Board may, with the approval of a majority of  Independent  Shareholders (or, after the  Separation  Time has occurred, holders of rights, other than rights which are void
pursuant to the provisions of the Rights Plan or which, prior to the Separation Time, are held otherwise than by Independent Shareholders), at any time prior to the occurrence of a
Flip-in  Event which has not been waived, elect to redeem all, but not less than all, of the then outstanding rights at a price of  CAN$0.00001 each, appropriately adjusted as
provided in the Rights Plan (the "Redemption Price”).

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Where  a  take-over  bid  that  is  not  a  Permitted  Bid  or  Competing  Permitted  Bid  is  withdrawn  or  otherwise  terminated  after  the  Separation  Time  has  occurred  and  prior  to  the
occurrence of a Flip-in Event, the Board may elect to redeem all the outstanding rights at the Redemption Price without the consent of the holders of the Common Shares or the
rights and reissue rights under the Rights Plan to holders of record of Common Shares immediately following such redemption. Upon the rights being so redeemed and reissued, all
the provisions of the Rights Plan will continue to apply as if the Separation Time had not occurred, and the Separation Time will be deemed not to have occurred and we shall be
deemed to have issued replacement rights to the holders of its then outstanding Common Shares.

Amendment to the Rights Plan

The Rights Plan may be amended to correct any clerical or typographical error or to make such changes as are required to maintain the validity of the Rights Plan as a result of any
change in any applicable legislation, regulations or rules thereunder, without the approval of the holders of the Common Shares or rights. Prior to the Separation Time, we may,
with the prior consent of the holders of Common Shares, amend, vary or delete any of the provisions of the Rights Plan in order to effect any changes which the Board, acting in
good faith, considers necessary or desirable. We may, with the prior consent of the holders of rights, at any time after the Separation Time and before the Expiration Time, amend,
vary or delete any of the provisions of the Rights Plan.

Protection Against Dilution

The Exercise Price, the number and nature of securities which may be purchased upon the exercise of rights and the number of rights outstanding are subject to adjustment from
time to time to prevent dilution in the event of stock dividends, subdivisions, consolidations, reclassifications or other changes in the outstanding  Common  Shares, pro rata
distributions to holders of Common Shares and other circumstances where adjustments are required to appropriately protect the interests of the holders of rights.

Fiduciary Duty of Board

The Rights Plan will not detract from or lessen the duty of the Board to act honestly and in good faith with a view to our best interests and the best interests of our shareholders.
The Board will continue to have the duty and power to take such actions and make such recommendations to our shareholders as are considered appropriate.

Exemptions for Investment Advisors

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fund managers, investment advisors (for fully-managed accounts), trust companies (acting in their capacities as trustees and administrators), statutory bodies whose business
includes the management of funds, and administrators of registered pension plans are exempt from triggering a Flip-in Event, provided that they are not making, or are not part of a
group making, a take-over bid.

Term

The Rights Plan will expire on the earlier of (i) the Termination Time; and (ii) the Close of Business on the date on which the annual meeting of the Company to be held in 2022 and
at every third annual meeting of the Company thereafter (each such annual meeting being a "Reconfirmation Meeting”) occurs and at which the Rights Plan is not reconfirmed or
presented for reconfirmation as contemplated in the Rights Plan (the "Expiration Time”).

Action Necessary to Change Rights of Shareholders

In order to change the rights of our shareholders, we would need to amend our Articles to effect the change. Such an amendment would require the approval of holders of two-
thirds of the issued and outstanding shares cast at a duly called special meeting. For certain amendments, a shareholder is entitled under the CBCA to dissent in respect of such a
resolution amending the Articles and, if the resolution is adopted and we implement such changes, demand payment of the fair value of its shares.

101

Disclosure of Share Ownership

In general, under applicable securities regulation in Canada, a person or company who beneficially owns, or who directly or indirectly exercises control or direction over voting
securities of a reporting issuer, voting securities of an issuer or a combination of both, carrying more than ten percent of the voting rights attached to all the issuer’s outstanding
voting securities is an insider and must, within ten days of becoming an insider, file a report in the required form effective the date on which the person became an insider,
disclosing any direct or indirect beneficial ownership of, or control or direction over, securities of the reporting issuer.

Additionally, securities regulation in Canada provides for the filing of a report by an insider of a reporting issuer whose holdings change, which report must be filed within five
days from the day on which the change takes place.

Section 13 of the Exchange Act imposes reporting requirements on persons who acquire beneficial ownership (as such term is defined in the Rule 13d-3 under the Exchange Act) of
more than five percent of a class of an equity security registered under Section 12 of the Exchange Act. Our Common Shares are so registered. In general, such persons must file,
within ten days after such acquisition, a report of beneficial ownership with the SEC containing the information prescribed by the regulations under Section 13 of the Exchange
Act. This information is also required to be sent to the issuer of the securities and to each exchange where the securities are traded.

Meeting of Shareholders

An annual meeting of shareholders is held each year for the purpose of considering the financial statements and reports, electing directors, appointing auditors and fixing or
authorizing the Board to fix their remuneration and for the transaction of other business as may properly come before a meeting of shareholders. Any annual meeting may also
constitute a special meeting to take cognizance and dispose of any matter of which a special meeting may take cognizance and dispose. Under the bylaws, our Chief Executive
Officer or our President has the power to call a meeting of shareholders.

The CBCA provides that the holders of not less than 5% of our outstanding voting shares may requisition our directors to call a meeting of shareholders for the purpose stated in
the requisition. Except in limited circumstances, including where a meeting of shareholders has already been called and a notice of meeting already given or where it is clear that the
primary purpose of the requisition is to redress a personal grievance against us or our directors, officers or shareholders, our directors, on receipt of such requisition, must call a
meeting of shareholders. If the directors fail to call a meeting of shareholders within twenty-one days after receiving the requisition, any shareholder who signed the requisition
may call the meeting of shareholders and, unless the shareholders resolve otherwise at the meeting, we shall reimburse the shareholders for the expenses reasonably incurred by
them in requisitioning, calling and holding the meeting of shareholders.

The  CBCA  also  provides  that,  except  in  limited  circumstances,  a  resolution  in  writing  signed  by  all  of  the  shareholders  entitled  to  vote  on  that  resolution  at  a  meeting  of
shareholders is as valid as if it had been passed at a meeting of shareholders.

A quorum of shareholders is present at an annual or special meeting of shareholders, regardless of the number of persons present in person at the meeting, if the holder(s) of
shares representing at least 10% of the outstanding voting shares at such meeting are present in person or represented in accordance with our bylaws. In the case where the
CBCA, our Articles or our bylaws require or permit the vote by class of holders of a given class of shares of our share capital, the quorum at any meeting will be one or more
persons representing 10% of the outstanding shares of such class.

Notice of the time and place of each annual or special meeting of shareholders must be given not less than 21 days, nor more than 50 days, before the date of each meeting to each
director, to the auditor and to each shareholder entitled to vote thereat. If the address of any shareholder, director or auditor does not appear in our books, the notice may be sent
to such address as the person sending the notice may consider to be most likely to reach such shareholder, director or auditor promptly. Every person who, by operation of the
CBCA, transfers or by any other means whatsoever, becomes entitled to any share, shall be bound by every notice given in respect of such share which, prior to the entry of his or
her name and address on our register, is given to the person whose name appears on the register at the time such notice is sent. Notice of meeting of shareholders called for any
other purpose other than consideration of the financial statements and auditor’s report, election of directors and reappointment of the incumbent auditor, must state the nature of
the business in sufficient detail to permit the shareholder to form a reasoned judgment on and must state the text of any special resolution or bylaw to be submitted to the meeting.

102

Our bylaws include an advance notice provision (the "Advance Notice Requirement”). The Advance Notice Requirement applies in certain circumstances where nominations of
persons for election to the Board are made by our shareholders other than pursuant to: (a) a requisition of a meeting made pursuant to the provisions of the CBCA; or (b) a
shareholder proposal made pursuant to the provisions of the CBCA.

Among other things, the Advance Notice Requirement fixes a deadline by which shareholders must submit a notice of director nominations to us prior to any annual or special
meeting of shareholders where directors are to be elected and sets forth the information that a shareholder must include in the notice for it to be valid. In the case of an annual
meeting of shareholders, we must be given not less than 30 nor more than 65 days’ notice prior to the date of the annual meeting; provided, however, that in the event that the
annual meeting is to be held on a date that is less than 50 days after the date on which the first public announcement of the date of the annual meeting was made, notice may be
made not later than the close of business on the 10th day following such public announcement. In the case of a special meeting of shareholders (which is not also an annual
meeting), we must be given notice not later than the close of business on the 15th day following the day on which the first public announcement of the date of the special meeting
was made.

The Board may, in its sole discretion, waive any requirement of the Advance Notice Requirement.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Limitations on Right to Own Securities

Neither Canadian law nor our Articles or bylaws limit the right of a non-resident to hold or vote our Common Shares, other than as provided in the Investment Canada Act (the
"Investment Act”).

The Investment Act requires any person that is a "non-Canadian” (as defined in the Investment Act) who acquires "control” (as defined in the Investment Act) of an existing
Canadian business to file either a pre-closing application for review or a post-closing notification with Innovation, Science and Economic Development Canada.

As of February 15, 2020, the threshold for review of a direct acquisition of control of a non-cultural Canadian business by a World Trade Organization member country investor
that is not a state-owned enterprise is an enterprise value of assets that exceeds CAN$1.075 billion. For "trade agreement investors” that are not state-owned enterprises (as
defined in the Investment Act), which as of March 2020 include investors ultimately controlled by nationals of Australia, Chile, Colombia, EU member states, Honduras, Japan,
Korea, Mexico, New Zealand, Panama, Peru, Singapore, the U.S. or Vietnam, the threshold for review of a direct acquisition of control of a non-cultural Canadian business is an
enterprise value of assets that exceeds  CAN$1.613 billion.  The enterprise value review thresholds for both  World  Trade  Organization member countries and trade agreement
investors are indexed to annual  GDP growth and are adjusted accordingly each year.  For purposes of a publicly traded company, the "enterprise value” of the assets of the
Canadian business is equal to the market capitalization of the entity, plus its liabilities (excluding its operating liabilities), minus its cash and cash equivalents.

As such, under the Investment Act, the acquisition of control of us (either through the acquisition of our Common Shares or all or substantially all our assets) by a non-Canadian
who is a World Trade Organization member country investor or a trade agreement investor, including a U.S. investor, would be reviewable only if the enterprise value of our assets
exceeds the specified threshold for review.

Where the acquisition of control is a reviewable transaction, the Investment Act generally prohibits the implementation of the reviewable transaction unless, after review, the
relevant Minister is satisfied or deemed to be satisfied that the acquisition is likely to be of net benefit to Canada.

103

The acquisition of a majority of the voting interests of an entity is deemed to be acquisition of "control” of that entity. The acquisition of less than a majority but one-third or more
of the total number of votes attached to all of the voting shares of a corporation or of an equivalent undivided ownership interest in the total number of votes attached to all of the
voting shares of the corporation is presumed to be an acquisition of control of that corporation unless it can be established that, on the acquisition, the corporation is not
controlled in fact by the acquiror through the ownership of voting shares. The acquisition of less than one-third of the total number of votes attached to all of the voting shares of
a corporation is deemed not to be acquisition of control of that corporation subject to certain discretionary rights relative to investments involving state-owned enterprises. Other
than in connection with a "national security” review, discussed below, certain transactions in relation to our Common Shares would be exempt from the Investment Act including:

● the acquisition of our Common Shares by a person in the ordinary course of that person’s business as a trader or dealer in securities;

● the acquisition or control of us in connection with the realization of security granted for a loan or other financial assistance and not for any purpose related to the provisions
of the Investment Act, if the acquisition is subject to approval under the Bank Act,  the Cooperative Credit Associations Act, the Insurance Companies Act or the Trust and
Loan Companies Act; and

● the acquisition or control of us by reason of an amalgamation, merger, consolidation or corporate reorganization following which the ultimate direct or indirect control in fact of

us, through the ownership of our voting interests, remains unchanged.

Under the national security regime in the Investment Act, review on a discretionary basis may also be undertaken by the federal government in respect of a much broader range of
investments by a non-Canadian to "acquire, in whole or in part, or to establish an entity carrying on all or any part of its operations in Canada”. The relevant test is whether such
an investment by a non-Canadian could be "injurious to national security”. The Minister of Innovation, Science and Economic Development has broad discretion to determine
whether an investor is a non-Canadian and therefore may be subject to national security review. Review on national security grounds is at the discretion of the federal government
and may occur on a pre- or post-closing basis.

There is no law, governmental decree or regulation in Canada that restricts the export or import of capital, or which would affect the remittance of dividends or other payments by
us to non-resident holders of our Common Shares, other than withholding tax requirements.

C.

Material contracts

The following are the only material agreements of the  Company that are in effect as of the date hereof (other than certain agreements entered into in the ordinary course of
business):

● the United States and Canada License Agreement (as described below); and

● the Licensing Agreement with Consilient Health (as described below).

United States and Canada License Agreement

On  January 16, 2018, the  Company, through AEZS  Germany, entered into a  License Agreement with  Strongbridge, to carry out development, manufacturing, registration and
commercialization of Macrilen™ (macimorelin) in the U.S. and Canada, and received a cash payment of $24 million (the "2018 Agreement”).

104

Effective  December 19, 2018,  Strongbridge sold its rights to  Macrilen™ (macimorelin) in  Canada and the  U.S. to  Novo, and  Novo agreed to fund  Strongbridge’ s  Macrilen™
(macimorelin) field organization as a contract field force to promote the product in the U.S. for up to three years. This service agreement was terminated as of December 1, 2019.

On November 16, 2020, the Company announced that, through a wholly owned subsidiary, it had entered into an amendment (the " Amendment”) of its existing License Agreement
with  Novo  related  to  the  development  and  commercialization  of  macimorelin.  Under  the  terms  of  the  original  License Agreement,  Novo  was  granted  the  exclusive  right  to
commercialize  macimorelin  in  the  U.S.  and  Canada.  Novo  is  currently  marketing  macimorelin  in  the  U.S.  under  the  tradename  Macrilen™  for  the  diagnosis  of  AGHD.  The
Amendment was intended to amend the 2018 Agreement to, among others:

●

●

●

Reflect the updated supply arrangement between the parties relating to the supply of the API Macimorelin acetate;

Grant Novo a joint ownership interest in the Aeterna Patent Rights and Trademarks;

Amend responsibility between the Parties for the pediatric clinical trial for the Pediatric Indication (100% cost reimbursement up to EUR 9 million and 50% of
exceeding costs per the Amendment, as compared to a total of 70% of costs in the 2018 Agreement); and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
●

Modify the future payment obligations, i.e. reduction of royalty rate and waiver by the Company of the future regulatory milestone payment on FDA approval of
Pediatric Indication.

Under the Amendment, Aeterna continued to retain all rights to macimorelin outside of the U.S. and Canada, but Novo agreed to make an upfront payment to Aeterna of $6,109
(€5,000), which the Company received in December 2020. Under the Amendment, the royalty payment Aeterna receives on sales in the U.S. and Canada was reduced from 15% to
8.5% for annual net sales up to U.S.$40 million and returns to 15% or more for annual net sales of macimorelin over U.S.$40 million. Additionally, the $5 million variable payment
owing to Aeterna by Novo, upon FDA approval of the pediatric indication, was waived. Under the Amendment, Novo and Aeterna agreed that solely Aeterna will conduct the
pivotal Study P02 in partnership with a contract research organization ("CRO”). Given the transfer of development activities to Aeterna, the percentage of Study P02 clinical trial
costs that Novo is required to reimburse to Aeterna was adjusted from 70% to 100% of costs up to €9,000 (approximately $10,980). Any additional external jointly approved Study
P02 trial costs incurred over €9,000 will be shared equally between Novo and Aeterna. In addition, certain changes to rights and responsibilities of the joint steering committee were
made

Under the Amendment, both companies will continue to closely coordinate the activities related to the development and commercialization of macimorelin in the U.S. and Canada
through a joint steering committee, with each party having decision rights in certain areas. Novo will also receive co-ownership of the U.S. and Canadian patents and trademarks
owned by Aeterna on macimorelin but will be required to transfer co-ownership in those patents back to Aeterna on the occurrence of certain termination events.

In addition, upon regulatory approval of macimorelin in the U.S. for the diagnosis of CGHD, if Novo determines not to commercialize macimorelin in Canada, then Aeterna has the
option to exclusively license rights to macimorelin in Canada (but not in U.S.) to a third party. The Amendment also confirms that Aeterna has the right to use the results from
Study P02, if successful, to support Aeterna in seeking regulatory approval and in its ongoing efforts to seek partnering opportunities for macimorelin in Europe and other regions
outside of the two countries licensed to Novo, the U.S. and Canada.

Under the Amendment, for as long as Macrilen™ (macimorelin) is patent-protected, the Company will be entitled to a 8.5% royalty on net sales up to $40 million, 15% royalty on net
sales  between  $40  million  and  $75  million,  and  an  18%  royalty  on  net  sales  above  $75  million.  Following  the  end  of  patent  protection  in  the  U.S.  or  Canada  for  Macrilen™
(macimorelin), the Company will be entitled to a 5% royalty on net sales in that country.

105

In addition, the Company will also receive one-time payments from Novo following the first achievement of the following commercial milestone events:

●

●

●

●

●

$4 million on achieving $25 million annual net sales,

$10 million on achieving $50 million annual net sales,

$20 million on achieving $100 million annual net sales,

$40 million on achieving $200 million annual net sales, and

$100 million on achieving $500 million annual net sales.

The Amendment will expire at the end of a defined royalty period in each of the U.S. and Canada, at which time the license that the Company granted will become irrevocable, fully
paid-up,  perpetual  and  royalty-free  in  such  country.  The  licensee  has  the  right  to  terminate  the Amendment  if  there  is  a  safety  concern  related  to  Macrilen™  (macimorelin),
withdrawal of regulatory approval for Macrilen™ (macimorelin) in the U.S. believed to be permanent, two hundred and seventy (270) days prior written notice, or if the Company
commits a material breach of any term of the Amendment that it fails to cure within ninety (90) days after receiving written notice of the breach. The Company has the right to
terminate the Amendment if the licensee commits a material breach of any term of the Amendment that it fails to cure within ninety (90) days after receiving written notice of the
breach. If the breach relates to Canada then the Company shall only have the right to terminate the Amendment in relation to Canada. If the breach relates to the U.S., then the
Company shall have the right to terminate the Amendment in its entirety. If Novo terminates the Amendment early or the Company terminates because of a material breach by
Novo, then the joint ownership rights will be returned to the Company.

The  Amendment  contains  customary  provisions  related  to,  among  other  things,  confidentiality  and  non-disclosure,  representations  and  warranties,  indemnity  and  dispute
resolution. The Amendment is governed by the laws of Switzerland.

European Economic Area and United Kingdom License Agreement

On December 7, 2020, the Company entered into an exclusive licensing agreement with Consilient Health Limited ("CH”) for the commercialization of macimorelin (the "Licensed
Product”) in the European Economic Area and the United Kingdom (the "CH License Agreement”).

Under the terms of the CH License Agreement, CH agreed to make a non-refundable, non-creditable upfront payment to the Company of $1,209 (€1.0 million), which the Company
received in  January 2021.  The  Company also is eligible to receive additional consideration, including regulatory milestones related to agreed-upon pricing and reimbursement
parameters; net sales milestones; and royalties, ranging from 10%-20% of net sales of macimorelin, subject to reduction in certain cases, or sublicense income recorded by CH.
Also on December 7, 2020, the Company and CH entered into an exclusive supply agreement, pursuant to which the Company agreed to provide the Licensed Product to CH, with
such Licensed Product to be manufactured by third-party manufacturers for a period of ten years, subject to renewal (the "CH Supply Agreement”).

As consideration for the right to commercialise the licensed product, CH has agreed certain milestones as summarized below:

One-time payment (non-refundable and non-creditable)

●

Payment of Euro 1 million thirty (30) days after the effective date of the Licensing Agreement;

Paediatric Use Regulatory payment (non-refundable and non-creditable)

●

Grant of first marketing authorization from the European Commission for Paediatric Use of Euro 500,000.

Regulatory payments (non-refundable and non-creditable)

●

Upon receipt of pricing and reimbursement approval in France, Germany, Italy, Spain and the United Kingdom upon price per test of:

● Above Euro 300: Euro 200,000 per country;

● Euro 250 to Euro 300: Euro 100,000 per country; and

● Achievement of a mean average reimbursement price of above Euro 300 in France, Germany, Italy, Spain and UK of Euro 500,000.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
106

Commercial milestones (non-refundable and non-creditable)

●

●

●

●

Royalties

●

●

●

●

Annual net sales reaching Euro 4 million for payment of Euro 250,000;

Annual net sales reaching Euro 6 million for payment of Euro 400,000;

Annual net sales reaching Euro 8 million for payment of Euro 600,000; and

Annual net sales reaching Euro 10 million for payment of Euro 1,000,000.

10.0% for up to Euro 2 million annual net sales;

12.5% between Euro 2 million and Euro 3 million net sales;

15.0% between Euro 3 million and Euro 4 million net sales; and

20.0% for above Euro 4 million net sales.

Sublicense Income Royalty

●

10.0% on any form of consideration other than running royalties on net sales

The license remains in full force and effect (i) as long as the licensed product is covered by a valid claim in any country covered by the licensing agreement; (ii) the expiration of
any regulatory marketing exclusivity period or other statutory designation that provides similar exclusivity for the commercialisation of the licensed product in any country covered
by the licensing agreement; or (iii) on a country by country of the covered territory, and licensed product by licensed product basis, for a period of ten (10) years after the first
commercial sale date in the respective country, whichever term is longer, subject to renewal. The licensee has the right to terminate the license in certain circumstances.

Employment and Service Agreements

We, or one of our subsidiaries, had entered into an employment agreement and, in some cases, a change of control agreement with each of our Named Executive Officers.

Klaus Paulini

We entered into an employment agreement with Dr. Klaus Paulini, effective as of October 4, 2019 (the " Employment Agreement”) for his position as Chief Executive Officer of the
Corporation. The Corporation, through AEZS Germany, also entered into a service agreement with Dr. Klaus Paulini effective as of July 26, 2019 (the "Services Agreement”) for his
position as Managing Director of AEZS Germany. The Employment Agreement provides that we will pay Dr. Paulini (the " Executive”) an initial base salary of €260,000 per annum,
which includes payment for his service as Managing Director of AEZS Germany. Additionally, pursuant to the Employment Agreement, we provided the Executive with an initial
grant of 35,000 stock options in November 2019. Under the terms of the Services Agreement, the Executive may receive subsequent grants of stock options at the discretion of the
Board of Directors or the NGCC, an annual bonus subject to the determination and approval of the NGCC and participation in an employer sponsored pension scheme.

If there is a termination of the Executive’s employment by us without "Cause”, then the Executive will be entitled to receive a severance payment in the amount equal to €300,000.

107

The Employment Agreement contains customary confidentiality, intellectual property and non-disparagement covenants.

For the purposes of the Employment Agreement, termination of employment for "Cause” includes (but is not limited to) (i) if the Executive commits any fraud, theft, embezzlement
or other criminal act of a similar nature, and (ii) if the Executive has committed serious misconduct or willful negligence in the performance of his duties.

Leslie Auld

We entered into a consulting agreement with Leslie Auld, Senior Vice President, Chief Financial Officer, effective as of September 24, 2018 (the " Consulting Agreement”).  The
Consulting Agreement provides that Ms. Auld (the " Consultant”) will perform specified services for us for up to 120 hours per month. The Consultant will be paid CAN$150 per
hour (plus HST) (the "base fees”) for these services. Additionally, the Consultant will be paid for up to eight (8) hours of travel time per round trip, at a rate of CAN$150 per hour.

The Consulting Agreement may be terminated by either party for convenience, upon thirty (30) days written notice. The Consulting Agreement may also be terminated by us upon
the material breach or default of any provision of the Consulting Agreement by the Consultant, immediately upon the Consultant’s death or upon the parties’ mutual agreement. In
the event of termination, the Consultant will be entitled to receive any outstanding base fees and reimbursement for incurred expenses to the effective date of termination.

The  Consulting Agreement  provides  the  Consultant  indemnifies  us  from  and  against  any  and  all  claims,  costs,  liabilities,  damages,  charges  and  expenses  arising  out  of  the
Consulting Agreement or the services, including in respect of misclassification.

Ms. Auld concluded her Consulting Agreement effective March 31, 2022.

Matthias Gerlach

AEZS Germany entered into an employment agreement in January 2001 with Dr. Gerlach, Vice President Manufacturing and Supply Chain. In accordance with the terms of his
employment agreement, Dr. Gerlach will receive a pension payment after he has reached the statutory retirement age, independent of whether he works with AEZS Germany until
such age, in an amount to be based on the contributions that were made during his employment with AEZS Germany.

Eckhard Guenther

AEZS Germany entered into an employment agreement in 1990 with Dr. Guenther, Vice President Business Development & Alliance Management. In accordance with the terms of
his employment agreement, Dr. Guenther will receive a pension payment after he has reached the statutory retirement age, independent of whether he works with AEZS Germany
until such age, in an amount to be based on the contributions that were made during his employment with AEZS Germany.

Nicola Ammer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
AEZS Germany entered into an employment agreement in April 2015 with Dr. Ammer, Chief Medical Officer and Senior Vice President Clinical Development. In accordance with the
terms of her employment agreement, Dr. Ammer will receive a pension payment after she has reached the statutory retirement age, independent of whether she works with AEZS
Germany until such age, in an amount to be based on the contributions that were made during her employment with AEZS Germany.

108

Name

Ammer, Nicola
Auld, Leslie
Gerlach, Matthias
Guenther, Eckhard
Paulini, Klaus

Termination Provisions
Value ($)(1) (2)

0 
0 
0 
0 
354,600 

(1) The termination values assume that the triggering event took place on the last business day of our financial year-end (December 31, 2021).

(2) Value of earned/unused vacation, if applicable, and amounts owing for expense reimbursement are not included as they are not considered as "incremental” payments made in

connection with termination of employment.

D.

Exchange controls

Canada has no system of exchange controls. There are no exchange restrictions on borrowing from foreign countries or on the remittance of dividends, interest, royalties and
similar payments, management fees, loan repayments, settlement of trade debts or the repatriation of capital.

E.

Taxation

THE FOLLOWING SUMMARY IS OF A GENERAL NATURE ONLY AND IS NOT INTENDED TO BE, NOR SHOULD IT BE CONSTRUED TO BE, LEGAL OR TAX ADVICE TO
ANY PARTICULAR HOLDER. CONSEQUENTLY, HOLDERS ARE URGED TO CONSULT THEIR OWN TAX ADVISORS FOR ADVICE AS TO THE TAX CONSEQUENCES OF
AN INVESTMENT IN THE COMMON SHARES HAVING REGARD TO THEIR PARTICULAR CIRCUMSTANCES.

Material Canadian Income Tax Considerations

The following summary describes the principal Canadian federal income tax considerations applicable to a holder of Common Shares and who, for the purposes of the Canadian
federal Income Tax Act, R.S.C. 1985, as amended (the " Tax Act ”), and at all relevant times, deals at arm’s length with, and is not affiliated with, the Company and holds their
Common Shares as capital property (a "holder”). Common Shares will generally be considered to be capital property to a holder for purposes of the Tax Act unless either the holder
holds such Common Shares in the course of carrying on a business of trading or dealing in securities, or the holder has held or acquired such Common Shares in a transaction or
transactions considered to be an adventure in the nature of trade.

This summary is not applicable to a holder (i) that is a "financial institution”, as defined in the Tax Act for purposes of the mark-to- market rules, (ii) that is a "specified financial
institution”, as defined in the Tax Act, (iii) an interest in which would be a "tax shelter investment” as defined in the Tax Act, (iv) that has made a functional currency reporting
election for purposes of the Tax Act, (v) that has entered or will enter into a "derivative forward agreement”, as defined in the Tax Act, in respect of Common Shares, or (vi) that
receives dividends on Common Shares under or as part of a dividend rental arrangement as defined in the Tax Act. Such holders should consult their own tax advisors.

Additional considerations, not discussed herein, may be applicable to a holder that is a corporation resident in Canada, and is, or becomes, or does not deal at arm’s length for
purposes of the Tax Act with a corporation resident in Canada that is or becomes, as part of a transaction or series of transactions or events that includes the acquisition of the
Common Shares, controlled by a non-resident person or a group of non-resident persons not dealing with each other at arm’s length for the purposes of the "foreign affiliate
dumping” rules in section 212.3 of the Tax Act. Such holders should consult their tax advisors with respect to the consequences of acquiring Common Shares.

109

This summary is based upon the current provisions of the Tax Act and the regulations promulgated thereunder (the " Regulations”) and the Company’s understanding of the
current published administrative policies and assessing practices of the Canada Revenue Agency (" CRA”). It also takes into account all proposed amendments to the Tax Act and
the Regulations publicly released by the Minister of Finance (Canada) prior to the date hereof ("Tax Proposals ”), and assumes that all such Tax Proposals will be enacted as
currently proposed. No assurance can be given that the Tax Proposals will be enacted in the form proposed or at all. This summary does not otherwise take into account or
anticipate any changes in law or administrative or assessing practice or policy of the CRA, whether by legislative, regulatory, judicial or administrative action or interpretation, nor
does it address any provincial, local, territorial or foreign tax considerations.

For purposes of the  Tax Act, all amounts, including dividends, adjusted cost base and proceeds of disposition, must generally be determined in  Canadian dollars. Amounts
denominated in a foreign currency must be converted to Canadian currency using exchange rates determined in accordance with the Tax Act. The amount of any capital gain or
any capital loss to a holder with respect to the Common Shares may be affected by fluctuations in Canadian dollar exchange rates.

Holders Not Resident in Canada

The following discussion applies to a holder who, at all relevant times, for purposes of the Tax Act, is neither resident nor deemed to be resident in Canada and does not, and is not
deemed to, use or hold Common Shares in carrying on a business or part of a business in Canada (a "Non-Resident holder”). In addition, this discussion does not apply to an
insurer who carries or is deemed to carry on, an insurance business in Canada and elsewhere.

Disposition of Common Shares

A Non-Resident holder generally will not be subject to tax under the Tax Act in respect of any capital gain realized by such Non- Resident holder on a disposition or deemed
disposition of Common Shares unless such shares constitute "taxable Canadian property” (as defined in the Tax Act) of the Non-Resident holder at the time of disposition and the
gain is not exempt from tax pursuant to the terms of an applicable income tax treaty or convention. As long as the Common Shares are listed on a designated stock exchange (which
currently includes the NASDAQ and the TSX) at the time of their disposition, the Common Shares generally will not constitute taxable Canadian property of a Non-Resident
holder, unless (a) at any time during the 60-month period immediately preceding the disposition (i) one or any combination of (A) the Non-Resident holder, (B) persons with whom
the Non-Resident holder did not deal at arm’s length, and (C) partnerships in which the Non-Resident holder or a person described in (B) holds a membership interest directly or
indirectly through one or more partnerships, owned 25% or more of the issued shares of any class or series of shares of the Company; and (ii) more than 50% of the fair market
value  of  the  shares  of  the  Company  was  derived  directly  or  indirectly  from  one  or  any  combination  of  real  or  immovable  property  situated  in  Canada,  "Canadian  resource
properties” (as defined in the Tax Act), "timber resource properties” (as defined in the Tax Act) or options in respect of, or interests in, or for civil law rights in, any such property
whether or not such property exists or (b) the Common Shares are otherwise deemed to be taxable Canadian property to the Non-Resident holder.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
A Non-Resident holder’s capital gain (or capital loss) in respect of Common Shares that constitute or are deemed to constitute taxable Canadian property (and are not "treaty-
protected property” as defined in the Tax Act) will generally be computed in the manner described below under the heading "Holders Resident in Canada - Disposition of Common
Shares”. If the Common Shares were to cease being listed on the NASDAQ, the TSX or another "recognized stock exchange” (as defined in the Tax Act), a Non-Resident holder
who disposes of Common Shares that are taxable Canadian property may be required to fulfill the requirements of section 116 of the Tax Act, unless the Common Shares are
"treaty-protected property” (as defined in the Tax Act) of the disposing Non-Resident holder.

Non-Resident holders whose Common Shares are taxable Canadian property should consult their own tax advisors.

Taxation of Dividends on Common Shares

Dividends paid or credited or deemed to be paid or credited to a Non-Resident holder by the Company are subject to Canadian withholding tax at the rate of 25% unless reduced by
the terms of an applicable tax treaty or convention.  Under the  Canada -  United  States  Tax  Convention (1980) (the "Convention”)  as  amended,  the  rate  of  withholding  tax  on
dividends paid or credited to a Non-Resident holder who is the beneficial owner of the dividends, is resident in the U.S. for purposes of the Convention and entitled to the benefits
of the Convention (a "U.S. holder”) is generally limited to 15% of the gross amount of the dividend (or 5% in the case of a U.S. holder that is a company beneficially owning at least
10% of the Company’s voting shares). Non-Resident holders should consult their own tax advisors.

110

Holders Resident in Canada

The following discussion applies to a holder of Common Shares who, at all relevant times, for purposes of the Tax Act, is or is deemed to be resident in Canada (a " Canadian
holder”). Certain Canadian holders whose Common Shares might not otherwise qualify as capital property may, in certain circumstances, treat the Common Shares and every other
"Canadian security” (as defined in the Tax Act) owned by the Canadian holder as capital property by making an irrevocable election provided by subsection 39(4) of the Tax Act.
Canadian holders should consult their own tax advisors for advice as to whether an election under subsection 39(4) of the Tax Act is available and/or advisable in their particular
circumstances.

Taxation of Dividends on Common Shares

Dividends received or deemed to have been received on the Common Shares will be included in a Canadian holder’s income for purposes of the Tax Act. Such dividends received
or deemed to have been received by a Canadian holder that is an individual (other than certain trusts) will be subject to the gross-up and dividend tax credit rules generally
applicable under the Tax Act in respect of dividends received on shares of taxable Canadian corporations. Generally, a dividend will be eligible for the enhanced gross-up and
dividend tax credit if the Company designates the dividend as an "eligible dividend” (within the meaning of the Tax Act) in accordance with the provisions of the Tax Act. There
may be limitations on the ability of the Company to designate dividends as eligible dividends. A Canadian holder that is a corporation will be required to include such dividends in
computing its income and will generally be entitled to deduct the amount of such dividends in computing its taxable income. In certain circumstances, subsection 55(2) of the Tax
Act may treat a taxable dividend received by a Canadian holder that is a corporation as proceeds of disposition or a capital gain. A Canadian holder that is a "private corporation”
or a "subject corporation” (as such terms are defined in the Tax Act), may be liable under Part IV of the Tax Act to pay a refundable tax on dividends received or deemed to have
been received on the Common Shares to the extent such dividends are deductible in computing the holder’s taxable income.

Disposition of Common Shares

A disposition, or a deemed disposition, of a Common Share by a Canadian holder will generally give rise to a capital gain (or a capital loss) equal to the amount by which the
proceeds of disposition of the share, net of any reasonable costs of disposition, exceed (or are less than) the adjusted cost base of the share to the holder. Such capital gain (or
capital loss) will be subject to the treatment described below under "Taxation of Capital Gains and Capital Losses”.

Additional Refundable Tax

A  Canadian  holder  that  is  a  "Canadian-controlled  private  corporation”  (as  such  term  is  defined  in  the  Tax Act)  may  be  liable  to  pay  an  additional  refundable  tax  on  certain
investment income including amounts in respect of "Taxable Capital Gains”, as defined below.

Taxation of Capital Gains and Capital Losses

In general, one half of any capital gain (a "Taxable Capital Gain”) realized by a Canadian holder in a taxation year will be included in the holder’s income in the year. Subject to and
in accordance with the provisions of the Tax Act, one half of any capital loss (an " Allowable Capital Loss”) realized by a Canadian holder in a taxation year must be deducted from
Taxable Capital Gains realized by the holder in the year and Allowable Capital Losses in excess of Taxable Capital Gains may be carried back and deducted in any of the three
preceding taxation years or carried forward and deducted in any subsequent taxation year against net Taxable Capital Gains realized in such years. The amount of any capital loss
realized by a Canadian holder that is a corporation on the disposition or deemed disposition of a Common Share may be reduced by the amount of dividends received or deemed to
have been received by it on such Common Share (or on a share for which the Common Share has been substituted) to the extent and under the circumstances prescribed by the Tax
Act. Similar rules may apply where a corporation is a member of a partnership or a beneficiary of a trust that owns Common Shares, directly or indirectly, through a partnership or a
trust.

111

Alternative Minimum Tax

A Taxable Capital Gain realized and taxable dividends received or deemed to have been received by a Canadian holder who is an individual (including a trust, other than certain
specified trusts) may give rise to liability for alternative minimum tax.

Material U.S. Federal Income Tax Considerations

The following discussion is a summary of the material U.S. federal income tax consequences applicable to the purchase, ownership and disposition of Common Shares by a U.S.
Holder (as defined below), but does not purport to be a complete analysis of all potential U.S. federal income tax effects. This summary is based on the Internal Revenue Code of
1986, as amended (the "Code”), U.S. Treasury regulations promulgated thereunder, IRS rulings and judicial decisions in effect on the date hereof. All of these are subject to change,
possibly with retroactive effect, or different interpretations. This summary does not discuss the potential effects, whether adverse or beneficial, of any proposed legislation that, if
enacted, could be applied on a retroactive basis. This summary is not binding on the IRS, and the IRS is not precluded from taking a position that is different from, and contrary to,
the positions taken in this summary.

This summary does not address all aspects of U.S. federal income taxation that may be relevant to particular U.S. Holders in light of their specific circumstances (for example, U.S.
Holders subject to the alternative minimum tax or the Medicare contribution tax on net investment income under the Code) or to holders that may be subject to special rules under
U.S. federal income tax law, including:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● dealers in stocks, securities or currencies;

● securities traders that use a mark-to-market accounting method;

● banks and financial institutions;

● insurance companies;

● regulated investment companies;

● real estate investment trusts;

● tax-exempt organizations;

● retirement plans, individual plans, individual retirement accounts and tax-deferred accounts;

● partnerships or other pass-through entities for U.S. federal income tax purposes and their partners or members;

● persons holding Common Shares as part of a hedging or conversion transaction straddle or other integrated or risk reduction transaction;

● persons who or that are, or may become, subject to the expatriation provisions of the Code;

● persons whose functional currency is not the U.S. dollar; and

● direct, indirect or constructive owners of 10% or more of the total combined voting power of all classes of our voting stock or 10% or more of the total value of shares of all

classes of our stock.

112

This summary also does not address the tax consequences of holding, exercising or disposing of warrants in the Company. If the Company is a PFIC, as described below, U.S.
Holders of its warrants will be subject to adverse tax rules and will not be able to make the mark-to-market or the QEF election described below with respect to such warrants. U.S.
Holders of warrants should consult their tax advisors with regard to the U.S. federal income tax consequences of holding, exercising or disposing of warrants in the Company,
including in the situation in which the Company is classified as a PFIC.

This summary also does not discuss any aspect of state, local or foreign law, or estate or gift tax law as applicable to U.S. Holders. In addition, this discussion is limited to U.S.
Holders holding Common Shares as capital assets. For purposes of this summary, "U.S. Holder” means a beneficial holder of Common Shares who or that for U.S. federal income
tax purposes is:

● an individual citizen or resident of the U.S.;

● a corporation or other entity classified as a corporation for U.S. federal income tax purposes created or organized in or under the laws of the U.S., any state thereof or the

District of Columbia;

● an estate, the income of which is subject to U.S. federal income taxation regardless of its source; or

● a trust, if (a) a court within the U.S. is able to exercise primary supervision over the administration of such trust and one or more "U.S. persons” (within the meaning of the
Code) have the authority to control all substantial decisions of the trust, or (b) a valid election is in effect to be treated as a U.S. person for U.S. federal income tax purposes.

If a partnership or other entity or arrangement classified as a partnership for U.S. federal income tax purposes holds Common Shares, the U.S. federal income tax treatment of a
partner generally will depend on the status of the partner and the activities of the partnership. This summary does not address the tax consequences to any such partner. Such a
partner should consult its own tax advisor as to the tax consequences of the partnership purchasing, owning and disposing of Common Shares.

U.S. HOLDERS SHOULD CONSULT THEIR OWN TAX ADVISORS WITH REGARD TO THE APPLICATION OF THE TAX CONSEQUENCES DESCRIBED BELOW TO THEIR
PARTICULAR SITUATIONS AS WELL AS THE APPLICATION OF ANY STATE, LOCAL, FOREIGN OR OTHER TAX LAWS, INCLUDING GIFT AND ESTATE TAX LAWS.

Tax Consequences if we are a Passive Foreign Investment Company ("PFIC”)

A foreign corporation will be classified as a PFIC for any taxable year in which, after taking into account the income and assets of the corporation and certain subsidiaries pursuant
to applicable "look-through rules”, either (i) at least 75% of its gross income is "passive income” or (ii) at least 50% of the average quarterly value of its assets is attributable to
assets which produce passive income or are held for the production of passive income. Passive income generally includes dividends, interest, rents and royalties (other than
certain rents and royalties derived in the active conduct of a trade or business), annuities and gains from assets that produce passive income. If a non-U.S. corporation owns at
least 25% by value of the stock of another corporation, the non-U.S. corporation is treated for purposes of the PFIC tests as owning its proportionate share of the assets of the
other corporation and as receiving directly its proportionate share of the other corporation’s income.

The Company believes it was a PFIC for the 2015 taxable year, but not for the 2016, 2017, 2018, 2019 or 2020 taxable years. However, the fair market value of the Company’s assets
may be determined in large part by the market price of the Common Shares, which is likely to fluctuate, and the composition of the Company’s income and assets will be affected by
how, and how quickly, the Company spends any cash that is raised in any financing transaction. Thus, no assurance can be provided that the Company will not be classified as a
PFIC for the 2021 taxable year or any future taxable year. U.S. Holders should consult their tax advisors regarding the Company’s PFIC status.

113

If the Company is classified as a PFIC for any taxable year during which a U.S. Holder owns Common Shares, the U.S. Holder, absent certain elections (including the mark-to-market
and QEF elections described below), will generally be subject to adverse rules (regardless of whether the Company continues to be classified as a PFIC) with respect to (i) any
"excess  distributions”  (generally,  any  distributions  received  by  the  U.S.  Holder  on  the  Common  Shares  in  a  taxable  year  that  are  greater  than  125%  of  the  average  annual
distributions received by the U.S. Holder in the three preceding taxable years or, if shorter, the U.S. Holder’s holding period for the Common Shares) and (ii) any gain realized on
the sale or other disposition of the Common Shares.

Under these adverse rules (a) the excess distribution or gain will be allocated ratably over the U.S. Holder’s holding period, (b) the amount allocated to the current taxable year and
any taxable year prior to the first taxable year in which the Company is classified as a PFIC will be taxed as ordinary income and (c) the amount allocated to each of the other taxable
years during which the Company was classified as a PFIC will be subject to tax at the highest rate of tax in effect for the applicable category of taxpayer for that year and an interest

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
charge will be imposed with respect to the resulting tax attributable to each such other taxable year. A U.S. Holder that is not a corporation will be required to treat any such
interest paid as "personal interest”, which is not deductible.

U.S. Holders can avoid the adverse rules described above in part by making a mark-to-market election with respect to the Common Shares, provided that the Common Shares are
"marketable”.  The  Common  Shares will be marketable if they are "regularly traded” on a "qualified exchange” or other market within the meaning of applicable  U.S.  Treasury
regulations. For this purpose, the Common Shares generally will be considered to be regularly traded during any calendar year during which they are traded, other than in de
minimis quantities, on at least 15 days during each calendar quarter. The Common Shares are currently listed on the NASDAQ, which constitutes a qualified exchange; however,
there can be no assurance that the Common Shares will be treated as regularly traded for purposes of the mark-to-market election on a qualified exchange. If the Common Shares
were not regularly traded on the NASDAQ or were delisted from the NASDAQ and were not traded on another qualified exchange for the requisite time period described above, the
mark-to-market election would not be available.

A U.S. Holder that makes a mark-to-market election must include in gross income, as ordinary income, for each taxable year an amount equal to the excess, if any, of the fair market
value of the U.S. Holder’s Common Shares at the close of the taxable year over the U.S. Holder’s adjusted tax basis in the Common Shares. An electing U.S. Holder may also claim
an ordinary loss deduction for the excess, if any, of the U.S. Holder’s adjusted tax basis in the Common Shares over the fair market value of the Common Shares at the close of the
taxable year, but this deduction is allowable only to the extent of any net mark-to-market gains previously included in income. A U.S. Holder that makes a mark-to-market election
generally will adjust such U.S. Holder’s tax basis in the Common Shares to reflect the amount included in gross income or allowed as a deduction because of such mark-to-market
election. Gains from an actual sale or other disposition of the Common Shares will be treated as ordinary income, and any losses incurred on a sale or other disposition of the
Common Shares will be treated as ordinary losses to the extent of any net mark-to-market gains previously included in income.

If the Company is classified as a PFIC for any taxable year in which a U.S. Holder owns Common Shares but before a mark-to-market election is made, the adverse PFIC rules
described above will apply to any mark-to-market gain recognized in the year the election is made. Otherwise, a mark-to-market election will be effective for the taxable year for
which the election is made and all subsequent taxable years. The election cannot be revoked without the consent of the IRS unless the Common Shares cease to be marketable, in
which case the election is automatically terminated.

If the Company is classified as a PFIC, a U.S. Holder of Common Shares will generally be treated as owning stock owned by the Company in any direct or indirect subsidiaries that
are also PFICs and will be subject to similar adverse rules with respect to distributions to the Company by, and dispositions by the Company of, the stock of such subsidiaries. A
mark-to-market election is not permitted for the shares of any subsidiary of the Company that is also classified as a PFIC. U.S. Holders should consult their tax advisors regarding
the availability of, and procedure for making, a mark-to-market election.

In some cases, a shareholder of a PFIC can avoid the interest charge and the other adverse PFIC consequences described above by making a QEF election to be taxed currently on
its share of the PFIC’s undistributed income. We will endeavor to satisfy the record keeping requirements that apply to a QEF and to supply requesting U.S. Holders with the
information that such U.S. Holders are required to report under the QEF rules. However, there can be no assurance that the Company will satisfy the record keeping requirements or
provide the information required to be reported by U.S. Holders.

114

A U.S. Holder that makes a timely and effective QEF election for the first tax year in which its holding period of its Common Shares begins generally will not be subject to the
adverse PFIC consequences described above with respect to its Common Shares. Rather, a U.S. Holder that makes a timely and effective QEF election will be subject to U.S. federal
income tax on such U.S. Holder’s pro rata share of (a) the Company’s net capital gain, which will be taxed as long-term capital gain to such U.S. Holder, and (b) the Company’s
ordinary earnings, which will be taxed as ordinary income to such U.S. Holder, in each case regardless of which such amounts are actually distributed to the U.S. Holder by the
Company. Generally, "net capital gain” is the excess of (i) net long-term capital gain over (ii) net short-term capital loss, and "ordinary earnings” are the excess of (A) "earnings and
profits” over (B) net capital gain.

A  U.S.  Holder  that  makes  a  timely  and  effective  QEF  election  with  respect  to  the  Company  generally  (a)  may  receive  a  tax-free  distribution  from  us  to  the  extent  that  such
distribution represents "earnings and profits” that were previously included in income by the U.S. Holder because of such QEF election and (b) will adjust such U.S. Holder’s tax
basis in the Common Shares to reflect the amount included in income or allowed as a tax-free distribution because of such QEF election. In addition, a U.S. Holder that makes a QEF
election generally will recognize capital gain or loss on the sale or other taxable disposition of Common Shares.

The QEF election is made on a shareholder-by-shareholder basis. Once made, a QEF election will apply to the tax year for which the QEF election is made and to all subsequent tax
years, unless the QEF election is invalidated or terminated or the IRS consents to revocation of the QEF election. In addition, if a U.S. Holder makes a QEF election, the QEF
election will remain in effect (although it will not be applicable) during those tax years in which the Company is not a PFIC.

If the Company is classified as a PFIC and then ceases to be so classified, a U.S. Holder may make an election (a "deemed sale election”) to be treated for U.S. federal income tax
purposes as having sold such U.S. Holder’s Common Shares on the last day of the taxable year of the Company during which it was a PFIC. A U.S. Holder that made a deemed sale
election would then cease to be treated as owning stock in a PFIC by reason of ownership of Common Shares in the Company. However, gain recognized as a result of making the
deemed sale election would be subject to the adverse rules described above and loss would not be recognized.

If the Company is a PFIC in any year with respect to a U.S. Holder, the U.S. Holder will be required to file an annual information return on IRS Form 8621 regarding distributions
received on Common Shares and any gain realized on the disposition of Common Shares.

In addition, if the Company is a PFIC, U.S. Holders will generally be required to file an annual information return with the IRS (also on IRS Form 8621, which PFIC shareholders are
required to file with their U.S. federal income tax or information returns) relating to their ownership of Common Shares.

U.S. Holders should consult their tax advisors regarding the potential application of the PFIC regime and any reporting obligations to which they may be subject under that regime.

Dividends

Subject to the PFIC rules discussed above, any distributions paid by the Company out of current or accumulated earnings and profits (as determined for U.S. federal income tax
purposes), before reduction for any Canadian withholding tax paid with respect thereto, will generally be taxable to a U.S. Holder as foreign source dividend income, and generally
will not be eligible for the dividends received deduction generally allowed to corporations.

Distributions in excess of current and accumulated earnings and profits will be treated as a non-taxable return of capital to the extent of the U.S. Holder’s adjusted tax basis in the
Common Shares and thereafter as capital gain. The Company does not, however, intend to calculate its earnings and profits under U.S. federal income tax principles. Therefore, U.S.
Holders should expect that any distribution from the Company generally will be treated for U.S. federal income tax purposes as a dividend. U.S. Holders should consult their own
tax advisors with respect to the appropriate U.S. federal income tax treatment of any distribution received from the Company.

115

Dividends paid to non-corporate U.S. Holders by the Company in a taxable year in which it is treated as a PFIC, or in the immediately following taxable year, will not be eligible for
the special reduced rates normally applicable to long-term capital gains. In all other taxable years, dividends paid by the Company should be taxable to a non-corporate U.S. Holder
at the special reduced rates normally applicable to long-term capital gains, provided that certain conditions are satisfied. (including a minimum holding period requirement). The

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Company believes it was not a PFIC for the 2020 taxable year. However, no assurance can be provided that the Company will not be classified as a PFIC for 2021 and, therefore, no
assurance can be provided that a U.S. Holder will be able to claim a reduced rate for dividends paid in 2021 or 2022 (if any). Please see the subsection above entitled "Material U.S.
Federal Income Tax Considerations—’Tax Consequences if we are a Passive Foreign Investment Company’” for a more detailed discussion.

Under current law, payments of dividends by the  Company to non-Canadian investors are generally subject to a 25%  Canadian withholding tax.  The rate of withholding tax
applicable to U.S. Holders that are eligible for benefits under the Canada-United States Tax Convention (the "Convention”) is reduced to a maximum of 15%. This reduced rate of
withholding will not apply if the dividends received by a U.S. Holder are effectively connected with a permanent establishment of the U.S. Holder in Canada. For U.S. federal
income tax purposes, U.S. Holders will be treated as having received the amount of Canadian taxes withheld by the Company, and as then having paid over the withheld taxes to
the Canadian taxing authorities. As a result of this rule, the amount of dividend income included in gross income for U.S. federal income tax purposes by a U.S. Holder with respect
to a payment of dividends may be greater than the amount of cash actually received (or receivable) by the U.S. Holder from the Company with respect to the payment.

Subject to certain limitations, a U.S. Holder will generally be entitled, at the election of the U.S. Holder, to a credit against its U.S. federal income tax liability, or a deduction in
computing its U.S. federal taxable income, for Canadian income taxes withheld by the Company. This election is made on a year-by-year basis and applies to all foreign taxes paid
(whether directly or through withholding) by a U.S. Holder during a year. For purposes of the foreign tax credit limitation, dividends paid by the Company generally will constitute
foreign  source  income  in  the  "passive  category  income”  basket.  The  foreign  tax  credit  rules  are  complex  and  U.S.  Holders  should  consult  their  tax  advisors  concerning  the
availability of the foreign tax credit in their particular circumstances.

Dividends paid in Canadian dollars will be included in the gross income of a U.S. Holder in a U.S. dollar amount calculated by reference to the exchange rate in effect on the date
the U.S. Holder (actually or constructively) receives the dividend, regardless of whether such Canadian dollars are actually converted into U.S. dollars at that time. If the Canadian
dollars received are not converted into U.S. dollars on the date of receipt, a U.S. Holder will have a tax basis in the Canadian dollars equal to their U.S. dollar value on the date of
receipt. Gain or loss, if any, realized on a sale or other disposition of the Canadian dollars will generally be U.S. source ordinary income or loss to a U.S. Holder.

The Company generally does not pay any dividends and does not anticipate paying any dividends in the foreseeable future.

Sale, Exchange or Other Taxable Disposition of Common Shares

Subject to the PFIC rules discussed above, upon a sale, exchange or other taxable disposition of Common Shares, a U.S. Holder generally will recognize capital gain or loss for U.S.
federal income tax purposes equal to the difference, if any, between the amount realized on the sale, exchange or other taxable disposition and the U.S. Holder’s adjusted tax basis
in the Common Shares.

This capital gain or loss will be long-term capital gain or loss if the U.S. Holder’s holding period in the Common Shares exceeds one year. The deductibility of capital losses is
subject to limitations. Any gain or loss will generally be U.S. source for U.S. foreign tax credit purposes.

116

Information Reporting and Backup Withholding

Payments made within the U.S., or by a U.S. payor or U.S. middleman, of dividends on, and proceeds arising from sales or other dispositions of Common Shares, generally will be
reported to the IRS and to the U.S. Holder as required under applicable regulations. Backup withholding tax may apply to these payments if the U.S. Holder fails to timely provide in
the appropriate manner an accurate taxpayer identification number or otherwise fails to comply with, or establish an exemption from, such backup withholding tax requirements.
Certain U.S. Holders are not subject to the information reporting or backup withholding tax requirements described herein. U.S. Holders should consult their tax advisors as to their
qualification for exemption from backup withholding tax and the procedure for establishing an exemption.

Backup withholding tax is not an additional tax. U.S. Holders generally will be allowed a refund or credit against their U.S. federal income tax liability for amounts withheld, provided
the required information is timely furnished to the IRS.

Subject to certain exceptions and future guidance, a U.S. Holder that is a "specified individual” or a "specified domestic entity” (as defined in the instructions to IRS Form 8938)
must report annually to the IRS on IRS Form 8938 such U.S. Holder’s interests in stock or securities issued by a non-U.S. person (such as the Company). U.S. Holders should
consult their tax advisors regarding the information reporting obligations that may arise from their acquisition, ownership or disposition of Common Shares.

F.

Dividends and paying agents

Not required.

G.

Statement by experts

Not required.

H.

Documents on display

In addition to placing our audited consolidated annual financial statements before every annual meeting of shareholders as described above, we are subject to the information
requirements of the Securities Exchange Act of 1934, as amended. In accordance with these requirements, we file and furnish reports and other information with the SEC. These
materials, including this Annual Report on Form 20-F and the exhibits hereto, may be inspected and copied at the SEC’s Public Reference Room at 100 F Street, N.E., Room 1580,
Washington, D.C. 20549. The public may obtain information on the operation of the SEC’s Public Reference Room by calling the SEC in the U.S. at 1-800-SEC-0330. The SEC also
maintains a website at www.sec.gov that contains reports, proxy statements and other information regarding registrants that file electronically with the SEC. Our annual reports and
some  of  the  other  information  we  submitted  to  the  SEC  may  be  accessed  through  this  website.  In  addition,  material  we  filed  can  be  inspected  on  the  Canadian  Securities
Administrators’ electronic filing system, SEDAR, accessible at the website www.sedar.com. This material includes our Management Information Circular for our annual meeting of
shareholders to be held in 2022 to be furnished to the SEC on Form 6-K, which provides information including directors’ and officers’ remuneration and indebtedness and principal
holders of securities. Additional financial information is provided in our audited annual financial statements for the year ended December 31, 2021 and our MD&A relating to these
statements included elsewhere in this Annual Report on Form 20-F. These documents are also accessible on SEDAR (www.sedar.com) and on EDGAR (www.sec.gov).

I.

Subsidiary information

Not required.

117

Item 11.

Quantitative and Qualitative Disclosures About Market Risk

Fair value

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Company classifies its financial instruments in the following categories: "Financial assets at amortized cost”; and "Financial liabilities at amortized cost”.

● The Company’s financial assets at amortized cost are comprised of cash and cash equivalents, trade and other receivables and restricted cash equivalents.

● Financial liabilities at amortized cost include payables and accrued liabilities, and lease liability.

The carrying values of all of the aforementioned financial instruments approximate their fair values due to their short-term maturity or to the prevailing interest rates of these
instruments which are comparable to those of the market.

The Black-Scholes valuation methodology uses inputs in calculating fair value, as defined in IFRS 13, which establishes a hierarchy that prioritizes the inputs used to measure fair
value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurement) and the lowest priority to
unobservable inputs (Level 3 measurement).

Financial risk factors

The following provides disclosures relating to the nature and extent of the Company’s exposure to risks arising from financial instruments, including credit risk, liquidity risk and
foreign exchange risk and how the Company manages those risks.

(a)

Credit risk

Credit risk is the risk of an unexpected loss if a customer or counterparty to a financial instrument fails to meet its contractual obligations. The Company regularly monitors credit
risk exposure and takes steps to mitigate the likelihood of this exposure resulting in losses. The Company’s exposure to credit risk currently relates to the financial assets at
amortized cost in the table above. The Company holds its available cash in amounts that are readily convertible to known amounts of cash and deposits its cash balances with
financial institutions that have an investment grade rating of at least "P-2” or the equivalent. This information is supplied by independent rating agencies where available and, if
not available, the  Company uses publicly available financial information to ensure that it invests its cash in creditworthy and reputable financial institutions.  Once there are
indicators that there is no reasonable expectation of recovery, such financial assets are written off but are still subject to enforcement activity.

As at December 31, 2021, trade accounts receivable for an amount of approximately $0.9 million were with three counterparties of which $0.1 million was past due and impaired and
fully provided for (2020 - $1.2 million with three counterparties and $0.1 million past due and impaired and fully provided for).

Generally,  the  Company  does  not  require  collateral  or  other  security  from  customers  for  trade  accounts  receivable;  however,  credit  is  extended  following  an  evaluation  of
creditworthiness. In addition, the Company performs ongoing credit reviews of all of its customers and determines expected credit losses. On this basis, as at December 31, 2021,
the Company has provided for all outstanding and unpaid amounts relating to its operations before its licensing of MacrilenTM.

The maximum exposure to credit risk approximates the amount recognized in the Company’s consolidated statement of financial position.

(b)

Liquidity risk

Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they become due. The Company manages this risk through the management of its
capital structure. It also manages liquidity risk by continuously monitoring actual and projected cash flows.

A portion of the Company’s cash is held in AEZS Germany, which is the counter-party to various license and distribution agreements for the Company’s only approved product.
In September 2019 and February, July and August of 2020 and February of 2021 the Company completed financings resulting in total funding (net of transaction costs) of $55,905.
Net cash proceeds were deposited in AEZS Canada accounts and such funds can be provided to its German subsidiary, if and when needed. During 2020, AEZS Germany signed
agreements  with  Novo  and  CH  whereby AEZS  Germany  received  cash  payments  of  $6.1  million  (€5.0  million)  in  fiscal  2020  and  $1.2  million  (€1.0  million)  in  January  2021,
respectively, and expects to use this cash to fund its operations directly.

118

The Board of Directors reviews and approves the Company’s operating and capital budgets, as well as any material transactions occurring outside of the ordinary course of
business. The Company has adopted an investment policy in respect of the safety and preservation of its capital to ensure the Company’s liquidity needs are met. The instruments
are selected with regard to the expected timing of expenditures and prevailing interest rates.

(c)

Foreign exchange risk

Entities using the Euro as their functional currency

The Company is exposed to foreign exchange risk due to its investments in foreign operations whose functional currency is the Euro. As at December 31, 2021, if the US dollar had
increased or decreased by 10% against the  Euro, with all other variables held constant, net loss for the year ended  December 31, 2021 would have been lower or higher by
approximately $0.3 million (2020 - $0.1 million and 2019 - $0.8 million).

Item 12.

Description of Securities Other than Equity Securities

A.

Debt securities

Not required.

B.

Warrants and rights

Not required.

C.

Other securities

Not required.

D.

American depositary shares

Not applicable.

PART II

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 13.

Defaults, Dividend Arrearages and Delinquencies

None.

Item 14.

Material Modifications to the Rights of Security Holders and Use of Proceeds

None.

Item 15.

Controls and Procedures

Under the supervision and with the participation of our management, including the Chief Executive Officer and the Chief Financial Officer, we have evaluated the effectiveness of
our disclosure controls and procedures as at December 31, 2021. Based on that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that these
disclosure controls and procedures were not effective as of December 31, 2021 due to a material weakness in internal control over financial reporting, as described below.

119

Management’s Annual Report on Internal Control over Financial Reporting

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  financial  reporting.  Our  internal  control  over  financial  reporting  is  a  process
designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with IFRS
as issued by the IASB.

Our internal control over financial reporting includes those policies and procedures that: (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly
reflect the transactions and dispositions of the assets of Aeterna Zentaris; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of
financial statements in accordance with IFRS, and that receipts and expenditures of the Company are being made only in accordance with authorizations of Company management;
and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of Company assets that could have a material effect
on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect 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 conditions, or that the degree of compliance with the policies or procedures may
deteriorate.

Management  conducted  an  evaluation  of  the  effectiveness  of  our  internal  control  over  financial  reporting  based  on  the  criteria  established  in Internal  Control  –  Integrated
Framework:  2013 issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on this evaluation, management has concluded that our internal
control over financial reporting was not effective as of  December 31, 2021 because a material weakness in internal control over financial reporting existed as of that date, as
described below.

Management identified a control deficiency that constitutes a material weakness. A material weakness is a control deficiency, or a combination of control deficiencies in internal
control  over  financial  reporting,  such  that  there  is  a  reasonable  possibility  that  a  material  misstatement  of  our  interim  or  annual  consolidated  financial  statements  or  related
disclosures will not be prevented or detected on a timely basis.

The material weakness resulted from a failure in the design and implementation of review controls over the accounting for license and collaboration agreements under IFRS and the
related revenue recognition. Specifically, our review control was not sufficiently designed to adequately review and assess an accounting analysis for revenue recognition for
complex revenue arrangements. This resulted in a restatement of our previously issued condensed interim consolidated financial statements as at and for the quarters and year-to-
date periods ended March 31, 2021, June 30, 2021 and September 30, 2021, with respect to revenue recognition on one agreement. As a result, Management determined that a
material weakness existed as described above.

We have developed and commenced implementation of a remediation plan to address the material weakness discussed above and to improve our internal control over financial
reporting. The remediation plan includes:

● strengthening our revenue recognition and financial reporting controls by adding new or additional resources with adequate technical knowledge and training, including the
hiring of a new Chief Financial Officer in January 2022, and utilizing the services of an external professional with requisite knowledge and experience in the area of revenue
recognition and of IFRS more broadly.

● designing and  implementing  effective  internal  controls  related  to  the  involvement  of  appropriate  finance and  accounting  staff  in  the  review  of  strategic  and  complex
transactions,  such  as  license and  collaboration  agreements,  including  as  those  transactions  are  negotiated  and  executed, to  ensure  that  any  matters  with  accounting
ramifications are addressed on a timely basis; and

● ensuring that all non-routine transactions, including those requiring the application of significant judgment or analysis, are thoroughly researched at the appropriate level and
are  sufficiently documented  by  qualified  accounting  and  finance  personnel  (including  third-party  subject  matter experts  as  necessary),  with  such  documentation  to  be
approved in a timely manner by the Company’s Chief Financial Officer.

There can be no assurance that the measures we take in response to the material weakness will be sufficient to remediate such material weakness or to avoid potential future
material weakness or significant deficiencies.

Changes in Internal Controls over Financial Reporting

There were no changes in our internal control over financial reporting during the year ended December 31, 2021 that materially affected, or are reasonably likely to materially affect,
our internal control over financial reporting, except as described above.

Item 16A. Audit Committee Financial Expert

Our Board has determined that we have at least one audit committee financial expert (as defined in paragraph (b) of Item 16A to Form 20-F). The name of the audit committee
financial expert is Mr. Dennis Turpin, the Audit Committee’s Chairman. In accordance with Item 16A, paragraph (d) of Form 20-F, the designation of Mr. Turpin as our audit
committee financial expert does not: (i) make Mr. Turpin an "expert” for any purpose, including without limitation for purposes of Section 11 of the Securities Act of 1933, as
amended, as a result of this designation; (ii) impose any duties, obligations or liability on  Mr.  Turpin that are greater than those imposed on him as a member of the Audit
Committee and the Board in the absence of such designation; or (iii) affect the duties, obligations or liability of any other member of the Audit Committee or the Board. The other
current members of the Audit Committee are Peter G. Edwards and Gilles Gagnon each of whom, along with Dennis Turpin (Chair), is independent, as that term is defined in the
NASDAQ listing standards. For a description of their respective education and experience, please refer to "Item 6. – Directors, Senior Management and Employees”.

120

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 16B. Code of Ethics

On December 16, 2017, the Board adopted a "Code of Conduct and Business Ethics”, which replaced the then existing Code of Ethical Conduct as of January 1, 2018. The Code of
Conduct  and  Business  Ethics  was  amended  on  January  24,  2018.  The  Code  of  Conduct  and  Business  Ethics  expanded  on  the  previous  Code  of  Ethical  Conduct  to  provide
additional details of expected conduct of all employees and directors of the Company, including specific obligations the Company and its employees has as a member of the
healthcare industry. We selected an independent third party supplier to provide a confidential and anonymous communication channel for reporting concerns about possible
violations to our Code of Ethical Conduct as well as financial and/or accounting irregularities or fraud. A copy of the Code of Ethical Conduct, as amended, is incorporated by
reference as Exhibit 11.1 to this Annual Report on Form 20-F and is also available on our Web site at www.zentaris.com under the Investors - Corporate Governance tab. The Code
of Ethical Conduct is a "code of ethics” as defined in paragraph (b) of Item 16B to Form 20- F. The Code of Ethical Conduct applies to all of our employees, directors and officers,
including our principal executive officer, principal financial officer, and principal accounting officer or controller, or persons performing similar functions, and includes specific
provisions dealing with integrity in accounting matters, conflicts of interest and compliance with applicable laws and regulations. On December 4, 2014, our Board adopted a "Code
of Business Conduct and Ethics for Members of the Board of Directors”, which is incorporated by reference as Exhibit 11.2 to this Annual Report on Form 20-F. We will provide
these documents without charge to any person or company upon request to our Corporate Secretary, at our head office at 315 Sigma Drive, Summerville, South Carolina 29486.

Item 16C.

Principal Accountant Fees and Services

(All amounts are in U.S. dollars)

The current auditors of the Company are Ernst & Young LLP. Following a comprehensive review of the Company’s external audit services, the Audit Committee sought proposals
to provide audit services for the financial year ending on December 31, 2021. After careful review of the proposals received and due consideration of all relevant factors, the Audit
Committee recommended to the Board that Ernst & Young LLP, and not PricewaterhouseCoopers LLP, be proposed for appointment as auditors of the Company for the financial
year ending on December 31, 2021. Ernst & Young LLP was appointed as the Company’s auditor and PricewaterhouseCoopers LLP resigned as the Company’s auditor effective
March 25, 2021.

(a)

Audit Fees

During the financial year ended December 31, 2021, the Company’s principal accountant, Ernst & Young LLP, billed $242,986 for the audit of the Company’s annual consolidated
financial statements and for services rendered in connection with statutory and regulatory filings. During the financial year ended December 31, 2020, the Company’s principal
accountant, PricewaterhouseCoopers LLP, billed $578,288, for the audit of the Company’s annual consolidated financial statements and for services rendered in connection with
statutory and regulatory filings.

(b)

Audit-related Fees

During the financial year ended December 31, 2021, the Company’s principal accountant, Ernst & Young LLP, billed $nil, for audit or attest services not required by statute or
regulation, for accounting consultations on proposed transactions, for the review of prospectuses and prospectus supplements, including the delivery of customary consent and
comfort letters in connection therewith. During the financial year ended December 31, 2020, the Company’s principal accountant, PricewaterhouseCoopers LLP, billed $70,535, for
audit or attest services not required by statute or regulation, for accounting consultations on proposed transactions, for the review of prospectuses and prospectus supplements,
including the delivery of customary consent and comfort letters in connection therewith.

(c)

Tax Fees

During the financial year ended December 31, 2021, the Company’s principal accountants, Ernst & Young LLP, billed $45,054, for services related to tax compliance, tax planning
and tax advice. During the financial years ended December 31, 2020, the Company’s principal accountants, PricewaterhouseCoopers LLP, billed $47,514, for services related to tax
compliance, tax planning and tax advice.

(d)

All Other Fees

During the financial years ended December 31, 2021, the Company’s principal accountant, Ernst & Young LLP, billed us $3,987 for services not included in audit fees, audit-related
fees and tax fees. During the financial years ended December 31, 2020, the Company’s principal accountant, PricewaterhouseCoopers LLP, did not bill us for services not included
in audit fees, audit-related fees and tax fees.

121

(e)

Audit Committee Pre-Approval Policies and Procedures

Under applicable Canadian securities regulations, we are required to disclose whether our Audit Committee has adopted specific policies and procedures for the engagement of
non-audit services and to prepare a summary of these policies and procedures. The Audit Committee Charter (incorporated by reference as Exhibit 11.3 to this Annual Report on
Form 20-F) provides that it is such committee’s responsibility to approve all audit engagement fees and terms as well as reviewing policies for the provision of non-audit services
by the external auditors and, when required, the framework for pre-approval of such services. The Audit Committee delegates to its Chairman the pre-approval of such non-audit
fees. The pre-approval by the Chairman is then presented to the Audit Committee at its first scheduled meeting following such pre-approval.

For each of the years ended December 31, 2021 and 2020, there were no non-audit services provided by our external auditor that required the approval from the Audit Committee.

Item 16D.

Exemptions from the Listing Standards for Audit Committees

None.

Item 16E.

Purchases of Equity Securities by the Issuer and Affiliated Purchasers

None.

Item 16F.

Change in Registrant’s Certifying Accountant

Following a comprehensive review of the Company’s external audit services, the Audit Committee sought proposals to provide audit services for the financial year ending on
December 31, 2021. After careful review of the proposals received and due consideration of all relevant factors, the Audit Committee recommended to the Board that Ernst & Young
LLP, and not PricewaterhouseCoopers LLP, be proposed for appointment as auditors of the Company for the financial year ending on December 31, 2021. Ernst & Young LLP was
appointed as the Company’s auditor and PricewaterhouseCoopers LLP resigned as the Company’s auditor effective March 25, 2021.

Item 16G. Corporate Governance

We are generally in compliance with the corporate governance requirements of the NASDAQ except as described below and in the risk factor entitled "Our Common Shares may be
delisted from the NASDAQ or the TSX, which could affect their market price and liquidity. If our Common Shares were to be delisted, investors may have difficulty in disposing

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
their Common Shares” in Item 3.D above. We are not in compliance with the NASDAQ requirement that a quorum for a meeting of the holders of our Common Shares be no less
than 33 1/3% of such outstanding shares. Our bylaws provide that a quorum for purposes of any meeting of our shareholders consists of at least 10% of the outstanding voting
shares. We benefit from an exemption from the NASDAQ from this quorum requirement because the quorum provided for in our bylaws complies with the requirements of the
CBCA, our governing corporate statute, and with the rules of the TSX, the home country exchange on which our voting shares are traded. In accordance with applicable current
NASDAQ requirements, we have in the past, and upon request, provided to the NASDAQ letters from outside counsel certifying that these practices are not prohibited by our
home country law.

Item 16H. Mine Safety Disclosure

None.

Item 16I.

Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

Not applicable.

Item 17

Financial Statements

The financial statements appear on pages [123] to [178].

Item 18.

Financial Statements

Not applicable.

Aeterna Zentaris Inc.

Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019

PART III

122

123

Report of Independent Registered Public Accounting Firm (PCAOB ID:1263)
Report of Predecessor Independent Registered Public Accounting Firm (PCAOB ID:271)
Consolidated Statements of Financial Position
Consolidated Statements of Changes in Shareholders’ Equity (Deficiency)
Consolidated Statements of Comprehensive Loss
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements

124

125
127
128
129
130
131
132

Report of independent registered public accounting firm

To the shareholders and the board of directors of
Aeterna Zentaris Inc.

Opinion on the financial statements

We  have  audited  the  accompanying  consolidated  statement  of  financial  position  of Aeterna  Zentaris  Inc.  (the  Company)  as  of  December  31,  2021,  the  related  consolidated
statement of changes in shareholders’ equity (deficiency), comprehensive loss, and cash flows, for the year ended December 31, 2021, and the related notes (collectively referred to
as the "consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of
December 31, 2021, and its financial performance and its cash flows for the year ended December 31, 2021, in conformity with International Financial Reporting Standards ("IFRSs”)
as issued by the International Accounting Standards Board.

Basis for opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our
audit. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect
to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about
whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of
its internal control over financial reporting. As part of our audit, we are required to obtain an understanding of internal control over financial reporting but not for the purpose of
expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audit included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that
respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included
evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements.
We believe that our audit provides a reasonable basis for our opinion.

Critical audit matter

The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be communicated to
the audit committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective or complex
judgments.  The communication of critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
communicating the critical audit matters below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which they relate.

125

Revenue from License and Collaboration Arrangements

Description of the matter

How we addressed the matter in
our audit

As described in Note 2, Note 3 and Note 5, the Company enters into license and collaboration arrangements that may include non-refundable
upfront license fees, the provision of development services, milestone payments, royalties on future product sales and supply arrangements.
The Company has recorded $5.3 million of total revenues during the year ended December 31, 2021 and $6.3 million as deferred revenues as of
December 31, 2021.  Management analyzes each agreement and applies significant judgment to determine whether contracts entered into at or
near the same time should be accounted for as a single arrangement and whether all parts of the contract fall within the scope of IFRS 15. In
addition, each agreement is analyzed to identify all performance obligations and to determine whether a performance obligation is distinct or
should be combined with other promised goods and services,  determine and allocate the transaction price on a relative stand-alone selling
price basis, determine whether a performance  obligation is satisfied at a point in time or over time, and, for performance obligations satisfied
over time, in concluding upon the appropriate method of measuring progress to be applied for purposes of recognizing revenue.

Auditing the Company’s accounting for revenues from the license and collaboration arrangements was complex given the significant judgment
required in evaluating the terms and multiple elements of the related agreements. A high degree of auditor judgment and effort was required in
performing procedures to evaluate the reasonableness of management’s assessment to identify all performance obligations and to determine
whether a performance obligation is distinct or should be combined with other promised goods and services.

To test the  Company’s accounting for revenue from license and collaboration arrangements, our audit procedures included, among others,
obtaining and evaluating management’s accounting analyses for all significant arrangements. We inspected the Company’s agreements and we
evaluated  whether  management’s  assessments  considered  all  relevant  terms  included  in  the  agreements.  We  assessed  management’s
consideration of whether contracts should be accounted for as a single arrangement and whether all elements fall within the scope of IFRS 15.
We assessed management’s identification of performance obligations and whether they are distinct  or combined with other promised goods
and services. We evaluated the reasonableness of management’s recognition of revenue  based on when each performance obligation will be
satisfied in conformity with the Company’s accounting policies.

/s/ Ernst & Young LLP

We have served as the Company’s auditor since 2021.

Montreal, Canada
March 28, 2022

126

Report of Independent Registered Public Accounting Firm

To the Board of Directors and Shareholders of Aeterna Zentaris Inc.

Opinion on the Financial Statements

We have audited the accompanying consolidated statement of financial position of Aeterna Zentaris Inc. and its subsidiaries (together, the Company) as of December 31, 2020,
and the related consolidated statements of changes in shareholders’ equity (deficiency), comprehensive loss and cash flows for each of the two years in the period ended
December 31, 2020, including the related notes (collectively referred to as the consolidated financial statements). In our opinion, the consolidated financial statements present
fairly, in all material respects, the financial position of the Company as of December 31, 2020, and its financial performance and its cash flows for each of the two years in the
period ended December 31, 2020 in conformity with International Financial Reporting Standards as issued by the International Accounting Standards Board.

Basis for Opinion

These  consolidated  financial  statements  are  the  responsibility  of  the  Company’s  management.  Our  responsibility  is  to  express  an  opinion  on  the  Company’s  consolidated
financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are
required  to  be  independent  with  respect  to  the  Company  in  accordance  with  the  U.S.  federal  securities  laws  and  the  applicable  rules  and  regulations  of  the  Securities  and
Exchange Commission and the PCAOB.

We conducted our audits of these consolidated financial statements in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit
to  obtain  reasonable  assurance  about  whether  the  consolidated  financial  statements  are  free  of  material  misstatement,  whether  due  to  error  or  fraud.  Our  audits  included
performing  procedures  to  assess  the  risks  of  material  misstatement  of  the  consolidated  financial  statements,  whether  due  to  error  or  fraud,  and  performing  procedures  that
respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits
also  included  evaluating  the  accounting  principles  used  and  significant  estimates  made  by  management,  as  well  as  evaluating  the  overall  presentation  of  the  consolidated
financial statements. We believe that our audits provide a reasonable basis for our opinion.

/s/PricewaterhouseCoopers LLP

Chartered Professional Accountants, Licensed Public Accountants

Toronto, Canada
March 24, 2021

We served as the Company’s auditor from 1993 to 2021.

PricewaterhouseCoopers LLP
PwC Tower, 18 York Street, Suite 2600, Toronto, Ontario, Canada M5J
0B2 T: +1 416 863 1133, F: +1 416 365 8215

"PwC” refers to PricewaterhouseCoopers LLP, an Ontario limited liability partnership.

127

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Aeterna Zentaris Inc.
Consolidated Statements of Financial Position
(in thousands of US dollars)

ASSETS
Current assets
Cash and cash equivalents (note 6)
Trade and other receivables (note 7)
Inventory (note 8)
Income taxes receivable (note 22)
Prepaid expenses and other current assets (note 9)
Total current assets
Restricted cash equivalents (note 10)
Property, plant and equipment (note 11)
Right of use assets (note 12)
Identifiable intangible assets (note 13)
Goodwill (note 14)
Total assets
LIABILITIES
Current liabilities
Payables and accrued liabilities (note 15)
Current portion of provisions (note 16)
Income taxes payable (note 22)
Current portion of deferred revenues (note 5)
Current portion of lease liabilities (note 17)
Total current liabilities
Deferred revenues (note 5)
Deferred gain (note 13)
Lease liabilities (note 17)
Employee future benefits (note 18)
Provisions (note 16)
Total liabilities
SHAREHOLDERS’ EQUITY
Share capital (note 19)
Warrants (note 19)
Other capital (note 19)
Deficit
Accumulated other comprehensive loss
Total shareholders’ equity
Total liabilities and shareholders’ equity

Commitments and contingencies (note 27)

  December 31, 2021

    December 31, 2020

$

$

65,300   
1,314   
73   
2,361   
1,772   
70,820   
335   
42   
150   
625   
8,130   
80,102   

2,672   
34   
115   
4,815   
130   
7,766   
1,493   
98   
31   
17,485   
243   
27,116   

293,410   
5,085   
89,788   
(334,619)  
(678)  
52,986   
80,102   

24,271 
1,681 
21 
601 
1,040 
27,614 
338 
22 
157 
59 
8,815 
37,005 

2,199 
92 
123 
2,193 
135 
4,742 
3,289 
— 
49 
15,435 
279 
23,794 

235,008 
12,402 
89,505 
(322,659)
(1,045)
13,211 
37,005 

The accompanying notes are an integral part of these consolidated financial statements.

Approved by the Board of Directors

/s/ Carolyn Egbert
Carolyn Egbert
Chair of the Board

/s/ Dennis Turpin
Dennis Turpin
Director

128

Aeterna Zentaris Inc.
Consolidated Statements of Changes in Shareholders’ Equity (Deficiency)
(in thousands of US dollars, except share data)

Balance - January 1, 2019
Net loss
Other comprehensive loss:
Foreign currency translation adjustments
Actuarial loss on defined benefit plans (note 18)
Comprehensive loss
Share issuance from the exercise of warrants, stock options and deferred
share units
Issuance of common shares and warrants, net (note 19)
Share-based compensation costs
Balance - December 31, 2019
Net loss
Other comprehensive loss:

Common
shares
  (number of)1    

Share
capital
$

    Warrants    
$

16,440,760      222,335     
—     

—     

—     
—     
—     

—     
—     
—     

228,750     
3,325,000     
—     

906     
1,287     
—     
19,994,510      224,528     
—     

—     

Other
capital     Deficit

Accumulated
other
comprehensive
income (loss)     Total

$
—      89,342     
—     
—     
—     
—     
—     
—     

—     
—     
—     

$

$

(309,781)    
(6,042)    

—     
(1,068)    
(7,110)    

—     
(329)    
—     
—     
793     
—     
—      89,806     
—     
—     

—     
—     
—     
(316,891)    
(5,118)    

$
1,907 
(6,042)

83 
(1,068)
(7,027)

577 
1,287 
793 
(2,463)
(5,118)

11     
—     

83     
—     
83     

—     
—     
—     
94     
—     

 
 
 
 
 
 
 
   
 
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
   
   
   
   
 
   
   
   
      
      
      
      
      
  
   
   
   
   
   
   
   
   
   
      
      
      
      
      
      
  
Foreign currency translation adjustments
Actuarial loss on defined benefit plan (note 18)
Comprehensive loss
Reclassification of warrants to equity (note 19)
Issuance of common shares and warrants, net of transaction costs (note 19)    
Share-based compensation costs (note 19)
Balance - December 31, 2020
Net loss
Other comprehensive loss:

—     
—     
—     
—     
—     
—     
—     
—     
10,480     
42,684,103     
—     
—     
    62,678,613      235,008     
—     
—     

Foreign currency translation adjustments
Actuarial loss on defined benefit plan (note 18)

—     
—     
—     
Comprehensive loss
Issuance of common shares and warrants, net of transaction costs (note 19)     23,586,207      29,082     
    35,111,187      29,833     
Exercise of warrants (note 19)
(532)    
Transfer of warrant issuance costs upon exercise of warrants (note 19)
—     
19     
21,000     
Exercise of deferred share units (note 19)
—     
—     
Share-based compensation costs (note 19)
    121,397,007      293,410     
Balance - December 31, 2021

—     
—     
—     

—     
—     
—     
7,377     
5,025     
—     

—     
—     
(650)    
—     
(5,768)    
—     
—     
—     
—     
(362)    
—     
61     
12,402      89,505      (322,659)    
(8,368)    
—     

—     

(1,139)    
—     
(1,139)    
—     
—     
—     

(1,139)
(650)
(6,907)
7,377 
15,143 
61 
(1,045)     13,211 
(8,368)

—     

—     
—     
—     
1,897     
(9,746)    
532     
—     
—     

—     
—     
(3,592)    
—     
(11,960)    
—     
—     
—     
—     
—     
—     
—     
—     
(28)    
—     
311     
5,085      89,788      (334,619)    

367     
—     

367 
(3,592)
367      (11,593)
—      30,979 
—      20,087 
— 
—     
(9)
—     
311 
—     
(678)     52,986 

1 Issued and paid in full.

The accompanying notes are an integral part of these consolidated financial statements.

129

Aeterna Zentaris Inc.
Consolidated Statements of Comprehensive Loss
(in thousands of US dollars, except share and per share data)

Revenues (notes 5 and 25)
License fees
Development services
Product sales
Royalties
Supply chain revenue
Total revenues
Operating expenses (note 20)
Cost of sales
Research and development expenses
General and administrative expenses
Selling expenses
Restructuring costs
Impairment of right of use asset
Gain on modification of building lease (notes 12 and 17)
(Reversal) impairment of other asset
Total operating expenses
Loss from operations
Gains due to changes in foreign currency exchange rates
Change in fair value of warrant liability
Other finance costs
Net finance income
Loss before income taxes
Income tax recovery (expense) (note 22)
Net loss
Other comprehensive loss:
Items that may be reclassified subsequently to profit or loss:
Foreign currency translation adjustments
Items that will not be reclassified to profit or loss:
Actuarial loss on defined benefit plans
Comprehensive loss
Net loss per share (basic) (note 26)
Net loss per share (diluted) (note 26)
Weighted average number of shares outstanding (note 26)
Basic
Diluted

2021
$

Years ended December 31,
2020
$

2019
$

1,670   
3,337   
—   
68   
185   
5,260   

90   
6,574   
5,916   
1,351   
—   
—   
—   
—   
13,931   
(8,671)  
215   
—   
(21)  
194   
(8,477)  
109   
(8,368)  

367   

(3,592)  
(11,593)  
(0.07)  
(0.07)  

911   
—   
2,370   
67   
304   
3,652   

2,317   
1,506   
4,759   
1,134   
—   
—   
(219)  
(139)  
9,358   
(5,706)  
572   
1,147   
(736)  
983   
(4,723)  
(395)  
(5,118)  

(1,139)  

(650)  
(6,907)  
(0.12)  
(0.12)  

74 
— 
129 
45 
284 
532 

410 
1,837 
6,615 
1,214 
507 
22 
— 
169 
10,774 
(10,242)
87 
4,518 
(593)
4,012 
(6,230)
188 
(6,042)

83 

(1,068)
(7,027)
(0.35)
(0.35)

114,924,497   
114,924,497   

41,083,163   
41,083,163   

17,494,472 
17,494,472 

The accompanying notes are an integral part of these consolidated financial statements.

130

Aeterna Zentaris Inc.
Consolidated Statements of Cash Flows
(in thousands of US dollars, except share data)

   
   
   
   
   
   
   
      
      
      
      
      
      
  
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
Cash flows from operating activities
Net loss
Items not affecting cash and cash equivalents:
Change in fair value of warrant liability
Transaction costs of warrants issued, expensed as finance cost
Provision for restructuring and other costs (note 16)
Impairment of right of use asset
(Reversal) impairment of other asset
Gain on modification of building lease (notes 12 and 17)
Depreciation and amortization (notes 11, 12 and 13)
Share-based compensation costs (note 19)
Employee future benefits (note 18)
Amortization of deferred revenues
Foreign exchange gain on items denominated in foreign currencies
(Gain) loss on disposal of property, plant and equipment (note 12)
Other non-cash items
Interest accretion on lease liabilities (note 17)
Payment of income taxes (note 22)
Changes in operating assets and liabilities (note 21)
Net cash used in operating activities
Cash flows from financing activities
Proceeds from issuance of common shares (note 19)
Proceeds from issuances of common shares and warrants (note 19)
Transaction costs
Proceeds from exercise of warrants, stock options and deferred share units
Proceeds on deferred gain (note 13)
Payments on lease liabilities (note 17)
Net cash provided by financing activities
Cash flows from investing activities
Proceeds for disposals of property, plant and equipment (note 11)
Purchase of intangible assets (note 13)
Purchase of property, plant and equipment (note 11)
(Decrease) increase in restricted cash equivalents
Net cash (used in) provided by investing activities
Effect of exchange rate changes on cash and cash equivalents
Net change in cash and cash equivalents
Cash and cash equivalents – beginning of year
Cash and cash equivalents – end of year (note 6)

2021
$

Years ended December 31,
2020
$

2019
$

(8,368)  

—   
—   
23   
—   
—   
—   
145   
311   
161   
(1,670)  
(179)  
(1)  
95   
7   
(1,605)  
2,500   
(8,581)  

34,200   
—   
(3,221)  
20,087   
98   
(127)  
51,037   

1   
(609)  
(30)  
(20)  
(658)  
(769)  
41,029   
24,271   
65,300   

(5,118)  

(1,147)  
732   
(383)  
—   
(139)  
(219)  
232   
61   
217   
1,257   
(688)  
(2)  
133   
(19)  
(1,448)  
2,402   
(4,129)  

—   
23,500   
(2,767)  
—   
—   
(265)  
20,468   

6   
—   
—   
50   
56   
38   
16,433   
7,838   
24,271   

(6,042)

(4,518)
550 
511 
22 
169 
— 
315 
793 
262 
(74)
(87)
10 
(126)
(66)
— 
(2,444)
(10,725)

— 
4,988 
(795)
314 
— 
(614)
3,893 

— 
— 
— 
50 
50 
108 
(6,674)
14,512 
7,838 

The accompanying notes are an integral part of these consolidated financial statements.

131

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

1.

Business overview

Summary of business

Aeterna  Zentaris  (the  "Company”  or  "Aeterna”)  is  a  specialty  biopharmaceutical  company  commercializing  and  developing  therapeutics  and  diagnostic  tests.  The
Company’s lead product, Macrilen™ (macimorelin), is the first and only United States ("US”) Food and Drug Administration ("FDA”) and European Medicines Agency-
approved oral test indicated for the diagnosis of patients with adult growth hormone deficiency ("AGHD”). Macrilen™ is currently marketed in the US through a license
agreement, as amended, between the Company and Novo Nordisk Health Care AG ("Novo”). The Company is also dedicated to the development of therapeutic assets and
has recently taken steps to establish a pre-clinical pipeline to potentially address unmet medical needs across a number of indications with a focus on rare or orphan
indications and with the potential for pediatric use.

COVID-19 impact

Coronavirus, or COVID-19, a contagious disease that was characterized by the World Health Organization as a pandemic in early 2020, continues to affect the global
community.

The spread of COVID-19 may continue to impact our operations, including the potential interruption of our clinical trial activities and of our supply chain. For example, the
rise in the Omicron variant in the COVID-19 pandemic has caused delays in site initiation and patient enrollment in our Phase 3 DETECT clinical trial for diagnostic use in
childhood-onset growth hormone deficiency. Additionally, sales activities for Macrilen™ in the US may be impacted due to delays of diagnostic activities on AGHD in
the  US.  Further,  the  COVID-19  pandemic  may  also  cause  some  patients  to  be  unwilling  to  enroll  in  our  trials  or  be  unable  to  comply  with  clinical  trial  protocols  if
quarantines impede patient movement or interrupt healthcare services, which would delay our ability to conduct clinical trials or release clinical trial results on a timely
basis and could delay our ability to obtain regulatory approval and commercialize our product candidates. Management will continue to monitor and assess the impact of
the pandemic on its judgments, estimates, accounting policies and amounts recognized in these consolidated financial statements. As of December 31, 2021, the Company
assessed  the  possible  impacts  of  COVID-19  on  its  consolidated  financial  results.  The  Company  has  evaluated  its  financial  assets,  property,  plant  and  equipment,
intangible assets, and goodwill for impairment and no changes from the carrying amount were required in the reporting period.

Reporting entity

 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The accompanying consolidated financial statements include the accounts of Aeterna Zentaris Inc., an entity incorporated under the Canada Business Corporations Act,
and its wholly owned subsidiaries. The Company and its subsidiaries are collectively referred to as the "Group”. Aeterna Zentaris Inc. is the ultimate parent company of
the Group. The Company currently has three wholly owned direct and indirect subsidiaries, Aeterna Zentaris GmbH ("AEZS Germany”), based in Frankfurt, Germany,
Zentaris IVF GmbH, a wholly owned subsidiary of AEZS Germany, based in Frankfurt, Germany, and Aeterna Zentaris, Inc., an entity incorporated in the state of Delaware
and with offices in Summerville, South Carolina, in the US.

The registered office of the Company is located at 222 Bay Street, Suite 3000, P.O. Box 53, Toronto, Ontario M5K 1E7, Canada.

The Company’s common shares are listed on both the Toronto Stock Exchange and on the NASDAQ Capital Market.

132

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Basis of presentation

(a) Statement of compliance

These consolidated financial statements as of December 31, 2021 and December 31, 2020 and for the years ended December 31, 2021, 2020 and 2019 have been prepared in
accordance with International Financial Reporting Standards as issued by the International Accounting Standards Board ("IFRS”).

These consolidated financial statements were approved by the Company’s Board of Directors, subject to confirmation by the Audit Committee of the Board of Directors,
which confirmation was received on March 28, 2022.

The preparation of financial statements in accordance with IFRS requires the use of certain critical accounting estimates and the exercise of management’s judgment in
applying the Company’s accounting policies. Areas involving a high degree of judgment or complexity and areas where assumptions and estimates are significant to the
Company’s  consolidated  financial  statements  are  discussed  in  note  3  -  Critical  accounting  estimates  and  judgments.  Certain  comparative  figures  for  the  year  ended
December 31, 2020 were reclassified to conform to the presentation adopted for December 31, 2021.

(b) Basis of measurement

The consolidated financial statements have been prepared under a historical cost convention.

(c) Principles of consolidation

These consolidated financial statements include any entity in which the  Company directly or indirectly holds more than 50% of the voting rights or over which the
Company exercises control. The Company controls an entity when the Company is exposed to, or has rights to, variable returns from its involvement with the entity and
has the ability to affect those returns through its power over the entity. An entity is included in the consolidation from the date that control is transferred to the Company,
while any entities that are sold are excluded from the consolidation from the date that control ceases. All inter-company balances and transactions are eliminated on
consolidation.

(d) Foreign currency

Items included in the financial statements of the Group’s entities are measured using the currency of the primary economic environment in which the entities operate (the
"functional currency”) which is the US dollar for the Company and its US subsidiary, Aeterna Zentaris, Inc., and the Euro ("EUR” or "€”) for its German subsidiaries.

Assets and liabilities of the German subsidiaries are translated from EUR balances at the period-end exchange rates, and the results of operations are translated from EUR
amounts at average rates of exchange for the period. The resulting translation adjustments are included in accumulated other comprehensive loss within shareholders’
equity (deficiency).

Foreign currency transactions are translated into the functional currency using the exchange rates prevailing at the dates of the underlying transaction. Foreign exchange
gains and losses resulting from the settlement of such transactions and from the translation of monetary assets and liabilities not denominated in the functional currency
are recognized in the consolidated statements of comprehensive loss.

2.

Summary of significant accounting policies

The  accounting  policies  set  out  below  have  been  applied  consistently  to  all  years  presented  in  these  consolidated  financial  statements  and  have  been  applied
consistently by all Group entities.

133

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Cash and cash equivalents

Cash and cash equivalents consist of unrestricted cash on hand and balances with banks, as well as short-term interest-bearing deposits, such as money market accounts,
that are readily convertible to known amounts of cash and are subject to an insignificant risk of changes in value, with a maturity of three months or less from the date of
acquisition.

Inventories

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Inventories are valued at the lower of cost or net realizable value. Cost is determined using the first-in, first-out method. The Company’s policy is to write down inventory
that has become obsolete and inventory that has a cost basis in excess of its expected net realizable value. Increases in the reserve are recorded as charges in cost of
sales. For product candidates that have not been approved by the FDA, inventory used in clinical trials is written down at the time of production and recorded as research
and development ("R&D”) costs. For products that have been approved by the FDA, inventory used in clinical trials is expensed at the time the inventory is packaged for
the clinical trial. All direct manufacturing costs incurred after approval are capitalized into inventory.

Restricted cash equivalents

Restricted cash equivalents are comprised of bank deposits, which are related to a guarantee for a long-term operating lease obligation, and for corporate credit card
programs that cannot be used for current purposes.

Property, plant and equipment and depreciation

Items of property, plant and equipment are recorded at cost, net of accumulated depreciation and impairment charges. Depreciation is calculated using the following
methods, annual rates and period:

Equipment
Furniture and fixtures
Computer equipment
Leasehold improvements

Methods
Declining balance and straight-line
Declining balance and straight-line
Straight-line
Straight-line

Annual rates and period
20%
10% to 20%
25% to 331/3%
Remaining lease term

Depreciation expense, which is recorded in the consolidated statement of comprehensive loss, is allocated to the appropriate functional expense categories to which the
underlying items of property, plant and equipment relate.

Identifiable intangible assets and amortization

Identifiable intangible assets with finite useful lives consist of in-process R&D acquired in business combinations, patents, trademarks, in-licensed technology and rights
to serialization equipment located at the Company’s third-party macimorelin manufacturer. In-process R&D acquired in business combinations is recognized at fair value
at the acquisition date. Patents and trademarks are comprised of costs, including professional fees incurred in connection with the filing of patents and the registration of
trademarks for product marketing and manufacturing purposes, net of related government grants, impairment losses and accumulated amortization. Identifiable intangible
assets with finite useful lives are amortized beginning at the time at which the assets are available for use, on a straight-line basis over the assets’ estimated useful lives,
which range from seven to 15 years for in-process  R&D and patents and are ten years for trademarks. Amortization expense, which is recorded in the consolidated
statement of comprehensive loss, is allocated to the appropriate functional expense categories to which the underlying identifiable intangible assets relate.

134

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Contingent payments

The  Company  accounts  for  contingent  variable  payments  for  separately  acquired  intangible  assets,  such  as  in-licensed  technology,  under  the  cost  accumulation
approach. Contingent consideration is not considered on initial recognition of the asset but instead is added to the cost of the asset initially recorded, when incurred.

Goodwill

Goodwill is recognized as the fair value of the consideration transferred, including the recognized amount of any non-controlling interest in the acquiree, less the fair value
of the net identifiable assets acquired, and liabilities assumed, as of the acquisition date. Subsequent to initial recognition, goodwill is measured at cost less accumulated
impairment losses. Goodwill acquired in business combinations is allocated to groups of cash generating units ("CGU”) that are expected to benefit from the synergies of
the combination.

Impairment of long-lived assets

Items of property, plant and equipment, right of use assets and identifiable intangible assets with finite lives that are subject to depreciation or amortization, respectively,
are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be recoverable. Intangible assets that
are not subject to amortization are tested when there are indications that their carrying value may not be recoverable, or, at a minimum, annually. Management is required
to  assess  at  each  reporting  date  whether  there  is  any  indication  that  an  asset  may  be  impaired.  Where  such  an  indication  exists,  the  asset’s  recoverable  amount  is
compared  to  its  carrying  value,  and  an  impairment  loss  is  recognized  for  the  amount  by  which  the  asset’s  carrying  amount  exceeds  its  recoverable  amount.  The
recoverable amount is the higher of an asset’s fair value less costs to sell and value in use. For purposes of assessing impairment, assets are grouped at the lowest levels
for which there are separately identifiable cash flows, or CGU. In determining value in use of a given asset or CGU, estimated future cash flows are discounted to their
present value using a pre-tax discount rate that reflects current market assessments of the time value of money and the risks specific to the asset.

Items  of  property,  plant  and  equipment  and  identifiable  intangible  assets  with  finite  lives  that  have  suffered  impairment  are  reviewed  for  possible  reversal  of  the
impairment if there has been a change, since the date of the most recent impairment test, in the estimates used to determine the impaired asset’s recoverable amount.
However, an asset’s carrying amount, increased due to the reversal of a prior impairment loss, must not exceed the carrying amount that would have been determined, net
of depreciation or amortization, had the original impairment not occurred.

135

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Goodwill is not subject to amortization, but instead is tested for impairment annually or more often if there is an indication that the CGU to which the goodwill has been

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
allocated may be impaired. Impairment is determined for goodwill by assessing whether the carrying value of a CGU, including the allocated goodwill, exceeds the CGU’s
recoverable amount, which is the higher of fair value less costs to sell and the CGU’s value in use. Fair value less costs of disposal is determined based on the Company’s
market capitalization, as well as relevant market data, such as control premiums, and other assumptions. In the event that the carrying amount of goodwill exceeds its
recoverable amount, an impairment loss is recognized in an amount equal to the excess. Impairment losses related to goodwill, which are recorded in the consolidated
statement of comprehensive loss, are not subsequently reversed.

Provisions

Provisions  represent  liabilities  to  the  Company  for  which  the  amount  or  timing  is  uncertain.  Provisions  are  recognized  when  the  Company  has  a  present  legal  or
constructive obligation as a result of past events, such as organizational restructuring, when it is probable that an outflow of resources will be required to settle the
obligation and where the amount can be reliably estimated. Provisions are not recognized for future operating losses.

Provisions are made for any contracts which are deemed onerous. A contract is onerous if the unavoidable costs of meeting the obligations under the contract exceed the
economic benefits expected to be received under it. Provisions for onerous contracts are measured at the present value of the lower of the expected cost of terminating the
contract and the expected net cost of continuing with the contract. Present value is determined based on expected future cash flows that are discounted at a pre-tax rate
that reflects current market assessments of the time value of money and the risks specific to the liability. The unwinding of the discount is recognized in finance costs.

Leases

At the inception of a contract, the Company assesses whether a contract is or contains a lease. A lease is a contract in which the right to control the use of an identified
asset is granted for an agreed-upon period of time in exchange for consideration. The Company assesses whether a contract conveys the right to control the use of an
identified asset when there is both the right to direct the use of the asset and obtain substantially all the economic benefits from that use. The Company recognizes a right
of use asset and a lease liability at the lease commencement date.

The lease liability is initially measured at the present value of the non-cancellable lease payments over the lease term and discounted at the rate implicit in the lease. If that
rate cannot be determined, the Company’s incremental borrowing rate, or the rate that Company would have to pay to borrow the funds necessary to obtain an asset of
similar value in a similar economic environment with similar terms and conditions, is used.  Lease payments include fixed payments and such variable payments that
depend on an index or a rate less any lease incentives receivable.

The lease liability is subsequently measured at amortized cost using the effective interest method and is remeasured when there is a change in future lease payments
arising from a change in an index or rate, if there is a change in the Company’s estimate of the amount expected to be payable under a residual value guarantee or if the
Company  changes  its  assessment  of  whether  it  will  exercise  a  purchase,  extension  or  termination  option.  When  the  lease  liability  is  remeasured,  a  corresponding
adjustment is made to the carrying amount of the right of use asset, with any difference recorded in the statement of comprehensive loss.

Right of use assets are measured at cost, which comprises the initial lease liability, lease payments made at or before the lease commencement date, initial direct costs and
restoration obligations, less lease incentives. Right of use assets are subsequently measured at amortized cost. The assets are depreciated over the shorter of the assets’
useful life and the lease terms on a straight-line basis, less any accumulated impairment losses, and adjusted for any remeasurement of the lease liability. The lease term
includes periods covered by an option to extend if the Company is reasonably certain to exercise that option.

136

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company accounts for a lease modification as a separate lease if both of the following conditions exist: (a) the modification increases the scope of the lease by adding
the right to use one or more underlying assets; and (b) the consideration for the lease increases by an amount equivalent to the standalone price for the increase in scope
and any appropriate adjustments to that stand-alone price to reflect the circumstances of the particular contract. Where the Company accounts for a lease modification as
a new lease, the separate lease is accounted for in the same way as a new lease, as described above.

Where the Company does not account for a lease modification as a separate lease, the lease liability is remeasured by: (a) decreasing the carrying amount of the right of
use asset to reflect the partial or full termination of the lease for lease modifications that decrease the scope of the lease, with any gain or loss relating to the partial or full
termination of the lease recorded in the consolidated statement of comprehensive loss; or (b) making a corresponding adjustment to the right of use asset for all other
lease modifications.

Payments  associated  with  short-term  leases  and  leases  of  low-value  assets  are  recognized  on  a  straight-line  basis  as  an  expense  in  the  consolidated  statement  of
comprehensive loss.

Employee benefits

Salaries and other short-term benefits

Salaries and other short-term benefit obligations are measured on an undiscounted basis and are recognized in the consolidated statement of comprehensive loss over the
related service period or when the Company has a present legal or constructive obligation to make payments as a result of past events and when the amount payable can
be estimated reliably.

Post-employment benefits

AEZS  Germany  provides  unfunded  and  partially  funded  defined  benefit  multi-employer  pension  plans,  namely  the  DUPK  pension  plan  and  the  RUK  1990  and  2006
pension  plans,  (the  "Pension  Benefit  Plans”)  and  unfunded  post-employment  benefit  plans  for  certain  groups  of  employees.  Provisions  for  pension  obligations  are
established for benefits payable in the form of retirement, disability and surviving dependent pensions. The Company also provides a defined contribution plans to some
of its employees.

For defined benefit pension plans and other post-employment benefits, net periodic pension expense is actuarially determined on a quarterly basis using the projected
unit credit method. The cost of pension and other benefits earned by employees is determined by applying certain assumptions, including discount rates, rate of pension
benefit increases, the projected age of employees upon retirement and the expected rate of future compensation. 

The employee future benefits liability is recognized at its present value, which is determined by discounting the estimated future cash outflows using interest rates of
high-quality corporate bonds that are denominated in the currency in which the benefits will be paid and that have terms to maturity approximating the terms of the related
future benefit liability. Actuarial gains and losses that arise in calculating the present value of the defined benefit obligation are recognized in other comprehensive loss,

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
net of tax, and simultaneously reclassified in the deficit in the consolidated statement of financial position in the year in which the actuarial gains and losses arise and
without recycling to the consolidated statement of comprehensive loss in subsequent periods.

For defined contribution plans, expenses are recorded in the consolidated statement of comprehensive loss as incurred–namely, over the period that the related employee
service is rendered.

Termination benefits

Termination benefits are recognized in the consolidated statement of comprehensive loss when the Company is demonstrably committed, without the realistic possibility
of withdrawal, to a formal detailed plan to terminate employment earlier than originally expected. Termination benefit liabilities expected to be settled after 12 months from
the end of a given reporting period are discounted to their present value, where material.

137

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Financial instruments

The Company classifies its financial instruments in the following categories: financial assets at fair value through profit or loss ("FVTPL”); financial liabilities at FVTPL;
financial assets at amortized cost; financial liabilities at amortized cost and financial assets at fair value through other comprehensive income ("FVTOCI”).

Financial assets at FVTPL: Financial assets carried at FVTPL are initially recorded at fair value, and transaction costs directly attributable to issuing the financial assets
are expensed in the statement of comprehensive loss. Realized and unrealized gains and losses arising from changes in the fair value of the financial assets held at FVTPL
are included in the statement of comprehensive loss in the period in which they arise. As of December 31, 2021 and 2020, the Company did not have any financial assets at
FVTPL.

Financial liabilities at FVTPL: These financial liabilities are initially recognized at fair value, and transaction costs directly attributable to issuing the financial liabilities
are expensed in the statement of comprehensive loss. Financial liabilities that are required to be measured at FVTPL are re-measured at each reporting date, with changes
in fair value reported in the statement of comprehensive loss. As of December 31, 2021 and 2020, the Company did not have any financial liabilities at FVTPL.

Financial assets at amortized cost: A financial asset is measured at amortized cost if the objective of the business model is to hold the financial asset for the collection of
contractual cash flows, and the asset’s contractual cash flows are comprised solely of payments of principal and interest. Financial assets at amortized cost are classified
as current or non-current based on their maturity date and are initially recognized at fair value and subsequently carried at amortized cost, less any impairment.

Financial liabilities at amortized cost: Financial liabilities classified as amortized cost are initially recognized at fair value, less directly attributable transaction costs.
After initial recognition, costs are subsequently measured at amortized cost using the effective interest rate method with interest expense recognized on an effective yield
basis. The effective interest rate is the rate that discounts estimated future cash payments through the expected life of the financial liability, or, where appropriate, a
shorter period. Interest accretion is recorded in interest expense in the consolidated statement of comprehensive loss.

Financial assets at FVTOCI: Investments in equity instruments at FVTOCI are initially recognized at fair value, plus incremental transaction costs. Subsequently, financial
assets at FVTOCI are measured at fair value, with gains and losses arising from changes in fair value recognized in other comprehensive loss in the period in which those
gains or losses arise. As of December 31, 2021 and 2020, the Company did not have any financial assets at FVTOCI.

Impairment of financial assets at amortized cost: The Company applies the simplified approach on trade receivables, which allows for the use of a lifetime expected credit
loss  ("ECL”)  provision  considering  the  probability  of  default  over  the  expected  life  of  the  financial  asset.  The  12-month  ECL  only  considers  default  events  that  are
possible within the year following the reporting date. The Company uses a provision matrix to calculate ECLs for trade receivables. The provision matrix is initially based
on the Company’s historical observed default rates and is subsequently evaluated and updated based on new and forward-looking information.

Share capital

Common shares are classified as equity. Incremental costs that are directly attributable to the issuance of common shares are recognized as a deduction from equity, net of
any tax effects.

138

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Where offerings result in the issuance of units (where each unit is comprised of a common share of the Company and a warrant, exercisable in order to purchase a common
share or fraction thereof) and the Company does not have the unconditional right to avoid delivering cash to the holders in the future, proceeds received in connection
with those offerings are allocated between share capital and warrants. Transaction costs in connection with such offerings are allocated to the liability and equity unit
components in proportion to the allocation of proceeds.

Where offerings result in the issuance of units (where each unit is comprised of a common share of the Company and a warrant, exercisable in order to purchase a common
share or fraction thereof) and the warrants issued meet the fixed-for-fixed criteria, discussed below, proceeds received in connection with those offerings are allocated
between share capital and warrants based on the relative fair value method. Transaction costs in connection with such offerings are allocated to share capital and warrant
components within equity in proportion to the allocation of proceeds.

Warrants

Warrants are classified as liabilities when the Company does not have the unconditional right to avoid delivering cash to the holders in the future, or when they can be
settled  with  a  variable  number  of  common  shares.  Each  of  the  Company’s  warrants  contains  a  written  put  option,  arising  upon  the  occurrence  of  a  fundamental
transaction, as that term is defined in the warrants, including a change of control.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The warrant liability is initially measured at fair value, and any subsequent changes in fair value are recognized as gains or losses through profit or loss. Any transaction
costs related to the warrants are expensed as incurred. Fair value of such warrants is determined at the issue date using the Black-Scholes option pricing model.

The warrant liability is classified as non-current, unless the underlying warrants will expire or be settled within 12 months from the end of a given reporting period.

When issued warrants meet the fixed-for-fixed criteria under  IAS 32, Financial Instruments, either upon initial issue or upon subsequent registration of the common
shares underlying the warrants, the Company classifies such warrants as equity-settled. Such warrants are accounted for by using the relative fair value method whereby
the  total  gross  proceeds  from  the  offering  are  allocated  to  each  of  common  shares  and  warrants  based  on  their  relative  fair  values.  Fair  value  of  such  warrants  is
determined at the issue date using the Black-Scholes option pricing model.

Share-based compensation costs

The Company operates an equity-settled share-based compensation plan under which the Company receives services from directors, senior executives, employees and
other collaborators as consideration for equity instruments of the Company. The Company accounts for all forms of share-based compensation using the fair value-based
method. Fair value of stock options is determined at the date of grant using the Black-Scholes option pricing model, which includes estimates of the number of awards that
are expected to vest over the vesting period. Where granted share options vest in installments over the vesting period (defined as graded vesting), the Company treats
each  installment  as  a  separate  share  option  grant.  Share-based  compensation  expense  is  recognized  over  the  vesting  period,  or  as  specified  vesting  conditions  are
satisfied, and credited to other capital. Any consideration received by the Company in connection with the exercise of stock options is credited to share capital. Any other
capital component of the share-based compensation is transferred to share capital upon the issuance of shares.

The Company grants deferred share units ("DSUs”) to members of its Board of Directors who are not employees or officers of the Company. DSUs cannot be redeemed
until the holder is no longer a director of the Company and are considered equity-settled instruments. Under the terms of the DSU agreement, the DSUs vest immediately
upon grant. The value attributable to the DSUs is based on the market value of the share price at the time of grant and share based compensation expense is recognized in
general and administrative expenses in the consolidated statement of comprehensive loss. At the time of redemption, each DSU may be exchanged for one common share
of the Company. Any consideration received by the Company in connection with the exercise of DSUs is credited to share capital. Any other capital component of the
share-based compensation is transferred to share capital upon the issuance of shares.

139

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Revenue recognition

The Company generates revenue from license and collaboration agreements with customers (license fees, milestone revenue, royalties), the provision of development
services, the sale of certain active pharmaceutical ingredients ("API”) and semi-finished goods and finished goods, and from certain supply chain activities, which are
comprised largely of oversight or supervisory support services related to stability studies or development activities carried out with respect to API batch production as
specified in underlying contracts with customers.

The Company applies the provisions of IFRS 15, Revenue from Contracts with Customers ("IFRS 15”), a single, comprehensive set of criteria for revenue recognition.
IFRS 15 applies to all contracts with customers except for contracts that are within the scope of other standards. IFRS 15 prescribes a five-step framework through which
revenue is recognized when control of promised goods or services is transferred to a customer at an amount that reflects the consideration to which the entity expects to
be entitled in exchange for those goods or services. Goods and services that are determined not to be distinct are combined with other promised goods or services until a
distinct bundle is identified. The Company allocates the transaction price (the amount of consideration to which the Company expects to be entitled in exchange for the
promised goods or services) to each performance obligation and recognizes the associated revenue when (or as) each performance obligation is satisfied. The Company’s
estimate of the transaction price for each contract includes all variable consideration to which the Company expects to be entitled, and that estimate is reassessed at the
end of each reporting period. When two or more contracts are entered into with the same customer at or near the same time, the Company evaluates the contracts to
determine whether the contracts should be accounted for as a single arrangement.

The transaction price is allocated among the performance obligations on a relative standalone selling price basis, and the applicable revenue recognition criteria are
applied to each of the separate performance obligations. Standalone selling prices may be estimated via methods that include, but are not limited to, an adjusted market
assessment  approach,  an  expected  cost-plus-margin  approach  or  a  residual  approach.  Determining  the  standalone  selling  price  for  performance  obligations  requires
significant judgment.

The Company applies judgment in determining whether a combined performance obligation is satisfied at a point in time or over time, and, for performance obligations
satisfied over time, in concluding upon the appropriate method of measuring progress to be applied for purposes of recognizing revenue. The Company evaluates the
measure of progress each reporting period and, as estimates related to the measure of progress change, related revenue recognition is adjusted accordingly. Changes in
the Company’s estimated measure of progress are accounted for on a cumulative catch-up basis as a change in accounting estimate and are recorded in the consolidated
statement of comprehensive loss in the period of adjustment.

License fees

If the license to the Company’s intellectual property is determined to be distinct from the other promises or performance obligations identified in the arrangement, the
Company recognizes revenue from non-refundable, upfront fees allocated to the license when the license is transferred to the customer and the customer is able to use
and benefit from the license. In assessing whether a license is distinct from the other promises, the Company considers whether the collaboration partner can benefit from
the license for its intended purpose without the receipt of the remaining promises, whether the value of the license is dependent on the unsatisfied promises, whether
there are other vendors that could provide the remaining promises and whether it is separately identifiable from the remaining promises. For licenses that are combined
with other promises, the Company utilizes judgment to assess the nature of the combined performance obligation and whether the license is the predominant promise
within the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time and, if over time, the
appropriate method of measuring progress for purposes of recognizing revenue.

140

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Development services

Arrangements that include a promise for the Company to provide development services are assessed to determine whether the services are capable of being distinct, are
not highly interdependent or do not significantly modify one another, and if so, the services are accounted for as a separate performance obligation as the services are
provided  to  the  customer.  Otherwise,  when  development  services  are  determined  not  to  be  capable  of  being  distinct,  such  services  are  added  to  the  performance
obligation that includes the underlying license. For development services that are combined with other promises, the Company applies judgment to assess the nature of
the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time. The Company utilizes judgment
to determine the appropriate method of measuring progress for purposes of recognizing revenue, which is generally an input measure such as costs incurred.

Milestone payments

At the inception of any contracts with a customer that includes milestone payments, which are oftentimes payable upon the successful achievement of development or
regulatory events, the Company evaluates whether the milestones are considered probable of being reached and estimates the amount to be included in the transaction
price using the most likely amount method. If the Company concludes it is highly probable that a significant revenue reversal will not occur, the associated milestone
payment is included in the transaction price.  Milestone payments that are not within the control of the  Company or the licensee, such as regulatory approvals, are
generally not considered probable of being achieved until those approvals are received.  The transaction price is then allocated to each performance obligation on a
relative stand-alone selling price basis, for which the Company recognizes revenue when (or as) the performance obligations under the contract are satisfied. At the end of
each subsequent reporting period, the  Company reassesses the probability of achievement of milestones and any related constraints, and, if necessary, adjusts the
estimate of the overall transaction price on a cumulative catch-up basis.

Royalty payments

For arrangements that include sales-based royalties, including milestone payments based on the level of sales, and when the license is deemed to be the predominant item
to which the royalties relate, the Company recognizes revenue at the later of (a) when the related sales occur, or (b) when the performance obligation to which some or all
of the royalty has been allocated has been satisfied or partially satisfied.

Product sales

The Company recognizes revenue from the sale of certain API and semi-finished goods, including MacrilenTM, upon delivery of such items to its customer.

141

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Supply chain revenue

Supply chain services are contracted with fixed fees and are provided over a period of time. The Company recognizes revenue on a straight-line basis over time as it best
represents the pattern of performance of the services.

While providing services, the Company incurs certain direct costs for subcontractors and other expenses that are recoverable directly from its customers. The recoverable
amounts of these direct costs are included in the Company’s operating expenses as the Company controls the services before they are transferred to the customer and
acts as a principal in these arrangements.

Contract costs

The Company recognizes as an asset the incremental costs of obtaining a contract with a customer if the costs are expected to be recovered, and any capitalized contract
costs are amortized on a systematic basis that is consistent with the transfer to the customer of the goods or services to which the asset relates. As a practical expedient,
the Company recognizes the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset that it otherwise would have
recognized is one year or less. To date, the Company has not incurred any incremental costs of obtaining a contract with a customer.

Contract modifications

Contract modifications are defined in IFRS 15 as changes in the scope or price (or both) of a contract that are approved by the parties to the contract, such as a contract
amendment.  Contract  modifications  exist  when  the  parties  to  a  contract  approve  a  modification  that  either  creates  new  or  changes  existing  enforceable  rights  and
obligations of the parties to the contract. Depending on facts and circumstances, the Company accounts for a contract modification in one of the following ways: (a) as a
separate  contract;  (b)  as  a  termination  of  the  existing  contract  and  a  creation  of  a  new  contract;  or  (c)  as  a  combination  of  the  preceding  treatments. A  contract
modification is accounted for as a separate contract if the scope of the contract increases because of the addition of promised goods or services that are distinct and the
price of the contract increases by an amount of consideration that reflects the Company’s standalone selling prices of the additional promised goods or services. When a
contract modification is not considered a separate contract and the remaining goods or services are distinct from the goods or services transferred on or before the date of
the contract modification, the Company accounts for the contract modification as a termination of the existing contract and a creation of a new contract. When a contract
modification is not considered a separate contract and the remaining goods or services are not distinct, the Company accounts for the contract modification as an add-on
to the existing contract and as an adjustment to revenue on a cumulative catch-up basis.

Income tax

Income tax on profit or loss comprises current and deferred tax. Tax is recognized in profit or loss, except that a change attributable to an item of income or expense
recognized  as  other  comprehensive  loss  or  directly  in  equity  is  also  recognized  directly  in  other  comprehensive  loss  or  directly  in  equity.  Management  periodically
evaluates  positions  taken  in  tax  returns  with  respect  to  situations  in  which  applicable  tax  regulation  is  subject  to  interpretation  and  establishes  provisions  where
appropriate on the basis of amounts expected to be paid to the tax authorities.

The current income tax charge is calculated in accordance with tax rates and laws that have been enacted or substantively enacted by the reporting date in the countries
where the Company’s subsidiaries operate and generate taxable income.

142

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Deferred  income  tax  is  recognized  on  temporary  differences  (other  than,  where  applicable,  temporary  differences  associated  with  unremitted  earnings  from  foreign
subsidiaries and associates, to the extent that the investment is essentially permanent in duration, and temporary differences associated with the initial recognition of
goodwill) arising between the tax bases of assets and liabilities and their carrying amounts in the consolidated financial statements and on unused tax losses or R&D non-
refundable tax credits in the Group. Deferred income tax is determined using tax rates and laws that have been enacted or substantively enacted by the reporting date.

Deferred income tax assets are recognized only to the extent that it is probable that future taxable profit will be available against which the temporary differences can be
utilized.

Deferred income tax assets and liabilities are offset when there is a legally enforceable right to offset current tax assets against current tax liabilities and when the deferred
income taxes assets and liabilities relate to income taxes levied by the same taxation authority on either the same taxable entity or different taxable entities where there is an
intention to settle the balances on a net basis.

The Company provides reserves for potential payments of tax to various tax authorities related to uncertain tax positions and other issues. Reserves are based on a
determination of whether and how much of a tax benefit taken by the Company in its tax filing is more likely than not to be realized following resolution of any potential
contingencies present related to the tax benefit.

Research and development expenses

Research costs are expensed as incurred. Development costs are expensed as incurred, except for those that meet the criteria for deferral, in which case the costs are
capitalized and amortized to operations over the estimated period of benefit. No development costs have been capitalized during any of the periods presented.

Net loss per share

Basic net loss per share is calculated using the weighted average number of common shares outstanding during the year.

Diluted net loss per share is calculated based on the weighted average number of common shares outstanding during the year, plus the effects of dilutive common share
equivalents, such as stock options and warrants. This method requires that diluted net loss per share be calculated using the treasury stock method, as if all common
share equivalents had been exercised at the beginning of the reporting period, or period of issuance, as the case may be, and that the funds obtained thereby were used to
purchase common shares of the Company at the average trading price of the common shares during the period.

143

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

3.

Critical accounting estimates and judgments

The  preparation  of  consolidated  financial  statements  in  accordance  with  IFRS  requires  management  to  make  judgments,  estimates  and  assumptions  that  affect  the
reported  amounts  of  the  Company’s  assets,  liabilities,  revenues,  expenses  and  related  disclosures.  Judgments,  estimates  and  assumptions  are  based  on  historical
experience, expectations, current trends and other factors that management believes to be relevant at the time at which the Company’s consolidated financial statements
are prepared.

Management reviews, on a regular basis, the Company’s accounting policies, assumptions, estimates and judgments in order to ensure that the consolidated financial
statements are presented fairly and in accordance with IFRS. Revisions to accounting estimates are recognized in the period in which the estimates are revised and in any
future periods affected.

Critical accounting estimates and assumptions are those that have a significant risk of causing material adjustment and are often applied to matters or outcomes that are
inherently uncertain and subject to change. As such, management cautions that future events often vary from forecasts and expectations and that estimates routinely
require adjustment.

The  following  discusses  the  most  significant  accounting  estimates  and  assumptions  that  the  Company  has  made  in  the  preparation  of  the  consolidated  financial
statements.

Accounting for a contract modification

The Novo Amendment, as defined and discussed in note 5 – License, supply and distribution arrangements, and which was determined to be a modification pursuant to
the provisions of IFRS 15, required management to apply significant judgments, including: assessment of any increases to the scope of the license agreement; assessment
of whether the remaining goods or services are distinct from goods or services transferred before the modification; and assessment as to whether a portion of the changes
in the transaction price was attributable to the amount of variable consideration promised before the modification. Any changes in the judgments or assumptions applied
to account for this agreement could have a significant impact on the Company’s revenue and deferred revenue.

License and collaboration arrangements with multiple elements

The  Company enters into licensing and supply agreements related to the licensing, development, supply and distribution for macimorelin in various territories.  Each
agreement may contain specific terms or clauses that require careful analysis by management under IFRS 15 in order to ensure the appropriate accounting treatment is
reached.  The  agreements  may  include  non-refundable  upfront  payments  and  licensing  fees,  the  provision  of  development  services,  pre-  and  post-commercialization
milestone payments, royalties on future product sales derived from such license agreements, and supply arrangements. Management analyzes each agreement and applies
significant judgment to determine whether contracts entered into at or near the same time should be accounted for as a single arrangement, whether all parts of the
contract are scoped within IFRS 15, to identify all performance obligations, determine whether a performance obligation is distinct or should be combined with other
promised  goods  and  services,  determine  and  allocate  the  transaction  price  on  a  relative  stand-alone  selling  price  basis,  determine  whether  a  combined  performance
obligation is satisfied at a point in time or over time, and, for performance obligations satisfied over time, in concluding upon the appropriate method of measuring

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
progress to be applied for purposes of recognizing revenue. Any changes in the judgments or assumptions applied can give rise to a significant impact on the Company’s
revenues and deferred revenues

Impairment of goodwill

The annual impairment assessment related to goodwill requires management to estimate the recoverable amount, which has been determined using fair value less cost of
disposal. The Company has a single cash generating unit and reportable segment, and management monitors goodwill based on an overall entity basis. The carrying
amount  of  its  consolidated  net  assets  is  compared  to  its  overall  market  capitalization  less  estimated  cost  of  disposal.  Based  on  this  calculation,  including  a  control
premium, management determined that goodwill was not impaired. Future events could cause the assumptions utilized in the impairment tests to change, resulting in a
potentially adverse effect on the Company’s future results due to increased impairment charges.

144

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Employee future benefits

The  determination  of  expenses  and  obligations  associated  with  employee  future  benefits  requires  the  use  of  assumptions,  such  as  the  discount  rate  to  measure
obligations, rate of pension benefit increases, the projected age of employees upon retirement and the expected rate of future compensation. Because the determination of
the costs and obligations associated with employee future benefits requires the use of various assumptions, there is measurement uncertainty inherent in the actuarial
valuation process. Actual results will differ from results that are estimated based on the aforementioned assumptions. Additional information is included in note 18 -
Employee future benefits.

Research and development accrual

As part of the process of preparing our financial statements, we are required to estimate accrued expenses including those pertaining to our research and development
expenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our
behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the
actual cost. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrued or prepaid expense balance accordingly.
Although  the  Company  does  not  expect  estimates  to  be  materially  different  from  amounts  actually  incurred,  if  those  estimates  of  the  status  and  timing  of  services
performed differ from the actual status and timing of services performed, the Company may report amounts that are too high or too low in any particular period.

4.

Recent accounting pronouncements

IFRS Pronouncements issued but not yet effective

(a) IAS 37, Provisions, Contingent Liabilities and Contingent Assets ("IAS 37”)

The amendment to IAS 37 clarifies the meaning of costs to fulfil a contract and that before a separate provision for an onerous contract is established, an entity recognizes
any impairment loss that has occurred on assets used in fulfilling the contract, rather than on assets dedicated to the contract. This amendment will be effective for annual
periods beginning on or after January 1, 2022. The Company is currently evaluating this guidance and the impacts that the amendments may have on the Company’s
consolidated financial statements.

5.

License, supply and distribution arrangements

License and supply agreements for Macrilen™ - United States and Canada

On  January  16,  2018,  the  Company,  through  AEZS  Germany,  entered  into  License  Agreement  with  Strongbridge  Ireland  Limited  ("Strongbridge”)  to  carry  out
development,  manufacturing,  registration,  regulatory  and  supply  chain  services  for  the  commercialization  of  Macrilen™  (macimorelin)  in  the  U.S.  and  Canada,  which
provides for (i) a right to use license relating to the adult indication (the "Adult Indication”); (ii) a license for a future FDA-approved pediatric indication (the "Pediatric
Indication”); (iii) the licensee to fund 70% of the costs of a pediatric clinical trial submitted for approval to the EMA and FDA to be run by the Company with oversight
from  a  joint  steering  committee  (the  "PIP”);  and  (iv)  for  an  Interim  Supply Arrangement.  In  January  2018,  the  Company  received  a  cash  payment  of  $24,000  from
Strongbridge and on July 23, 2018, Strongbridge launched product sales of Macrilen™ (macimorelin) in the U.S. The Company is also entitled to receive a milestone
payment of $5,000 upon FDA approval of the Pediatric Indication. Effective December 19, 2018, Strongbridge sold the entity which owned the License Agreement for the
U.S. and Canadian rights to Macrilen™ (macimorelin) to Novo. In 2019, the Interim Supply Arrangement was concluded and Novo contracted AEZS Germany to provide
supply chain services for the manufacture of Macrilen™ (macimorelin).

145

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

On November 16, 2020, the Company, through AEZS Germany, entered into an amendment (the "Novo Amendment”) of its existing License Agreement with Novo related
to the development and commercialization of macimorelin.

Under the Novo Amendment, Aeterna continues to retain all rights to macimorelin outside of the  U.S. and  Canada but  Novo agreed to make an upfront payment to
Aeterna of $6,109 (€5,000), which the Company received in December 2020. Under the Novo Amendment, the royalty payment Aeterna receives on sales in the U.S. and
Canada was reduced from 15% to 8.5% for annual net sales up to U.S.$40 million and returns to 15% or more for annual net sales of macimorelin over U.S.$40  million.
Additionally, the $5,000 variable payment owing to Aeterna by Novo, upon FDA approval of the pediatric indication, was waived. Under the Novo Amendment, Novo and
Aeterna agreed that solely Aeterna will conduct the pivotal Study P02 in partnership with a contract research organization ("CRO”). Given the transfer of development
activities to Aeterna, the percentage of Study P02 clinical trial costs that Novo is required to reimburse to Aeterna was adjusted from 70% to 100% of costs up to €9,000
(approximately $10,980). Any additional external jointly approved Study P02 trial costs incurred over €9,000 will be shared equally between Novo and Aeterna. In addition,

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
certain changes to rights and responsibilities of the joint steering committee were made.

Under the amended terms, Novo was also granted co-ownership of the U.S. and Canadian patents and trademarks owned by Aeterna on macimorelin but will be required
to transfer co-ownership in those patents back to Aeterna on the occurrence of certain termination events.

Management  has  determined  that  the  modification  that  grants  co-ownership  of  the  U.S.  and  Canadian  patents  and  trademarks  that  were  previously  licensed  by  the
Company to Novo is not a distinct performance obligation as the related benefits are highly interdependent and interrelated with the licensed indications granted under
the existing license contract prior to the modification.

In addition, upon regulatory approval of macimorelin in the U.S. for the diagnosis of CGHD, if Novo determines not to commercialize macimorelin in Canada, then Aeterna
has the option to exclusively license rights to macimorelin in Canada (but not in U.S.) to a third party. The Amendment also confirms that Aeterna has the right to use the
results from  Study  P02, if successful, to support Aeterna seeking regulatory approval and ongoing efforts to seek  partnering  opportunities  for  macimorelin  in  other
regions outside of the two countries licensed to Novo, the U.S. and Canada.

Analysis prior to modification

At  contract  inception,  upon  analysis  of  the  total  discounted  cash  flows  of  both  the  $24,000  payment  and  the  $5,000  payment  upon  FDA  approval  of  the  Pediatric
Indication, the Company determined that 84% of the future revenue streams would be derived from the Adult Indication and 16% from the Pediatric Indication. On a
relative fair value basis, the Company had allocated the transaction price to the performance obligations resulting in $23,600 being allocated to the Adult Indication and
being recognized as license fee revenue in the consolidated statement of comprehensive loss for the year ended, December 31, 2018, and $400 being allocated to the
Pediatric  Indication,  which  was  recognized  as  deferred  revenue  on  the  consolidated  statement  of  financial  position  and  amortized  on  a  straight-line  basis  beginning
January 2018, over a period of 5.4 years, into the consolidated statements of comprehensive loss.

146

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Under the License Agreement, the Company considered the funding arrangement under the PIP to be a collaboration arrangement under IFRS 11 and has accounted for
the invoicing as a reduction of costs incurred. During 2020, the Company invoiced its licensee $1,099 (2019 - $979) as its share of the costs incurred by the Company.

Analysis post modification

On November 16, 2020, the Company announced that it had entered into the Novo Amendment of its existing License Agreement and received an upfront payment of
$6,109 (€5,000) in December 2020. Management determined that the remaining performance obligation under the contract which provides the customer with the license of a
future FDA approved Pediatric Indication is a distinct performance obligation before and after the modification. Accordingly, the Company accounted for the modification
to the License Agreement as an adjustment to the existing License Agreement with Novo, on a prospective basis. The portion of the changes in the transaction price that
was attributable to the change in royalty rate was allocated to both the Adult Indication and the Pediatric Indication. Based on the change in future royalty rates, the
Company determined that $550 of the additional upfront payment should be allocated to the Adult Indication. Accordingly, the Company allocated $ 550 (€470)  to  the
Adult Indication which was recognized in revenues for the year ended December 31, 2020 and deferred $5,559 (€4,530).

As required per  IFRS 11, given changes in facts and circumstances with respect to the development activities associated with the pediatric indication—namely, the
substantive changes to rights and responsibilities granted to  Novo pursuant to the  Novo Amendment—management reassessed whether the classification of those
activities should change. Management concluded that the parties to the Novo Amendment no longer share joint control of the related activities. As such, the Pediatric
Indication  development  activities  are  no  longer  accounted  for  under  IFRS  11,  and  the  incremental  performance  obligation  associated  with  the  Pediatric  Indication
development services has been combined with the pediatric license for revenue recognition purposes. No other additional performance obligations were identified in the
Novo Amendment.

Based on the preceding analysis, management determined that the total modified transaction price was $5,754 (€4.7 million), which is comprised of $195 (€0.2 million) pre-
Novo Amendment  unamortized  pediatric  license  fee  and  $5,559  (€4.5  million)  post-Novo  Amendment  Pediatric  Indication  and  has  been  allocated  to  the  remaining
combined  performance  obligation.  Revenue  associated  with  this  performance  obligation  is  being  recognized  as  pediatric  development  services  using  a  cost-to-cost
measure of progress method. The transfer of control to Novo occurs over time, and as such, in management’s judgment, this input method is the best measure of progress
towards satisfying the performance obligation and reflects a faithful depiction of the transfer of goods and services. As of December 31, 2021, management expects that
the remaining performance obligation will be recognized through December 31, 2022. Management reevaluates the transaction price at the end of each reporting period or
as changes in circumstances occur and adjusts the transaction price and the timing of recognition thereof as necessary.

147

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Supply Chain Arrangement

The Company agreed, in the Interim Supply Arrangement to the License Agreement, to supply ingredients for the manufacture of Macrilen™ (macimorelin) during an
interim period at a price that is set ‘at cost’ without any profit margin. The Company believes the stand-alone selling price of the manufacturing ingredients to be their
cost, as that approximates the amount at which Novo would be able to procure those same goods with other suppliers. In November 2019, Novo contracted with AEZS
Germany, to provide supply chain services including provision of supervision of stability studies (support services) as well as API batch production and delivery of
certain API and semi-finished goods.

License and supply agreements for macimorelin - European Union and United Kingdom

Background

On December 7, 2020, the Company entered into an exclusive licensing agreement with Consilient Health Limited ("CH”) for the commercialization of macimorelin (the

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
"Licensed Product”) in the European Economic Area and the United Kingdom (the "CH License Agreement”).

Under the terms of the CH License Agreement, CH agreed to make a non-refundable, non-creditable upfront payment to the Company of $1,209 (€1.0 million), which the
Company received in January 2021. The Company also is eligible to receive additional consideration, including regulatory milestones related to agreed-upon pricing and
reimbursement parameters; net sales milestones; and royalties, ranging from 10%-20% of net sales of macimorelin, subject to reduction in certain cases, or sublicense
income recorded by CH. Also on December 7, 2020, the Company and CH entered into an exclusive supply agreement, pursuant to which the Company agreed to provide
the Licensed Product to CH, with such Licensed Product to be manufactured by third-party manufacturers for a period of ten years, subject to renewal (the "CH Supply
Agreement”).

The total transaction price associated with the CH Agreement is $1,209 (€1.0 million), which consists of the non-refundable, non-creditable upfront payment, discussed
above. At  the  inception  of  the  contract,  all  other  contractual  consideration  to  which  the  Company  may  be  entitled  represents  variable  consideration,  including  the
regulatory  milestones,  which  were  determined  to  be  zero,  based  on  management’s  estimate  of  the  most  likely  amount,  given that  the  achievement  of  the  underlying
milestones is uncertain and highly susceptible to factors outside of the Company’s control.

The Company allocated the transaction price to the two combined performance obligation of the license agreement and the supply agreement for the adult and pediatric
indication, using the application of an adjusted market assessment approach. Revenue will be recognized over time using an outputs method based on units of Licensed
Product supplied to CH. The total units that the Company expects to supply to CH pursuant to the CH Agreement is an estimate, based on current projections and
anticipated market demand, and therefore will be a significant judgment that will be relied upon when using the outputs method to recognize revenue.

148

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

In December 2021, the Department of Health and Social Care in the United Kingdom approved a list price which triggered a $226 (€0.2 million) pricing milestone payment,
which was allocated to the Adult license performance obligation and deferred to the consolidated statement of financial position.

The aggregate amount of the transaction price allocated to the Company’s unsatisfied or partially unsatisfied performance obligations under the CH Agreement was
$1,358 (€1.2 million) as of December 31, 2021. The Company expects to recognize the balance of the relevant deferred revenue over the remaining period of ten years,
subject to extension based on the outcome of the ongoing clinical development related to the Pediatric Indication and related patent application initiatives.

For the year ended December 31, 2021, the Company recognized $nil as license fee revenue associated with the CH Agreement.

License and supply agreements for macimorelin - Korea

The Company and NK Meditech Limited ("NK”) entered into a licensing agreement, effective November 30, 2021 and pursuant to which the Company granted to NK the
exclusive right to commercialize (including marketing, selling and offering to sell) macimorelin in the Republic of Korea (the "ROK”) and as applicable, in the Democratic
People’s Republic of Korea ("DPRK”) to the extent NK is allowed to use the aforementioned licensed rights in the latter ("NK License Agreement”).

Under the terms of the NK License Agreement, NK agreed to make a non-refundable, non-creditable upfront payment to the Company of $136 (€0.1 million), which the
Company  received  in  December  2021.  The  Company  also  is  eligible  to  receive  additional  consideration,  including  a  regulatory  milestone  related  to  the  approval  of
macimorelin in the Pediatric Indication in the ROK and/or DPRK. Additionally, NK has agreed to pay AEZS royalties of 12% of any sublicense income (i.e., royalties,
upfront payments, license or option fees, lump sum payments, equity securities, milestone payments or other non-cash consideration) that may be received by NK from
any future sublicensees ("Sublicense Income”).

Also, effective November 30, 2021, the Company and NK entered into an exclusive supply agreement, pursuant to which the Company agreed to provide macimorelin to
NK for a period of ten years, subject to renewal (the "NK Supply Agreement”).

Management determined that the total transaction price associated with the  NK  License Agreement was $136 (€0.1  million),  which  consists  of  the  upfront  payment,
discussed above, that was received by the Company in 2021. The Company allocated the $136 (€0.1 million) transaction price to the single combined performance using an
outputs method based on units of macimorelin supplied to NK over a 10-year period.

Distribution agreement for macimorelin - Israel and the Palestinian Authority

In June 2020, the Company entered into an exclusive distribution and quality agreement with MegaPharm Ltd. ("MegaPharm”) for the commercialization in Israel and in the
Palestinian Authority of MacrilenTM, to be used in the diagnosis of patients with adult growth hormone deficiency and in clinical development for the diagnosis of
pediatric  growth  hormone  deficiency  (the  "MegaPharm Agreement”).  Under  the  terms  of  the  MegaPharm Agreement,  MegaPharm  will  be  responsible  for  obtaining
registration to market MacrilenTM in Israel and the Palestinian Authority, while the Company will be responsible for manufacturing, product supply, quality assurance and
control, regulatory support, and maintenance of the relevant intellectual property. In June 2021 MegaPharm filed an application to the Ministry of Health of Israel for
regulatory approval of macimorelin in Israel and, as of December 31, 2021, there have been no products supplied under this agreement.

Summary of revenue recognized, deferred revenue and contract asset balances associated with license, supply and distribution arrangements

The following table provides a summary of deferred revenue balances for the Novo Amendment, CH Agreement and NK License Agreement as of December 31:

Novo Amendment
CH Agreement
NK License Agreement
Total

Current
$

4,791   
24   
—   
4,815   

2021
Non-Current
$

23   
1,334   
136   
1,493   

Current
$

2020
Non-Current
$

4,814 
1,358 
136 
6,308 

Total
$

Total
$

Novo Amendment

2,193   

3,289   

5,482 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
Total

2,193   

3,289   

5,482 

The following table provides a summary of revenue recognized for the Strongbridge agreement and Novo Amendment:

License fee associated with the Strongbridge Agreement
License fee associated with the Novo Amendment (of which $1,670 (2020 - $264 and 2019 - $nil)
in deferred revenue was recognized)
Development services associated with Novo Amendment
Product sales associated with Novo Supply Agreement (of which $nil (2020 - $852 and 2019 -
$nil) in deferred revenue was recognized for prepayments received from Novo)
Royalties associated with the Strongbridge Agreement
Royalties associated with the Novo Amendment
Supply chain revenue associated with the Novo Supply Agreement (of which $nil (2020 - $67
and 2019 - $nil) in deferred revenue was recognized upon sale of Macrilen™ to Novo)
Total

2021
$

Years ended December 31,
2020
$

2019
$

—   

1,670   
3,337   

—   
—   
68   

185   
5,260   

68   

843   
—   

2,370   
56   
11   

304   
3,652   

74 

— 
— 

129 
45 
— 

284 
532 

As of December 31, 2021, the Company had $132 in contract assets associated with the Novo Amendment which is presented in other receivables in the Company’s
consolidated statement of financial position (note 7).

149

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

6.

Cash and cash equivalents

Cash on hand and balances with banks
Interest-bearing deposits with maturities of three months or less

7.

Trade and other receivables

Trade accounts receivable (net of expected credit losses of $55 (2020 - $55))
Value added tax
Other receivables

See also note 24 - Financial instruments and financial risk management for discussion of credit losses.

8.

Inventory

Work in process

150

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

2021
$

2021
$

December 31,

55,600   
9,700   
65,300   

December 31,

877   
372   
65   
1,314   

2020
$

2020
$

23,920 
351 
24,271 

1,190 
468 
23 
1,681 

December 31,

2021
$

2020
$

73   
73   

21 
21 

The Company recognized $nil of inventory costs and $nil as impairment in inventory in the consolidated statement of comprehensive loss for the year ended December 31,
2021 (2020 - $1,980 and $131, respectively and 2019 - $101 and $106, respectively).

9.

Prepaid expenses and other current assets

Prepaid insurance

December 31,

2021
$

2020
$

421   

1,021 

 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
Prepaid research and development
Other

10.

Restricted cash equivalents

1,329   
22   
1,772   

— 
19 
1,040 

The Company had restricted cash equivalents amounting to $335 at December 31, 2021 (2020 - $338). These balances consist of certificates of deposit that are used as
collateral for corporate credit cards and leases.

11.

Property, plant and equipment

Components of the Company’s property, plant and equipment are summarized below.

At January 1, 2020
Disposals / Retirements
Impact of foreign exchange rate changes
At December 31, 2020
Additions
Disposals / Retirements
Impact of foreign exchange rate changes
At December 31, 2021

At January 1, 2020
Disposals / Retirements
Depreciation expense
Impact of foreign exchange rate changes
At December 31, 2020
Disposals / Retirements
Depreciation expense
Impact of foreign exchange rate changes
At December 31, 2021

At December 31, 2020
At December 31, 2021

Equipment
$

Furniture and
fixtures
$

Cost
Computer
equipment
$

Leasehold
improvements
$

Total
$

422   
(245)  
38   
215   
6   
(5)  
(17)  
199   

7   
(7)  
—   
—   
—   
—   
—   
—   

314   
(3)  
24   
335   
24   
(69)  
(22)  
268   

34   
(38)  
4   
—   
—   
—   
—   
—   

  Equipment

$

Accumulated Depreciation 
Computer
equipment
$

Furniture and
fixtures
$

Leasehold
improvements  
$

Total
$

400   
(247)  
6   
40   
199   
(5)  
4   
(17)  
181   

7   
(7)  
—   
—   
—   
—   
—   
—   
—   

  Equipment

$

16   
18   
151

Furniture and
fixtures
$

—   
—   

307   
(3)  
3   
22   
329   
(69)  
5   
(21)  
244   
Carrying amount
Computer
equipment
$

6   
24   

28   
(38)  
—   
10   
—   
—   
—   
—   
—   

Leasehold
improvements  
$

—   
—   

Total
$

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

12.

Right of use assets

Cost
At January 1, 2020
Modification of building lease
Additions
Disposals
Impact of foreign exchange rate changes
At December 31, 2020
Additions
Modification of building lease
Impact of foreign exchange rate changes
At December 31, 2021

Accumulated Depreciation
At January 1, 2020
Disposals
Depreciation
Impact of foreign exchange rate changes
At December 31, 2020
Depreciation

Building
$

Vehicles and
equipment
$

Total
$

757   
(259)  
—   
—   
48   
546   
16   
109   
(48)  
623   

106   
—   
7   
(21)  
2   
94   
—   
—   
(7)  
87   

Building
$

Vehicles and equipment
$

Total
$

242 
— 
180 
15 
437 
94 

39 
(21) 
23 
5 
46 
26 

777 
(293)
66 
550 
30 
(74)
(39)
467 

742 
(295)
9 
72 
528 
(74)
9 
(38)
425 

22 
42 

863 
(259)
7 
(21)
50 
640 
16 
109 
(55)
710 

281
(21)
203
20
483
120

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
    
 
 
 
 
 
 
Impact of foreign exchange rate changes
At December 31, 2021

Carrying amount
As of December 31, 2020
As of December 31, 2021

(38) 
493 

Building
$

(5) 
67 

(43)
560

Vehicles and
equipment
$

Total
$

109   
130   

48   
20   

157 
150 

Effective August 25, 2021, the  Company and its landlord mutually agreed to a one-year extension to its existing building lease agreement for its  German subsidiary,
continuing such terms until March 31, 2023, resulting in a modification being recorded to the building right of use asset in the amount of $109. Upon the renegotiation of
the building lease agreement completed on April 30, 2020, a modification was recorded to the building right of use asset in the amount of $259, representing the reduction
in the square footage leased from the landlord. Also see note 17 - Lease liabilities.

152

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

13.

Identifiable intangible assets

Changes in the carrying value of the Company’s identifiable intangible assets are summarized below.

Balances – Beginning of the year
Additions
Amortization expense
Impact of foreign exchange rate changes
Balances – End of the year

Carrying
value
$

Cost
$

Year ended December 31, 2021
Accumulated
amortization    
$
(34,961)  
—   
(16)  
3,191   
(31,786)  

35,020   
609   
—   
(3,218)  
32,411   

59   
609   
(16)  
(27)  
625   

Carrying
value
$

Year ended December 31, 2020
Accumulated
amortization    
$
(31,382)  
—   
(20)  
(3,559)  
(34,961)  

Cost
$
31,422   
34   
—   
3,564   
35,020   

40 
34 
(20)
5 
59 

During  2021,  the  Company  recorded  additions  of  $609,  for  separately  identified  intangibles  related  to  upfront  payments  under  certain  license  agreements  with  the
University of Wuerzburg €400 ($471) and the University of Sheffield £100 ($138). These intangible assets were not subject to amortization in the year ended December 31,
2021 as they are not ready for their intended use. Amortization of intangible assets with finite lives of $16 (2020 - $20 and 2019 - $20)  is  presented  in  research  and
development expenses.

Cetrotide

On August  10,  2021,  the  Company  entered  into  a  trademark  maintenance  and  assignment  option  agreement  with ARES  Trading  SA,  a  subsidiary  of  Merck  KGaA
("Merck”), with respect to the trademarks owned by the Company on Cetrotide® (cetrorelix acetate for injection), a luteinizing hormone-releasing hormone antagonist
approved for therapeutic use as part of in vitro fertilization programs in women undergoing infertility treatment (the "Cetrotide Agreement”). The Company had transferred
all Cetrotide activities to Merck in 2013 via a license and supply agreement ("LSA”).

153

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Pursuant to the Cetrotide Agreement, the Company has granted to Merck the exclusive option to acquire any and all rights in the Cetrotide trademarks at the end of the
term of the LSA (the "Option”), which currently is May 2029 (the "Transfer Date”), when, as agreed, the Company will convey and assign to Merck all rights and interest
in, as well as title to, the Cetrotide trademarks. The transfer of the trademarks on the Transfer Date shall constitute a sale, after which the Company will no longer have any
ownership in or obligations related to the Cetrotide trademarks.

As consideration for having been granted the Option, Merck has agreed to pay the Company a total of $566 (€0.5 million) a portion of which is to be calculated as a
reimbursement of all internal and external trademark fees incurred by the Company for all years beginning with 2019 until the Transfer Date. If the Company is not able to
transfer the trademarks to Merck on the Transfer Date, all consideration paid by Merck to the Company through the Transfer Date shall be refunded to Merck, and all
rights associated with the Trademarks shall revert back to the Company.

The carrying value of the trademarks underlying Cetrotide is $nil and the Company received proceeds of $98 through December 31, 2021. Any proceeds that are received
pursuant to the Cetrotide Agreement have been or will be recorded as a deferred gain in the Company’s consolidated statement of financial position. The Company will
recognize the entirety of the gain on the Transfer Date to the extent that the transfer is successful.

14.

Goodwill

Balances at January 1, 2020
Impact of foreign exchange rate changes

Cost
$

8,050   
765   

Accumulated

impairment loss     Carrying amount 

$

—   
—   

$

8,050 
765 

 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
   
 
 
 
 
 
 
 
 
 
Balances at December 31, 2020
Impact of foreign exchange rate changes
Balances at December 31, 2021

8,815   
(685)  
8,130   

—   
—   
—   

8,815 
(685)
8,130 

Management’s evaluation of impairment in goodwill is based on fair value less costs of disposal based on the Company’s market capitalization at December 31, 2021,
including a control premium, less estimated cost of disposal of approximately $1,774. There was no impairment assessed at December 31, 2021.

15.

Payables and accrued liabilities

Trade accounts payable
Accrued research and development costs
Salaries, employment taxes and benefits
Other accrued liabilities

154

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

16.

Provisions

Balance at January 1, 2020
Utilization of provision
Change in the provision
Unwinding of discount and impact of foreign exchange rate changes
Balance at December 31, 2020
Utilization of provision
Change in the provision
Unwinding of discount and impact of foreign exchange rate changes
Balance at December 31, 2021
Less: current portion
Non-current portion

December 31,

2021
$

2020
$

934   
531   
596   
611   
2,672   

Cetrotide
onerous
contracts
$

German
restructuring:
severance
$

Total
$

396   
(93)  
33   
35   
371   
(90)  
23   
(27)  
277   
34   
243   

330   
(323)  
—   
(7)  
—   
—   
—   
—   
—   
—   
—   

1,187 
23 
474 
515 
2,199 

726 
(416)
33 
28 
371 
(90)
23 
(27)
277 
34 
243 

In 2013, the Company recognized a provision for certain non-cancellable contracts related to the Cetrotide activities, discussed in note 13 – Identifiable intangible assets,
that were deemed onerous. The provisions for onerous contracts represent the present value of estimated unavoidable future royalty and patent costs associated with the
intellectual property underlying Cetrotide.

On June 6, 2019, the Company announced that it was reducing the size of its German workforce to more closely reflect the Company’s ongoing commercial activities. This
restructuring was completed on January 31, 2020.

17.

Lease liabilities

Balance – Beginning of period
Additions
Interest paid as charged to comprehensive loss as other finance costs
Payment against lease liabilities
Modification of lease liability
Impact of foreign exchange rate changes
Balance – End of period
Current lease liabilities
Non-current lease liabilities

155

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Years Ended December 31,

2021
$

2020
 $

184   
15   
(7)  
(127)  
103   
(7)  
161   
130   
31   

903 
7 
(19)
(265)
(463)
21 
184 
135 
49 

Effective March 31, 2020, the Company and its landlord mutually agreed to modify its existing building lease agreement for its German subsidiary, extended the lease term
for its portion of the reduced space from April 30, 2021 to March 31, 2022 and retained one sub-lessee until April 30, 2021. On May 5, 2020, the sub-lessee terminated its
lease with the Company effective April 30, 2020. Concurrent with this termination, the Company was able to renegotiate a further reduction in leased square footage with

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
the landlord, which resulted in a lease modification and a resulting gain of $34 which was recorded in the consolidated statement of comprehensive loss. Effective August
25, 2021, the Company and its landlord mutually agreed to a one-year extension to its existing building lease agreement for its German subsidiary, continuing such terms
until March 31, 2023, resulting in a lease modification and a resulting gain of $nil (2020 - $34) which was recorded in the consolidated statement of comprehensive loss.

Future lease payments as of December 31, 2021 are as follows:

Less than 1 year
1 – 3 years
Total

18.

Employee future benefits

$

130 
31 
161 

AEZS  Germany  provides  unfunded  and  partially  funded  defined  benefit  multi-employer  pension  plans,  namely  the  DUPK  pension  plan  and  the  RUK  1990  and  2006
pension  plans,  (the  "Pension  Benefit  Plans”)  and  unfunded  post-employment  benefit  plans  for  certain  groups  of  employees.  Provisions  for  pension  obligations  are
established for benefits payable in the form of retirement, disability and surviving dependent pensions. The Company also provides a defined contribution plans to some
of its employees.

The  Pension  Benefit  Plans are final salary pension plans, which provide benefits to members (or to their surviving dependents) in the form of a guaranteed level of
pension payable for life. The level of benefits provided depends on the member’s length of service and on the member’s base salary in the final years leading up to
retirement. Current pensions vary in accordance with applicable statutory requirements, which foresee an adjustment every three years on an individual basis that is
based on inflationary increases or in relation to salaries of comparable groups of active employees in the Company. Generally, the Company has not authorized actual
pension increases, given the economic situation of the Company, and any legally required increases have been funded from the related pension surpluses. In 2020, the
Company became responsible for pension increases for one of its Pension Benefit Plans and, in 2021, the Company became additionally responsible for pension increases
for two of its Pension Benefit Plans.

An increase may be denied by the Company if the Company’s financial situation does not allow for an increase in pensions. As most German pension plans grant lifelong
pension benefits, rising life expectancy could increase the Company’s benefit obligation. These plans are fully or partially unfunded and the Company meets benefit
payment obligations as they fall due.

In the past, certain Pension Benefit Plans were accounted for as defined contribution plans as sufficient information was not available for the Company to account for its
proportionate  share  of  the  defined  benefit  obligation,  plan  assets  and  cost  associated  with  such  Pension  Benefit  Plans.  During  2021,  additional  information  became
available  to  the  Company,  which  began  to  account  for  its  proportionate  share  of  the  defined  benefit  obligation  and  plan  assets  amounting  to  $16,137  and  $11,963,
respectively, which amounts were recorded through other comprehensive income.

156

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The change in the Company’s accrued benefit obligations associated with the Employee future obligation is summarized for the year ended December 31, 2021:

Change in benefit obligation:
Balances – Beginning of the year
Current service cost
Interest cost
Actuarial loss (gain) arising from changes in financial assumptions
Past service cost associated with multi-employer plan
Actuarial loss arising from change in current assumptions on funding of future pension
increases
Benefits paid
Impact of foreign exchange rate changes
Balances – End of the year
Obligation is attributable to:
Active members
Vested terminees
Retirees

Change in plan assets
Balances – Beginning of the year
Presentation of plan assets as of December 31, 2021
Impact of foreign exchange rate changes
Balances – End of the year

Net liability of the unfunded plans
Net liability of the funded plans
Net amount recognized as Employee future benefits

Amounts recognized:
In net loss
In other comprehensive (loss)

157

Pension Benefit
Plans
$

Other benefit
plan
$

Total
$

15,341   
60   
87   
(1,138)  
16,137   

556   
(509)  
(1,221)  
29,313   

4,242   
13,799   
11,272   
29,313   

—   
11,963   
(36)  
11,927   

12,650   
4,736   
17,386   

(147)  
2,407   

94   
5   
1   
8   
—   

—   
(2)  
(7)  
99   

99   
—   
—   
99   

—   
—   
—   
—   

99   
—   
99   

(6)  
1   

15,435 
65 
88 
(1,130)
16,137 

556 
(511)
(1,228)
29,412 

4,341 
13,799 
11,272 
29,412 

— 
11,963 
(36)
11,927 

12,749 
4,736 
17,485 

(153)
2,408 

 
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The cumulative amount of actuarial net losses recognized in other comprehensive loss as of December 31, 2021 is $9,385 ($5,793 as of December 31, 2020 and $5,143 as of
December 31, 2019).

The change in the Company’s accrued benefit obligations associated with the Employee future benefits is summarized for the years ended December 31, 2020 and 2019:

Pension Benefit Plans
Years ended December 31,
2019
2020
$
$

Other benefit plans
Years ended December 31,
2019
2020
$
$

Balances – Beginning of the year  
Current service cost  
Interest cost  
Actuarial loss (gain) arising from changes in financial assumptions  
Benefits paid  
Impact of foreign exchange rate changes  
Balances – End of the year  

Amounts recognized:
In net loss  
In other comprehensive loss  

13,704   
50   
162   
650   
(529)  
1,304   
15,341   

(212)  
(1,954)  

13,100   
41   
239   
1,068   
(483)  
(261)  
13,704   

(280)  
(807)  

The Company’s proportionate share of the multi-employer pension plan assets as of December 31, 2021 is as follows:

Quoted equities (Level 1)
Quoted bonds (Level 1)
Cash (Level 1)
Real estate (Level 3)
Other (Level 3)
Total

The significant actuarial assumptions applied to determine the Company’s accrued benefit obligations are as follows:

84   
4   
1   
1   
(3)  
7   
94   

(6)  
(7)  

105 
8 
2 
(28)
— 
(3)
84 

18 
3 

$

826 
7,445 
67 
2,207 
1,382 
11,927 

Actuarial assumptions

Discount rate  
Pension benefits increase  
Rate of compensation increase  

Pension Benefit Plans
Years ended December 31,
2020
  %  
0.60   
0.50   
2.00   

2021
  %  
1.10   
0.50   
2.50   

2019
  %  
1.10   
1.50   
2.00   

Other benefit plans
Years ended December 31,
2020
  %  
0.60   
0.50   
2.00   

2021
  %  
1.10   
0.50   
2.50   

2019
  %  
1.90 
1.50 
2.00 

During 2020, management expanded its assumptions of possible future compensation scenarios from its current three-year forecast to a thirty-year forecast and from using
an expected average inflation rate to an expected inflation rate. Additionally, the Company included the potential claims of retirees within the thirty-year time horizon. The
Company expects to invest in its R&D opportunities, which would not change its economic situation in the short term but, if successful, does allow for scenarios that
such pension increases would be owing. Such potential future pension compensation obligations have been included in the revised forecast assumptions, at a rate of
0.50%, in addition to an expected inflation rate of 1.75%. These assumptions remain unchanged in 2021.

158

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Assumptions regarding future mortality are set based on actuarial advice in accordance with published statistics and experience in Germany. These assumptions translate
into an average remaining life expectancy in years for a pensioner retiring at age 65:

Retiring at the end of the reporting period:

Male
Female

Retiring 20 years after the end of the reporting period:

Male
Female

2021

2020

2019

21   
24   

28   
31   

20   
24   

28   
31   

20 
24 

28 
31 

The most recent actuarial reports give effect to the pension and post-employment benefit obligations as of December 31, 2021. The next actuarial reports are planned for
December 31, 2022.

In accordance with the assumptions used as of December 31, 2021, undiscounted defined pension benefits expected to be paid are as follows:

Total
$

 
 
 
 
 
 
 
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
 
 
 
 
   
 
 
 
   
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
   
 
2022
2023
2024
2025
2026
Thereafter

801 
823 
853 
868 
894 
32,685 
36,924 

The weighted average duration of the defined benefit obligation is 16.0 years.

If variations in the following assumptions had occurred during 2021, the impact on the Company’s pension benefit obligation of $29,313 as of December 31, 2021 would
have been as follows:

Assumption

Change in discount rate of 0.25%
Change in salary rate of 0.25%
Change in pension rate assumption by 0.25%
Change mortality by one year

Increase

Decrease

(1,252)  
18   
905   
968   

1,338 
(18)
(867)
(974)

Total expenses for the defined benefit plan that the Company accounts for as a defined contribution plan amounted to approximately $45 for the year ended December 31,
2021 (2020 - $38 and 2019 - $54).

159

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

19.

Share capital, warrants and other capital

(a) Share capital

The  Company  has  an  unlimited  number  of  authorized  common  shares  (being  voting  and  participating  shares)  with  no  par  value,  as  well  as  an  unlimited  number  of
preferred, first and second ranking shares, issuable in series, with rights and privileges specific to each class, with no par value.

2021

During the year ended December 31, 2021, certain warrant holders exercised outstanding warrants to purchase 35,111,187 of our common shares for gross proceeds of
approximately $20.1 million (such exercises, the "2021 Warrant Exercises”).

On February 19, 2021, the Company completed an underwritten public offering of 20,509,746 common shares at $1.45 per common share, resulting in aggregate gross
proceeds  of  $29,739,  less  underwriting  discounts,  commissions  and  offering  expenses  of  $2,837  (the  "February  2021  Financing”).  The  Company  also  granted  to  the
underwriter and placement agent (the "Underwriter”), a 30-day over-allotment option to purchase up to 3,076,461 additional common shares at a price of $1.45 per common
share  (the  "Underwriter  Option”). Additionally,  the  Company  issued  warrants  underlying  1,435,682 common shares to the  Underwriter, with each warrant bearing an
exercise price of $1.8125 (the "February 2021 Placement Agent Warrants”). The February 2021 Placement Agent Warrants expire on February 17, 2026.

On February 22, 2021, the Underwriter exercised the Underwriter Option and received 3,076,461 common shares in exchange for gross proceeds to the Company of $4,461.
Upon exercise of the Underwriter Option, the Underwriter also received an additional 215,352 February 2021 Placement Agent Warrants.

Aggregate gross proceeds received in connection with the February 2021 Financing totaled $34,200, less cash transaction costs of $3,221 and non-cash transaction costs,
which represent the issue-date fair value of the February 2021 Placement Agent Warrants, of $1,897.

2020

On  February  21,  2020,  the  Company  closed  a  registered  direct  offering  for 3,478,261  common  shares,  at  a  purchase  price  of  $1.29  per  share,  priced  at-the-market.
Additionally, 2,608,696 investor warrants were issued at an exercise price of $1.20 per common share and 243,478 broker warrants were issued at an exercise price of $1.62
per common share. The net cash proceeds to the Company from the offering totaled $3,900. The gross proceeds of $4,500 was allocated as $2,325 to warrant liability based
on the ascribed fair value and the remaining gross proceeds of $2,174 were allocated to share capital. The transaction costs of $600 were allocated between share capital
and warrants based on their relative fair values. The fair value of the share capital was recorded within equity net of the allocated transaction costs. The transaction costs
of $311 allocated to the warrant liability were recorded as expense in the consolidated statement of comprehensive loss.

160

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

On July 7, 2020, the Company closed a public offering of 26,666,666 units at a price of $0.45 per unit, for net cash proceeds to the Company of $10,596. Each unit contained
one common share (or common share equivalent in lieu thereof) and one investor warrant to purchase one common share. In total, 26,666,666 common shares, 26,666,666
investor warrants at an exercise price of $0.45 per share expiring July 7, 2025 (the "July 2020 Investor Warrants”) and 1,866,667 placement agent warrants with an exercise
price of $0.5625 per share, expiring July 1, 2025 (the "July 2020 Placement Agent Warrants”) were issued. As these warrants were registered and can be settled for a fixed
number of the Company’s underlying common shares, the warrants meet the requirements of the fixed-for-fixed rule and have been classified as equity.

Because the warrants were classified as equity, the gross proceeds of $12,000 were allocated as $6,308 to share capital and $5,691 to warrants based on their relative fair
values. The transaction costs of $1,420 were reduced from share capital and warrants in the amounts of $754 and $666, respectively, and charged to share issuance costs

   
   
   
   
   
   
 
   
 
 
 
 
   
 
 
 
    
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
and classified as equity. The values ascribed to the share capital and warrants were recorded within equity, net of the allocated transaction costs.

On August 5, 2020, the Company closed a securities purchase agreement of 12,427,876 common shares at a purchase price of $0.56325 per common share. The offering
resulted in gross proceeds of $7,000. Concurrently, the Company issued to the purchasers unregistered warrants to purchase up to an aggregate of 9,320,907  common
shares. The warrants are exercisable for a period of five and one-half years, exercisable immediately following the issuance date and have an exercise price of $0.47 per
common share. In addition, the Company issued unregistered warrants to the placement agent to purchase up to an aggregate of 869,952 common shares, with an exercise
price of $0.7040625 per share and an expiration date of August 3, 2025. The gross proceeds of $7,000 was allocated as $3,944 to warrant liability based on the ascribed fair
value and the remaining gross proceeds of $3,056 were allocated to share capital. The transaction costs of $748 were allocated between share capital and warrants based
on their relative fair values. The fair value of the share capital was recorded within equity net of the allocated transaction costs of $327. The transaction costs of $421
allocated to the warrant liability were recorded as expense in the consolidated statement of comprehensive loss.

2019

On September 20, 2019, the Company entered into a securities purchase agreement with US institutional investors to purchase $4,988 (before total transaction costs of
$795) of its common shares in a registered direct offering and warrants with a cashless exercise feature to purchase common shares in a concurrent private placement
(together, the "Offering”). The combined purchase price for one common share and one warrant was $1.50. Under the terms of the securities purchase agreement, the
Company  sold 3,325,000 common shares. The gross proceeds of $4,988 was allocated as $3,457 to warrants based on the ascribed fair value and the remaining gross
proceeds of $1,531 were allocated to share capital. The transaction costs of $795 were allocated between share capital and warrants based on their relative fair values. The
fair value of the share capital was recorded within equity net of the allocated transaction costs.  The transaction costs of $550 allocated to the warrant liability were
recorded as expense in the consolidated statements of comprehensive loss.

161

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Shareholder rights plan

Effective May 8, 2019, the shareholders re-approved the Company’s shareholder rights plan (the "Rights Plan”) that provides the board of directors and the Company’s
shareholders with additional time to assess any unsolicited take-over bid for the Company and, where appropriate, to pursue other alternatives for maximizing shareholder
value. Under the Rights Plan, one right has been issued for each currently issued common share, and one right will be issued with each additional common share that may
be issued from time to time.

(b) Warrants

Balance – January 1, 2020
Warrant liability reclassified to equity
Warrants issued as equity
Balance – December 31, 2020
February 2021 Placement Agent Warrants
Warrants exercised
Allocation of transaction costs to share capital
Balance – December 31, 2021

i) Warrants granted in 2021

Weighted average

exercise price    

Number

($)

$

—   
16,368,033   
28,533,333   
44,901,366   
1,651,034   
(35,111,187)  
—   
11,441,213   

—   
0.8556   
0.4574   
0.6025   
1.8125   
0.5725   
—   
0.8668   

— 
7,377 
5,025 
12,402 
1,897 
(9,746)
532 
5,085 

The table presented below shows the inputs and assumptions applied to the Black-Scholes option pricing model in order to determine the fair value of the February 2021
Placement Agent Warrants:

February 2021 Placement Agent Warrants issued on February 19,
2021
February 2021 Placement Agent Warrants issued on February 22,
2021

Number of
equivalent
shares
#

  1,435,682   

215,352   

Market
value per
share
price
$

Weighted
average
exercise
price
$

Risk-free
annual
interest
rate
(i)

Expected
volatility  
(ii)

Expected
life

(years)    

(iii)

Expected
dividend

yield  
(iv)

1.48   

1.48   

1.8125   

0.58734% 

119.18% 

1.8125   

0.58544% 

119.57% 

4.99   

4.98   

0.00%

0.00%

(i) Based on United States Treasury Government Bond interest rates with a term that is consistent with the expected life of the warrants.
(ii) Based on the historical volatility of the Company’s stock price over the most recent period consistent with the expected life of the warrants.
(iii) Based upon time to expiry from the issuance date.
(iv) The Company has not paid dividends and it does not intend to pay dividends in the foreseeable future.

162

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

ii) Warrants exercised in 2021

 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
   
   
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
During 2021, certain warrant holders exercised their warrants as follows:

September 2019 Investor warrants
February 2020 Investor warrants
July 2020 Investor warrants
July 2020 Placement Agent warrants
August 2020 Investor warrants
August 2020 Placement Agent warrants

iii) Warrant liability reclassified to equity in 2020

Warrants
exercised (number
of underlying
common shares)    
2,000,000   
1,739,130   
21,045,555   
1,866,667   
7,589,883   
869,952   
35,111,187   

$

Exercise Price

Aggregate
proceeds to the
Company

1.65   
1.20   
0.45   
0.5625   
0.47   
0.7040625   

$

$

3,300 
2,087 
9,471 
1,050 
3,567 
612 
20,087 

The  Company  had  issued 3,325,000 unregistered investor warrants in the September 2019 closed direct offering (the "September 2019 Warrants”) as well as 2,608,696
unregistered  investor  warrants  (the  "February  2020  Investor  Warrants”)  and 243,478  unregistered  placement  agent  warrants  (the  "February  2020  Placement  Agent
Warrants”) in the February 2020 closed direct offering transaction. The terms of the warrant agreement stated that if the warrants remained unregistered, the warrant
holder could elect to exercise the warrants by way of a cashless exercise. This violated the fixed-for-fixed criterion due to the cashless exercise option, and accordingly
these warrants had been accounted for as a liability.

Effective June 16, 2020, the Company registered the common shares underlying these warrants by way of a registration statement which eliminated the cashless exercise
option on the warrants, on a one-for-one basis. Accordingly, as of June 16, 2020, the warrant liability was remeasured at fair value using the Black-Scholes option pricing
model,  with  the  amount  of  the  remeasurement  loss  recognized  in  the  consolidated  statement  of  comprehensive  loss.  The  carrying  value  of  the  warrants  was  then
reclassified from warrant liability to other capital within equity.

163

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The  Company  also  issued 9,320,907  unregistered  investor  warrants  (the  "August  2020  Investor  Warrants”)  and 869,952  unregistered  placement  agent  warrants  (the
"August 2020  Placement Agent  Warrants”) in the August 2020 registered direct offering transaction.  The terms of the warrant agreement stated that if the warrants
remained unregistered, the warrant holder could elect to exercise the warrants by way of a cashless exercise. This violated the fixed-for-fixed criterion due to the cashless
exercise option, and accordingly these warrants were accounted for as a liability on issuance and measured at fair value using the Black-Scholes option pricing model.
Effective September 14, 2020, the Company registered the common shares underlying these warrants by way of a registration statement which eliminated the cashless
exercise option on the warrants, on a one-for-one basis. Accordingly, as of September 14, 2020, the warrant liability was remeasured at fair value using the Black-Scholes
option pricing model, with the amount of the remeasurement loss recognized in the consolidated statement of comprehensive loss. The carrying value of the warrants was
then reclassified from warrant liability to other capital within equity.

The table presented below shows the inputs and assumptions applied to the Black-Scholes option pricing model in order to determine the fair value of such warrants as of
the noted dates of reclassification:

As of June 16, 2020:
September 2019 Warrants
February 2020 Investor Warrants
February 2020 Placement Agent Warrants
As of September 14, 2020:
August 2020 Investor Warrants
August 2020 Placement Agent Warrants

Market
value per
share
price
($)

Weighted
average
exercise
price
($)

Risk-
free
annual
interest
rate
(i)

Expected
volatility  
(ii)

Expected
life

(years)    
(iii)

Expected
dividend
yield  
(iv)

0.96   
0.96   
0.96   

1.65   
1.20   
1.62   

0.38   
0.38   

0.47   
  0.704063   

0.30% 
0.36% 
0.32% 

0.31% 
0.26% 

104.5% 
119.3% 
113.3% 

120.5% 
114.6% 

4.3   
5.2   
4.7   

5.4   
4.9   

0.00%
0.00%
0.00%

0.00%
0.00%

Number of
equivalent
shares

  3,325,000   
  2,608,696   
243,478   

  9,320,907   
869,952   

(i) Based on United States Treasury Government Bond interest rates with a term that is consistent with the expected life of the warrants.
(ii) Based on the historical volatility of the Company’s stock price over the most recent period consistent with the expected life of the warrants, as well as on future

expectations.

(iii) Based upon time to expiry from the reporting period date.
(iv) The Company has not paid dividends and it does not intend to pay dividends in the foreseeable future.

164

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

iv) Warrants issued as equity in 2020

On July 7, 2020, the Company closed a public offering of 26,666,666 units at a price of $0.45 per unit, for net cash proceeds to the Company of $10,596. Each unit contained
one common share (or common share equivalent in lieu thereof) and one investor warrant to purchase one common share. In total, 26,666,666 common shares, 26,666,666
July 2020 Investor Warrants and 1,866,667 July 2020 Placement Agent Warrants were issued. As these warrants were registered and can be settled for a fixed number of

 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
    
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
the Company’s underlying common shares, the warrants meet the requirements of the fixed-for-fixed rule were classified as equity.

The table presented below shows the inputs and assumptions applied to the Black-Scholes option pricing model in order to determine the fair value of such warrants:

July 2020 Investor Warrants
July 2020 Placement Agent Warrants

Number of
equivalent
shares

Market
value per
share
price
($)

  26,666,666   
  1,866,667   

0.52   
0.52   

Weighted
average
exercise
price
($)
0.457   
0.5625   

Risk-
free
annual
interest
rate
(i)
0.2879% 
0.2879% 

Expected
volatility  
(ii)
  123.1048% 
  123.1048% 

Expected
life

(years)    
(iii)

Expected
dividend
yield  
(iv)

5   
5   

0.00%
0.00%

(i) Based on United States Treasury Government Bond interest rates with a term that is consistent with the expected life of the warrants.
(ii) Based on the historical volatility of the Company’s stock price over the most recent period consistent with the expected life of the warrants, as well as on future

expectations.

(iii) Based upon time to expiry from the reporting period date.
(iv) The Company has not paid dividends and it does not intend to pay dividends in the foreseeable future.

(c) Other capital

Long-term incentive plan

At the 2018 annual and special meeting of shareholders, the Company’s shareholders approved the adoption of the 2018 long-term incentive plan (the "LTIP”), which
allows the Board of Directors to issue up to 11.4% of the total issued and outstanding common shares at any given time to eligible individuals at an exercise price to be
determined by the Board of Directors at the time of the grant, subject to a ceiling, as stock options, stock appreciation rights, stock awards, deferred stock units ("DSUs”),
performance  shares,  performance  units,  and  other  stock-based  awards.  This  LTIP  replaces  the  stock  option  plan  (the  "Stock  Option  Plan”)  for  its  directors,  senior
executives, employees and other collaborators who provide services to the Company. Options granted under the LTIP expire after seven years following the date of grant,
vest over three years, beginning one year after date of grant. The Company’s Board of Directors amended the Stock Option Plan on March 20, 2014 and the Company’s
Shareholders approved, ratified and confirmed the Stock Option Plan on May 10, 2016. Options granted under the Stock Option Plan prior to the 2014 amendment expire
after a maximum period of 10 years following the date of grant. Options granted after the 2014 amendment expire after a maximum period of seven years following the date
of grant.

165

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company settles stock options exercised through the issuance of new common shares as opposed to purchasing common shares on the market to settle stock option
exercises.

As of December 31, 2021, the total compensation cost related to unvested US dollar stock options not yet recognized amounted to $96 (2020 - $43 and 2019 - $101). This
amount is expected to be recognized over a weighted average period of 1.54 years (2020 - 1.43 years and 2019 1.21 years).

Balance – January 1, 2021
Granted
Expired
Exercised
Balance – December 31, 2021

Balance – Beginning of year

Granted
Exercised
Canceled/Forfeited
Expired

Balance – End of year

Balance – Beginning of year

Granted
Exercised
Canceled/Forfeited

Year ended December 31, 2021
Weighted average

exercise price    

($)

Stock options
(Number)

DSUs
(Number)

506,400   
580,000   
(32)  
—   
1,086,368   

1.44   
0.42   
590.25   
—   
0.88   

173,000 
280,000 
— 
(30,000)
423,000 

Year ended December 31, 2019

US$ Stock
options
(Number)

Weighted
average

exercise price    

(US$)

DSUs
(Number)

CAN$ Stock
options
(Number)

Weighted
average
exercise price  
(CAN$)

727,816   
185,000   
(64,850)  
(6,000)  
(100,850)  
741,116   

4.07   
1.07   
2.75   
13.39   
2.24   
3.61   

161,000   
150,000   
(99,000)  
—   
—   
212,000   

869   
—   
—   
—   
(428)  
441   

743.56 
— 
— 
— 
570.00 
912.00 

US$ Stock
options
(Number)

741,116   
180,000   
—   
(330,350)  

Year ended December 31, 2020

Weighted
average

exercise price    

(US$)

DSUs
(Number)

CAN$ Stock
options
(Number)

3.61   
0.37   
—   
2.56   

212,000   
120,000   
(159,000)  
—   

441   
—   
—   
—   

Weighted
average
exercise price  
(CAN$)

912.00 
— 
— 
— 

 
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Expired

Balance – End of year

(84,366)  
506,400   

166

2.14   
1.44   

—   
173,000   

(441)  
—   

912.00 
— 

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Fair value input assumptions for US dollar stock option grants

The  table  below  shows  the  assumptions,  or  weighted  average  parameters,  applied  to  the  Black-Scholes  option  pricing  model  in  order  to  determine  share-based
compensation costs over the life of the awards.

Expected dividend yield
Expected volatility
Risk-free annual interest rate
Expected life (years)
Weighted average share price
Weighted average exercise price
Weighted average grant date fair value

_________________________

2021

Years ended December 31,
2020

2019

(a)
(b)
(c)
(d)

$
$
$

0.00%  
115.80%  
1.23%  
5.71 
0.42 
0.42 
0.35 

$
$
$

0.00% 
112.50% 
0.27% 
4.02 
0.37 
0.37 
0.27 

$
$
$

0.00%
110.02%
1.86%
5.94 
2.00 
2.00 
2.00 

(a) The Company has not paid dividends and it does not intend to pay dividends in the foreseeable future.

(b) Based on the historical volatility of the Company’s stock price over the most recent period consistent with the expected life of the stock options, as well as on future

expectations.

(c) Based on United States Treasury Government Bond interest rates with a term that is consistent with the expected life of the stock options.

(d) Based upon historical data related to the exercise of stock options, on post-vesting employment terminations and on future expectations related to exercise behavior.

Range of US dollar stock option exercise prices
0.37 to 0.50
0.51 to 1.78
1.79 to 3.14
3.15 to 217.00

Options outstanding
Weighted
average
remaining
contractual
life
(years)

  Number (#)   
760,000   
160,000   
85,000   
81,368   
  1,086,368   

6.72   
4.91   
3.21   
1.70   
5.81   

Weighted
average
exercise
price
($)

0.41   
0.91   
2.08   
3.95   
0.88   

Number
(#)
60,006   
106,672   
76,667   
81,368   
  324,713   

Options exercisable
Weighted
average
remaining
contractual
life
(years)

Weighted
average
exercise
price
($)

0.37 
0.90 
2.07 
3.95 
1.84 

5.95   
4.91   
3.06   
1.70   
3.86   

167

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

20.

Operating expenses

The nature of the Company’s operating expenses includes the following:

Key management personnel compensation(1)
Salaries and short-term employee benefits
Consultant’s fees
Termination benefits
Post-employment benefits, including defined contribution plan benefits of $33
in 2021, $33 in 2020 and $195 in 2019
Share-based compensation costs

Other employees compensation:

Salaries and short-term employee benefits
Post-employment benefits, including defined contribution plan benefits of $15
in 2021, $9 in 2020 and $25 in 2019
Share-based compensation costs

2021
$

Years ended December 31,
2020
$

2019
$

1,646   
163   
—   

70   
295   
2,174   

1,160   

139   
16   

1,540   
167   
—   

86   
160   
1,953   

1,004   

159   
(99)  

1,705 
194 
503 

257 
784 
3,443 

1,257 

78 
9 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
Cost of inventory used and services provided
Professional fees
Insurance
Third-party research and development
Consulting fees
Restructuring costs
Travel
Marketing services
Laboratory supplies
Other goods and services
Leasing costs, net of sublease receipts of $nil in 2021, $nil in 2020 and $214 in 2019 
Modification of building lease
(Reversal) impairment of other asset and inventory
Depreciation and amortization of property, equipment and intangibles
Depreciation - right to use assets
Impairment of right of use asset
Operating foreign exchange losses (gains)

______________________

(1) Key management includes the Company’s executive management team and directors.

1,315   
90   
2,749   
1,077   
5,047   
553   
—   
130   
222   
114   
162   
112   
—   
—   
25   
120   
—   
41   
10,442   
13,931   

1,064   
2,186   
1,969   
861   
414   
587   
—   
66   
39   
36   
72   
218   
(219)  
(8)  
29   
203   
—   
(112)  
6,341   
9,358   

1,344 
309 
2,599 
890 
322 
144 
507 
154 
18 
23 
137 
247 
— 
270 
37 
278 
22 
30 
5,987 
10,774 

Most of the employment agreements entered into between the Company and its executive officers include termination provisions, whereby the executive officers would be
entitled to receive benefits that would be payable if the Company were to terminate the executive officers’ employment without cause or if their employment is terminated
following a change of control. Separation benefits generally are calculated based on an agreed-upon multiple of applicable base salary and incentive compensation and, in
certain cases, other benefit amounts.

168

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

21.

Supplemental disclosure of cash flow information

Changes in operating assets and liabilities:

Trade and other receivables
Inventory
Prepaid expenses and other current assets
Payables and accrued liabilities
Income taxes payable
Deferred revenues
Provision for restructuring and other costs
Employee future benefits (note 18)

22.

Income taxes

2021
$

Years ended December 31,
2020
$

2019
$

120   
(56)  
(750)  
634   
(109)  
3,010   
—   
(349)  
2,500   

(1,023)  
1,182   
(702)  
51   
395   
3,031   
—   
(532)  
2,402   

Significant components of the current and deferred income tax recovery (expense) for the years ended December 31, 2021, 2020 and 2019 are as follows:

Current income tax recovery (expense)
Deferred tax:

Origination and reversal of temporary differences
Change in unrecognized tax assets
Total income tax recovery (expense)

2021
$

Years ended December 31,
2020
$

2019
$

109   

1,291   
(1,291)  
109   

(395)  

1,509   
(1,509)  
(395)  

(371)
(971)
(170)
(615)
(188)
743 
(389)
(483)
(2,444)

188 

2,755 
(2,755)
188 

From time to time, the Company is subject to tax audits. While the Company believes that its filing positions are appropriate and supportable, periodically, certain matters
are challenged by tax authorities. Although the Company believes its tax provisions are adequate, the final determination of tax audits and any related disputes could be
materially different from historical income tax provisions and accruals. In 2020, AEZS Germany underwent a tax audit regarding the taxation years 2013 to 2016. As of
December 31, 2021, the tax authorities concluded the audit for those years. The subsequent years remain unaudited, and the Company has accrued $115 as an uncertain
tax provision for those years. In addition, as of December 31, 2021, AEZS Germany paid instalments in the amount of $1,605 for the 2021 tax year and $1,448 in estimated
taxes payable for the 2020 tax year.

169

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in thousands of US dollars, except share and per share data and where otherwise noted)

The reconciliation of the combined Canadian federal and provincial corporate income tax rate to the income tax expense is provided below:

2021

Years ended December 31,
2020

2019

26.5%  

26.5% 

26.5%

2021
$

Years ended December 31,
2020
$

2019
$

2,246   
(1,291)  

367   
—   
—   
(1,724)  
151  
—   
(82)  
226   
—   
216   
109   

1,252   
(1,872)  

363   
—   
—   
(481)  
—   
304   
(16)  
99   
(123)  
79   
(395)  

1,615 
(2,820)

65 
35 
(27)
— 
— 
1,197 
(210)
321 
— 
12 
188 

2021
$

Years ended December 31,
2020
$

2019
$

(4,383)  
(3,860)  
(234)  
(8,477)  

2021
$

(2,042)  
(2,463)  
(218)  
(4,723)  

(6,010)
812 
(1,032)
(6,230)

December 31,

2020
$

205   
776   
981   

375   
7   
47   
492   
60   
981   
981   
—   

46 
1,318 
1,364 

126 
49 
1,073 
116 
1,364 
1,364 
— 

Combined Canadian federal and provincial statutory income tax rate

Income tax (expense) recovery based on combined statutory income tax rate
Change in unrecognized tax assets

Share issuance costs
Permanent difference attributable to the use of local currency for tax reporting
Change in enacted rates used
Impact of expiring tax credits
Provision to filed return adjustments
Permanent difference attributable to net change in fair value of warrant liability
Share-based compensation costs
Difference in statutory income tax rate of foreign subsidiaries
Uncertain tax position
Other

170

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

(Loss) income before income taxes

(Loss) income before income taxes is attributable to the Company’s tax jurisdictions as follows:

Germany
Canada
United States

Significant components of deferred tax assets and liabilities are as follows:

Deferred tax assets

Operating losses carried forward
Intangible assets

Deferred tax liabilities

Accounts receivable
Payables and accrued liabilities
Property, plant and equipment
Deferred revenues
Other

Deferred tax assets (liabilities), net

171

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Significant components of deferred tax assets and losses are as follows:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Unrecognized deferred tax assets

Deferred revenues and other provisions
Operating losses carried forward
Capital losses carried forward
SR&ED Pool
Unused tax credits
Employee future benefits
Property, plant and equipment
Intangible assets
Share issuance expenses
Other

Unrecognized deferred tax assets

December 31,

2021
$

2020
$

1,680   
87,734   
105   
9,138   
2,945   
3,396   
523   
—   
1,110   
84   
106,715   
106,715   

1,494 
89,144 
— 
9,138 
4,668 
2,570 
495 
541 
623 
— 
108,673 
108,673 

Deferred income tax assets are recognized to the extent that the realization of the related tax benefit through reversal of temporary differences and future taxable profits is
probable. Based on the current forecasted future taxable profits and reversal of temporary differences, the company does not believe it will have sufficient future earnings
to offset the deferred tax assets and has an unrecognized deferred tax asset balance of $106,715.

As at December 31, 2021, the Corporation has total accumulated non-capital losses of $77,867 federally and $76,545 provincially, which may be carried forward for twenty
years and used to reduce taxable income in future years. The Corporation has not recognized deferred tax assets on any of the non-capital losses, due to the uncertainty
that there will be sufficient taxable income or that the taxable temporary differences will be reversing in the same reporting period and jurisdiction. The losses will be
expiring as follows:

2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041

Canada

Federal
$

Provincial
$

8,054   
4,791   
4,104   
1,753   
4,250   
3,721   
4,153   
10,418   
10,592   
7,343   
6,557   
3,501   
3,808   
4,822   
77,867   

6,668 
4,773 
4,089 
1,737 
4,250 
3,721 
4,153 
10,452 
10,592 
7,343 
6,557 
3,580 
3,808 
4,822 
76,545 

172

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company has non-refundable R&D investment tax credits of approximately $4,006 which can be carried forward to reduce Canadian federal income taxes payable and
which expire at dates ranging from 2022 to 2035. Furthermore, the Company has unrecognized tax assets in respect of operating losses to be carried forward in Germany
and in the US The federal tax losses amount to approximately $210,709 in Germany (€ 185,271) for which there is no expiry date, and to $4,793 in the US. The losses in the
US will be expiring as follows:

2028
2029
2034
2035
2036
2037
2038
2039
2040
2041

United States
$

369 
178 
151 
447 
195 
709 
1,224 
771 
515 
234 
4,793 

The operating loss carryforwards and the tax credits claimed are subject to review, and potential adjustment, by tax authorities. Other deductible temporary differences for
which tax assets have not been booked are not subject to a time limit, except for share issuance expenses which are amortizable over five years.

23.

Capital disclosures

The  Company’s objective in managing capital, consisting of shareholders’ equity, with cash and cash equivalents and restricted cash equivalents being its primary
components, is to ensure sufficient liquidity to fund R&D costs, selling expenses, general and administrative expenses and working capital requirements. Over the past

 
 
 
 
 
   
 
 
 
   
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
several years, the Company has raised capital via public and private equity offerings and issuances as its primary source of liquidity, as discussed in note 19 - share
capital, warrants and other capital. The capital management objective of the Company remains the same as that in previous periods. The policy on dividends is to retain
cash  to  keep  funds  available  to  finance  the  activities  required  to  advance  the  Company’s  product  development  portfolio  and  to  pursue  appropriate  commercial
opportunities as they may arise.

The Company is not subject to any capital requirements imposed by any regulators or by any other external source.

173

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

24.

Financial instruments and financial risk management

Financial assets and liabilities as of December 31, 2021 and December 31, 2020 are presented below.

December 31, 2021

Cash and cash equivalents (note 6)
Trade and other receivables (note 7)
Restricted cash equivalents (note 10)
Payables and accrued liabilities (note 15)
Lease liability (note 17)

December 31, 2020

Cash and cash equivalents (note 6)
Trade and other receivables (note 7)
Restricted cash equivalents (note 10)
Payables and accrued liabilities (note 15)
Lease liability (note 17)

Fair value

Financial assets at
amortized cost
$

Financial liabilities at
amortized cost
$

65,300   
1,314   
335   
—   
—   
 66,949   

— 
— 
— 
1,530 
161 
1,691 

Financial assets at
amortized cost
$

Financial liabilities at
amortized cost
$

24,271   
1,681   
338   
—   
—   
26,290   

— 
— 
— 
2,176 
184 
2,360 

IFRS  13, Fair Value Measurement ("IFRS 13”) establishes a hierarchy that prioritizes the inputs used to measure fair value. The hierarchy gives the highest priority to
unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurement) and the lowest priority to unobservable inputs (Level 3 measurement).

The input levels discussed in IFRS 13 are:

Level 1 – Unadjusted quoted prices in active markets for identical assets or liabilities.

Level 2 – Inputs other than quoted prices included within Level 1 that are observable for an asset or liability, either directly (i.e. prices) or indirectly (i.e. derived from
prices).

Level 3 – Inputs for an asset or liability that are not based on observable market data (unobservable inputs).

The carrying values of the Company’s cash and cash equivalents, trade and other receivables, restricted cash equivalents, payables and accrued liabilities and provision
for restructuring and other costs approximate their fair values due to their short-term maturities or to the prevailing interest rates of the related instruments, which are
comparable to those of the market.

174

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Financial risk factors

The following provides disclosures relating to the nature and extent of the Company’s exposure to risks arising from financial instruments, including credit risk, liquidity
risk and foreign exchange risk and how the Company manages those risks.

(a) Credit risk

Credit risk is the risk of an unexpected loss if a customer or counterparty to a financial instrument fails to meet its contractual obligations. The Company regularly monitors
credit risk exposure and takes steps to mitigate the likelihood of this exposure resulting in losses. The Company’s exposure to credit risk currently relates to the financial
assets at amortized cost in the table above. The Company holds its available cash in amounts that are readily convertible to known amounts of cash and deposits its cash
balances with financial institutions that have an investment grade rating of at least "P-2” or the equivalent. This information is supplied by independent rating agencies
where available and, if not available, the Company uses publicly available financial information to ensure that it invests its cash in creditworthy and reputable financial
institutions. Once there are indicators that there is no reasonable expectation of recovery, such financial assets are written off but are still subject to enforcement activity.

 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2021, trade accounts receivable for an amount of approximately $932 were with three counterparties of which $55 was past due and impaired and fully
provided for (2020 - $1,245 with three counterparties and $55 past due and impaired and fully provided for).

Generally, the Company does not require collateral or other security from customers for trade accounts receivable; however, credit is extended following an evaluation of
creditworthiness. In addition, the Company performs ongoing credit reviews of all of its customers and determines expected credit losses. On this basis, as of December
31, 2021, the Company has provided for all outstanding and unpaid amounts relating to its operations before its licensing of MacrilenTM.

The maximum exposure to credit risk approximates the amount recognized in the Company’s consolidated statement of financial position.

(b) Liquidity risk

Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they become due. As indicated in note 24, the Company manages this risk
through the management of its capital structure. It also manages liquidity risk by continuously monitoring actual and projected cash flows.

A portion of the Company’s cash is held in AEZS Germany, which is the counter-party to various license and distribution agreements for the Company’s only approved
product. In September 2019 and February, July and August of 2020 and February of 2021 the Company completed financings resulting in total funding (net of transaction
costs) of $55,905 (note 19). Net cash proceeds were deposited in AEZS Canada accounts and such funds can be provided to its German subsidiary, if and when needed.
During 2020, AEZS Germany signed agreements with NOVO and CH whereby AEZS Germany received cash payments of €5,000 ($6,109) in fiscal 2020 and €1,000 ($1,209)
in January 2021, respectively (note 5), and expects to use this cash to fund its operations directly.

175

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Board of Directors reviews and approves the Company’s operating and capital budgets, as well as any material transactions occurring outside of the ordinary course
of business. The Company has adopted an investment policy in respect of the safety and preservation of its capital to ensure the Company’s liquidity needs are met. The
instruments are selected with regard to the expected timing of expenditures and prevailing interest rates.

All  of  the  Company’s  financial  liabilities  except  lease  liabilities  are  current  liabilities  with  expected  settlement  dates  within  one  year.  The  maturity  analysis  for  lease
liabilities is disclosed in note 17.

(c) Foreign exchange risk

Entities using the Euro as their functional currency

The Company is exposed to foreign exchange risk due to its investments in foreign operations whose functional currency is the Euro. As of December 31, 2021, if the US
dollar had increased or decreased by 10% against the Euro, with all other variables held constant, net loss for the year ended December 31, 2021 would have been lower or
higher by approximately $300 (2020 - $110 and 2019 - $841).

25.

Segment information

The Company operates in a single operating segment, being the biopharmaceutical segment.

Geographical information

Revenues by geographical area have been allocated to geographic regions based on the country of residence of the Company’s external customers or licensees and are
detailed as follows:

Switzerland
Ireland
Denmark
Other

2021
$

Years ended December 31,
2020
$

2019
$

5,075   
—   
185   
—   
5,260   

905   
73   
2,655   
19   
3,652   

— 
74 
413 
45 
532 

Non-current assets include restricted cash equivalents, right of use assets, property, plant and equipment, identifiable intangible assets, other asset and goodwill and are
detailed by geographical area as follows:

176

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

Germany
United States

December 31,

2021
$

2020
$

9,212   
70   
9,282   

9,341 
50 
9,391 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
Major customers representing 10% or more of the Company’s revenues in each of the last three years are as follows:

Company 1

26.

Net loss per share

2021
$

Years ended December 31,
2020
$

2019
$

5,260   

3,634   

532 

The following table sets forth pertinent data relating to the computation of basic and diluted net loss per share attributable to common shareholders.

Net loss
Basic weighted average number of shares outstanding
Diluted weighted average number of shares outstanding
Items excluded from the calculation of diluted net loss per share because the exercise price was
greater than the average market price of the common shares or due to their anti-dilutive effect  
Stock options and DSUs
Share purchase warrants

2021
$

Years ended December 31,
2020
$

(8,368)  
114,924,497   
114,924,497   

(5,118)  
41,083,163   
41,083,163   

2019
$

(6,042)
17,494,472 
17,494,472 

1,509,368   
11,441,213   

679,400   
44,901,366   

953,557 
6,629,144 

Net loss per share is calculated by dividing net loss by the weighted average number of shares outstanding during the relevant period. Diluted weighted average number
of shares reflects the dilutive effect of equity instruments, such as any "in the money” stock options, DSUs and warrants. In periods with reported net losses, all stock
options and warrants are deemed anti-dilutive such that basic net loss per share and diluted net loss per share are equal, and thus "in the money” stock options and
warrants have not been included in the computation of net loss per share because to do so would be anti-dilutive.

177

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2021 and December 31, 2020 and for the years ended
December 31, 2021, 2020 and 2019
(in thousands of US dollars, except share and per share data and where otherwise noted)

27.

Commitments and contingencies

Contractual obligations and commitments as of December 31, 2021

Less than 1 year
1 – 3 years
4 – 5 years
More than 5 years
Total

Service and

manufacturing    

$

R&D
contracts
$

1,085   
6   
—   
—   
1,091   

2,252   
1,049   
—   
—   
3,301   

TOTAL
$

3,337 
1,055 
— 
— 
4,392 

During  2021,  the  Company  executed  various  agreements  including  in-licensing  and  similar  arrangements  with  development  partners  (note  13).  Such  agreements  may
require  the  Company  to  make  payments  on  achievement  of  stages  of  development,  launch  or  revenue  milestones,  although  the  Company  generally  has  the  right  to
terminate these agreements at no penalty. The Company recognizes research and development milestones as an intangible asset once it is committed to the payment,
which is generally when the Company reaches a set point in the development cycle.

Based on the closing exchange rates at December 31, 2021, the Company expects to pay $3,301, including $3,124 (€2.8 million), and $177 (£0.1 million), in R&D contracts
and up to $8,937, including $7,386 (€6.5 million) and $1,551 (£1.2 million), in R&D milestone payments and up to $32,942, including $31,255 (€27.6 million) and $1,687 (£1.3
million), in revenue related milestone payments. The table below contains all potential R&D and revenue-related milestone payments that the Company may be required to
make under such agreements:

Less than 1 year
1 – 3 years
4 – 5 years
More than 5 years
Total

Future potential
R&D milestone
payments
$

Future potential
revenue
milestone
payments
$

28   
113   
927   
7,869   
8,937   

—   
—   
—   
32,942   
32,942   

Total
$

28 
113 
927 
40,811 
41,879 

The  table  excludes  any  payments  already  capitalized  in  the  consolidated  statement  of  financial  position.  The  future  payments  that  are  disclosed  represent  contract
payments and are not discounted and are not risk-adjusted. The development of any pharmaceutical product candidates is a complex and risky process that may fail at
any stage in the development process due to a number of factors. The timing of the payments is based on the Company’s current best estimate of achievement of the
relevant milestone.

Securities class action lawsuit

On March 9, 2020, the Company settled the previously disclosed class-action lawsuit against it pending in the US District Court for the District of New Jersey. This
settlement was approved by the US District Court for the District of New Jersey on June 3, 2021. The settlement payment was funded entirely by the Company’s insurers.
As no appeals were filed within the 30-day appeal period, this matter is fully and finally settled.

 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
178

Item 19. Exhibits

Exhibit Index

1.1

  Restated Certificate of Incorporation and Restated Articles of Incorporation of the Registrant (incorporated by reference to Exhibit 99.2 to the Registrant’s report on

Form 6-K furnished to the Commission on May 25, 2011)

1.2

  Certificate of Amendment and Articles of Amendment of the Registrant (incorporated by reference to Exhibit 99.2 to the Registrant’s report on Form 6-K furnished to the

Commission on October 3, 2012)

1.3

  Certificate of Amendment and Articles of Amendment of the Registrant (incorporated by reference to Exhibit 99.1 to the Registrant’s report on Form 6-K furnished to the

Commission on November 17, 2015)

1.4

  Amended and Restated By-Law One of the Registrant (incorporated by reference to Exhibit 1.3 of the Registrant’s Annual Report on Form 20-F for the financial year

ended December 31, 2012 filed with the Commission on March 22, 2013)

2.1

  Amended and Restated Shareholder Rights Plan Agreement between the Registrant and Computershare Trust Company of Canada, as Rights Agent, dated as of May 8,

2019 (incorporated by reference to Exhibit 99.2 to the Registrant’s report on Form 6-K furnished to the Commission on May 9. 2019)

4.1

  Second Amended and Restated Stock Option Plan of the Registrant (incorporated by reference to Exhibit 4.1 of the Registrant’s Annual Report on Form 20-F for the

financial year ended December 31, 2013 filed with the Commission on March 21, 2014)

4.2
4.3

  2018 Long-Term Incentive Plan of the Registrant (incorporated by reference to Exhibit 4.7 of the Registrant’s Form S-8 filed with the Commission on May 8, 2018)
  License and Assignment Agreement, dated January 16, 2018 by and between Aeterna Zentaris GmbH and Strongbridge Ireland Limited (incorporated by reference to

Exhibit 99.2 of the Registrant’s report on Form 6-K furnished to the Commission on January 19, 2018)

4.4

  Independent  Contractor Agreement dated  September 18, 2018 between  Leslie Auld and the  Registrant (incorporated by reference to  Exhibit 4.8 of the  Registrant’s

Annual Report on Form 20-F for the financial year ended December 31, 2018 filed with the Commission on April 1, 2019)

4.5
4.6

  Form of Warrant Agreement (incorporated by reference to Exhibit 99.1 of the Registrant’s report on Form 6-K furnished to the Commission on September 20, 2019)
  Placement  Agency  Agreement  between  the  Registrant  and  Maxim  Group  LLC,  dated  as  of  September  20,  2019  (incorporated  by  reference  to  Exhibit  99.2  of  the

Registrant’s report on Form 6-K furnished to the Commission on September 20, 2019)

4.7

  Form of Securities Purchase Agreement by and between the Registrant and certain institutional investors, dated as of September 20, 2019 (incorporated by reference to

Exhibit 99.3 of the Registrant’s report on Form 6-K furnished to the Commission on September 20, 2019)

  Form of Investor Warrant (incorporated by reference to Exhibit 99.1 of the Registrant’s report on Form 6-K furnished to the Commission on February 21, 2020)
  Form of Placement Agent Warrant (incorporated by reference to Exhibit 99.4 of the Registrant’s report on Form 6-K furnished to the Commission on February 21, 2020)

4.8
4.9
4.10   Form of Common Share Purchase Warrant (incorporated by reference to Exhibit 4.5 of the Registrant’s Registration Statement on Form F-1 filed with the Commission on

June 30, 2020)

4.11   Form of Pre-Funded Warrant (incorporated by reference to Exhibit 4.6 of the Registrant’s Registration Statement on Form F-1 filed with the Commission on June 30, 2020)
4.12   Form of Placement Agent Warrant (incorporated by reference to Exhibit 4.7 of the Registrant’s Registration Statement Form F-1 filed with the Commission on June 30,

2020)

4.13   Form of Investor Warrant (incorporated by reference to Exhibit 99.1 of the Registrant’s report on Form 6-K furnished to the Commission on August 5, 2020)
4.14   Form of Placement Agent Warrant (incorporated by reference to Exhibit 99.5 of the Registrant’s report on Form 6-K furnished to the Commission on August 5, 2020)
4.15   Amendment Agreement dated November 16, 2020, by and between Aeterna Zentaris GmbH and Novo Nordisk Biopharm Limited. (incorporated by reference to Exhibit

99.1 of the Registrant’s report on Form 6-K furnished to the Commission on November 16, 2020)

4.16   License Agreement effective December 7, 2020, by and between Aeterna Zentaris GmbH and Consilient Health Ltd. (incorporated by reference to Exhibit 99.1 of the

Registrant’s report on Form 6-K furnished to the Commission on December 7, 2020)

4.17   Engagement Letter dated February 14, 2021 between the Registrant and H.C. Wainwright & Co.
4.18   Form of Underwriter Warrant (incorporated by reference to Exhibit 99.2 of the Registrant’s report on Form 6-K furnished to the Commission February 18, 2021)
4.19   Consulting Agreement dated January 4, 2022 between Giuliano La Fratta and the Registrant
4.20   Employment Agreement dated January 15, 2022 between Giuliano La Fratta and the Registrant
8.1

  Subsidiaries of the Registrant

179

11.1   Code of Conduct and Business Ethics of the Registrant (incorporated by reference to Exhibit 11.1 of the Registrant’s Annual Report on Form 20-F for the financial year

ended December 31, 2017 filed with the Commission on March 28, 2018)

11.2   Code of Business Conduct and Ethics for Members of the Board of Directors (incorporated by reference to Exhibit 11.2 of the Registrant’s Annual Report on Form 20-F

for the financial year ended December 31, 2014 filed with the Commission on March 17, 2015)

11.3   Audit  Committee  Charter  of  the  Registrant  (incorporated  by  reference  to  Exhibit  11.3  of  the  Registrant’s Annual  Report  on  Form  20-F  for  the  financial  year  ended

December 31, 2014 filed with the Commission on March 17, 2015)

12.1   Certification of the Principal Executive Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002
12.2   Certification of the Principal Financial Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002
13.1   Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
13.2   Certification of the Principal Financial Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
15.1   Consent of Ernst &Young LLP
15.2   Consent of PricewaterhouseCoopers LLP
15.3   Letter from PricewaterhouseCoopers LLP to the SEC provided pursuant to Item 16F(a)(3) of Form 20-F

Exhibit Index

101. INS XBRL Instance Document

101. SCH XBRL Taxonomy Extension Schema

101. CAL XBRL Taxonomy Extension Schema Calculation Linkbase

101. DEF XBRL Taxonomy Extension Schema Definition Linkbase

101. LAB XBRL Taxonomy Extension Schema Label Linkbase

101. PRE XBRL Taxonomy Extension Schema Presentation Linkbase

180

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The registrant hereby certifies that it meets all of the requirements for filing on Form 20-F and that it has duly caused and authorized the undersigned to sign this annual report on
its behalf.

SIGNATURES

Date: March 28, 2022

AETERNA ZENTARIS INC.

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

181

 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 4.17

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 4.19

Aeterna Zentaris Inc.
c/o Norton Rose Fulbright Canada LLP 
222 Bay Street, Suite 3000 
P.O. Box 53 
Toronto ON M5K 1E7 Canada

January 4, 2022

Privileged and Confidential

Sent By E-mail

Giuliano La Fratta
4995 rue de la morandiere
Pierrefonds, Quebec H9K 1S7
Dear Giuliano:

Re:

Consulting Arrangement in Advance of Employment

As discussed, we have agreed that in preparation for your pending employment with the Company, which is anticipated to commence on January 24, 2022, AETERNA ZENTARIS
INC. (the “Company”) will engage you to provide financial consulting services to the Company on an interim basis in order to facilitate your transition into the Company and the
sharing in advance of information as we may determine appropriate. To clarify, you will not be required to, and are not assuming the duties of the Company’s chief financial officer
until the commencement of your employment.

The term of this consulting arrangement will commence upon the return to us of a copy of this letter executed by you. The financial consulting services are intended to facilitate
your transition to employment and will involve services as agreed between you and the Company.

The Company will pay you a lump sum fee of $1000 as full compensation for all services provided under this consulting arrangement. This will be paid to you within 2 weeks of the
completion of the services. Since you are starting as a consultant for the Company, the Company may grant to you the award of 50,000 stock options to purchase Common Stock in
the capital of the Company referred to in section 4.3 of your employment agreement with the Company (the “Initial Grant”) but may now do so in advance of the effective date of
your employment, Accordingly, you hereby acknowledge that even though it may be made prior to the start of your employment with the Company, such Initial Grant will satisfy
the obligation of the Company in respect of such grant described in section 4.3 of your employment .

You will receive confidential information of the Company in the course of providing the services. All such information is the property of the Company, you will not use or disclose
any such information except and only as required to perform the services under this arrangement and that the terms of confidentiality and no-use set out in the employment
agreement  between  you  and  the  Company  apply  to  this  information  received  by  you  under  this Agreement.  This  obligation  will  survive  the  termination  of  this  consulting
arrangement.

This consulting arrangement will terminate immediately prior to the commencement of your employment with the Company without further notice or liability on the Company or, if
earlier, on written notice by you or the Company to the other.

1 | P a g e

You  acknowledge  that  this  consulting  arrangement  does  not  constitute  employment  and  is  not  intended  to  create  an  employment  relationship.  We  expressly  agree  that  this
consulting arrangement be drafted, read, and interpreted in the English language.

Les parties ont expressément demande que ce contrat soit rédigé en langue anglaise.

Please let us know if you have any questions.

AETERNA ZENTARIS INC.

Per:

Dr. Klaus Paulini

Date: January 10, 2022

I agree to the terms of the consulting arrangement set out in this letter.

Giuliano La Fratta

Date: January 10, 2022

Giuliano La Fratta

2 | P a g e

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EMPLOYMENT AGREEMENT

Exhibit 4.20

This Agreement is made by and between AETERNA ZENTARIS INC., a corporation duly incorporated under the laws of Canada, (the “ Corporation”) and Giuliano La Fratta, of
4995 de la Monrandiere Pierrefonds, Quebec, H9K 1S7 Canada (the “Executive”) and shall be effective as of January 15, 2022 or such other date as the parties agree (the “Effective
Date”):

SECTION 1 - PURPOSE:

1.1

The Corporation wishes to employ at the  Effective  Date the  Executive as its  Senior  Vice  President,  Finance and  Chief  Financial  Officer (“CFO”),  performing  the
associated duties of this position (including executing the Corporation’s quarterly financial certifications for filing) and such other duties as may be assigned from
time to time by the Corporation, and the Executive agrees to be employed in such manner on the terms and conditions set forth herein.

SECTION 2 - TERM:

2.1

Subject to a background check that is satisfactory to the Corporation, this Agreement will be effective from the Effective Date and will continue in effect until it is
terminated in accordance with Section 6 - (the “Term”). The Executive recognizes that the employment is conditional upon completion, to the Employer’s satisfaction,
of background checks including criminal record check. The Executive will sign and return any forms or consents and take any steps necessary for the Corporation to
conduct the background checks as required by the Corporation. The Corporation may use the services of a third-party background checking firm to conduct some or
all of the background checks, and that the Employer will provide personal information, including any forms and consents, to the background checking firm for this
purpose. If the background check is not satisfactory to the Corporation, then this Agreement is null and void.

SECTION 3 - DUTIES:

3.1

The Executive will work on a full-time basis and will devote the Executive’s full time, attention, skill and efforts to the faithful performance and discharge of the duties
and responsibilities  as  CFO  in  conformity  with  the  highest  professional  standards,  in  a  prudent and  workmanlike  manner  and  in  a  manner  consistent  with  the
obligations imposed under applicable law. While working and in his off hours the Executive shall promote the best interests of the Corporation, and shall not take any
action, or fail to take any action which failure could, or could reasonably be expected to, have an adverse effect on the business of the Corporation. The Executive
shall hold no other paid employment or office during the Term, except as may be permitted by the Corporation in its discretion.

3.2

The Executive shall report to and closely partner with the President and Chief Executive Officer of the Corporation. The Executive shall serve as a member of the
executive management team of the Corporation and report to the Corporation’s Audit Committee and Board, as required.

1

3.3

3.4

The Executive’s principal place of business is at his home office in Montreal and any reassignment of his principal place of business outside Montreal will be to a
place mutually agreed upon by the Executive and the Corporation. The Executive will comply with any reasonable directions of the Corporation related to working
from his home, including confidentiality, privacy, and occupational health and safety considerations. The Executive understands that the Executive will be required to
travel domestically and internationally from time to time to further the business and interests of the Corporation.

The Executive acknowledges that during the Term the Executive must comply with (i) the lawful policies and procedures established by the Corporation from time to
time, including any code of ethics or business conduct adopted by the Corporation (including any future revisions of such policies, procedures or other codes of
business conduct) and the Executive acknowledges having been given a copy of the Corporation’s Code of Conduct in advance of executing this Agreement; and (ii)
all applicable laws, rules and regulations, and all requirements of all applicable regulatory, self-regulatory and administrative bodies.

SECTION 4 - COMPENSATION:

4.1

4.2

4.3

4.4

4.5

4.6

Annual Base Salary. The Corporation shall pay the Executive a base annual salary (the “Base Salary”), which initially shall be $275,000(CAD), subject to applicable
withholdings and deductions and payable in accordance with the Corporation’s standard payroll practices for executive officers. The Base Salary shall be reviewed
annually  by  the  Board  or  a  committee of  the  Board  and  may  be  increased  in  accordance  with  the  Corporation’s  compensation policy.  Finally,  all  or  part  of  the
Executive’s Base Salary may be paid through an Affiliate of the Corporation.

Annual Cash Bonus. The Executive shall be eligible to earn an annual cash bonus (the “Annual Bonus”) of up to 30% of the Base Salary. The granting of an Annual
Bonus, if any, shall be based on the mutually agreed objectives for the performance of the business and the Executive and it is subject to the approval by the Board in
its sole discretion. The Annual Bonus, if any, payable for any calendar year shall be paid no later than March 15 of the following calendar year. To be eligible to
receive any Annual Bonus, the Executive must not have given notice of termination or received notice of termination of employment for Cause (as defined below)
under this Agreement at the time that Annual Bonus payments are made.

Stock Options. Subject to any required shareholder and/or regulatory approval, the Executive shall be eligible to receive an annual grant of stock options to purchase
shares  of  the  Corporation’s publicly-traded  common  stock  (the  “Common  Stock”),  subject  to  vesting, exercise,  pricing  and  all  other  applicable  terms  of  the
Corporation’s Stock Option Plan. Granting of such annual stock options shall also be subject to the prior approval and the sole discretion of the Board and the parties
agree that any such grant is a prospective benefit intended to compensate the Executive for future performance. If any shareholder or regulatory approval is required,
the Corporation shall promptly undertake all reasonable efforts to secure such approval. Within 60 days of the later of Effective Date and the expiry of any blackout
period in effect as of the Effective Date, the Corporation will seek Board approval to grant to the Executive 50,000 options to purchase Common Stock with a strike
price to be determined on the day of the grant. These options will have a 7 year term and will vest in equal one-third amounts on each of the first three anniversaries
of the grant date.

2

Business Expenses. The Corporation shall reimburse the Executive, upon presentation of valid receipts or vouchers, for reasonable entertainment, travel and other
business expenses, incurred on behalf of or at the request of the Corporation, so long as they are in incurred accordance with the Corporation’s policies and rules for
such reimbursements.

RRSP Contribution. The Corporation will contribute to Executive’s RRSP an amount equal to 5% of the Base Salary paid to the Executive or, if less, the maximum
annual contribution permitted by law, without regard to any prior year’s contribution room or any allowable  over contribution. This contribution will be paid directly
to the Executive on a bi- weekly basis through the Corporation payroll system. The RRSP contribution is not part of the Base Salary.

Benefits. The Corporation shall reimburse the Executive on a monthly basis for the cost of a health and welfare insurance program purchased by the Executive to a
maximum annual amount of 3% of the Base Salary. This reimbursement will be paid to the Executive on a bi- weekly basis through the Corporation payroll system. The

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
benefits reimbursement is not part of the Base Salary. The Corporation will not be responsible for providing any health and welfare benefits to the Executive provided
that if the Corporation becomes obligated to provide any such benefits as a result of a change in the applicable law, the obligation of the Corporation to reimburse the
Executive will be adjusted accordingly.

4.7

No other entitlement. The Executive is not entitled to any other payment, compensation, benefit, perquisite, allowance or entitlement other than as specifically set out
in this Agreement or as otherwise agreed to in writing by the Corporation and the Executive.

SECTION 5 - VACATION:

5.1

The Executive shall be entitled to an annual vacation of four weeks, which will vest on a monthly basis, in accordance with the Corporation’s vacation policy for
executives, subject to the approval of the Corporation’s CEO or the CEO’s designee. All of the vacation  shall be taken during each calendar year and shall not be
carried over in any amount into succeeding years, except as required by applicable employment standards legislation and provided that, at the written request of the
CFO in advance, the Corporation may in its discretion allow up to 5 days of annual vacation to be carried over to the next calendar year for use in that next calendar
year.

SECTION 6 - TERMINATION:

6.1

6.2

6.3

6.4

6.5

6.6

Termination. Notwithstanding any other term of this Agreement, either the Corporation or the Executive may terminate the Executive’s employment at any time for
any reason, with or without Cause, as set out below.

Termination for Cause. The Executive’s employment may be terminated by the Corporation for Cause upon notice in writing transmitted to the Executive, with the
Corporation being bound to pay only earned but unpaid wages, including vested vacation that is owed, to the date of termination and reimbursement for business
expenses  properly  incurred  but  not  reimbursed as  of  the  date  of  termination.  For  the  purpose  of  this  subsection Fehler!  Verweisquelle konnte  nicht  gefunden
werden. and this Agreement, “Cause” means any of the following reasons:

3

(a)

(b)

(c)

(d)

(e)

(f)

The Executive  is  declared  bankrupt  or  insolvent  or  makes  an  assignment  of  substantially  all  of the  Executive’s  property  or  is  placed  under  protective
supervision.

The Executive materially fails or refuses to adequately perform the duties or responsibilities assigned by the Corporation or its Board.

The Executive engages in fraud, theft, embezzlement or other criminal act of a similar nature, or commits an act of serious misconduct or willful or gross
negligence in the performance of the Executive’s duties.

Any act or failure to act by the Executive, the result of which is materially detrimental to the business or reputation of the Corporation.

The Executive materially breaches Section 7 -, Section 8 - or Section 9 - of this Agreement.

Any other act or omission or series of acts or omissions by the Executive that would, pursuant to applicable law, permit the Corporation to terminate the
Executive’s employment for cause.

Termination for  Disability.  Subject  to  any  legal  duty  to  accommodate  the  Executive,  the  Executive’s employment  may  be  terminated  if  the  Executive  becomes
physically or mentally disabled to such an extent as to render the Executive unable to perform the essential functions as CFO for an aggregate of 26 weeks during a
period of 12 consecutive months. If there is any disagreement between the Corporation and the Executive as to the Executive’s disability or as to the date any such
disability began or ended, such disagreement will be determined by a physician mutually acceptable to the Corporation and the Executive whose determination will be
conclusive evidence of any such disability and of the date any such disability began or ended. In such a case, the Corporation shall be bound to pay the Executive 1)
any earned but unpaid wages, including vested vacation, to the date of termination and reimbursement for business expenses properly incurred but not reimbursed as
of the date of termination; and 2) those termination and severance payments required by applicable employment standards legislation. The Executive shall not be
entitled to any other notice, or payment in lieu of notice in respect of the termination of the Executive’s employment.

Termination by Death. In the event of the Executive’s death during the Term, the Corporation’s  obligation to make payments under this Agreement shall terminate on
the date of death, except the Corporation shall pay the Executive’s estate or surviving designated beneficiary or beneficiaries, as appropriate, any earned but unpaid
wages, including vested vacation, and reimburse business expenses incurred but not reimbursed as of the date of death.

4

Voluntary Termination. If the event the Executive wishes to resign for any reason, the Executive shall give at least 30 days, and no more than 3 months, prior written
notice  of  such  resignation and  will  assist  with  transitional  duties  as  required  by  the  Corporation. Any  such  notice shall  not  relieve  either  the  Executive  or  the
Corporation of their mutual obligations to perform under this Agreement, provided that the Corporation is under no obligation to utilize the Executive’s services
during  this  period,  or  to  relieve  the  Corporation  to  compensate the  Executive  during  such  notice  period  for  any  earned  but  unpaid  wages,  vested  vacation and
reimburse business expenses incurred but not reimbursed as of the date of termination. Upon receipt of such notice, the Corporation may terminate the employment of
the Executive at any time by providing the Executive with an amount equal the lesser of 30 days Base Salary and the Base Salary for the balance of the notice period
provided by the Executive.

Termination Without Cause. The Corporation may terminate the Executive’s employment at any time without Cause by providing written notice to the Executive. The
Corporation will pay to the Executive any earned but unpaid wages, including the vested vacation, and reimburse business expenses incurred but not reimbursed to
the Executive as of the date of termination. In the event that the Corporation terminates the Executive’s employment without Cause, other than as contemplated in
subsection Fehler! Verweisquelle konnte nicht gefunden werden. the Corporation shall pay to the Executive Base Salary, benefit reimbursement, RRSP and Average
Annual Bonus (as defined below) equal to:

(a)

(b)

(c)

(d)

6 months, if the employment is terminated within 12 months of the Effective Date;

8 months, if the employment is terminated on or after the first anniversary, and before the second anniversary, of the Effective Date;

10 months, if the employment is terminated on or after the second anniversary, and before the third anniversary, of the Effective Date; or

12 months, if the employment is terminated on or after the third anniversary of the Effective Date, (the “Severance Pay”).

The Severance Pay will be made as a lump sum or salary continuance, at the Corporation’s discretion. In case of salary continuance, payments will be made to the
Executive in accordance with the Corporation’s regular payroll schedule and will include an amount for the Average Annual Bonus. The “Average Annual Bonus”

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6.7

6.8

will be the annual average of the Annual Bonus paid to the Executive for the two full bonus years preceding the date of termination provided that if the Executive has
been employed for less than one full bonus year, then the Average Annual Bonus will be the target Annual Bonus award and if the Executive has been employed for
more than one full bonus year but less than two full bonus years, then the Average Annual Bonus will be the amount of any Annual Bonus paid to the Executive.

Release. The parties agree that the provisions of subsection 6.6 are fair and reasonable and that the payments, benefits and entitlements referred to in subsection 6.6
above  are  reasonable estimates  of  the  damages  which  will  be  suffered  by  the  Executive  in  the  event  of  the  termination of  the  Executive’s  employment  with  the
Corporation. Except as otherwise provided in subsection 6.6, the Executive shall not be entitled to any further notice of termination, payment in lieu of notice of
termination,  severance,  damages,  or  any  additional  compensation whatsoever  including  at  common  law  and  the  amounts  payable  are  inclusive  of  any  statutory
payments.  As  a  condition  to  receiving  any  payment  pursuant  to  Subsection  6.6  (except  for the  Corporation’s  obligations  pursuant  to  employment  standards
legislation),  the  Executive must  deliver  a  full  and  final  release  from  all  actions  or  claims  in  connection  therewith in  favour  of  the  Corporation,  the  Corporation’s
affiliates, and all of their respective officers, directors, trustees, shareholders, employees, attorneys, insurers and agents, such release to be in a form satisfactory to
the Corporation. In the absence of providing such a signed release, the Executive will only be entitled to the minimum notice or pay in lieu of notice, if any, required
by the applicable employment standards legislation.

Clawback Entitlement. If the Corporation finds, after full consideration of the facts, that the Executive engaged in fraud, theft, embezzlement or any other criminal
act of a similar nature during the Executive’s employment with the Corporation, the Corporation is entitled to obtain reimbursement from the Executive, to the full
extent permitted by governing law and to the extent it determines (in its sole discretion) that it is in the Corporation’s best interest to do so. Such reimbursement
shall include 1) any portion of any performance-based compensation paid or awarded to the Executive, whether cash or equity based, that is greater than would
have been paid or awarded in the absence of fraud, theft, embezzlement or any other criminal act of a similar nature in the performance of the Executive’s duties to
the Corporation; and 2) immediately repayment to the Corporation of all amounts that were paid the  Executive pursuant to subsection 6.6 of the Agreement
(except for the Corporation’s obligations pursuant to employment standards legislation). This subsection 6.8 does not limit the Corporation’s right to take other
appropriate actions with respect to the Executive, including termination of his employment and other remedial and recovery action.

SECTION 7 - NO COMPETITION, NO SOLICITATION AND LOYALTY:

5

7.1

7.2

7.3

7.4

7.5

7.6

7.7

Competitive Business.  The  Corporation’s  business  includes  developing  and  commercializing  endocrinology products  for  sale  in  Canada,  the  United  States,  and
Europe (the “Business”). The Executive will hold a senior executive role for the Corporation, will have extensive access to, and will be entrusted with, highly sensitive
Confidential  Information (as defined below) and will be involved in, and responsible for strategic, supervisory and managerial decisions for the Corporation. The
Executive will develop important relationships with key stakeholders of the Business, including customers, partners, suppliers, prospects and employees, such that
the goodwill and competitiveness of the Corporation depend in part on the Executive. As a result, the Business would be vulnerable to, and harmed by, the Executive
performing duties  and  work  that  are  competitive  with  or  detrimental  to  the  Business  for  a  reasonable period  after  the  employment  of  the  Executive  with  the
Corporation terminates.

No Competition. During the Term, the Executive will not compete with the Corporation in any manner whatsoever. For a period of 12 months following the date of
termination  of  the Executive’s  employment  (for  any  reason),  the  Executive  shall  not,  in  any  capacity,  compete  with  the  Corporation,  directly  or  indirectly,  in  the
development  and/or  commercialization of  the  endocrinology  products  that  compete,  or  could  compete,  in  the  territory  with  endocrinology products  that  the
Corporation  is  developing  or  commercializing.  For  the  purpose  of  this  subsection 7.2 and subsections 7.4 and 7.5, “capacity”  means  as  an  executive,  employee,
director, officer, employer, principal, agent, partner, contractor, franchisor, franchisee,  distributor or consultant, “territory” means the United States, the provinces of
Quebec, Ontario, Alberta and British Columbia within Canada, , Germany, Italy, France, Spain, and Great Britain, and “compete” means to engage in work that:

(a)

(b)

is the same or similar to any of the duties of the Executive as CFO under this Agreement and relates to products and/or services that are competitive with
any of the products and/or services of the Business or involve the management, direction or supervision of any person performing such duties; or

is executive, management, supervisory, consultation or strategic work in circumstances where the Executive has Confidential Information that if used or
disclosed in performing such work could be advantageous to a competitor of the Business or detrimental to the Business.

The non-competition covenant in subsection 7.2 does not prevent the Executive from engaging in purely passive investments in the shares or other securities of a
corporation or entity other than the Corporation whose securities are publicly traded on a recognized stock exchange where the securities so held by the Executive do
not represent more than five percent (5%) of the voting shares of such other corporation or entity and do not allow for its control.

No Solicitation – Customers, Suppliers and Prospects. For a period of 12 months following the date of termination of the Executive’s employment (for any reason)
and in respect of the territory, the Executive shall not, without the prior written consent of Corporation, whether directly or indirectly, in any capacity, alone, or with
any person, solicit, in a manner that is competitive with or potentially detrimental to the Corporation, customers, suppliers, or prospects of the Corporation or its
affiliates with which the Executive either had material contact on behalf of the Corporation during the Term, or in respect of which had Confidential Information. A
“prospect” is a prospective customer of the Corporation that was solicited by the Corporation in the 12 month period prior to the termination date and with respect to
whom  the  Executive  either  had  a  direct  and  material involvement  in  the  solicitation  or  had  Confidential  Information.  The  term  “suppliers”  includes  distributors,
representatives, agents and other parties with whom the Corporation or any of its affiliates deals and with whom the Executive either had direct and material contact
with during the Term or with respect to whom had Confidential Information.

No Solicitation – Employees. For a period of 12 months following the date of termination of the Executive’s employment (for any reason), the Executive shall not,
without  the prior written consent of Corporation, whether directly or indirectly, in any capacity, alone,  or through any person, solicit any of the personnel of the
Corporation to leave their employment or terminate their engagement with the Corporation or any of its affiliates nor to hire the personnel of the Corporation or any of
its  affiliates  for  any  enterprise  in  which  the  Executive has  an  interest  (whether  or  not  such  individual  would  commit  any  breach  of  their  contract or  terms  of
employment  or  engagement  by  leaving  the  employ  or  the  engagement  of  the  Corporation or  any  of  its  affiliates).  For  clarity,  the  placement  by  the  Executive  of
advertising in a newspaper or other publication of general circulation, or the engagement of a personnel search agency by the Executive generally (i.e. not specifically
in respect of the Corporation or targeting its personnel), that results in an employee or other individual engaged by the Corporation leaving the employment of or
engagement with the Corporation shall not be considered a violation of this subsection 7.5.

6

Corporate Opportunities. The Executive also undertakes, during the Term, to fully disclose and make available to the Corporation and not to appropriate under any
circumstance,  any  business opportunities relating in any way to the business and affairs of the  Corporation or any of its affiliates which become known to the
Executive.

Acknowledgement. The Executive acknowledges that the provisions of this Section 7 - are reasonably limited as to the time period, the geographic area and the nature
of the activities to what the parties deem necessary to protect the legitimate interests of the Corporation and its affiliates, while allowing the Executive to earn a living.
The Executive also acknowledge that the Corporation may over time develop and commercialize other products and may make it a condition of any improvement in the
compensation of the Executive that the Executive sign a revised restrictive covenant agreement to amend or replace this Section 7 -.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
7.8

Loyalty. Nothing in this Section 7 - shall operate to reduce or extinguish the obligations of the Executive arising at law or under this contract which survive at the
termination  of  this Agreement,  in  particular,  without  limiting  the  foregoing,  the  Executive’s  duty  of  loyalty,  duty  of  confidentiality,  fiduciary  obligations  and
obligation to act faithfully, honestly and ethically.

SECTION 8 - CONFIDENTIALITY:

8.1

The Executive acknowledges that the Executive will receive or conceive, in carrying out the duties of CFO, confidential information pertaining to the activities, the
technologies,  the  operations and  the  business,  past,  present  and  future,  of  the  Corporation,  which  information  is  not in  the  public  domain  (“Confidential
Information”).  The  Executive  acknowledges that such  Confidential  Information belongs to the  Corporation and that its disclosure or unauthorized  use  could  be
damaging or prejudicial to the Corporation and contrary to the Corporation’s best interests.

Accordingly, the Executive will respect and maintain the confidentiality of Confidential Information and not to make use of or disclose it to, or to discuss it with, any
person, other than in the ordinary course of his duties with the Corporation, or as required under applicable law, without the explicit prior written authorization of the
Corporation.

This undertaking to respect the confidentiality of  Confidential  Information shall survive and continue to have full effect notwithstanding the termination of the
Executive’s employment with the Corporation to the greatest extent permitted by applicable law, so long as the Confidential Information does not become public as a
result of an act by the Corporation or a third party, which act does not involve the fault of the Executive.

8.2

The term Confidential Information includes, among other things:

7

(a)

(b)

(c)

(d)

(e)

(f)

(g)

(h)

(i)

(j)

work product resulting from or related to work or projects performed or to be performed by the Corporation, including, but not limited to, the interim and final
lines of inquiry, hypotheses, research and conclusions related thereto and the methods, processes, procedures, analysis, techniques and audits used in
connection therewith;

products, formulae,  processes  and  composition  of  products,  as  well  as  raw  materials  and  ingredients, of  whatever  kind,  that  are  used  in  their
manufacture;

technical knowledge and methods, quality control processes, inspection methods, laboratory and testing methods, information processing programs and
systems, manufacturing processes, plans, drawings, tests, test reports and software;

equipment, machinery, devices, tools, instruments and accessories;

information relating to Developments (as defined below) prior to any public disclosure thereof, including, but not limited to, the nature of the developments,
production data, technical and engineering data, test data and test results, the status and details of research and development of products and services, and
information regarding acquiring, protecting, enforcing and licensing proprietary rights (including patents, copyrights and trade secrets);

financial information, production cost data, marketing strategies, raw materials supplies, suppliers, staff and customer lists and related information, marketing
plans,  sales  techniques  and  policies, including  pricing  policies,  sales  and  distribution  data,  purchasing  and  internal  cost  information, internal  services,
operational manuals and present and future expansion plans;

contracts and their contents, customer services, data provided by customers and the type, quantity and specifications of products and services purchased,
leased, licensed or received by customers of the Corporation;

research, experiments, inventions, discoveries, developments, improvements, ideas, industrial secrets and know-how;

personnel information of employees of the Corporation; and

both the existence and the terms of this Agreement.

8.3

8.4

In the event the Executive is required to disclose Confidential Information pursuant to any law, regulation, governmental authority or court, the Executive shall give
prompt  notice to the Corporation of such requirement (where it is within the Executive’s control to provide such notice) so as to allow the Corporation sufficient
opportunity to contest such requirement. The Executive will cooperate with the Corporation in any lawful efforts to prevent or limit the disclosure of such information.
Any disclosure under this subsection 8.3 must be limited solely to the extent of the legal requirement.

Nothing in this Section 8 - shall be read to prevent the Executive from discussing or disclosing confidential information in connection with an investigation by the
U.S. Securities and Exchange Commission, or another Canadian or U.S state or federal agency, or from filing and/or pursuing a charge or complaint with any such
agency.

8

SECTION 9 - OWNERSHIP OF INTELLECTUAL PROPERTY:

9.1

9.2

The Executive  acknowledges  and  agrees  that  all  rights,  titles  and  interests  in  or  to  any  Developments (meaning any discovery, invention, design, improvement,
concept, design, specification, creation, development, treatment, computer program, method, process, apparatus, specimen, formula, formulation, product, hardware or
firmware, any drawing, report, memorandum, article, letter, notebook and any other work of authorship and ideas (whether or not patentable or copyrightable) and
legally recognized proprietary rights (including, but not limited to, patents, copyrights, trademarks, topographies, know-how and trade secrets), and all records and
tangible embodiments relating to the foregoing, that 1) result or derive from the Executive’s employment with the Corporation or from the Executive’s knowledge or
use of Confidential Information; 2) are conceived or made by the Executive (alone or jointly) in the discharge of the Executive’s duties as CFO; 3) result from or derive
from the use or application of the resources of the Corporation; or 4) relate to the business operations of the Corporation or the actual or demonstrably anticipated
research and development by the Corporation) and all Intellectual Property (meaning all common law, statutory and other intellectual and industrial property rights,
including, without limiting the generality of the foregoing: 1) rights to any patents, trademarks, service marks, trade names, domain names, copyright, database rights,
designs, industrial  designs,  trade  secrets,  integrated  circuit  rights  and  topography  rights;  and  2) all domestic and foreign registrations, applications, divisionals,
continuations, continuations-in-part, re-examinations and renewals thereof) in and to the Developments shall be owned exclusively by the Corporation.

Without further  compensation,  the  Executive  hereby  irrevocably  quit-claims,  assigns  and  agrees  to assign  to  the  Corporation  all  of  the  Executive’s  Intellectual
Property  rights,  title and  interest  in  and  to  as  of  their  creation  and  to  make  full  and  prompt  disclosure  to  the Corporation  of  all  information  relating  to  any
Developments unless specifically released from such obligation in writing by the Corporation’s Board of Directors. The Executive understands that this assignment is
intended to, and does, extend to Developments currently in existence, in development, as well as Developments which have yet to be created.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
9.3

9.4

In addition,  without  further  compensation,  the  Executive  renounces  all  legal  rights  in  any  Developments. The  Executive  irrevocably  waives,  in  favour  of  the
Corporation, its successors, assigns and nominees, all moral rights arising under the Copyright Act (Canada) as amended (or any successor legislation of similar
effect) or similar legislation in any applicable jurisdiction, or at common law, to the full extent that such rights may be waived in each respective jurisdiction, that the
Executive  may  have  now  or  in  the  future  with  respect  to  the  Developments.  The  Executive acknowledges  that  the  Corporation  has  the  right  to  use,  modify  or
reproduce  any  Developments realized  by  the  Executive,  at  its  entire  discretion,  without  the  Executive’s  authorization and  without  the  Executive’s  name  being
mentioned.

9

At any time during the Term or after the termination of the employment of the Executive, the Executive shall sign, acknowledge and deliver, at the Corporation’s
expense,  but  without compensation other than a reasonable sum for the  Executive’s time devoted thereto if the employment has then terminated, any document
required by the Corporation to give effect to this Section 9 -. The Executive shall also provide such other assistance as the Corporation or one of its affiliates may
require, without compensation other than a reasonable sum for the  Executive’s time devoted thereto if the employment has then terminated, with respect to  any
proceeding or litigation relating to the protection or defense of intellectual property rights belonging to the  Corporation or any of its affiliates.  In particular, the
Executive agrees  to  execute  on  demand,  whether  during  or  after  the  Term,  any  applications,  transfers, assignments  or  other  documents  as  the  Corporation  may
consider necessary for the purpose of either:

(a)

(b)

obtaining, maintaining, vesting or assigning absolute title in any Developments and any Intellectual Property related thereto in, to or for the Corporation; or

applying for, prosecuting, obtaining or protecting any patent, copyright, industrial design or trade-mark registration or any other similar right pertaining to
any Intellectual Property in Developments in any country. The Executive further agrees to cooperate and assist the Corporation in every way possible in the
application for or prosecution of rights pertaining to such Intellectual Property.

9.5

The entirety of this Section 9 - shall be binding on the Executive’s heirs, assigns and legal representatives.

SECTION 10 - RECOGNITION AND REMEDIES:

10.1

Recognition. The Executive expressly recognizes and expressly acknowledges that:

(a)

(b)

(c)

Section 7 -, Section 8 - and Section 9 - of this Agreement are of the essence of this Agreement,  and that the Corporation would not have entered into this
Agreement without the inclusion of those provisions and the Executive’s commitment to abide by same.

the application of Section 7 -, Section 8 - and Section 9 - of this Agreement will not have the effect of prohibiting the Executive from earning a living in a
satisfactory manner in the event of the termination of employment under this Agreement.

Section 7 -, Section 8 - and Section 9 - of this Agreement grant to the Corporation only such reasonable protection as is necessary to preserve the legitimate
interests of the Corporation and the Executive equally recognizes, in this respect, that the description of the business and the territory contained in Section 7
- are reasonable.

10.2

Remedies. The Executive recognizes and expressly acknowledges that the Corporation would be subject to irreparable harm should any of the provisions of Section 7
-, Section 8 - and Section 9 - be infringed, or should any of the Executive’s obligations under this Agreement  be breached by the Executive, and that damages alone
will be an inadequate remedy for any breach or violation thereof and that the Corporation, in addition to all other remedies, will be entitled as a matter of right to
equitable relief, including temporary or permanent injunction to restrain such breach or a threatened breach.

10

SECTION 11 - OWNERSHIP OF FILES AND OTHER PROPERTY:

11.1

Any property of the Corporation, including any file, sketch, drawing, letter, report, memorandum or other document, any equipment, machinery,  tool, instrument or
other device, any diskette, recording tape, compact disc, software, electronic communication device or any other property, which comes into the Executive’s control
or possession during the Term, regardless of whether the Executive participated in its preparation or design, how it may have come under the Executive’s control or
into the Executive’s possession and whether it is an original or a copy, shall at all times remain the property of the Corporation and, forthwith upon any request by
t h e Corporation  and  upon  the  termination  of  the  Executive’s  employment  (for  any  reason),  shall  promptly  be  returned  to  the  Corporation or  its  designated
representative by the Executive. The Executive may not keep a copy or give one to a third party without the prior expressly written permission of the Chairman of the
Board.

SECTION 12 - NON DISPARAGEMENT:

12.1

Except as  may  be  required  by  law,  during  and  following  the  Term  neither  the  Corporation  nor  the  Executive  shall  make  any  disparaging  statements or  remarks
(including, without limitation, the repetition or distribution of disparaging rumours, allegations, negative reports or comments), verbally or in writing, in any medium,
including social media, about the other to any person or entity outside the Corporation except to the extent required by law.

SECTION 13 - TERMINATION OF PRIOR CONTRACTS:

13.1

As of the effective date hereof, this Agreement supersedes and cancels any prior agreement, including but not limited to any understandings, negotiations  and
discussions, verbal or written, with respect to the Executive’s employment with the Corporation.

SECTION 14 - NO CONFLICTING OBLIGATIONS:

14.1

The Executive represents and warrants to the Corporation that:

(a)

(b)

there exists  no  agreement  or  contract,  and  the  Executive  is  not  subject  to  any  obligation,  which restricts  the  Executive  from  (i)  being  employed  by  the
Corporation; (ii) performing the duties of CFO; (iii) soliciting business for the Corporation; or (iv) using information within his knowledge or control which
may be useful in the performance of the CFO duties for the Corporation;

in the performance of the duties as CFO for the Corporation, the Executive shall not improperly bring to the Corporation or use any trade secrets, confidential
information or other proprietary information of any third party; and

(c)

the Executive shall not infringe the intellectual property of any third party.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
11

SECTION 15 - SUSPENSION WITH PAY:

15.1

The Executive acknowledges that, during the course of the  Executive’s employment, the  Board may exercise its discretion to suspend the  Executive with pay in
furtherance of any internal investigation relating to the Executive’s conduct.

SECTION 16 - SURVIVAL:

16.1

Notwithstanding the termination of the employment of the Executive under this Agreement, each party shall remain bound by the provisions of this Agreement  which
by their terms impose obligations upon that party that extend beyond the termination of the employment of the Executive under this Agreement.

SECTION 17 - FURTHER ASSURANCES:

17.1

The parties shall, with reasonable diligence, do all things and provide all reasonable assurances as may be required to give effect to this Agreement and carry out its
provisions, including providing such further documents or instruments reasonably required by any other party.

SECTION 18 - ASSIGNMENT:

18.1

Except as otherwise expressly provided herein, neither this Agreement nor any rights or obligations are assignable by the Executive. The Corporation may assign this
Agreement to any of its affiliates or subsidiaries or to any successor (whether direct or indirect, by purchase, amalgamation, arrangement, merger, consolidation or
otherwise) to all or substantially all of the business or assets of the Corporation. The Executive, by the Executive’s signature hereto, expressly consents to such
assignment  and,  provided  that  such  successor  agrees  to  assume and  be  bound  by  the  terms  and  conditions  of  this  Agreement,  all  references  to  the  “the
Corporation” herein shall include its successor.

SECTION 19 - AMENDMENT OF THE AGREEMENT:

19.1

To be valid and enforceable, any amendment to this Agreement must be confirmed in writing by each of the Corporation and the Executive.

SECTION 20 - COMPLIANCE WITH EMPLOYMENT STANDARDS LEGISLATION:

20.1

In the event that the minimum standards set out in the applicable employment standards legislation (as may be amended from time to time) are more favorable to the
Executive in any respect than a term or provision provided for in this Agreement, the statutory provisions will apply in respect of that term or provision.

SECTION 21 - NOTICES:

21.1

Any notice given hereunder shall be given in writing and sent by registered or certified mail or hand-delivered. If such notice is sent by registered or certified mail, it
shall be deemed to have been received five business days following the date of its mailing if the postal services are working normally. If such is not the case, the
notice must be hand-delivered. In the case of hand-delivery, the notice shall be deemed to have been received the same day. It is agreed that if the delivery date is a
non-business day, the notice shall be deemed to have been received on the following business day.

For purposes of mailed or hand-delivered notices to be effectively delivered under this provision, the notices must be addressed as follows:

For the Corporation, the address is: c/o Norton Rose Fulbright Canada, LLP, 222 Bay Street, Suite 3000, PO Box 53, Toronto Ontario M5K 1E7, Canada.

For the Executive, the address is: 4995 de la Monrandiere, Pierrefonds, Quebec, H9K 1S7 Canada.

SECTION 22 - SUCCESSORS:

22.1

This Agreement shall be binding on the successors, heirs, assignees and legal representatives of all of the parties hereto.

SECTION 23 - CHOICE OF LAW AND JURISDICTION:

23.1

This Agreement shall be governed by and interpreted in accordance with the laws, including conflicts of laws, by the Province of Quebec and the laws of Canada
applicable therein. Both during and after the performance of this Agreement, each of the parties will make bona fide efforts to resolve any disputes arising between
them by amicable negotiations. All disputes arising out of or in connection with this Agreement, or in respect of any relationship between the parties, will be referred
to and finally and confidentially resolved by arbitration under the Quebec Code of Civil Procedure. The place of arbitration will be Montreal, Quebec, Canada. Either
party  may apply  to  the  arbitrator(s)  appointed  pursuant  to  the  Code  of  Civil  Procedure  seeking  injunctive  relief  until  the  arbitration  award is  rendered  or  the
controversy is otherwise resolved.  Before an arbitrator makes a final determination on the merits of the controversy, either party also may, without waiving any
remedy under this Agreement, seek from any Quebec Court having jurisdiction any interim or provisional relief that is necessary to protect the rights or property of
that party.

SECTION 24 - SEVERABILITY:

24.1

If any provision of this Agreement or the application thereof is held invalid, the invalidity shall not affect other provisions or applications of this Agreement, which
can be given effect without the invalid provisions or applications and, to this end, the provisions of this Agreement are declared to be severable. Moreover, if any
provision of this Agreement is deemed to be overbroad or otherwise unenforceable as written, the parties agree that such provision should be modified and reformed,
and then enforced, to the maximum extent permitted by applicable law.

12

SECTION 25 - LANGUAGE:

25.1

All of the parties hereto expressly agree that this Agreement be drafted, read and interpreted in the English language. Les parties ont expressément demande que ce
contrat soit rédigé en langue anglaise.

SECTION 26 - INDEPENDENT LEGAL ADVICE:

26.1

The Executive acknowledges that the Executive has been advised to obtain, and either has obtained or has been afforded the opportunity to obtain, independent
legal advice with respect to this Agreement and understands the nature and consequences of this Agreement.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SECTION 27 - PERSONAL INFORMATION

27.1

The Executive acknowledges that the Corporation will collect, use and disclose health and other personal information for employment and business related purposes.
The Executive consents to the Corporation collecting, using and disclosing health and other personal information of the Executive for employment and business
related purposes in accordance with the privacy policy of the Corporation.

SECTION 28 - COUNTERPARTS:

28.1

This Agreement  may  be  executed  in  counterparts,  each  of  which  when  so  executed  and  delivered  shall  be  deemed  to  be  an  original  and  such counterparts  will
together constitute one and the same Agreement. This Agreement may be executed and transmitted electronically and any version so executed and transmitted will be
deemed to be as effective as if originally executed.

NOW, THEREFORE, the Corporation and the Executive have duly signed this Agreement on the dates shown by their names below.

AETERNA ZENTARIS INC.

By:

Title:President and Chief Executive Officer (CEO)
Printed Name: Dr. Klaus Paulini

Date:10. December 2021

GIULIANO LA FRATTA

Giuliano La Fratta

Date: Dec 13, 2021

  WITNESS

Printed Name _________________________

13

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
            
 
 
 
SUBSIDIARIES OF THE REGISTRANT

AETERNA ZENTARIS INC.

Exhibit 8.1

 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002 Certification

Exhibit 12.1

I, Klaus Paulini, certify that:

1.

2.

3.

4.

I have reviewed this annual report on Form 20-F of Aeterna Zentaris Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,
results of operations and cash flows of the company as of, and for, the periods presented in this report;

The company’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-
15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the company and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the company, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the
period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally
accepted accounting principles;

Evaluated the effectiveness of the company’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the company’s internal control over financial reporting that occurred during the period covered by the annual report that
has materially affected, or is reasonably likely to materially affect, the company’s internal control over financial reporting; and

5.

The company’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the company’s auditors
and the audit committee of the company’s board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the company’s ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the company’s internal control over financial
reporting.

Date: March 28, 2022

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 12.2

Certification of the Principal Financial Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002 Certification

I, Giuliano La Fratta, certify that:

1.

2.

3.

4.

I have reviewed this annual report on Form 20-F of Aeterna Zentaris Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,
results of operations and cash flows of the company as of, and for, the periods presented in this report;

The company’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-
15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the company and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the company, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the
period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally
accepted accounting principles;

Evaluated the effectiveness of the company’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as for the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the company’s internal control over financial reporting that occurred during the period covered by the annual report that
has materially affected, or is reasonably likely to materially affect, the company’s internal control over financial reporting; and

5.

The company’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the company’s auditors
and the audit committee of the company’s board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the company’s ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the company’s internal control over financial
reporting.

Date: March 28, 2022

/s/ Giuliano La Fratta
Giuliano La Fratta
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

Exhibit 13.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the annual report of Aeterna Zentaris Inc. (the “Company”) on Form 20-F for the year ended December 31, 2021 as filed with the Securities and Exchange
Commission on the date hereof (the “Report”), I, Klaus Paulini, President and Chief Executive Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to
§ 906 of the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Dated: March 28, 2022

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

Exhibit 13.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the annual report of Aeterna Zentaris Inc. (the “Company”) on Form 20-F for the year ended December 31, 2021 as filed with the Securities and Exchange
Commission on the date hereof (the “Report”), I, Giuliano La Fratta, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of
the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Dated: March 28, 2022

/s/ Giuliano La Fratta
Giuliano La Fratta
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consent of Independent Registered Public Accounting Firm

We consent to the incorporation by reference in the Registration Statements on Forms S-8 (No. 333-224737, No. 333-210561 and No. 333-200834), Forms F-3 (No.333-232935 and No.
333-254680) and  Forms  F-1 (No.333-239264,  No. 333-248561 and  No. 333-239019) of Aeterna  Zentaris  Inc. of our report dated  March 28, 2022 with respect to the consolidated
financial statements of Aeterna Zentaris Inc. as of and for the year ended December 31, 2021, included in this Annual Report on Form 20-F.

Exhibit 15.1

/s/ Ernst & Young LLP

Montreal, Canada
March 28, 2022

 
 
 
 
 
 
 
Consent of Independent Registered Public Accounting Firm

We hereby consent to the incorporation by reference in the Registration Statements on Forms S-8 (No. 333-224737, No. 333-210561 and No. 333-200834), Forms F-3 (No.333-232935
and No. 333-254680) and Forms F-1 (No.333-239264, No. 333-248561 and No. 333-239019) of Aeterna Zentaris Inc. of our report dated March 24, 2021 relating to the consolidated
financial statements, which appears in this Form 20-F.

Exhibit 15.2

/s/ PricewaterhouseCoopers LLP

Chartered Professional Accountants, Licensed Public Accountants

Toronto, Canada
March 28, 2022

 
  
 
 
 
 
 
 
Exhibit 15.3

March 28, 2022

Securities and Exchange Commission
100 F Street, N.E.
 Washington DC 20549 Commissioners:

We have read the statements made by Aeterna Zentaris Inc. (copy attached), which we understand will be included under Item 16.F of its Annual Report on Form 20-F which will
be filed with the Securities and Exchange Commission on March 28, 2022. We agree with the statements concerning our Firm contained therein.

Very truly yours,

/s/ PricewaterhouseCoopers LLP

Toronto, Canada Attachment

PricewaterhouseCoopers LLP
PwC Tower, 18 York Street, Suite 2600, Toronto, Ontario, Canada M5J 0B2 T: +1 416 863 1133, F: +1 416 365 8215, www.pwc.com/ca

“PwC” refers to PricewaterhouseCoopers LLP, an Ontario limited liability partnership.