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Amicus Therapeutics

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FY2022 Annual Report · Amicus Therapeutics
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A N   E X T R A O R D I N A R Y 

S T O R Y   I N   R A R E 

D I S E A S E .

2 0 2 2   A N N U A L   R E P O R T

2

To our 
shareholders

Bradley L. Campbell
President and Chief Executive Officer

At  Amicus,  we  are  driven  by  a 
sense  of  purpose  and  a  commitment 
to making a difference for people living 
with rare diseases. Our work is rooted 
in  the  belief  that  every  person  living 
with  a  rare  disease  deserves  access 
to innovative and effective treatments 
and  that  by  making  and  delivering 
transformative  medicines  for  these 
patients we can also create great value 
for our shareholders. 

2022  marked  a  year  of  broad  execution  and 

sustained  growth  across  our  business  and  has  laid 

the  foundation  for  what  we  believe  will  be  a  pivotal 

year  at  Amicus.  I  am  pleased  to  report  that  in  2022 

we furthered our mission for patients while delivering 

another year of strong financial performance. It is also 

my privilege to report on our achievements and write 

to  you  for  the  first  time  as  the  new  CEO  of  Amicus, 

following the tenure of John F. Crowley, whose spirit of 

compassion and innovation has guided Amicus since 

the Company’s inception. 

Amicus Therapeutics 2022 Annual Report3

2022 was highlighted by:

• 

Increasing  access  to  Galafold  to  more  than 

2,000 people living with Fabry disease around 

the world with revenue of $329 million.

With  a  strong  foundation 

in  place,  we  are 

committed  to  increasing  our  leadership  in  rare 

diseases and achieving our next level of growth. A 

growth supported by delivering our therapies to 

those in need, advancing our pipeline, maintaining 

•  Providing AT-GAA to nearly 200 people living 
with  Pompe  disease  through  our  clinical 

financial  strength,  and  building  an  enduring 

organization  of  passionate  entrepreneurs.  The 

studies and expanded access programs.

pursuit of excellence and innovation on behalf of 

•  Advancing  the  global  regulatory  reviews  and 

launch plans for AT-GAA.

•  Strategically  focusing  our  R&D  efforts  to  our 
priority  growth  franchises  of  Fabry  disease 

and Pompe disease. 

people living with rare diseases will position us for 

success and create value for all our stakeholders.

Finally, I would like to recognize the many people 

who have helped Amicus along our extraordinary 

journey. Thank you to the people living with rare 

diseases and their families who inspire us, to our 

•  Continuing  to 

integrate  sustainability  best 

employees for their passion and drive, and to you, 

practices  in  our  operations  while  delivering 

our shareholders, for supporting our mission.

strong business growth.

•  Ending  2022  with  a  strong  cash  balance  of 
$294  million  and  positioning  the  company  to 

achieve  non-GAAP  profitability  in  the  second 

half of 2023.

Looking  ahead,  2023  will  be  an 

incredibly 

important year, as we look to launch our second 

home  grown  medicine,  and  I  couldn’t  be  more 

confident  that  Amicus  will  continue  to  make  a 

significant impact on the rare disease community, 

shaping a brighter future for many.

Amicus Therapeutics 2022 Annual Report4

A Rare Company.

Amicus Therapeutics is a global, patient-dedicated 
biotechnology company focused on developing and 
delivering high-quality medicines for people living 
with rare diseases.

as of December 31, 2022

$329M 

Net Product Sales

484 

Dedicated  
Employees Globally

$294M

in Cash

Global

Regulatory and 
Commercial Infrastructure 

Focused Rare Disease

Non-GAAP 

Pipeline

in Fabry Disease  
and Pompe Disease

Profitability

Projected in 2H 2023

Amicus Therapeutics 2022 Annual Report5

Natalie
Living with Fabry Disease

An Extraordinary 
Story in Rare Disease

Amicus, the Latin word for friend, signifies our collaborative 
approach to developing medicines by incorporating the patient 
perspective every step of the way. This spirit of empathy, 
compassion, and tenacity permeates our culture and influences all 
aspects of our approach to advancing cutting-edge technologies.

Amicus Therapeutics 2022 Annual Report6

Core Value Drivers

Galafold: Building a Leadership Position in the Treatment of Fabry Disease

2,000+ patients and $329M global sales in FY22

Projecting Galafold revenue growth of 12-17% at CER in 2023

Fastest-growing treatment for Fabry disease globally and greatest contributor of global market growth in 2022

AT-GAA in Pompe Disease: Potential to Become the Standard of Care

Focused on securing global regulatory approvals and initiating successful launches of AT-GAA in the three 
largest Pompe disease markets

Growing demand for AT-GAA with ~200 people living with Pompe disease treated through clinical studies and 
expanded access mechanisms 

~75 centers worldwide currently participating in clinical trials and access programs

Maintaining Financial Discipline to Achieve Non-GAAP Profitability in Second Half 2023

Continue to execute on global commercialization of Galafold 

Preparing for global regulatory approvals of AT-GAA and anticipated commercial launches

Investments in next-generation therapies in Fabry disease and Pompe disease programs and capabilities 

Leverage global commercial infrastructure to become a leader in rare diseases

Discovery

Preclinical

Phase 1/2

Phase 3

Regulatory

Commercial

Fabry Disease Franchise

Galafold® (migalastat) 

Fabry Gene Therapy

Next-Generation Chaperone

Pompe Disease Franchise

AT-GAA (cipaglucosidase alfa + miglustat)

Pompe Gene Therapy

Additional Gene Therapy Programs

CLN3 Batten Disease Gene Therapy

Next-Generation Research Programs

Amicus Therapeutics 2022 Annual Report7

Kody
Living with Late-Onset Pompe Disease

Discovery

Preclinical

Phase 1/2

Phase 3

Regulatory

Commercial

Fabry Disease Franchise

Galafold® (migalastat) 

Fabry Gene Therapy

Next-Generation Chaperone

Pompe Disease Franchise

AT-GAA (cipaglucosidase alfa + miglustat)

Pompe Gene Therapy

Additional Gene Therapy Programs

CLN3 Batten Disease Gene Therapy

Next-Generation Research Programs

Amicus Therapeutics 2022 Annual Report8

Our People & DEI
Mission-Focused Culture. We are a Rare company, full of passionate 
entrepreneurs, striving to be champions of the rare disease community. 

We take pride in the talented individuals that comprise our organization. At Amicus, we look to make 
a  meaningful  impact  on  organizational  performance  and  enable  a  competitive  advantage  through  our  people.  We 
have employees across the U.S. and select international countries who are key to advancing our programs and who 
contribute to our mission-focused culture with passion, dedication, and excitement for the work that we do.

Diversity,  Equity,  and  Inclusion.  We  know  our  unique  experiences,  backgrounds,  and  range  of  cultural 
perspectives  enrich  how  we  approach  opportunities,  pushing  ideas  as  far  and  as  fast  as  possible  with  patients 
always our top priority. Employee expertise, intelligence, and creativity drives our innovation, our passion, and our 
commitment  to  excellence.  We  have  made  the  promise  to  foster  and  support  an  inclusive  corporate  culture  and 
pledge to maintain gender diversity and increase overall diversity throughout our global workforce.

Gender Breakdown by Level1

male          female

82%

18%

53%

47%

63%

37%

entry-level /
non-manager

middle 
management

senior level / 
VP & above

Diversity in Overall Hiring and Promotions2

97%

% Hiring slate diversity

61%

Diversity of new hires & promotions:  
Director and above

83%

Diversity of new hires & promotions:  
Associate Director and below

1.  As of 12/31/2022

2. Diversity includes maintaining/increasing gender diversity and increasing representation of all underrepresented races, veterans, disabled, and LGBTQ employees

Amicus Therapeutics 2022 Annual Report9

Amicus Therapeutics 2022 Annual Report10

Corporate Responsibility & ESG

It is our belief that a sound governance structure, coupled with a socially and 
environmentally  responsible  mindset,  provides  the  foundation  for  collective 
decision making and accountability across all facets of Amicus.

Corporate Responsibility. The rare disease community always has a voice within Amicus. This is shown through our 
corporate social responsibility initiative Healing Beyond Disease – our unique promise to further serve the needs of the 

rare disease community in extraordinary ways.

Time

Talent 

Treasure

Pledge 

Bridges

Evolve volunteerism 
company-wide 
to further our 
commitment to 
the rare disease 
patient community 
with information 
and incentives for 
employees

Leverage the 
expertise within 
Amicus to empower 
organizations and 
individuals impacted 
by rare diseases to 
accomplish their 
mission

Advance 
philanthropy for 
rare diseases by 
providing a broader 
opportunity for 
financial support 
and contributions

Designate a portion 
of sales from any 
Amicus marketed 
drug and reinvest 
back into that 
specific disease until 
there is a cure

Build rare bridges 
across the globe 
to provide access 
to our medicines 
in the near and in 
the long-term in 
the developed and 
developing world

Environmental, Social, and Governance (ESG). Building strong ESG practices and oversight into our scientific 
and business activities creates a culture of integrity at every level of the organization. 

To access the full ESG report, please visit the Responsibility section of our corporate website.

Environmental Stewardship

We seek to produce transformative medicines while practicing  
environmental responsibility.

Patient Advocacy

Access to Medicines

Employees

Governance

We are committed to providing access to support and essential services to 
patients and their families across their disease experience.

We made the promise that our medicines must be fairly priced and broadly 
accessible.

We foster a mission-focused culture where employees can contribute to  
winning teams, feel included, supported, and heard.

We believe in a compliance culture driven by integrity and a commitment to 
never prioritize short-term profit over sustainable long-term success.

Amicus Therapeutics 2022 Annual ReportUNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-K 

(Mark One)

☒       ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES 

EXCHANGE ACT OF 1934

For the fiscal year ended December 31, 2022

OR

        ☐       TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES 
EXCHANGE ACT OF 1934

For the transition period from             to

Commission file number 001-33497 
Amicus Therapeutics, Inc. 
(Exact Name of Registrant as Specified in Its Charter)

Delaware
(State or Other Jurisdiction of
Incorporation or Organization)

3675 Market Street, Philadelphia, PA
(Address of Principal Executive Offices)

71-0869350
(I.R.S. Employer
Identification Number)

19104
(Zip Code)

(215) 921-7600

(Registrant's Telephone Number, Including Area Code)

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

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, par value $0.01 per share

FOLD

NASDAQ Global Market

Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.  Yes 

☒  No ☐

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.  

Yes ☐  No ☒

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the 
Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to 
file such reports), and (2) has been subject to such filing requirements for the past 90 days.   Yes ☒  No ☐

Indicate  by  check  mark  whether  the  registrant  has  submitted  electronically  every  Interactive  Data  File  required  to  be 
submitted  pursuant  to  Rule  405  of  Regulation  S-T  (§232.405  of  this  chapter)  during  the  preceding  12  months  (or  for  such 
shorter period that the registrant was required to submit such files).   Yes ☒  No ☐

Indicate  by  check  mark  whether  the  registrant  is  a  large  accelerated  filer,  an  accelerated  filer,  a  non-accelerated  filer,  a 
smaller reporting company, or an emerging growth company. See the definitions of "large accelerated filer," "accelerated filer," 
the  Exchange  Act.
"smaller 

"emerging  growth  company" 

in  Rule  12b-2  of 

reporting  company,"  and 
☒
☐

Large accelerated filer 
Non-accelerated filer 

Accelerated filer
Smaller reporting company
Emerging growth company

☐
☐
☐

If  an  emerging  growth  company,  indicate  by  check  mark  if  the  registrant  has  elected  not  to  use  the  extended  transition 
period  for  complying  with  any  new  or  revised  financial  accounting  standards  provided  pursuant  to  Section  13(a)  of  the 
Exchange Act. ☐

 
 
 
 
Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the 
effectiveness  of  its  internal  control  over  financial  reporting  under  Section  404(b)  of  the  Sarbanes-Oxley  Act  (15  U.S.C. 
7262(b)) by the registered public accounting firm that prepared or issued its audit report  .☒

If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of 

the registrant included in the filing reflect the correction of an error to previously issued financial statements. ☐

Indicate  by  check  mark  whether  any  of  those  error  corrections  are  restatements  that  required  a  recovery  analysis  of 
incentive-based  compensation  received  by  any  of  the  registrant’s  executive  officers  during  the  relevant  recovery  period 
pursuant to §240.10D-1(b). ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes ☐  

No ☒

The  aggregate  market  value  of  the  277,450,967  shares  of  voting  common  equity  held  by  non-affiliates  of  the  registrant, 
computed  by  reference  to  the  closing  price  as  reported  on  The  NASDAQ  Global  Market,  as  of  the  last  business  day  of  the 
registrant's most recently completed second fiscal quarter (June 30, 2022) was $2,979,823,386. Shares of voting and non-voting 
stock held by executive officers, directors, and holders of more than 10% of the outstanding stock have been excluded from this 
calculation  because  such  persons  or  institutions  may  be  deemed  affiliates.  This  determination  of  affiliate  status  is  not  a 
conclusive determination for other purposes.

The number of shares outstanding of the registrant's common stock, $0.01 par value per share, as of February 13, 2023 was 

282,714,738 shares.

DOCUMENTS  INCORPORATED  BY  REFERENCE:  Portions  of  the  Proxy  Statement  for  the  registrant's  2022  Annual 
Meeting of Stockholders which is to be filed subsequent to the date hereof are incorporated by reference into Part III of this 
Annual Report on Form 10-K.

Table of Contents

BUSINESS

Item 1.
Item 1A. RISK FACTORS
Item 1B. UNRESOLVED STAFF COMMENTS
Item 2.

PROPERTIES

Item 3.
LEGAL PROCEEDINGS
Item 4. MINE SAFETY DISCLOSURES

PART I

PART II

Item 5. MARKET FOR THE REGISTRANT'S COMMON EQUITY, RELATED STOCKHOLDER MATTERS 

AND ISSUER PURCHASES OF EQUITY SECURITIES

Item 6.
Item 7. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF 

[RESERVED]

OPERATIONS

Item 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Item 8.

FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND 
FINANCIAL DISCLOSURE

Item 9.

Item 9A. CONTROLS AND PROCEDURES
Item 9B. OTHER INFORMATION
Item 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS

PART III

Item 10. DIRECTORS, EXECUTIVE OFFICERS, AND CORPORATE GOVERNANCE
Item 11. EXECUTIVE COMPENSATION
Item 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND 

RELATED STOCKHOLDER MATTERS

Item 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS AND DIRECTOR INDEPENDENCE
Item 14. PRINCIPAL ACCOUNTING FEES AND SERVICES

Item 15. EXHIBITS, FINANCIAL STATEMENT SCHEDULES
Item 16. FORM 10-K SUMMARY

SIGNATURES

PART IV

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  We  have  filed  applications  to  register  certain  trademarks  in  the  United  States  and  abroad,  including  AMICUS 
THERAPEUTICS and design, AMICUS ASSIST and design, CHART and design, AT THE FOREFRONT OF THERAPIES 
FOR RARE AND ORPHAN DISEASES, HEALING BEYOND DISEASE, OUR GOOD STUFF, and Galafold® and design. 

 
Table of Contents

SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

This Annual Report on Form 10-K contains forward-looking statements that involve risks, uncertainties, and assumptions. 
Forward-looking statements are all statements, other than statements of historical facts, that discuss our current expectation and 
projections  relating  to  our  strategy,  future  operations,  future  financial  position,  future  revenues,  projected  costs,  prospects, 
plans,  and  objectives  of  management.  These  statements  may  be  preceded  by,  followed  by  or  include  the  words  "aim," 
"anticipate,"  "believe,"  "can,"  "could,"  "estimate,"  "expect,"  "forecast,"  "intend,"  "likely,"  "may,"  "might,"  "outlook,"  "plan," 
"potential," "predict," "project," "seek," "should," "will," "would," the negatives or plurals thereof, and other words and terms 
of similar meaning, although not all forward-looking statements contain these identifying words.

We  have  based  these  forward-looking  statements  on  our  current  expectations  and  projections  about  future  events. 
Although we believe that our assumptions made in connection with the forward-looking statements are reasonable, we cannot 
assure you that the assumptions and expectations will prove to be correct. You should understand that the following important 
factors could affect our future results and could cause those results or other outcomes to differ materially from those expressed 
or implied in our forward-looking statements:

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

the scope, progress, results and costs of clinical trials for our drug candidates;

the  cost  of  manufacturing  drug  supply  for  our  commercial,  clinical  and  preclinical  studies,  including  the  cost  of 
manufacturing Pompe Enzyme Replacement Therapy ("ERT" or "ATB200" or "cipaglucosidase alfa");

the  future  results  of  preclinical  research  and  subsequent  clinical  trials  for  pipeline  candidates  we  may  identify  from 
time to time, including our ability to obtain regulatory approvals and commercialize these therapies and obtain market 
acceptance for such therapies;

the costs, timing, and outcome of regulatory review of our product candidates, including AT-GAA;

any changes in regulatory standards relating to the review of our product candidates, including AT-GAA;

the number and development requirements of other product candidates that we pursue;

the costs of commercialization activities, including product marketing, sales, and distribution;

the emergence of competing technologies and other adverse market developments;

the estimates regarding the potential market opportunity for our product and product candidates, including AT-GAA; 

our ability to successfully commercialize Galafold® (also referred to as "migalastat HCl") and, if our regulatory 
applications are approved, AT-GAA;

our ability to manufacture or supply sufficient clinical or commercial products, including Galafold® and AT-GAA;

our ability to obtain reimbursement for Galafold® and, if our regulatory applications are approved, AT-GAA;

our ability to satisfy post-marketing commitments or requirements for continued regulatory approval of Galafold®, 
and, if approved and applicable, AT-GAA;

our ability to obtain market acceptance of Galafold® and, if our regulatory applications are approved, AT-GAA;

the  costs  of  preparing,  filing,  and  prosecuting  patent  applications  and  maintaining,  enforcing,  and  defending 
intellectual property-related claims, including Hatch-Waxman litigation;

the impact of litigation that has been or may be brought against us or of litigation that we are pursuing or may pursue 
against others, including Hatch-Waxman litigation;

the extent to which we acquire or invest in businesses, products, and technologies;

our ability to successfully integrate our acquired products and technologies into our business, or successfully divest or 
license existing products and technologies from our business, including the possibility that the expected benefits of the 
transactions will not be fully realized by us or may take longer to realize than expected;

our ability to establish licensing agreements, collaborations, partnerships or other similar arrangements and to obtain 
milestone, royalty, or other payments from any such collaborators; 

-1-

 
 
Table of Contents

•

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•

•

the extent to which our business could be adversely impacted by the effects of the novel coronavirus ("COVID-19") 
outbreak,  including  actions  by  us,  governments,  our  customers,  our  suppliers,  or  other  third  parties  to  control  the 
spread of COVID-19, or by other health epidemics or pandemics;

the costs associated with, and our ability to comply with, emerging environmental, social and governance standards;

our ability to accurately forecast revenue, operating expenditures, or other metrics impacting profitability;

fluctuations in foreign currency exchange rates; and

changes in accounting standards.

In light of these risks and uncertainties, we may not actually achieve the plans, intentions or expectations disclosed in our 
forward-looking  statements,  and  you  should  not  place  undue  reliance  on  our  forward-looking  statements.  Actual  results  or 
events could differ materially from the plans, intentions, and expectations disclosed in the forward-looking statements we make. 
We have included important factors in the cautionary statements included in this Annual Report on Form 10-K, particularly in 
Part  I,  Item  1A  "—  Risk  Factors",  a  summary  of  which  may  be  found  below,  that  we  believe  could  cause  actual  results  or 
events to differ materially from the forward-looking statements that we make. Those factors and the other risk factors described 
herein are not necessarily all of the important factors that could cause actual results or developments to differ materially from 
those expressed in any of our forward-looking statements. Other unknown or unpredictable factors also could harm our results. 
Our  forward-looking  statements  do  not  reflect  the  potential  impact  of  any  future  collaborations,  alliances,  business 
combinations, partnerships, strategic out-licensing of certain assets, the acquisition of preclinical-stage, clinical-stage, marketed 
products  or  platform  technologies  or  other  investments  we  may  make.  Consequently,  there  can  be  no  assurance  that  actual 
results  or  developments  anticipated  by  us  will  be  realized  or,  even  if  substantially  realized,  that  they  will  have  the  expected 
consequences  to,  or  effects  on,  us.  Given  these  uncertainties,  investors  are  cautioned  not  to  place  undue  reliance  on  such 
forward-looking statements.

You  should  read  this  Annual  Report  on  Form  10-K  and  the  documents  that  we  incorporate  by  reference  in  this  Annual 
Report  on  Form  10-K  completely  and  with  the  understanding  that  our  actual  future  results  may  be  materially  different  from 
what we expect. These forward-looking statements speak only as of the date of this report. We undertake no obligation, and 
specifically  decline  any  obligation,  to  publicly  update  or  revise  any  forward-looking  statements,  even  if  experience  or  future 
developments make it clear that projected results expressed or implied in such statements will not be realized, except as may be 
required by law.

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Table of Contents

Summary Risk Factors

The following is a summary of the principal risks that make an investment in our common stock speculative or risky. This 
summary  does  not  address  all  of  the  risks  that  we  face  and  is  qualified  in  its  entirety  by  reference  to  the  more  detailed 
descriptions  included  in  Part  I,  Item  1A  "—  Risk  Factors".  This  summary  should  be  read  together  with  those  more  detailed 
descriptions, along with our other SEC filings before making an investment decision.

• We  depend  heavily  on  sales  of  Galafold®  in  Europe,  the  U.S.  and  Japan.  If  we  are  delayed  or  unable  to  commercialize 

Galafold® successfully, our business could be materially harmed.
If we are not able to obtain, or delayed in obtaining, required regulatory approvals, we will not be able to commercialize 
our product or product candidates, materially impairing our ability to generate revenue.

If we are unable to establish and maintain sales and marketing capabilities, or relationships, to market and sell our product 
or, if approved, product candidates, their commercialization may suffer.

If the market opportunities for our product or product candidates are smaller than we believe they are, then our revenues 
may be adversely affected, and our business may suffer.

•

•

•

• Galafold®  or  any  of  our  product  candidates  that  receive  regulatory  approval  may  fail  to  achieve  the  degree  of  market 

acceptance necessary for commercial success.

• We face substantial competition, which may result in others discovering, developing or commercializing products before or 

more successfully than we do.

• A variety of risks associated with international operations could adversely affect our business.

• Our product or any product candidates receiving approval may become subject to unfavorable pricing regulations, third-

party coverage and reimbursement practices or healthcare reform initiatives.

•

If we are found to have promoted off-label uses by regulatory authorities, we may become subject to significant liability.

• Product  liability  lawsuits  against  us  could  cause  us  to  incur  substantial  liabilities  and  limit  commercialization  of  any 

products that we may develop.

•

If  applicable  regulatory  authorities  approve  generic  or  biosimilar  products  with  claims  that  compete  with  our  product  or 
any of our product candidates, it could reduce our sales.

• We may expend our limited resources to pursue a particular product, product candidate or indication and fail to capitalize 

on an alternative for which there is a greater likelihood of success.

• Our product or product candidates may cause undesirable side effects or have other properties that could delay or prevent 

their regulatory approval or commercialization.

• Any product or product candidate we obtain marketing approval for could be subject to restrictions or withdrawal from the 

market and we may be subject to penalties or enforcement actions if we fail to comply with regulatory requirements.

• Certain  relationships  will  be  subject  to  applicable  anti-kickback,  fraud  and  abuse,  anti-bribery  and  corruption  and  other 
healthcare  laws  and  regulations,  which  could  expose  us  to  criminal  sanctions,  civil  penalties,  contractual  damages, 
reputational harm and diminished profits and future earnings.

•

•

•

•

•

If clinical trials of our product candidates do not produce results satisfactory to regulatory authorities, the development and 
commercialization of our product candidates may not be completed.

If  we  experience  unforeseen  events  in  connection  with  our  clinical  trials,  potential  regulatory  approval  or 
commercialization of our product candidates could be delayed or prevented.

If we experience delays or difficulties in the enrollment of patients in our clinical trials, our receipt of necessary regulatory 
approvals could be delayed or prevented.

Initial  results  from  a  clinical  trial  do  not  ensure  that  the  trial  will  be  successful  and  success  in  preclinical  or  early  stage 
clinical trials does not ensure success in later-stage clinical trials.

If our competitors obtain orphan drug exclusivity for their products and we do not, we may not unable to have competing 
products approved in the applicable jurisdiction for a significant period of time.

• Failure to obtain or maintain regulatory approval outside the U.S. would prevent us from marketing our products abroad.
• Our business activities involve the use of hazardous materials which could subject us to significant adverse consequences if 

we fail to comply with the applicable laws regulating their use.

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•

If we are unable to obtain marketing approval, or if approved unable to successfully commercialize AT-GAA, our business 
could be materially harmed.

• Our gene therapy product candidates are based on novel technologies, which makes it difficult to predict the time and cost 

of their development and subsequently obtaining regulatory approval.

• Use of third parties to manufacture our product or product candidates may increase the risk that we will not have sufficient 
quantities  of  our  product  or  product  candidates  or  such  quantities  at  an  acceptable  cost,  which  could  delay,  prevent  or 
impair our development or commercialization efforts.

• We may be unable to enter into agreements with third-party manufacturers, or unable to do so on acceptable terms. 

• We rely on third parties to conduct certain preclinical activities and our clinical trials, who may not perform satisfactorily.

• We may not be successful in maintaining or establishing collaborations, which could adversely affect our ability to develop 

and, particularly in international markets, commercialize products.

• Materials  necessary  to  manufacture  our  product  or  product  candidates  may  not  be  available  on  commercially  reasonable 

terms, which may delay their development and commercialization.

• Manufacturing issues may arise that could increase costs or delay commercialization.

• We have incurred significant losses and anticipate that we will continue to incur losses in the future.

• We may never become profitable even though we currently generate revenue from the sale of products.

•

If  we  require,  and  fail  to  obtain,  additional  necessary  financing,  we  may  be  unable  to  complete  the  development  and 
commercialization of our product and product candidates.

• Raising additional capital may cause dilution to our existing stockholders, restrict our operations, or require us to relinquish 

rights to our technologies, Galafold® or product candidates.

• We may not have sufficient cash flow from our business to pay our substantial debt.

• Foreign currency exchange rate fluctuations could harm our financial results.

• Our ability to use our net operating loss carryforwards and certain other tax attributes may be limited.

• Our executive officers, directors and principal stockholders maintain the ability to exert significant influence and control 

over matters submitted to our stockholders for approval.

• We do not anticipate paying cash dividends so capital appreciation, if any, will be our stockholders sole source of gain.

• Our disclosure controls and procedures may not prevent or detect all errors or acts of fraud.

•

If we are unable to obtain and maintain sufficiently broad patent protection, our ability to successfully commercialize our 
technology and products may be adversely affected.

• We currently are and may become involved in lawsuits to protect or enforce our patents or other intellectual property.

• Third  parties  may  initiate  legal  proceedings  alleging  that  we  are  infringing  their  intellectual  property  rights  which  could 

have a material adverse effect on the success of our business.

• We  may  be  subject  to  claims  by  third  parties  asserting  that  we  or  our  employees  have  misappropriated  their  intellectual 

property, or claiming ownership of what we regard as our own intellectual property.

•

If we fail to comply with our obligations in our intellectual property licenses with third parties, we could lose license rights 
that are important to our business.

• Failure to secure trademark registrations could adversely affect our business.

• Our  rights  to  develop  and  commercialize  our  gene  therapy  product  candidates  are  subject,  in  part,  to  the  terms  and 

conditions of licenses granted to us by others.

• The novel coronavirus ("COVID-19") pandemic may negatively impact our business and operations.

• Our future success depends on our ability to retain key executives and to attract, retain and motivate qualified personnel.

• We expect to expand our development, regulatory and sales and marketing capabilities, and as a result, we may encounter 

difficulties in managing our growth, which could disrupt our operations.

• Our  employees,  independent  contractors,  principal  investigators,  consultants  and  vendors  may  engage  in  misconduct  or 

•

improper activities which could lead to significant liability and harm our reputation.
If  our  enterprise  risk  program,  global  risk  committee  and  other  compliance  methods  are  not  effective,  our  business, 
financial condition and operating results may be adversely affected.

• Our business and reputation may be adversely affected by environmental, social and governance matters. 

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Item 1.    BUSINESS

Overview

PART I

We  are  a  global,  patient-dedicated  biotechnology  company  focused  on  discovering,  developing,  and  delivering  novel 
medicines  for  rare  diseases.  We  have  a  portfolio  including  the  first,  oral  monotherapy  for  Fabry  disease  that  has  achieved 
widespread global approval and a differentiated biologic for Pompe disease that is under review with the U.S. Food and Drug 
Administration  ("FDA"),  the  European  Medicines  Agency  ("EMA"),  and  the  United  Kingdom  ("U.K.")  Medicines  and 
Healthcare products Regulatory Agency ("MHRA"). We are committed to discovering and developing next generation therapies 
in Fabry and Pompe diseases.

The cornerstone of our portfolio is Galafold® (also referred to as "migalastat"), the first and only approved oral precision 
medicine for people living with Fabry disease who have amenable genetic variants. Migalastat is currently approved under the 
trade  name  Galafold®  in  the  United  States  ("U.S."),  European  Union  ("E.U."),  U.K.,  and  Japan,  with  multiple  additional 
approvals granted and applications pending in several geographies around the world. 

The lead biologics program of our pipeline is Amicus Therapeutics GAA ("AT-GAA", also known as ATB200/AT2221, or 
cipaglucosidase alfa/miglustat), a novel, two-component, potential best-in-class treatment for Pompe disease. In February 2019, 
the  FDA  granted  Breakthrough  Therapy  designation  ("BTD")  to  AT-GAA  for  the  treatment  of  late  onset  Pompe  disease.  In 
September 2021, the FDA set the Prescription Drug User Fee Act ("PDUFA") target action date of May 29, 2022 for the New 
Drug Application ("NDA") for miglustat and July 29, 2022 for the Biologics License Application ("BLA") for cipaglucosidase 
alfa. The EMA validated the Marketing Authorization Application (“MAA”) in the fourth quarter of 2021. In May 2022, the 
FDA extended the review period for the NDA for miglustat and the BLA for cipaglucosidase alfa resulting in revised PDUFA 
action dates of August 29, 2022 and October 29, 2022, respectively. In October 2022, the FDA deferred action on the BLA for 
cipaglucosidase alfa, citing the inability to complete the manufacturing facility inspection prior to the PDUFA action date.  We 
are  actively  engaged  with  the  FDA  and  an  inspection  has  been  scheduled.  In  December  2022,  the  Committee  for  Medicinal 
Products  for  Human  Use  ("CHMP")  of  the  EMA  adopted  a  positive  opinion  recommending  market  authorization  of 
cipaglucosidase  alfa,  or  Pombiliti™.  The  regulatory  submission  process  for  AT-GAA  in  the  U.K.  was  initiated  in  December 
2022.

Our Strategy

Our strategy is to create, manufacture, test, and deliver the highest quality medicines for people living with rare diseases 
through internally developed, jointly developed, acquired, or in-licensed products and product candidates that have the potential 
to  obsolete  current  treatments,  provide  significant  benefits  to  patients,  and  be  first-  or  best-in-class.  We  are  leveraging  our 
global  capabilities  to  develop  and  broaden  our  lead  franchises  in  Fabry  and  Pompe  disease,  with  focused  discovery  work  on 
next generation therapies and novel platform technologies. 

We  continue  to  monitor  the  novel  coronavirus  ("COVID-19")  pandemic.  Our  commercial  operations  have  not  been 
significantly impacted by the COVID-19 pandemic and we gradually continue to see an improvement in patient identification 
and Galafold® initiation. We have been able to continue to meet required commercial demand for Galafold® as well as supply 
our ongoing Pompe disease clinical studies and access programs including the Early Access to Medicines Scheme ("EAMS") 
without interruption. In regard to our regulatory operations, the FDA deferred action on the pending BLA for cipaglucosidase 
alfa,  as  a  facility  inspection  was  necessary,  however,  could  not  be  completed  by  the  PDUFA  action  date  due  to  COVID-19 
related travel restrictions. The facility inspection has subsequently been scheduled. Per FDA guidance relating to pre-approval 
inspections during the COVID-19 pandemic, receipt of a deferral action indicates no deficiencies have been identified and the 
application otherwise satisfies the requirements for approval.

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Highlights of our progress include:

•

•

•

•

Commercial and regulatory success in Fabry disease. For the year ended December 31, 2022, Galafold® revenue was 
$329.0 million of consolidated revenue, which represented an increase of $23.5 million compared to the prior year. We 
continue to see strong commercial momentum and expansion into additional geographies. In countries where we have 
been operating the longest, we see an increasing proportion of previously untreated patients come onto Galafold® as 
compared to treatment experienced patients. In the U.S., we continue to see a significant increase in patients from a 
growing and very wide prescriber base. Across all markets, we see a high rate of compliance and adherence to this oral 
treatment option. 

Pompe disease program milestones. AT-GAA is under regulatory reviews in the U.S., E.U. and U.K., respectively. In 
December  2022,  the  CHMP  of  the  EMA  adopted  a  positive  opinion  recommending  marketing  authorization  of 
Pombiliti™  (cipaglucosidase  alfa),  a  long-term  enzyme  replacement  therapy  ("ERT")  used  in  combination  with 
miglustat for adults with late-onset Pompe disease ("LOPD"). Additionally, multiple expanded access mechanisms are 
in place around the globe, including in the U.S., U.K., Germany, France, Japan, and others.

Pipeline  advancement  and  growth.  We  are  leveraging  our  global  capabilities  to  develop  and  broaden  our  lead 
franchises in Fabry and Pompe disease, with focused discovery work on next generation therapies and novel platform 
technologies. 

Financial  strength.  Total  cash,  cash  equivalents,  and  marketable  securities  as  of  December  31,  2022  was  $293.6 
million.  Based  on  the  current  operating  model,  we  believe  that  the  current  cash  position,  which  includes  expected 
revenues, is sufficient to fund our operations and ongoing research programs for at least the next 12 months. Potential 
impacts  of  the  COVID-19  pandemic,  business  development  collaborations,  pipeline  expansion,  and  investment  in 
manufacturing capabilities could impact our future capital requirements.

Our Commercial Product and Product Candidates

Galafold® (migalastat HCl) for Fabry Disease

Our oral precision medicine Galafold® was granted accelerated approval by the FDA in August 2018 under the brand name 
Galafold® for the treatment of adults with a confirmed diagnosis of Fabry disease and an amenable galactosidase alpha gene 
("GLA") variant based on in vitro assay data. The FDA has approved Galafold® for 350 amenable GLA variants. Galafold® was 
approved in the E.U. and U.K. in May 2016 as a first-line therapy for long-term treatment of adults and adolescents, aged 16 
years and older, with a confirmed diagnosis of Fabry disease and who have an amenable mutation (variant). The approved E.U. 
and U.K. labels include 1,384 mutations amenable to Galafold® treatment, which represent up to half of all patients with Fabry 
disease. In countries where mutations are provided only on the amenability website, these 1,384 amenable mutations are now 
available. Marketing authorization approvals have been granted in over 40 countries around the world. In July 2021, Galafold® 
was approved in the E.U. for adolescents aged 12 years and older weighing 45 kg or more. Throughout 2022, Galafold® was 
approved in 7 additional countries, including the U.K. and Japan, for adolescents aged 12 years and older weighing 45 kg or 
more. We plan to continue to launch Galafold® in additional countries during 2023, including for adolescents aged 12 years and 
older. 

As an orally administered monotherapy, Galafold® is designed to bind to and stabilize an endogenous alpha-galactosidase 
A ("alpha-Gal A") enzyme in those patients with genetic variants identified as amenable in a Good Laboratory Practice ("GLP") 
cell-based  amenability  assay.  Galafold®  is  an  oral  precision  medicine  intended  to  treat  Fabry  disease  in  patients  who  have 
amenable genetic variants, and at this time, it is not intended for concomitant use with ERT. 

Next Generation for Fabry Disease

We are committed to continued innovation for all people living with Fabry disease. As part of our long-term commitment, 
we  have  an  academic  research  collaboration  agreement  to  explore  next  generation  pharmacological  chaperones  for  Fabry 
disease. 

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Fabry Disease Background

Patients with Fabry disease have an inherited deficiency of the alpha-Gal A enzyme that would normally degrade the lipid 
substrate globotriaosylceramide in the lysosome. Genetic variants that cause changes in the amino acid sequence of alpha-Gal A 
result  in  an  unstable  enzyme  that  does  not  efficiently  fold  into  its  correct  three-dimensional  shape  and  cannot  be  trafficked 
properly  in  the  cell,  even  if  it  has  the  potential  for  biological  activity.  Galafold®  is  an  oral  small  molecule  pharmacological 
chaperone  that  is  designed  to  bind  to  and  stabilize  a  patient’s  own  endogenous  target  protein.  This  is  considered  a  precision 
medicine because Galafold® targets only patients with GLA variants amenable to Galafold®.

Fabry disease is an X-linked disease caused by mutations in the GLA gene, which encodes the alpha-Gal A enzyme. These 
mutations can cause alpha-Gal A to be either absent or deficient. When alpha-Gal A is absent or deficient the substrates, GL-3 
and  lyso-Gb3  accumulate,  leading  to  damage  of  cells  within  affected  parts  of  the  individual's  body  and  causing  the  various 
pathologies  seen  in  Fabry  disease.  Fabry  disease  leads  to  progressive,  irreversible  organ  damage,  typically  involving  the 
nervous,  cardiac,  and  renal  systems,  as  well  as  multiple  other  tissues.  The  symptoms  can  be  severe,  differ  from  patient  to 
patient,  and  begin  at  an  early  age,  resulting  in  significant  clinical,  humanistic,  and  healthcare  costs.  Fabry  disease  requires 
lifelong medical intervention to manage the complications of this devastating disease across multiple organ systems.

Fabry disease is a relatively rare disorder. The annual incidence of Fabry disease in newborn males has been historically 
estimated  to  be  1:40,000-1:60,000  (Journal  of  the  American  Medical  Association  January  1999  and  The  Metabolic  and 
Molecular  Bases  of  Inherited  Disease  8th  edition  2001).  However,  more  recent  newborn  screening  studies  in  Italy,  Taiwan, 
Austria, Spain and the U.S., which collectively screened more than 500,000 male and female newborns, found the incidence of 
GLA  mutations  to  be  between  1:2,445  to  1:8,454,  more  than  ten  times  higher  than  previous  estimates  for  classic  patients 
(American Journal of Human Genetics 2006, Human Mutation 2009, the Lancet 2011, Journal of Pediatrics 2017, and JAMA 
Pediatrics 2018). When looking at only male newborns within these studies, the incidence of Fabry disease mutations is as high 
as  1:1,316  –  1:7,575  (Circulation  in  Cardiovascular  Genetics  2009,  American  Journal  of  Human  Genetics  2006,  European 
Journal of Pediatrics 2017).

We believe that approximately 35-50% of the Fabry disease patient population may benefit from treatment with Galafold® 
as  a  monotherapy.  Additionally,  we  expect  that  as  awareness  of  late-onset  symptoms  of  Fabry  disease  grows,  the  number  of 
patients  diagnosed  with  the  disease  will  increase.  Increased  awareness  of  Fabry  disease,  particularly  for  specialists  not 
accustomed to treating Fabry disease patients, may lead to increased testing and diagnosis of patients with the disease.

Currently,  two  other  products,  both  ERTs,  are  approved  for  the  treatment  of  Fabry  disease:  agalsidase  beta  by  Sanofi 

Aventis and agalsidase alfa by Takeda, the latter of which is not approved in the U.S. 

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Novel ERT for Pompe Disease

We are leveraging our biologics capabilities to develop AT-GAA, a novel treatment paradigm for Pompe disease. AT-GAA 
consists of a uniquely engineered rhGAA enzyme, ATB200, or cipaglucosidase alfa, with an optimized carbohydrate structure 
to enhance lysosomal uptake, administered in combination with AT2221, or miglustat, that functions as an enzyme stabilizer. 
Miglustat  binds  to  and  stabilizes  ATB200  preventing  inactivation  of  rhGAA  in  circulation  to  improve  the  uptake  of  active 
enzyme in key disease-relevant tissues, resulting in increased clearance of accumulated substrate, ("glycogen"). Miglustat is not 
an active ingredient that contributes directly to glycogen reduction. 

We  initiated  ATB200-03  (or  "PROPEL"),  a  global  Phase  3  clinical  study  of  AT-GAA  in  adult  patients  with  late  onset 
Pompe  disease  in  December  2018  and  completed  last  patient,  last  visit  in  December  2020.  In  February  2021,  we  reported 
topline  results  from  the  Phase  3  PROPEL  study.  Patients  in  PROPEL  were  randomized  2:1  so  that  for  every  two  patients 
randomized  to  be  treated  with  AT-GAA,  one  was  randomized  to  be  treated  with  alglucosidase  alfa.  Of  the  Pompe  disease 
patients enrolled, 77% were being treated with alglucosidase alfa (n=95) immediately prior to enrollment (“Switch”) and 23% 
had  never  been  treated  with  any  ERT  (n=28)  (“Naïve”).  117  patients  completed  the  PROPEL  study  and  all  117  voluntarily 
enrolled in the long-term extension study. The primary endpoint of the study was the mean change in 6-minute walk distance as 
compared with baseline measurements at 52 weeks across the combined ERT Switch and ERT Naïve patient populations. In 
this  combined  population  patients  taking  AT-GAA  (n=85)  walked  on  average  21  meters  farther  at  52  weeks  compared  to  7 
meters with those treated with alglucosidase alfa (n=37). This primary endpoint in the combined population was assessed for 
superiority and while numerically greater, statistical significance for superiority on this combined population was not achieved 
for the AT-GAA arm as compared to the alglucosidase alfa arm (p=0.072).

Per  the  hierarchy  of  the  statistical  analysis  plan,  the  first  key  secondary  endpoint  of  the  study  was  the  mean  change  in 
percent-predicted  Forced  Vital  Capacity  (“FVC”)  at  52  weeks  across  the  combined  population.  In  this  combined  population 
patients taking AT-GAA demonstrated a nominally statistically significant and clinically meaningful difference for superiority 
over  those  treated  with  alglucosidase  alfa.  AT-GAA  significantly  slowed  the  rate  of  respiratory  decline  in  patients  after  52 
weeks. Patients treated with AT-GAA showed a 0.9% absolute decline in percent-predicted FVC, compared to a 4.0% absolute 
decline  in  the  alglucosidase  alfa  arm  (p=0.023).  Patients  within  the  combined  study  population  demonstrated  statistically 
significant  improvements  on  the  Gait,  Stairs,  Gower’s  Chair  ("GSGC")  key  secondary  endpoint,  which  captures  strength, 
coordination and mobility, compared to a worsening for alglucosidase alfa treated patients in the overall population (p<0.05). 
Additionally,  lower  Manual  Muscle  Testing  ("MMT"),  Patient-Reported  Outcomes  Measurement  Information  System 
(“PROMIS”) physical function and PROMIS fatigue secondary endpoints favored AT-GAA treated patients over alglucosidase 
alfa treated patients. Results also showed improvements in the two important biomarker endpoints of Pompe disease (Hex-4 and 
CK), which significantly favored AT-GAA compared to alglucosidase alfa (p<0.001). AT-GAA demonstrated a similar safety 
profile to alglucosidase alfa. 

The PROPEL Switch patients entered the study having been treated with alglucosidase alfa for a minimum of two years. 
More  than  two  thirds  (67%+)  of  those  patients  had  been  on  ERT  treatment  for  more  than  five  years  prior  to  entering  the 
PROPEL study (mean of 7.4 years). A pre-specified analysis of the patients switching from alglucosidase alfa on 6-minute walk 
distance  showed  that  after  52  weeks  from  switching,  AT-GAA  treated  patients  (n=65)  walked  16.9  meters  farther  than  their 
baseline, compared to 0.0 meters for those patients who were randomized to remain on alglucosidase alfa (n=30) (p=0.046). A 
pre-specified analysis of the patients switching from alglucosidase alfa on percent-predicted FVC showed that AT-GAA treated 
patients stabilized and slightly improved their respiratory function on this important measure while those patients remaining on 
alglucosidase alfa continued to significantly decline in respiratory muscle function. AT-GAA patients showed a 0.1% absolute 
increase in percent-predicted FVC while the alglucosidase alfa patients showed a 4.0% absolute decline over the course of the 
year (p=0.006).

The PROPEL Naïve patients treated with AT-GAA for 52 weeks (n=20) walked 33 meters farther than their baseline, on 
the 6-minute walk distance endpoint. The Naïve patients treated with alglucosidase alfa (n=7) walked 38 meters further than 
their  baseline.  The  difference  between  the  two  groups  was  not  statistically  significant  (p=0.60).  Additionally,  patients  never 
previously treated with any ERT showed similar declines in percent-predicted FVC at 52 weeks of –4.1% for AT-GAA treated 
patients  and  –3.6%  for  alglucosidase  alpha  treated  patients.  The  difference  between  the  two  groups  was  not  statistically 
significant (p=0.57). 

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In October 2022 and February 2023, we reported positive long-term data from our ongoing phase 1/2 clinical study and 
Phase 3 open-label extension study, respectively. Phase 1/2 and 3 study participants treated with AT-GAA for up to 48 months 
and up to 2 years, respectively, demonstrated persistent and durable effects on six-minute walk test distance and measures of 
motor  function  and  muscle  strength,  stability,  or  increase  in  forced  vital  capacity,  and  reductions  in  biomarkers  of  muscle 
damage and disease substrate.

In  December  2022  the  CHMP  of  the  EMA  adopted  a  positive  opinion  recommending  marketing  authorization  of 
cipaglucosidase  alfa  or  Pombiliti™.    Additionally,  we  initiated  the  regulatory  submission  process  with  the  U.K.  MHRA  in 
December 2022.

In  addition,  we  are  conducting  ongoing  clinical  studies  in  pediatric  patients  for  both  LOPD  and  infantile-onset  Pompe 

disease ("IOPD") populations. 

Next Generation for Pompe Disease

We are committed to continued innovation for all people living with Pompe disease. As part of our long-term commitment, 

we are also continuing discovery for next-generation genetic medicines for Pompe disease. 

Pompe Disease Background

Pompe disease is a lysosomal disorder ("LD") that results from a deficiency in an enzyme, GAA. Signs and symptoms of 
Pompe disease can be severe and debilitating and include progressive muscle weakness throughout the body, particularly the 
heart and skeletal muscles. GAA deficiency causes accumulation of glycogen in cells, which is believed to result in the clinical 
manifestations of Pompe disease. Pompe disease ranges from a rapidly fatal infantile form with severe cardiac involvement to a 
more  slowly  progressive,  late-onset  form  primarily  affecting  skeletal  muscle.  All  forms  are  characterized  by  severe  muscle 
weakness that worsens over time. In the early-onset form, patients are usually diagnosed shortly after birth and often experience 
enlargement  of  the  heart  and  severe  muscle  weakness.  In  late-onset  Pompe  disease,  symptoms  may  not  appear  until  late 
childhood or adulthood and patients often experience progressive muscle weakness.

According  to  reported  estimates  of  the  Acid  Maltase  Deficiency  Association,  the  United  Pompe  Foundation,  and  the 
Lysosomal  Disease  Program  at  Massachusetts  General  Hospital,  there  are  5,000-10,000  patients  with  Pompe  disease 
worldwide.

Currently,  two  products,  both  ERTs,  are  approved  for  the  treatment  of  Pompe  disease:  alglucosidase  alfa  and 

avalglucosidase alfa-ngpt by Sanofi Aventis.

Additional Development and Next Generation Programs

We  are  researching  potential  therapies  for  CDKL5  deficiency  disorder  ("CDD").  We  are  collaborating  with  the  LouLou 
Foundation to assess the natural history of the disease to identify endpoints for potential use in future studies. We also have a 
number  of  additional  gene  therapies  in  clinical  and  preclinical  development,  including  potential  gene  therapies  in  multiple 
forms of Batten disease. 

Strategic Alliances and Arrangements

We will continue to evaluate business development opportunities as appropriate to build stockholder value and provide us 
with  access  to  the  financial,  technical,  clinical,  and  commercial  resources  necessary  to  develop  and  market  technologies  or 
products  with  a  focus  on  rare  and  orphan  diseases.  We  are  exploring  potential  collaborations,  alliances,  and  other  business 
development  opportunities  on  a  regular  basis.  These  opportunities  may  include  business  combinations,  partnerships,  the 
strategic out-licensing of certain assets, or the acquisition of preclinical-stage, clinical-stage, or marketed products or platform 
technologies consistent with our strategic plan to develop and provide therapies to patients living with rare and orphan diseases.

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Acquisitions

Celenex, Inc.

In connection with our acquisition of Celenex, Inc. ("Celenex"), we may be obligated to pay up to an additional $10 million 
in  connection  with  the  achievement  of  certain  development  milestones,  $220  million  in  connection  with  the  achievement  of 
certain  regulatory  approval  milestones  across  multiple  programs  and  up  to  $75  million  in  tiered  sales  milestone  payments. 
Celenex has an exclusive license agreement with Nationwide Children’s Hospital ("Nationwide Children’s"). Under this license 
agreement, Nationwide Children’s is eligible to receive development and sales-based milestones of up to $7.8 million for each 
product.

MiaMed, Inc.

In  connection  with  our  acquisition  of  MiaMed,  Inc.,  ("MiaMed"),  we  may  be  obligated  to  pay  up  to  an  additional 
$83  million  in  connection  with  the  achievement  of  certain  clinical,  regulatory,  and  commercial  milestones,  for  a  potential 
aggregate deal value of $89.5 million. 

Callidus Biopharma, Inc.

In  connection  with  our  acquisition  of  Callidus  Biopharma,  Inc.  ("Callidus"),  we  may  be  obligated  to  make  additional 
payments to the former stockholders of Callidus upon the achievement of certain clinical milestones of up to $35 million and 
regulatory milestones of up to $80 million set forth in the merger agreement, provided that the aggregate merger consideration 
shall not exceed $130 million. 

Intellectual Property

Patents and Trade Secrets

Our  success  depends  in  part  on  our  ability  to  maintain  proprietary  protection  surrounding  our  product  candidates, 
technology, and know-how, to operate without infringing the proprietary rights of others, and to prevent others from infringing 
our proprietary rights. Our policy is to seek to protect our proprietary position by filing U.S. and foreign patent applications 
related  to  our  proprietary  technology,  including  both  new  inventions  and  improvements  of  existing  technology,  that  are 
important to the development of our business, unless this proprietary position would be better protected using trade secrets. Our 
patent  strategy  includes  obtaining  patent  protection,  where  possible,  on  compositions  of  matter,  methods  of  manufacture, 
methods  of  use,  combination  therapies,  dosing  and  administration  regimens,  formulations,  therapeutic  monitoring,  screening 
methods,  and  assays.  We  also  rely  on  trade  secrets,  know-how,  continuing  technological  innovation,  in-licensing,  and 
partnership opportunities to develop and maintain our proprietary position. Lastly, we monitor third parties for activities that 
may infringe our proprietary rights, as well as the progression of third-party patent applications that may have the potential to 
create blocks to our products or otherwise interfere with the development of our business. We are aware, for example, of U.S. 
patents,  and  corresponding  international  counterparts,  owned  by  third  parties  that  contain  claims  related  to  ERTs,  and  small 
molecules  for  stabilizing  enzymes.  If  any  of  these  patents  were  to  be  asserted  against  us,  there  is  no  assurance  that  a  court 
would  find  in  our  favor  or  that,  if  we  choose  or  are  required  to  seek  a  license,  a  license  to  any  of  these  patents  would  be 
available to us on acceptable terms or at all.

We own or hold license rights to several issued patents and numerous pending and issued applications, filed in the U.S., 

Europe, Japan, and other jurisdictions that are related to Galafold® and our ongoing clinical programs:

• We own issued U.S. patents that cover the use of migalastat, the active pharmaceutical ingredients in Galafold®, in the 
treatment  of  Fabry  disease,  which  expire  between  2027  and  2039  and  are  listed  in  the  FDA  Orange  Book.  Foreign 
counterparts  of  the  U.S.  patents  are  pending  or  issued  in  Europe,  Japan,  and  certain  other  jurisdictions.  Further,  we 
have pending U.S. patent applications covering various aspects of Galafold®, including composition-of-matter methods 
of treating a patient diagnosed with Fabry disease with migalastat and their foreign counterparts. Any patents issuing 
from  these  applications  will  expire  between  2036  and  2043.  We  anticipate  listing  these  patents  in  the  FDA  Orange 
Book if issued.

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• We own several issued U.S. patents that cover various aspects of our investigational new treatment for Pompe disease, 
AT-GAA (ATB200/AT2221, an ERT/pharmacological chaperone combination) as well as foreign counterparts to the 
issued  patents,  some  of  which  are  still  pending.  Issued  U.S.  patents  cover  ATB200  compositions-of-matter, 
formulations, methods of manufacturing and methods of treatment and will expire between 2033 and 2037. We also 
have  pending  U.S.  patent  applications  covering  compositions,  methods  of  treatment,  methods  of  manufacture,  and 
formulations with anticipated expiry between 2033 and 2043.

•

•

From  the  Celenex  acquisition,  we  acquired  an  exclusive  license  to  composition-of-matter  and  intrathecal  method  of 
treatment patent applications covering the gene therapy for treating Batten disease that are pending in the U.S., Europe, 
Japan,  and  other  jurisdictions.  Any  patents  issued  from  these  applications  will  expire  in  2033  or  2040.  The  patent 
covering an intrathecal method of treatment, which expires in 2033, has issued in Europe and Japan.

From our agreement with Penn, we have a license to Penn’s patent portfolio pertaining to vector and other platform 
technologies for treating Pompe disease and Fabry disease. Any patents issued from these applications will expire in 
2039.

Patent  term  extensions  and  adjustments,  supplementary  protection  certificates,  and  pediatric  exclusivity  periods  are  not 

reflected in the expiration dates listed above and may extend protection. 

In addition to our clinical programs, we actively monitor and file patent applications in the U.S. and in foreign countries on 
relevant  technologies  and  pre-clinical  programs.  For  example,  we  own  or  hold  license  rights  to  U.S.  and  foreign  patents  or 
patent applications covering the following:

•

•

Gene therapy protein engineering technology;

Gene therapy (e.g., Pompe, Fabry) and ERT (e.g., CDKL5) programs and the use to treat specified diseases.

We  cannot  be  certain,  however,  that  issued  patents  will  be  enforceable  or  provide  adequate  protection  or  that  pending 

patent applications will result in issued patents.

•

Individual patents extend for varying periods depending on the effective date of filing of the patent application or the 
date of patent issuance, and the legal term of the patents in the countries in which they are obtained. Generally, patents 
issued in the U.S. are effective for 20 years from the earliest nonprovisional filing date. This period may be shortened 
by terminal disclaimer or further extended by patent term adjustment or extension. The term of foreign patents varies 
in accordance with provisions of applicable local law, but typically is 20 years from the earliest nonprovisional filing 
date.

The  U.S.  Drug  Price  Competition  and  Patent  Term  Restoration  Act  of  1984,  and  amendments  thereto,  more  commonly 
known as the Hatch-Waxman Act, provides for an extension of one patent, known as a Hatch-Waxman statutory extension, for 
each  New  Chemical  Entity  ("NCE")  to  compensate  for  a  portion  of  the  time  spent  in  clinical  development  and  regulatory 
review. However, the maximum extension is five years and the extension cannot extend the patent beyond 14 years from the 
NDA approval. Similar extensions are available in European countries, known as Supplemental Protection Certificate ("SPC") 
extensions, Japan, and other countries. However, in the U.S. we will not know what, if any, extensions are available until a drug 
is approved. In addition, in the U.S., under provisions of the Best Pharmaceuticals for Children Act, we may be entitled to an 
additional six-month period of patent protection or market exclusivity for completing pediatric clinical studies in response to an 
FDA issued Pediatric Written Request before said exclusivities expire.

In the fourth quarter of 2022, we received Paragraph IV Certification Notice Letters from Teva Pharmaceuticals USA, Inc. 
("Teva"), Aurobindo Pharma Limited ("Aurobindo"), and Lupin Limited ("Lupin") in connection with Abbreviated New Drug 
Applications (“ANDA”) filed with the FDA requesting approval to market generic Galafold®. In November 2022, we filed four 
lawsuits  against  Teva,  Lupin,  and  Aurobindo  in  the  U.S.  District  Court  for  the  District  of  Delaware  for  infringement  of  our 
Orange Book-listed patents and will vigorously enforce our Galafold® intellectual property rights.

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The  patent  positions  of  companies  like  ours  are  generally  uncertain  and  involve  complex  legal,  technical,  scientific,  and 
factual questions. Our ability to maintain and solidify our proprietary position for our technology will depend on our success in 
promptly  filing  patent  applications  on  new  discoveries,  and  in  obtaining  effective  claims  and  enforcing  those  claims  once 
granted.  We  focus  special  attention  on  filing  patent  applications  for  formulations  and  delivery  regimens  for  our  products  in 
development to further enhance our patent exclusivity for those products. We seek to protect our proprietary technology and 
processes,  in  part,  by  contracting  with  our  employees,  collaborators,  scientific  advisors,  and  our  commercial  consultants  to 
ensure  that  any  inventions  resulting  from  the  relationship  are  disclosed  promptly,  maintained  in  confidence  until  a  patent 
application is filed, and preferably until publication of the patent application, and assigned to us or subject to a right to obtain a 
license. We do not know whether any of our owned patent applications or those patent applications that are licensed to us will 
result in the issuance of any patents. Our issued patents and those that may issue in the future, or those licensed to us, may be 
challenged, narrowed, invalidated, circumvented, or be found to be invalid or unenforceable, which could limit our ability to 
stop competitors from marketing related products and reduce the term of patent protection that we may have for our products. 
Neither  we  nor  our  licensors  can  be  certain  that  we  were  the  first  to  invent  the  inventions  claimed  in  our  owned  or  licensed 
patents  or  patent  applications.  In  addition,  our  competitors  may  independently  develop  similar  technologies  or  duplicate  any 
technology  developed  by  us  and  the  rights  granted  under  any  issued  patents  may  not  provide  us  with  any  meaningful 
competitive  advantages  against  these  competitors.  Furthermore,  because  of  the  extensive  time  required  for  development, 
testing, and regulatory review of a potential product, it is possible that any related patent may expire prior to or shortly after 
commencing commercialization, thereby reducing the advantage of the patent to our business and products.

We  may  rely,  in  some  circumstances,  on  trade  secrets  to  protect  our  technology.  However,  trade  secrets  are  difficult  to 
protect. We seek to protect our trade secret technology and processes, in part, by entering into confidentiality agreements with 
commercial partners, collaborators, employees, consultants, scientific advisors, and other contractors, and by contracting with 
our  employees  and  some  of  our  commercial  consultants  to  ensure  that  any  trade  secrets  resulting  from  such  employment  or 
consulting  are  owned  by  us.  We  also  seek  to  preserve  the  integrity  and  confidentiality  of  our  data  and  trade  secrets  by 
maintaining  physical  security  of  our  premises  and  physical  and  electronic  security  of  our  information  technology  systems. 
While we have confidence in these individuals, organizations, and systems, agreements or security measures may be breached, 
and  we  may  not  have  adequate  remedies  for  any  breach.  In  addition,  our  trade  secrets  may  otherwise  become  known  or  be 
discovered  independently  by  others.  To  the  extent  that  our  consultants,  contractors,  or  collaborators  use  intellectual  property 
owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.

Collaboration and License Agreements

We have acquired rights to develop and commercialize our product candidates through licenses granted by various parties. 

The following summarizes our material rights and obligations under those licenses:

Nationwide Children's Hospital

In September 2018, we expanded our pipeline by acquiring the rights and related intellectual property of ten gene therapy 
programs through our acquisition of Celenex. Celenex has an exclusive license agreement with Nationwide Children’s. Under 
this  license  agreement,  Nationwide  Children’s  is  eligible  to  receive  development  and  sales-based  milestones  of  up  to  $7.8 
million for each product.

University of Pennsylvania

In October 2018, as amended, we entered into a collaboration agreement with Penn to pursue research and development of 
novel  gene  therapies.  Our  gene  therapy  portfolio  pipeline  expanded  to  include  Pompe  disease,  Fabry  disease  and  other  rare 
diseases.

In December 2022, we entered into a mutual termination agreement (the "Termination Agreement") pursuant to which we 
and  Penn  mutually  agreed  to  terminate  the  collaboration  agreement,  as  amended.  In  connection  with  the  Termination 
Agreement, we agreed to pay Penn an aggregate of $23.7 million in connection with an unpaid portion of the discovery support 
payments, research program wind-down activities, and outstanding patent costs.

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Concurrently, we entered into a license agreement with Penn pursuant to which we obtained a license with respect to the 
pre-clinical research and development of next generation parvovirus gene therapy products for the treatment of Pompe disease 
and Fabry disease. Under the agreement, we will be responsible for clinical development and commercialization of the licensed 
products  for  the  indications  and  Penn  is  eligible  to  receive  certain  milestone  and  royalty  payments  with  respect  to  licensed 
products  for  each  indication,  up  to  an  aggregate  of  $86.5  million  per  indication.  Royalty  payments  are  based  on  net  sales  of 
licensed products on a licensed product-by-licensed product and country-by-country basis.

GlaxoSmithKline

In July 2012, as amended in November 2013, we entered into an agreement with GlaxoSmithKline ("GSK"), pursuant to 
which Amicus obtained global rights to develop and commercialize Galafold® as a monotherapy and in combination with ERT 
for  Fabry  disease  (“Collaboration  Agreement”).  Under  the  terms  of  the  Collaboration  Agreement,  GSK  is  eligible  to  receive 
post-approval and sales-based milestones up to $40 million, as well as tiered royalties in the mid-teens in eight major markets 
outside the U.S. 

Manufacturing

We continue to rely on contract manufacturers to supply the active biopharmaceutical ingredients and finished goods for 
our  products  and  product  candidates.  The  active  biopharmaceutical  ingredients  and  final  formulations  for  these  products  are 
manufactured under current Good Manufacturing Practice ("cGMP"). The components in the final formulation for each product 
are commonly used in other biopharmaceutical products and are well characterized ingredients. Although we rely on contract 
manufacturers, we have personnel with extensive manufacturing and quality experience to oversee our contract manufacturers. 
We have implemented appropriate controls for assuring the quality of both active biopharmaceutical ingredients and final drug 
products. Product specifications will be established in concurrence with regulatory bodies at the time of product registration. 
Our  current  arrangement  with  third-party  manufacturers  provide  sufficient  quantities  of  our  program  materials  to  meet 
anticipated clinical and commercial demands.

Competition

Overview

The biotechnology and pharmaceutical industries are characterized by rapidly advancing technologies, intense competition, 
and a strong emphasis on proprietary products. In addition, several large pharmaceutical companies are increasingly focused on 
developing therapies for the treatment of rare diseases through organic growth, acquisitions, and partnerships. While we believe 
that  our  technologies,  knowledge,  experience,  and  scientific  resources,  provide  us  with  competitive  advantages,  we  face 
potential  competition  from  many  different  sources,  including  commercial  enterprises,  academic  institutions,  government 
agencies, and private and public research institutions. Any product candidates that we successfully develop and commercialize 
will compete with both existing and new therapies that may become available in the future.

Many  of  our  competitors  may  have  significantly  greater  financial  resources  and  expertise  associated  with  research  and 
development, regulatory approvals, and marketing approved products. These competitors also compete with us in recruiting and 
retaining qualified scientific and management personnel, as well as in acquiring technologies complementary to, or necessary 
for,  our  programs.  Smaller  or  early-stage  companies  may  also  prove  to  be  significant  competitors,  particularly  through 
collaborative arrangements with large and established companies.

Our commercial opportunities could be reduced or eliminated if our competitors develop and commercialize products that 
are  safer,  more  effective,  have  fewer  side  effects,  are  more  convenient,  and/or  are  less  expensive  than  products  that  we  may 
develop. In addition, our ability to compete may be affected because in some cases insurers or other third-party payors seek to 
encourage the use of generic products. This may have the effect of making branded products less attractive to buyers.

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Major Competitors

Our  major  competitors  include  pharmaceutical  and  biotechnology  companies  in  the  U.S.  and  abroad  that  have  approved 
therapies or therapies in development for LDs. Other competitors are pharmaceutical and biotechnology companies that have 
approved  therapies  or  therapies  in  development  for  rare  diseases  for  which  pharmacological  chaperone  technology,  or  next-
generation ERT may be applicable. Additionally, we are aware of several early-stage, niche pharmaceutical, and biotechnology 
companies whose core business revolves around protein misfolding; however, we are not aware that any of these companies are 
currently working to develop products that would directly compete with ours. We are also aware of several pharmaceutical and 
biotechnology companies who are developing various treatments for novel ERTs and gene therapy. The key competitive factors 
affecting the success of our product candidates are likely to be their efficacy, safety, convenience, and price.

Any  product  candidates  that  we  successfully  develop  and  commercialize  will  compete  with  existing  therapies  and  new 
therapies  that  may  become  available  in  the  future.  The  following  table  lists  our  principal  competitors  and  publicly  available 
information on the status of their clinical-stage product offerings:

Competitor (1)

Indication

Product

Class of Product

Status

Fabry Disease

Fabrazyme®

Pompe Disease

Myozyme®/ Lumizyme®

Sanofi Aventis

Pompe Disease

Nexviazyme®/ Nexviadyme®

Takeda (2)

Idorsia 

Protalix Biotherapeutics / 
Chiesi Farmaceutici S.p.A

Freeline

Sangamo

4DMT

Bayer

Astellas

Roche

Fabry Disease

Venglustat

Fabry Disease

Fabry Disease

Fabry Disease

Fabry Disease

Replagal®

Lucerastat

PRX-102

FLT-190

Fabry Disease

Isaralgagene civaparvovec

Fabry Disease

Pompe Disease

Pompe Disease

Pompe Disease

4D-310

ACTUS-101

AT-845

SPK-3006

ERT

ERT

ERT

Oral glucosylceramide 
synthase ("GCS") 
Inhibitor

ERT

Oral GCS Inhibitor

ERT

Gene Therapy

Gene Therapy

Gene Therapy

Gene Therapy

Gene Therapy

Gene Therapy

Maze Therapeutics 

Pompe Disease

GYS1

Oral glycogen synthase 
("GYS1") Inhibitor

Marketed

Marketed

Marketed

Phase 3

Marketed

Phase 3

Regulatory

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

_____________________________
(1) Reflects commercial products and product candidates for which IND has been filed or are in clinical development.
(2) Reflects running 12 month revenue as of December 31, 2022, as Takeda's fiscal year ends on March 31, 2023.  

2022 Sales

(in millions)

€938 

€958 

€196 

N/A

¥62,700 

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Government Regulation

FDA Approval Process

In  the  U.S.,  biopharmaceutical  products,  including  gene  therapies,  are  subject  to  extensive  regulation  by  the  FDA.  The 
Federal Food, Drug, and Cosmetic Act, Public Health Services Act, and other federal and state statutes and regulations, govern, 
among other things, the research, development, testing, manufacture, storage, recordkeeping, approval, labeling, promotion and 
marketing,  distribution,  post-approval  monitoring  and  reporting,  sampling,  and  import  and  export  of  biopharmaceutical 
products. Failure to comply with applicable U.S. requirements may subject a company to a variety of administrative or judicial 
sanctions,  such  as  FDA  refusal  to  file  a  marketing  application,  to  issue  complete  response  letters  or  to  not  approve  pending 
NDAs  or  BLAs,  or  to  issue  warning  letters,  untitled  letters,  Form  483s,  product  recalls,  product  seizures,  total  or  partial 
suspension  of  production  or  distribution,  injunctions,  fines,  civil  penalties,  litigation,  government  investigation,  and  criminal 
prosecution.

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Biopharmaceutical  product  development  in  the  U.S.  typically  involves  nonclinical  laboratory  and  animal  tests,  the 
submission  to  the  FDA  of  an  Investigational  New  Drug  application  ("IND"),  which  must  become  effective  before  clinical 
testing may commence, and adequate and well-controlled clinical trials to establish the safety and effectiveness of the drug for 
each indication for which FDA approval is sought. Satisfaction of FDA pre-market approval requirements typically takes many 
years and the actual time required varies substantially based upon the type, complexity, and novelty of the product or disease. 
Preclinical  tests  include  laboratory  evaluation  of  product  chemistry,  formulation,  and  toxicity,  as  well  as  animal  studies  to 
assess the characteristics, potential safety, and efficacy of the product. The conduct of the preclinical tests must comply with 
federal regulations and requirements including GLP. The results of preclinical testing are submitted to the FDA as part of an 
IND along with other information including information about product chemistry, manufacturing and controls, and at least one 
proposed  clinical  trial  protocol.  Long-term  preclinical  safety  evaluations,  such  as  animal  tests  of  reproductive  toxicity  and 
carcinogenicity, continue during the IND phase of development. Reproductive toxicity studies are required to allow inclusion of 
women of childbearing potential in clinical trials, whereas carcinogenicity studies are required for registration. The results of 
these long-term studies would eventually be described in product labeling.

A  30-day  review  period  after  the  submission  and  receipt  of  an  IND  is  required  prior  to  the  commencement  of  clinical 
testing in humans. The IND becomes effective 30 days after its receipt by the FDA, and trials may begin at that point unless the 
FDA notifies the sponsor that the investigations are subject to a clinical hold.

Clinical trials usually involve the administration of the investigational new drug to healthy volunteers or patients under the 
supervision of a qualified investigator. Clinical trials must be conducted in compliance with applicable government regulations, 
Good  Clinical  Practice  ("GCP"),  as  well  as  under  protocols  detailing  the  objectives  of  the  trial,  the  parameters  to  be  used  in 
monitoring  safety,  and  the  effectiveness  criteria  to  be  evaluated.  Each  protocol  involving  testing  on  U.S.  patients  and 
subsequent protocol amendments must be submitted to the FDA as part of the IND.

The FDA may order the temporary or permanent discontinuation of a clinical trial at any time or impose other sanctions if 
it believes that the clinical trial is not being conducted in accordance with FDA requirements or presents an unacceptable risk to 
the  clinical  trial  patients.  The  study  protocol  and  informed  consent  information  for  patients  in  clinical  trials  must  also  be 
submitted to an Institutional Review Board ("IRB"), for approval. An IRB may also require the clinical trial at the site to be 
halted, either temporarily or permanently, for failure to comply with the IRB's requirements, or may impose other conditions.

Clinical trials to support an NDA or BLA for marketing approval are typically conducted in three sequential phases, but the 
phases may overlap. In Phase 1, the initial introduction of the drug into healthy human subjects or patients, the drug is tested to 
assess metabolism, pharmacokinetics, pharmacological actions, side effects associated with increasing doses, and, if possible, 
early evidence on pharmacodynamics effects and effectiveness.

Phase  2  usually  involves  trials  in  a  limited  patient  population  to  determine  the  effectiveness  of  the  drug  for  a  particular 
indication  or  indications,  dosage  tolerance,  and  optimum  dosage,  and  identify  common  adverse  effects  and  safety  risks.  If  a 
compound  demonstrates  evidence  of  efficacy  and  an  acceptable  safety  profile  in  Phase  2  evaluations,  Phase  3  trials  are 
undertaken  to  obtain  the  additional  information  about  clinical  efficacy  and  safety  in  a  larger  number  of  patients  over  longer 
treatment periods, typically at geographically dispersed clinical trial sites, to permit the FDA to evaluate the overall benefit-risk 
relationship of the drug and to provide adequate information for the labeling of the drug.

The  FDA  has  established  the  Office  of  Tissue  and  Advanced  Therapies  within  the  Center  for  Biologics  Evaluation  and 
Research, or CBER, to consolidate the review of gene therapy and related products, and has established the Cellular, Tissue and 
Gene Therapies Advisory Committee to advise CBER in its review.

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In  addition  to  the  regulations  discussed  above,  there  are  a  number  of  additional  standards  that  apply  to  clinical  trials 
involving gene therapies. The FDA has issued various guidance documents regarding gene therapies, which outline additional 
factors  that  the  FDA  will  consider  at  each  of  the  above  stages  of  development  and  relate  to,  among  other  things:  the  proper 
preclinical assessment of gene therapies; the CMC information that should be included in an IND application; the proper design 
of tests to measure product potency in support of an IND or BLA application; and measures to observe delayed adverse effects 
in  subjects  who  have  been  exposed  to  investigational  gene  therapies  when  the  risk  of  such  effects  is  high.  Further,  the  FDA 
usually  recommends  that  sponsors  observe  subjects  for  potential  gene  therapy-related  delayed  adverse  events  for  a  15-year 
period, including a minimum of five years of annual examinations followed by 10 years of annual queries, either in person or 
by  questionnaire.  NIH  and  the  FDA  have  a  publicly  accessible  database,  the  Genetic  Modification  Clinical  Research 
Information System, which includes information on gene therapy trials and serves as an electronic tool to facilitate the reporting 
and analysis of adverse events on these trials. 

After  completion  of  the  required  clinical  testing,  an  NDA  or  BLA  is  prepared  and  submitted  to  the  FDA  for  the 
determination of efficacy and safety. FDA approval of the NDA or BLA is required before marketing of the product may begin 
in the U.S. The NDA or BLA must include the results of all preclinical, clinical, and other testing and a compilation of data 
relating to the product's pharmacology, chemistry, manufacture, and controls. The cost of preparing and submitting an NDA or 
BLA  is  substantial.  Under  federal  law,  the  submission  of  most  NDAs  and  BLAs  is  additionally  subject  to  a  substantial 
application user fee; although for orphan drugs these fees are waived, and the holder of an approved NDA or BLA may also be 
subject to annual product and establishment user fees. These fees are typically increased annually.

The FDA has 60 days from its receipt of an NDA or BLA to determine whether the application will be accepted for filing 
based on the agency's threshold determination that it is sufficiently complete to permit substantive review. Once the submission 
is accepted for filing, the FDA begins an in-depth review. The FDA has agreed to certain performance goals in the review of 
NDAs  and  BLAs.  Marketing  applications  are  assigned  review  status  during  the  filing  period.  Review  status  could  be  either 
standard or priority. Most such applications for standard review are reviewed within 12 months under PDUFA V (two months 
for filing plus ten months for review). The FDA attempts to review a drug candidate that is eligible for priority review within 
six months, as discussed below. The review process may be extended by the FDA for three additional months to evaluate major 
amendments submitted during the pre-specified PDUFA V review clock. The FDA may also refer applications for novel drug 
products or drug products which present difficult questions of safety or efficacy to an advisory committee for public review, 
typically  a  panel  that  includes  clinicians  and  other  experts,  for  review,  evaluation,  and  a  recommendation  as  to  whether  the 
application  should  be  approved.  The  FDA  is  not  bound  by  the  recommendation  of  an  advisory  committee,  but  it  generally 
follows such recommendations. Before approving an NDA or BLA, the FDA will typically inspect one or more clinical sites to 
assure compliance with GCP. Additionally, the FDA will inspect the facility or the facilities at which the drug is manufactured. 
The FDA may also undertake an audit of nonclinical and clinical trial sites. The FDA will not approve the product candidate 
unless compliance with cGMP is satisfactory and the NDA or BLA contains data that provide substantial evidence that the drug 
is  safe  and  effective  in  the  indication  studied  and  to  be  marketed.  During  the  product  approval  process,  the  FDA  also  will 
determine  whether  a  risk  evaluation  and  mitigation  strategy,  or  REMS,  is  necessary  to  assure  the  safe  use  of  the  product 
candidate. A REMS could include medication guides, physician communication plans and elements to assure safe use, such as 
restricted distribution methods, patient registries, and other risk minimization tools. If the FDA concludes a REMS is needed, 
the sponsor of the NDA or BLA must submit a proposed REMS; the FDA will not approve the NDA or BLA without a REMS, 
if required.

After  the  FDA  evaluates  the  NDA  or  BLA  and  the  manufacturing  facilities,  it  issues  an  approval  letter  or  a  complete 
response  letter.  Complete  response  letters  outline  the  deficiencies  in  the  submission  that  prevent  approval  and  may  require 
substantial additional testing or information for the FDA to reconsider the application. If and when those deficiencies have been 
addressed to the FDA's satisfaction in an amendment submitted to the NDA or BLA, the FDA will then issue an approval letter. 
The FDA has committed to reviewing such resubmissions in two or six months depending on the type and extent of information 
included.

An  approval  letter  authorizes  commercial  marketing  of  the  drug  with  specific  prescribing  information  for  specific 
indications.  As  a  condition  of  NDA  or  BLA  approval,  the  FDA  may  require  substantial  post-approval  commitments  or 
requirements  to  conduct  additional  testing  and/or  surveillance  to  monitor  the  drug's  safety  or  efficacy  and  may  impose  other 
conditions, including distribution and labeling restrictions which can materially affect the potential market and profitability of 
the  drug.  Once  granted,  product  approvals  may  be  withdrawn  if  compliance  with  regulatory  standards  is  not  maintained, 
problems are identified following initial marketing, or post-marketing commitments are not met.

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The Hatch-Waxman Act

In seeking approval for a drug through an NDA, applicants are required to list with the FDA certain patent(s) with claims 
that  cover  the  applicant's  product  or  approved  method  of  use.  Upon  approval  of  a  drug,  each  of  the  patents  listed  in  the 
application  for  the  drug  is  then  published  in  the  FDA's  Approved  Drug  Products  with  Therapeutic  Equivalence  Evaluations, 
commonly  known  as  the  Orange  Book.  Drugs  listed  in  the  Orange  Book  can,  in  turn,  be  cited  by  potential  competitors  in 
support  of  approval  of  an  ANDA.  An  ANDA  provides  for  marketing  of  a  drug  product  that  has  the  same  route  of 
administration,  active  ingredients  strength,  and  dosage  form  as  the  listed  drug  and  has  been  shown  through  bioequivalence 
testing  to  be,  in  most  cases,  therapeutically  equivalent  to  the  listed  drug.  ANDA  applicants  are  not  required  to  conduct  or 
submit results of preclinical or clinical tests to prove the safety or effectiveness of their drug product, other than the requirement 
for bioequivalence testing. Drugs approved in this way are commonly referred to as "generic equivalents" to the listed drug and 
can often be substituted by pharmacists under prescriptions written for the original listed "innovator" drug.

The ANDA applicant is required to certify to the FDA concerning any patents listed for the approved product in the FDA's 
Orange Book. Specifically, the applicant must certify that: (i) the required patent information has not been filed; (ii) the listed 
patent has expired; (iii) the listed patent has not expired but will expire on a particular date and approval is sought after patent 
expiration; or (iv) the listed patent is invalid or will not be infringed by the new product. A certification that the new product 
will  not  infringe  the  already  approved  product's  listed  patents  or  that  such  patents  are  invalid  is  called  a  Paragraph  4 
certification. If the applicant does not challenge the listed patents, the ANDA application will not be approved until all the listed 
patents claiming the referenced product have expired.

If  the  ANDA  applicant  submits  a  Paragraph  4  certification  to  the  FDA,  the  applicant  must  also  send  notice  of  the 
Paragraph 4 certification to the NDA and patent holders once the ANDA has been accepted for filing by the FDA. The NDA 
and patent holders may then initiate a patent infringement lawsuit in response to the notice of the Paragraph 4 certification. The 
filing of a patent infringement lawsuit within 45 days of the receipt of a Paragraph 4 certification automatically prevents the 
FDA from approving the ANDA until the earlier of 30 months, expiration of the patent, settlement of the lawsuit or a decision 
in the infringement case that is favorable to the ANDA applicant.

Patent  term  and  data  exclusivity  run  in  parallel.  An  ANDA  application  also  will  not  be  approved  until  any  non-patent 
exclusivity,  such  as  exclusivity  for  obtaining  approval  of  an  NCE,  listed  in  the  Orange  Book  for  the  referenced  product  has 
expired ("New Chemical Entity Market Exclusivity"). Federal law provides a period of five years following approval of a drug 
containing  no  previously  approved  active  ingredients,  during  which  ANDAs  for  generic  versions  of  those  drugs  cannot  be 
submitted  unless  the  submission  contains  a  Paragraph  4  certification  that  challenges  a  listed  patent,  in  which  case  the 
submission may be made four years following the original product approval.

Federal law provides for a period of three years of exclusivity following approval of a listed drug that contains previously 
approved active ingredients but is approved in a new dosage form, route of administration or combination, or for a new use, the 
approval of which was required to be supported by new clinical trials conducted by or for the sponsor, during which the FDA 
cannot grant effective approval of an ANDA based on that listed drug for the same new dosage form, route of administration or 
combination, or new use.

Other Regulatory Requirements

Once an NDA or BLA is approved, a product will be subject to certain post-approval requirements. For instance, the FDA 
closely  regulates  the  post-approval  marketing  and  promotion  of  drugs,  including  standards  and  regulations  for  direct-to-
consumer advertising, communications regarding unindicated uses, industry-sponsored scientific and educational activities, and 
promotional activities involving the internet. Products approved under Subpart H or Subpart E carry additional post-marketing 
considerations and requirements.

Drugs  may  be  promoted  only  for  approved  indications  and  in  accordance  with  the  provisions  of  the  approved  labeling. 
Changes  to  some  of  the  conditions  established  in  an  approved  application,  including  changes  in  indications,  new  safety 
information,  labeling,  or  manufacturing  processes  or  facilities,  require  submission  and  FDA  approval  of  a  new  NDA,  NDA 
supplement,  BLA,  or  BLA  supplement  before  the  change  can  be  implemented.  New  efficacy  claims  require  submission  and 
approval of an NDA supplement and BLA supplement for each new indication.

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The efficacy claims typically require new clinical data similar to those included in the original application. The FDA uses 
the same procedures and actions in reviewing NDA and BLA supplements as it does in reviewing NDAs and BLAs. Additional 
exclusivity may be granted for new efficacy claims. Generic ANDAs cannot be labeled for these types of claims until the new 
exclusivity period expires.

Adverse event reporting and submission of periodic reports is required following FDA approval of an NDA or BLA. The 
FDA  also  may  require  post-marketing  testing,  known  as  Phase  4  testing,  risk  evaluation  and  mitigation  strategies,  and 
surveillance to monitor the effects of an approved product, or place conditions on an approval that could restrict the distribution 
or  use  of  the  product.  In  addition,  quality  control  as  well  as  drug  manufacture,  packaging,  and  labeling  procedures  must 
continue  to  conform  to  cGMP,  after  approval.  Drug  manufacturers  and  certain  subcontractors  are  required  to  register  their 
establishments with FDA and certain state agencies and are subject to routine inspections by the FDA during which the agency 
inspects manufacturing facilities to access compliance with cGMP. Accordingly, manufacturers must continue to expend time, 
money, and effort in the areas of production and quality control to maintain compliance with cGMP. Regulatory authorities may 
withdraw product approvals or request product recalls if a company fails to comply with regulatory standards, if it encounters 
problems following initial marketing, or if previously unrecognized problems are subsequently discovered.

Orphan Drugs

Under  the  Orphan  Drug  Act,  the  FDA  may  grant  orphan  drug  designation  to  drugs  intended  to  treat  a  rare  disease  or 
condition,  which  is  generally  a  disease  or  condition  that  affects  fewer  than  200,000  individuals  in  the  U.S.  Orphan  drug 
designation must be requested before submitting an NDA or BLA. After the FDA grants orphan drug designation, the generic 
identity of the drug and its potential orphan use are disclosed publicly by the FDA. Orphan drug designation does not convey 
any advantage in or shorten the duration of the regulatory review and approval process. The first NDA or BLA applicant with 
FDA orphan drug designation for a particular active ingredient to receive FDA approval of the designated drug for the disease 
indication for which it has such designation, is entitled to a seven-year exclusive marketing period ("Orphan Drug Exclusivity") 
in  the  U.S.  for  that  product,  for  that  indication.  During  the  seven-year  period,  the  FDA  may  not  finally  approve  any  other 
applications  to  market  the  same  drug  for  the  same  disease,  except  in  limited  circumstances,  such  as  a  showing  of  clinical 
superiority to the product with orphan drug exclusivity or if the license holder cannot supply sufficient quantities of the product. 
Orphan drug exclusivity does not prevent the FDA from approving a different drug for the same disease or condition, or the 
same drug for a different disease or condition, provided that the sponsor has conducted appropriate clinical trials required for 
approval. Among the other benefits of orphan drug designation are tax credits for certain research and a waiver of the NDA or 
BLA application user fee for the orphan indication.

Pediatric Information

Under the Pediatric Research Equity Act of 2007 ("PREA"), NDAs or supplements to NDAs and BLAs or supplements to 
BLAs must contain data to assess the safety and effectiveness of the drug for the claimed indications in all relevant pediatric 
subpopulations  and  to  support  dosing  and  administration  for  each  pediatric  subpopulation  for  which  the  drug  is  safe  and 
effective.  The  FDA  may  grant  deferrals  for  submission  of  data  or  full  or  partial  waivers.  Unless  otherwise  required  by 
regulation, PREA does not apply to any drug for an indication for which orphan designation has been granted.

Fast Track Designation

Under the Fast Track program, the sponsor of an IND may request the FDA to designate the drug candidate as a Fast Track 
drug  if  it  is  intended  to  treat  a  serious  condition  and  fulfill  an  unmet  medical  need.  The  FDA  must  determine  if  the  drug 
candidate qualifies for Fast Track designation within 60 days of receipt of the sponsor's request. Once the FDA designates a 
drug as a Fast Track candidate, it is required to facilitate the development and expedite the review of that drug by providing 
more frequent communication with and guidance to the sponsor.

In addition to other benefits such as greater interactions with the FDA, the FDA may initiate review of sections of a Fast 
Track drug's NDA or BLA before the application is complete. This rolling review is available if the applicant provides, and the 
FDA  approves,  a  schedule  for  the  submission  of  the  remaining  information  and  the  applicant  pays  applicable  user  fees. 
However, the FDA's review period as specified under PDUFA V for filing and reviewing an application does not begin until the 
last section of the NDA or BLA has been submitted. Additionally, the Fast Track designation may be withdrawn by the FDA if 
the FDA believes that the designation is no longer supported by data emerging in the clinical trial process.

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Breakthrough Therapy Designation

Breakthrough Therapy designation is intended to expedite the development and review of a candidate that is planned for 
use  to  treat  a  serious  or  life-threatening  disease  or  condition  when  preliminary  clinical  evidence  indicates  that  the  drug  may 
demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints. A Breakthrough 
Therapy designation conveys all of the Fast Track program features, as well as more intensive FDA guidance on an efficient 
drug development program. The FDA also has an organizational commitment to involve senior management in such guidance.

Priority Review

Under  FDA  policies,  a  drug  candidate  is  eligible  for  priority  review,  or  review  within  six  months  from  filing  for  a  new 
molecular  entity  ("NME")  or  six  months  from  submission  for  a  non-NME  if  the  drug  candidate  provides  a  significant 
improvement  compared  to  marketed  drugs  in  the  treatment,  diagnosis,  or  prevention  of  a  disease,  rather  than  the  standard 
review  of  ten  months  under  current  PDUFA  guidelines.  A  Fast  Track  designated  drug  candidate  would  ordinarily  meet  the 
FDA's  criteria  for  priority  review.  The  FDA  makes  its  determination  of  priority  or  standard  review  during  the  60-day  filing 
period after an initial NDA or BLA submission.

Accelerated Approval

Under the FDA's accelerated approval regulations, the FDA may approve a drug for a serious or life-threatening illness that 
provides meaningful therapeutic benefit to patients over existing treatments based upon a surrogate endpoint that is reasonably 
likely to predict clinical benefit. This approval mechanism is provided for under 21CRF314 Subpart H and Subpart E. In this 
case,  clinical  trials  are  conducted  in  which  a  surrogate  endpoint  is  used  as  the  primary  outcome  for  approval.  A  surrogate 
endpoint is reasonably likely to predict clinical benefit, or an effect on a clinical endpoint that can be measured earlier than an 
effect on irreversible morbidity or mortality, that is reasonably likely to predict an effect on irreversible morbidity or mortality 
or other clinical benefit, taking into account the severity, rarity, or prevalence of the condition and the availability or lack of 
alternative treatments. This surrogate endpoint substitutes for a direct measurement of how a patient feels, functions, or survives 
and is considered reasonably likely to predict clinical benefit. Such surrogate endpoints may be measured more easily or more 
rapidly  than  clinical  endpoints.  A  drug  candidate  approved  on  this  basis  is  subject  to  rigorous  post-marketing  compliance 
requirements, including the completion of Phase 4 or post-approval clinical trials to confirm the effect on the clinical endpoint. 
Under the Food and Drug Omnibus Reform Act of 2022 (“FDORA”), the FDA is now permitted to require, as appropriate, that 
such  trials  be  underway  prior  to  approval  or  within  a  specific  time  period  after  the  date  of  approval  for  a  product  granted 
accelerated  approval.  When  the  Phase  4  commitment  is  successfully  completed,  the  biomarker  is  deemed  to  be  a  surrogate 
endpoint. Failure to conduct required post-approval studies or confirm a clinical benefit during post-marketing studies, could 
lead  the  FDA  to  withdraw  the  drug  from  the  market  on  an  expedited  basis.  All  promotional  materials  for  drug  candidates 
approved under accelerated regulations are subject to prior review by the FDA.

Section 505(b) (2) New Drug Applications

Most drug products obtain FDA marketing approval pursuant to an NDA, an ANDA, or a BLA. A fourth alternative is a 
special type of NDA, commonly referred to as a Section 505(b) (2) NDA, which enables the applicant to rely, in part, on the 
safety and efficacy data of an existing product, or published literature, in support of its application.

505(b)  (2)  NDAs  often  provide  an  alternate  path  to  FDA  approval  for  new  or  improved  formulations  or  new  uses  of 
previously approved products. Section 505(b)(2) permits the submission of an NDA for which at least some of the information 
required for approval comes from studies not conducted by or for the applicant and for which the applicant has not obtained a 
right of reference. The applicant may rely upon certain preclinical or clinical studies conducted for an approved product. The 
FDA  may  also  require  companies  to  perform  additional  studies  or  measurements  to  support  the  change  from  the  approved 
product. The FDA may then approve the new product candidate for all or some of the label indications for which the referenced 
product has been approved, as well as for any new indication sought by the Section 505(b) (2) applicant.

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To  the  extent  that  the  Section  505(b)  (2)  applicant  is  relying  on  studies  conducted  for  an  already-approved  product,  the 
applicant is required to certify to the FDA concerning any patents listed for the approved product in the Orange Book to the 
same extent as an ANDA applicant. Thus approval of a 505(b)(2) NDA can be stalled until all the listed patents claiming the 
referenced product have expired, until any non-patent exclusivity, such as exclusivity for obtaining approval of an NCE, listed 
in the Orange Book for the referenced product has expired, and, in the case of a Paragraph 4 certification and subsequent patent 
infringement suit, until the earlier of 30 months, settlement of the lawsuit or a decision in the infringement case that is favorable 
to the Section 505(b)(2) applicant.

Biologics Price Competition and Innovation Act 

The  Biologics  Price  Competition  and  Innovation  Act  of  2009  ("BPCIA"),  which  was  enacted  as  part  of  the  Patient 
Protection  and  Affordable  Care  Act  of  2010,  as  amended  by  the  Health  Care  and  Education  Reconciliation  Act  of  2010 
("PPACA")  created  an  abbreviated  approval  pathway  for  biological  products  that  are  demonstrated  to  be  "biosimilar"  or 
"interchangeable"  with  an  FDA-licensed  reference  biological  product  via  an  approved  BLA.  Biosimilarity  to  an  approved 
reference product requires that there be no differences in conditions of use, route of administration, dosage form, and strength, 
and no clinically meaningful differences between the biological product and the reference product in terms of safety, purity, and 
potency. Biosimilarity is demonstrated in steps beginning with rigorous analytical studies or "fingerprinting", in vitro studies, in 
vivo animal studies, and generally at least one clinical study, absent a waiver from the Secretary of Health and Human Services. 
The biosimilarity exercise tests the hypothesis that the investigational product and the reference product are the same. If at any 
point  in  the  stepwise  biosimilarity  process  a  significant  difference  is  observed,  then  the  products  are  not  biosimilar,  and  the 
development of a stand-alone NDA or BLA is necessary. In order to meet the higher hurdle of interchangeability, a sponsor 
must demonstrate that the biosimilar product can be expected to produce the same clinical result as the reference product, and 
for  a  product  that  is  administered  more  than  once,  that  the  risk  of  switching  between  the  reference  product  and  biosimilar 
product is not greater than the risk of maintaining the patient on the reference product. Complexities associated with the larger, 
and  often  more  complex,  structures  of  biological  products,  as  well  as  the  process  by  which  such  products  are  manufactured, 
pose significant hurdles to implementation that are still being evaluated by the FDA. Under the BPCIA, a reference biologic is 
granted 12 years of exclusivity from the time of first licensure of the reference product.

Anti-Kickback, False Claims Laws, the Prescription Drug Marketing Act and Other Regulations

Our activities are subject to various federal and state fraud and abuse laws, including, without limitation, the federal Anti-
Kickback  Statute,  the  federal  civil  False  Claims  Act,  and  laws  and  regulations  pertaining  to  limitations  on  and  reporting  of 
healthcare  provider  payments  (physician  sunshine  laws).  These  laws  and  regulations  are  interpreted  and  enforced  by  various 
federal,  state  and  local  authorities  including  CMS,  the  Office  of  Inspector  General  for  the  U.S.  Department  of  Health  and 
Human Services, the U.S. Department of Justice, individual U.S. Attorney offices within the Department of Justice, and state 
and local governments. These laws include:

•

•

the U.S. federal Anti-Kickback Statute, which prohibits, among other things, persons or entities from knowingly and 
willfully soliciting, offering, receiving or paying any remuneration, directly or indirectly, overtly or covertly, in cash or 
in kind, to induce or reward either the referral of an individual for, or the purchase, lease, order, or arranging for or 
recommending the purchase, lease or order of, any good or service, for which payment may be made, in whole or in 
part,  under  federal  healthcare  programs  such  as  Medicare  and  Medicaid.  A  person  or  entity  does  not  need  to  have 
actual knowledge of the statute or specific intent to violate it in order to have committed a violation;

the U.S. civil False Claims Act (which can be enforced through “qui tam,” or whistleblower actions, by private citizens 
on behalf of the federal government), prohibits any person from, among other things, knowingly presenting, or causing 
to be presented false or fraudulent claims for payment of government funds or knowingly making, using or causing to 
be made or used, a false record or statement material to an obligation to pay money to the government or knowingly 
and improperly avoiding, decreasing or concealing an obligation to pay money to the U.S. federal government; 

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•

•

•

U.S. federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, which imposes criminal liability 
and amends provisions on the reporting, investigation, enforcement, and penalizing of civil liability for, among other 
things,  knowingly  and  willfully  executing,  or  attempting  to  execute,  a  scheme  to  defraud  any  healthcare  benefit 
program,  or  knowingly  and  willfully  falsifying,  concealing  or  covering  up  a  material  fact  or  making  any  materially 
false statement, in connection with the delivery of, or payment for healthcare benefits, items or services by a healthcare 
benefit program, which includes both government and privately funded benefits programs; similar to the U.S. federal 
Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to 
violate it in order to have committed a violation; 

state  laws  and  regulations,  including  state  anti-kickback  and  false  claims  laws,  that  may  apply  to  our  business 
practices, including but not limited to, research, distribution, sales and marketing arrangements and claims involving 
healthcare  items  or  services  reimbursed  by  any  third-party  payer,  including  private  insurers;  state  laws  that  require 
pharmaceutical  companies  to  comply  with  the  pharmaceutical  industry’s  voluntary  compliance  guidelines  and  the 
relevant compliance guidance promulgated by the U.S. federal government, or otherwise restrict payments that may be 
made  to  healthcare  providers  and  other  potential  referral  sources;  and  state  laws  and  regulations  that  require  drug 
manufacturers  to  file  reports  relating  to  pricing  and  marketing  information,  which  requires  tracking  gifts  and  other 
remuneration and items of value provided to healthcare professionals and entities; and

the Physician Payments Sunshine Act, implemented as the Open Payments program, and its implementing regulations, 
requires certain manufacturers of drugs, devices, biologics and medical supplies that are reimbursable under Medicare, 
Medicaid,  or  the  Children’s  Health  Insurance  Program  to  report  annually  to  CMS  information  related  to  certain 
payments made in the preceding calendar year and other transfers of value to physicians and teaching hospitals, as well 
as  ownership  and  investment  interests  held  by  physicians  and  their  immediate  family  members;  beginning  in  2022, 
applicable manufacturers are required to report such information regarding payments and transfers of value provided, 
as well as ownership and investment interests held, during the previous year to physician assistants, nurse practitioners, 
clinical nurse specialists, certified nurse anesthetists, and certified nurse-midwives. 

Violations of any of these laws or any other governmental regulations that may apply to us, may subject us to significant 
civil, criminal and administrative sanctions including penalties, damages, fines, imprisonment, and exclusion from government 
funded  healthcare  programs,  such  as  Medicare  and  Medicaid,  and/or  adverse  publicity.    Moreover,  government  entities  and 
private  litigants  have  asserted  claims  under  state  consumer  protection  statutes  against  pharmaceutical  and  medical  device 
companies  for  alleged  false  or  misleading  statements  in  connection  with  the  marketing,  promotion  and/or  sale  of 
pharmaceuticals.

Physician Drug Samples

As  part  of  the  sales  and  marketing  process,  pharmaceutical  companies  frequently  provide  samples  of  approved  drugs  to 
physicians. The Prescription Drug Marketing Act (the "PDMA") imposes requirements and limitations upon the provision of 
drug samples to physicians, as well as prohibits states from licensing distributors of prescription drugs unless the state licensing 
program meets certain federal guidelines that include minimum standards for storage, handling, and record keeping. In addition, 
the PDMA sets forth civil and criminal penalties for violations.

Regulation Outside the U.S.

In  addition  to  regulations  in  the  U.S.,  we  are  subject  to  a  variety  of  regulations  in  other  jurisdictions  governing  clinical 
studies,  commercial  sales,  and  distribution  of  our  products.  Most  countries  outside  the  U.S.  require  that  clinical  trial 
applications be submitted to and approved by the local regulatory authority for each clinical study. In addition, whether or not 
we  obtain  FDA  approval  for  a  product,  we  must  obtain  approval  of  a  product  by  the  comparable  regulatory  authorities  of 
countries outside the U.S. before we can commence clinical studies or marketing of the product in those countries. The approval 
process varies from country to country, and the time may be longer or shorter than that required for FDA approval.

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To obtain regulatory approval of an orphan drug under the E.U. regulatory system, we are mandated to submit a MAA to 
be assessed in the centralized procedure. The centralized procedure, which came into operation in 1995, allows applicants to 
obtain a marketing authorization that is valid throughout the E.U. It is compulsory for medicinal products manufactured using 
biotechnological  processes,  for  orphan  medicinal  products  and  for  human  products  containing  a  new  active  substance  which 
was not authorized in the community before 20 May 2004 (date of entry into force of Regulation (EC) No 726/2004) and which 
are intended for the treatment of AIDS, cancer, neurodegenerative disorder or diabetes. The centralized procedure is optional 
for any other products containing new active substances not authorized in the community before 20 May 2004 or for products 
which constitute a significant therapeutic, scientific or technical innovation or for which a community authorization is in the 
interests of patients at community level. When a company wishes to place on the market a medicinal product that is eligible for 
the centralized procedure, it sends an application directly to the EMA, to be assessed by the CHMP. The procedure results in a 
commission decision, which is valid in all E.U. member states. Centrally-authorized products may be marketed in all member 
states. Under the centralized procedure, full copies of the MAA are sent to a rapporteur and a co-rapporteur designated by the 
competent EMA scientific committee. They coordinate the EMA's scientific assessment of the medicinal product and prepare 
draft  reports.  Once  the  draft  reports  are  prepared  (other  experts  might  be  called  upon  for  this  purpose),  they  are  sent  to  the 
CHMP,  whose  comments  or  objections  are  communicated  to  the  applicant.  The  rapporteur  is  therefore  the  privileged 
interlocutor of the applicant and continues to play this role, even after the MAA has been granted approval.

The rapporteur and co-rapporteur then assess the applicant's replies, submit them for discussion to the CHMP and, taking 
into  account  the  conclusions  of  this  debate,  prepare  a  final  assessment  report.  Once  the  evaluation  is  completed,  the  CHMP 
gives a favorable or unfavorable opinion as to whether to grant the authorization. When the opinion is favorable, it shall include 
the  draft  summary  of  the  product's  characteristics,  the  package  leaflet  and  the  texts  proposed  for  the  various  packaging 
materials. The time limit for the evaluation procedure is 210 days. The EMA then has fifteen days to forward its opinion to the 
commission.  This  is  the  start  of  the  second  phase  of  the  procedure:  the  decision-making  process.  The  Agency  sends  to  the 
commission its opinion and assessment report, together with annexes containing: the SmPC ("Annex 1"); the particulars of the 
MAH  responsible  for  batch  release,  the  particulars  of  the  manufacturer  of  the  active  substance  and  the  conditions  of  the 
marketing authorization ("Annex 2"); and the labelling and the package leaflet ("Annex 3"). The annexes are translated into the 
22 other official languages of the E.U. During the decision-making process, the commission services verify that the marketing 
authorization complies with Union law. The commission has fifteen days to prepare a draft decision. The medicinal product is 
assigned  a  community  registration  number,  which  will  be  placed  on  its  packaging  if  the  marketing  authorization  is  granted. 
During this period, various commission directorates-general are consulted on the draft marketing authorization decision.

The draft decision is then sent to the Standing Committee on Medicinal Products for Human Use, (member states have one 
representative each in both of these committees) for their opinions. The centralized procedure provides for the grant of a single 
marketing authorization that is valid for all E.U. member states. The "decentralized procedure" provides for approval by one or 
more  other,  or  concerned,  member  states  of  an  assessment  of  an  application  performed  by  one  member  state,  known  as  the 
reference member state. Under this procedure, an applicant submits an application, or dossier, and related materials including a 
draft summary of product characteristics, and draft labeling and package leaflet, to the reference member state and concerned 
member states. The reference member state prepares a draft assessment and drafts of the related materials within 120 days after 
receipt  of  a  valid  application.  Within  90  days  of  receiving  the  reference  member  state's  assessment  report,  each  concerned 
member state must decide whether to approve the assessment report and related materials. If a member state cannot approve the 
assessment report and related materials on the grounds of potential serious risk to the public health, the disputed points may 
eventually be referred to the European Commission, whose decision is binding on all member states.

We have obtained an orphan medicinal product designation in the E.U. from the EMA for Galafold® for the treatment of 
Fabry disease and the combination product, ATB200/AT2221, for the treatment of Pompe disease. Applications from persons 
or companies seeking "orphan medicinal product designation" for products they intend to develop for the diagnosis, prevention, 
or treatment of life-threatening or very serious conditions that affect not more than 5 in 10,000 persons in the E.U. are reviewed 
by the Committee for Orphan Medicinal Products ("COMP"). In addition, orphan drug designation can be granted if the drug is 
intended for a life threatening, seriously debilitating, or serious and chronic condition in the E.U. and that without incentives it 
is unlikely that sales of the drug in the E.U. would be sufficient to justify developing the drug. Orphan drug designation is only 
available if there is no other satisfactory method approved in the E.U. of diagnosing, preventing, or treating the condition, or if 
such a method exists, the proposed orphan drug will be of significant benefit to patients.

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Orphan  drug  designation  provides  opportunities  for  fee  reductions,  protocol  assistance  and  access  to  the  centralized 
procedure  before  and  during  the  first  year  after  marketing  approval.  Fee  reductions  are  not  limited  to  the  first  year  after 
marketing  approval  for  small  and  medium  enterprises.  In  addition,  if  a  product  which  has  an  orphan  drug  designation 
subsequently receives EMA marketing approval for the indication for which it has such designation, the product is entitled to 
orphan market exclusivity, which means the EMA may not approve any other application to market a similar drug for the same 
indication for a period of 10 years. The exclusivity period may be reduced to six years if the designation criteria are no longer 
met,  including  where  it  is  shown  that  the  product  is  sufficiently  profitable  not  to  justify  maintenance  of  market  exclusivity. 
Competitors may receive marketing approval of different drugs or biologics for the indications for which the orphan product 
has exclusivity. In order to do so, however, they must demonstrate that the new drugs or biologics are clinically superior over 
the existing orphan product. This demonstration of clinical superiority may be done at the time of initial approval or in post-
approval studies, depending on the type of marketing authorization granted.

In March 2016, the EMA launched an initiative, the Priority Medicines (“PRIME”) scheme, to facilitate development of 
product candidates in indications, often rare, for which few or no therapies currently exist. The PRIME scheme is intended to 
encourage  drug  development  in  areas  of  unmet  medical  need  and  provides  accelerated  assessment  of  products  representing 
substantial innovation reviewed under the centralized procedure. Many benefits accrue to sponsors of product candidates with 
PRIME designation, including but not limited to, early and proactive regulatory dialogue with the EMA, frequent discussions 
on clinical trial designs and other development program elements, and accelerated MAA assessment once a dossier has been 
submitted. Importantly, a dedicated contact and rapporteur from the CHMP is appointed early in the PRIME scheme facilitating 
increased understanding of the product at EMA’s committee level. An initial meeting initiates these relationships and includes a 
team  of  multidisciplinary  experts  at  the  EMA  to  provide  guidance  on  the  overall  development  and  regulatory  strategies.  In 
September 2020, AT-GTX-501 was granted PRIME designation.

We have obtained a positive opinion for our pediatric investigation plan ("PIP") in the E.U. for Galafold® for the treatment 
of  Fabry  disease  as  well.  A  PIP  is  a  development  plan  aimed  at  ensuring  that  the  necessary  data  are  obtained  to  support  the 
authorization  of  a  medicine  for  children,  through  studies  in  children.  All  applications  for  marketing  authorization  for  new 
medicines  have  to  include  the  results  of  studies  as  described  in  an  agreed  PIP,  unless  the  medicine  is  exempt  because  of  a 
deferral  or  waiver.  This  requirement  also  applies  when  a  marketing-authorization  holder  wants  to  add  a  new  indication, 
pharmaceutical form, or route of administration for a medicine that is already authorized and covered by intellectual property 
rights.  Several  rewards  and  incentives  for  the  development  of  pediatric  medicines  for  children  are  available  in  the  E.U. 
Medicines authorized across the E.U. with the results of studies from a PIP included in the product information are eligible for 
an  extension  of  their  supplementary  protection  certificate  by  six  months.  This  is  the  case  even  when  the  studies'  results  are 
negative. For orphan medicines, the incentive is an additional two years of market exclusivity. Scientific advice and protocol 
assistance  at  the  agency  are  free  of  charge  for  questions  relating  to  the  development  of  pediatric  medicines.  Medicines 
developed  specifically  for  children  that  are  already  authorized  but  are  not  protected  by  a  patent  or  supplementary  protection 
certificate are eligible for a pediatric-use marketing authorization ("PUMA"). If a PUMA is granted, the product will benefit 
from 10 years of market protection as an incentive.

Effective January 1, 2021, following the U.K. exit of the E.U., the MHRA is the U.K.’s standalone medicines and medical 
devices regulator. As a result of the Northern Ireland protocol, different rules apply in Northern Ireland than in England, Wales 
and Scotland (together Great Britain, "GB"); broadly, Northern Ireland continues to follow the E.U. regulatory regime, but its 
national competent authority remains the MHRA. The MHRA has published a draft guidance outlining the various aspects of 
the  U.K.  regulatory  regime  for  medicines  in  GB  and  in  Northern  Ireland.  The  guidance  includes  clinical  trials,  marketing 
authorizations,  importing,  exporting  and  pharmacovigilance  and  is  relevant  to  any  business  involved  in  the  research, 
development or commercialization of medicines in the U.K. The new guidance has been given effect via the Human Medicines 
Regulations ("Amendment etc.") ("E.U. Exit") Regulations 2019 (the "Exit Regulations"). The U.K. regulatory regime largely 
mirrors that of the E.U. 

The  MHRA  has  introduced  changes  to  national  licensing  procedures,  including  procedures  to  prioritize  access  to  new 
medicines that will benefit patients, an accelerated assessment procedure and new routes of evaluation for novel products and 
biotechnological  products.  All  existing  E.U.  marketing  authorizations  ("MAs")  for  centrally  authorized  products  were 
automatically  converted  ("grand  fathered")  into  U.K.  MAs  free-of-charge  on  January  1,  2021.  Amicus  has  completed  the 
necessary baseline submission for conversion and was granted Marketing Authorization on August 4, 2021 with an effective 
date of January 1, 2021. 

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There  is  no  pre-marketing  authorization  orphan  designation.  Instead,  the  MHRA  reviews  applications  for  orphan 
designation in parallel to the corresponding MA application. The criteria are essentially the same, but have been tailored for the 
GB  market,  e.g.  the  prevalence  of  the  condition  in  GB  (rather  than  the  E.U.)  must  not  be  more  than  5  in  10,000.  Should  an 
orphan designation be granted, the period or market exclusivity will be set from the date of first approval of the product in GB 
or E.U./European Economic Area, wherever is earliest.

The  PIP  application  process  for  applicants  is  simplified  by  offering  an  expedited  assessment  where  possible,  and  by 
mirroring the submission format, content and terminology of the E.U.-PIP system. The MHRA is taking decisions on PIP and 
waiver  opinions,  modifications  and  compliance  statements  to  support  pediatric  market  authorization  decisions,  while 
acknowledging that Northern Ireland continues to be part of the E.U.’s system for pediatric medicines development including 
agreement of E.U. PIPs or waivers.

The MHRA has maintained the EAMS. EAMS is designed to give patients with life threatening or seriously debilitating 
conditions  access  to  medicines  that  do  not  yet  have  a  marketing  authorization  when  there  is  a  clear  unmet  medical  need. 
Medicines  with  a  positive  EAMS  opinion  could  be  made  available  to  patients  12-18  months  ahead  of  formal  marketing 
authorization. As the initial step in this process, the applicant must apply for and be granted a Promising Innovative Medicine 
(“PIM”) designation. The designation is issued after an MHRA scientific designation meeting on the basis of non-clinical and 
clinical data available on the product, in a defined disease area. Following designation, the applicant is expected to complete a 
clinical  development  program  within  a  reasonable  time  period,  in  order  to  continue  with  an  application  under  the  EAMS.  In 
January  2020,  the  MHRA  issued  a  PIM  designation  for  AT-GAA  for  the  treatment  of  late-onset  Pompe  disease  and 
subsequently granted a positive opinion under  EAMS in June 2021.

We have obtained orphan drug designation in Japan for migalastat for the treatment of Fabry Disease. We also have other 
Orphan  Drug  applications  approved  in  other  world  markets  including  Switzerland,  Australia,  South  Korea  and  Taiwan.  The 
Ministry of Health, Labor, and Welfare, based on the opinion of the Pharmaceutical Affairs and Food Sanitation Council, grants 
orphan status to drugs intended to address serious illnesses with high unmet medical need that affect fewer than 50,000 patients 
in  Japan.  In  2020,  orphan  drug  designation  was  granted  in  Japan  for  AT-GAA  for  the  treatment  of  Pompe  disease.  Orphan 
designation  provides  certain  benefits  and  incentives,  including  priority  review  for  marketing  authorization  and  a  period  of 
10 years of market exclusivity if the drug candidate is approved for the designated indication.

U.S. Foreign Corrupt Practices Act

The Foreign Corrupt Practices Act, or the FCPA, generally prohibits offering, promising, giving, or authorizing others to 
give anything of value, either directly or indirectly, to a non-U.S. government official in order to influence official action, or 
otherwise  obtain  or  retain  business.  The  FCPA  also  requires  public  companies  to  make  and  keep  books  and  records  that 
accurately  and  fairly  reflect  the  transactions  of  the  corporation  and  to  devise  and  maintain  an  adequate  system  of  internal 
accounting  controls.  Our  industry  is  heavily  regulated  and  therefore  involves  significant  interaction  with  public  officials, 
including  officials  of  non-U.S.  governments.  Additionally,  in  many  other  countries,  the  health  care  providers  who  prescribe 
pharmaceuticals are employed by their government, and the purchasers of pharmaceuticals are government entities; therefore, 
our dealings with these prescribers and purchasers are subject to regulation under the FCPA. Recently, the SEC and Department 
of Justice have increased their FCPA enforcement activities with respect to pharmaceutical companies. Violations could result 
in fines, criminal sanctions against us, our officers, or our employees, the closing down of our facilities, requirements to obtain 
export  licenses,  cessation  of  business  activities  in  sanctioned  countries,  implementation  of  compliance  programs,  and 
prohibitions on the conduct of our business. Enforcement actions may be brought by the Department of Justice or the Securities 
and Exchanges Commission (“SEC”), and recent enacted legislation has expanded the SEC’s power to seek disgorgement in all 
FCPA cases filed in federal court and extended the statute of limitations in SEC enforcement actions in intent-based claims such 
as those under the FCPA from five years to ten years.

 United States Healthcare Reform

The United States and many foreign jurisdictions have enacted or proposed legislative and regulatory changes affecting the 
healthcare system, including implementing cost-containment programs to limit the growth of government-paid healthcare costs, 
including  price  controls,  restrictions  on  reimbursement  and  requirements  for  substitution  of  generic  products  for  branded 
prescription drugs. 

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In  the  United  States,  the  Patient  Protection  and  Affordable  Care  Act,  as  amended  by  the  Health  Care  and  Education 
Affordability Reconciliation Act, or collectively the Affordable Care Act, was intended to broaden access to health insurance, 
reduce  or  constrain  the  growth  of  healthcare  spending,  enhance  remedies  against  fraud  and  abuse,  add  transparency 
requirements for the healthcare and health insurance industries, impose new taxes and fees on the health industry and impose 
additional health policy reforms. 

Among the provisions of the Affordable Care Act that have been implemented since enactment and are of importance to 

the commercialization of our product and product candidates, if approved, are the following: 

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an  annual,  nondeductible  fee  on  any  entity  that  manufactures,  or  imports  specified  branded  prescription  drugs  or 
biologic agents; 

an increase in the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program; 

expansion of healthcare fraud and abuse laws, including the U.S. civil False Claims Act and the Anti-Kickback Statute, 
new government investigative powers, and enhanced penalties for noncompliance; 

a  Medicare  Part  D  coverage  gap  discount  program,  in  which  manufacturers  must  agree  to  offer  50%  point-of-sale 
discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a 
condition for a manufacturer’s outpatient drugs to be covered under Medicare Part D; 

extension  of  manufacturers’  Medicaid  rebate  liability  to  covered  drugs  dispensed  to  individuals  who  are  enrolled  in 
Medicaid managed care organizations; 

a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated 
for drugs that are inhaled, infused, instilled, implanted, or injected; 

expansion of eligibility criteria for Medicaid programs; 

expansion of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program; 

requirements to report certain financial arrangements with physicians and teaching hospitals; 

a  requirement  to  annually  report  certain  information  regarding  drug  samples  that  manufacturers  and  distributors 
provide to physicians; and 

a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical 
effectiveness research, along with funding for such research.

There  have  been  significant  ongoing  judicial,  administrative,  executive  and  legislative  efforts  to  modify  or  eliminate  the 
Affordable Care Act. For example, the Tax Act enacted on December 22, 2017, repealed the shared responsibility payment for 
individuals who fail to maintain minimum essential coverage under section 5000A of the Internal Revenue Code, commonly 
referred  to  as  the  individual  mandate.  Other  legislative  changes  have  been  proposed  and  adopted  since  passage  of  the 
Affordable  Care  Act.  The  Budget  Control  Act  of  2011,  among  other  things,  created  the  Joint  Select  Committee  on  Deficit 
Reduction to recommend proposals in spending reductions to Congress. The Joint Select Committee did not achieve its targeted 
deficit  reduction  of  an  amount  greater  than  $1.2  trillion  for  the  fiscal  years  2012  through  2021,  triggering  the  legislation’s 
automatic reductions to several government programs. These reductions included aggregate reductions to Medicare payments to 
healthcare providers of up to 2.0% per fiscal year, which went into effect in April 2013. Subsequent litigation extended the 2% 
reduction,  on  average,  to  2030  unless  additional  Congressional  action  is  taken.  The  Coronavirus  Aid,  Relief  and  Economic 
Security Act, or the CARES Act, which was designed to provide financial support and resources to individuals and businesses 
affected by the COVID-19 pandemic, suspended the 2% Medicare sequester from May 1, 2020 to March 31, 2022. As of July 2, 
2022, the 2% sequester reduction resumed. The sequester will remain in place through 2030. On January 2, 2013, the American 
Taxpayer Relief Act was signed into law, which, among other things, reduced Medicare payments to several types of providers, 
including  hospitals,  imaging  centers  and  cancer  treatment  centers,  and  increased  the  statute  of  limitations  period  for  the 
government to recover overpayments to providers from three to five years.

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The Affordable Care Act has also been subject to challenges in the courts.  On December 14, 2018, a Texas U.S. District 
Court Judge ruled that the Affordable Care Act is unconstitutional in its entirety because the “individual mandate” was repealed 
by  Congress.    On  December  18,  2019,  the  Fifth  Circuit  U.S.  Court  of  Appeals  held  that  the  individual  mandate  is 
unconstitutional and remanded the case to the Texas District Court to reconsider its earlier invalidation of the entire Affordable 
Care  Act.    An  appeal  was  taken  to  the  U.S.  Supreme  Court.  On  June  17,  2021,  the  Supreme  Court  ruled  that  the  plaintiffs 
lacked standing to challenge the law as they had not alleged personal injury traceable to the allegedly unlawful conduct. As a 
result, the Supreme Court did not rule on the constitutionality of the ACA or any of its provisions.

Further changes to and under the Affordable Care Act remain possible but it is unknown what form any such changes or 
any law proposed to replace or revise the Affordable Care Act would take, and how or whether it may affect our business in the 
future. We expect that changes to the Affordable Care Act, the Medicare and Medicaid programs, changes allowing the federal 
government  to  directly  negotiate  drug  prices  and  changes  stemming  from  other  healthcare  reform  measures,  especially  with 
regard  to  healthcare  access,  financing  or  other  legislation  in  individual  states,  could  have  a  material  adverse  effect  on  the 
healthcare industry.  We also expect that the Affordable Care Act, as well as other healthcare reform measures that have and 
may be adopted in the future, may result in more rigorous coverage criteria and in additional downward pressure on the price 
that  we  receive  for  our  product  and  product  candidates,  if  approved.    Any  reduction  in  reimbursement  from  Medicare, 
Medicaid, or other government programs may result in a similar reduction in payments from private payers. 

The Inflation Reduction Act of 2022 (the "IRA") contains substantial drug pricing reforms, including the establishment of a 
drug price negotiation program within the U.S. Department of Health and Human Services that would require manufacturers to 
charge a negotiated "maximum fair price" for certain selected drugs or pay an excise tax for noncompliance, the establishment 
of  rebate  payment  requirements  on  manufacturers  of  certain  drugs  payable  under  Medicare  Parts  B  and  D  to  penalize  price 
increases that outpace inflation, and requires manufacturers to provide discounts on Part D drugs. Substantial penalties can be 
assessed for noncompliance with the drug pricing provisions in the IRA. The IRA could have the effect of reducing the prices 
we can charge and reimbursement we receive for our products, if approved, thereby reducing our profitability, and could have a 
material adverse effect on our financial condition, results of operations, and growth prospects. The effects of the IRA on our 
business and the pharmaceutical industry in general is not yet known.

Human Capital

At  Amicus,  one  of  our  founding  principles  is  that  we  believe  in  each  other  to  foster  teamwork  and  respect  for  each 
individuals'  contribution.  Our  passion  for  making  a  difference  unites  us.  Supporting  our  globally  diverse  employees  is  an 
essential part of the core values and culture at Amicus. Tied to these values and culture, we believe our success and our ability 
to help patients depends on our capability to attract, develop and retain key personnel. 

We are committed to the advancement of Diversity, Equity and Inclusion (“DEI”) in the workplace. DEI creates a work 
environment  where  every  voice  is  heard  and  valued,  resulting  in  a  dimensional  way  of  thinking  that  is  used  when  meeting 
company goals. This ensures that every employee feels they are treated fairly regardless of identities and differences, which is 
evidenced through our most recent engagement survey where we came within 2% of the global benchmark for DEI. 

As of December 31, 2022, we had 484 full-time employees. As of December 31, 2022, 57% of our global workforce, 45% 
of  our  executive  management  team  and  30%  of  our  board  of  directors  were  women.  In  addition,  we  have  made  a  strong 
commitment  to  overall  diversity,  as  97%  of  all  hiring  slates  included  diverse  candidates,  where  diversity  is  defined  as 
maintaining/increasing  gender  diversity  and  increasing  representation  of  minority  race,  veteran,  disabled,  and  LGBTQ 
employees.  We  also  saw  the  impact  of  this  diversity  in  hiring  and  promoting,  where  61%  of  all  those  hired  or  promoted  to 
Director  and  above  roles  were  diverse  and  83%  of  all  those  hired  or  promoted  to  Associate  Director  and  below  roles  were 
diverse.

Our  Mission  to  ‘Always  Put  Patients  First’  helps  keep  our  employees  engaged  with  this  sense  of  purpose.  We  support 
engagement  through  communicating  frequently  and  transparently  with  our  employees  through  a  variety  of  communication 
methods,  including  video  and  written  communications,  town  hall  meetings,  round  tables,  employee  pulse  surveys,  company 
intranet, and we acknowledge individual contributions through a number of reward and recognition programs. We believe these 
engagement efforts keep employees informed about our strategy, culture and purpose and motivated to do their best work. 

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We  believe  in  a  strong  compliance  culture  and  provide  robust  trainings  to  employees  on  our  code  of  conduct  and  the 
various policies contained therein. As part of our commitment to our employees, these trainings cover our zero-tolerance policy 
towards the use of child labor, forced labor, or other forms of modern slavery, educating our workforce on discrimination and 
harassment, and periodically refreshing the organization’s understanding of our global anti-bribery and corruption policy.

We  support  and  develop  our  employees  through  global  development  programs  that  build  and  strengthen  employees’ 
leadership skills through global leadership development programs, targeted development for high-potential talent, development 
plans and career paths, tuition reimbursement, and the ability to attend industry conferences and trainings, and patient-mission 
focused Lunch and Learns. Additionally, we strive to attract and retain the most talented employees in the industry and across 
the globe by offering competitive compensation and benefits that support their health, financial and emotional well-being. Our 
compensation philosophy is based on rewarding each employee’s individual contributions and striving to achieve equal pay for 
equal work regardless of gender, race or ethnicity.

Our Corporate Information

We were incorporated under the laws of the State of Delaware on February 4, 2002. The address of our global headquarters 
is  3675  Market  Street,  Philadelphia,  PA  19104  and  our  telephone  number  is  215-921-7600.  Our  website  address  is 
www.amicusrx.com.  We  make  available  free  of  charge  on  our  website  our  annual,  quarterly,  and  current  reports,  including 
amendments to such reports, as soon as reasonably practicable after we electronically file such material with, or furnish such 
material to, the U.S. Securities and Exchange Commission.

Information  relating  to  our  corporate  governance,  including  our  Code  of  Business  Conduct  for  Employees,  Executive 
Officers  and  Directors  (the  "Code  of  Conduct"),  Corporate  Governance  Guidelines,  and  information  concerning  our  senior 
management team, Board of Directors, including Board Committees and Committee charters, and transactions in our securities 
by  directors  and  executive  officers,  is  available  free  of  charge  on  our  website  at  www.amicusrx.com  under  the  "Investors  — 
Corporate Governance" caption and in print to any stockholder upon written request to our Chief Legal Officer at the address 
set forth on the cover of this Annual Report. Any waivers or material amendments to the Code will be posted promptly on our 
website.

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ITEM 1A.   RISK FACTORS

You should carefully consider these risk factors, together with all of the other information included in this Annual Report 
on  Form  10-K,  including  our  Consolidated  Financial  Statements  and  the  related  notes  thereto,  before  you  decide  whether  to 
make an investment in our securities. The risks set forth below are not the only risks we face. Additional risks and uncertainties 
not currently known to us or that we currently deem to be immaterial also may materially and adversely affect our business, 
prospects,  financial  condition,  cash  flows,  liquidity,  funds  from  operations,  results  of  operations,  stock  price  and  ability  to 
service our indebtedness. In such case, the value of our common stock and the trading price of our securities could decline, and 
you  may  lose  all  or  a  significant  part  of  your  investment.  Some  statements  in  the  following  risk  factors  constitute  forward 
looking  statements.  Please  refer  to  the  explanation  of  the  qualifications  and  limitations  on  forward-looking  statements  under 
“Forward-Looking Statements” of this Form 10-K.

Risks Related to our Ability to Generate and Sustain Revenue

We  depend  heavily  on  sales  of  our  first  product,  Galafold®,  in  Europe,  the  U.S.,  Japan,  and  other  geographies. 
Moreover, if we are unable to commercialize Galafold® successfully, or experience significant delays in doing so, our 
business could be materially harmed.

We  have  invested  a  significant  portion  of  our  efforts  and  financial  resources  in  the  development  of  Galafold®  for  the 
treatment of Fabry disease and rely upon sales of Galafold® primarily in Europe and growing sales in the U.S., Japan, and other 
geographies. Our ability to generate material product revenues will depend heavily on the successful development, regulatory 
approval,  and  commercialization  of  Galafold®.  We  will  continue  to  study  Galafold®  in  Phase  4  studies.  If  the  results  of  the 
Phase  4  studies  negatively  change  the  benefit/risk  profile  of  Galafold®,  the  commercial  success  of  Galafold®  may  be 
substantially  diminished.  Any  adverse  market  event  with  respect  to  Galafold®,  including  failure  to  obtain  sufficient  market 
acceptance, could have a material adverse effect on our business, financial condition and results of operations. If our sales of 
Galafold®  were  to  decrease,  or  such  sales  were  substantially  or  completely  displaced  in  the  market,  or  if  we  are  unable  to 
achieve  sufficient  market  acceptance  of  Galafold®  by  physicians,  patients,  third-party  payors  and  others  in  the  medical 
community, or if we fail to receive commercial approval in any additional jurisdictions, it could have a material adverse effect 
on our business, financial condition and results of operations. In addition, if Galafold® or similar products from our competitors 
were to become the subject of litigation and/or an adverse governmental action requiring us or such competitors, as applicable, 
to cease sales of Galafold®, such an event could have a material adverse effect on our business, financial condition and results 
of  operations.  In  addition,  the  entry  into  the  market  of  competitors  with  new  or  generic  treatments,  including  oral,  ERT  and 
gene therapies, may erode the market for Galafold® and have a material impact on our business.

Any delay or impediment in our ability to obtain regulatory approval in any region to commercialize, or, when approved, 
obtain coverage and adequate reimbursement from third parties, including government payors, for Galafold® may cause us to be 
unable to meet our revenue guidance or to generate the revenues necessary to continue our research and development pipeline 
activities, thereby adversely affecting our business and our prospects for future growth.

Further, the success of Galafold® will depend on a number of factors, including the following:

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obtaining a sufficiently broad label in each territory that would not unduly restrict patient access;

obtaining additional foreign approvals for Galafold®;

continuing  to  build  and  maintain  an  infrastructure  capable  of  supporting  product  sales,  marketing,  and 
distribution  of  Galafold®  in  the  U.S.,  Europe,  Japan  and  other  territories  where  we  pursue  commercialization 
directly;

maintaining commercial manufacturing arrangements with third-party manufacturers;

maintaining commercial distribution agreements with third-party distributors;

launching commercial sales of Galafold®, where approved, whether alone or in collaboration with others;

acceptance of Galafold®, where approved, by patients, the medical community and third-party payors;

effectively competing with other therapies, including potential generics and gene therapies;

successfully identifying new patients who could benefit from Galafold®;

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a continued acceptable safety profile of Galafold®;

obtaining and maintaining patent and trade secret protection and regulatory exclusivity;

protecting and enforcing our rights in our intellectual property portfolio;

obtaining and maintaining a commercially viable price for our product and product candidates, if approved; and

continuing to successfully mitigate the impact of the COVID-19 pandemic.

If we do not achieve one or more of these factors in a timely manner or at all, we could experience significant delays or an 
inability to successfully commercialize Galafold®, which would materially harm our business and ability to meet our financial 
goals.

If we are not able to obtain, or if there are delays in obtaining, required regulatory approvals, we will not be able to 
commercialize our product or product candidates and our ability to generate revenue will be materially impaired.

Our product and product candidates, including Galafold® and AT-GAA and the activities associated with their development 
and  commercialization,  including  their  testing,  manufacture,  safety,  efficacy,  recordkeeping,  labeling,  storage,  approval, 
advertising, promotion, sale, distribution, commercialization and reimbursement are subject to comprehensive regulation by the 
European  Medicines  Agency  (“EMA”),  the  Pharmaceutical  and  Medical  Devices  Agency  (“PMDA”),  the  Food  and  Drug 
Administration (“FDA”), and other regulatory agencies in the U.S. and by comparable authorities in other countries. Failure to 
obtain  regulatory  approval  for  our  product  and  product  candidates  will  prevent  us  from  commercializing  our  product  in 
jurisdictions beyond those in which we have obtained regulatory approval for our product or in any jurisdictions for our product 
candidates.

Securing  marketing  approval  for  all  our  product  candidates,  including  AT-GAA,  requires  the  submission  of  extensive 
preclinical and clinical data and supporting information to regulatory authorities for each therapeutic indication to establish the 
product  candidate's  safety  and  efficacy.  We  will  continue  to  rely  on  third  parties  to  assist  us  with  filing  and  supporting  the 
applications necessary to obtain marketing approvals for product candidates in this process. Securing marketing approval also 
requires the submission of information about the product manufacturing process to, and inspection of manufacturing facilities 
by,  the  regulatory  authorities.  Regulatory  authorities  may  determine  that  any  of  our  products  or  product  candidates  are  not 
effective  or  only  moderately  effective,  or  have  undesirable  or  unintended  side  effects,  toxicities,  safety  profiles  or  other 
characteristics that preclude us from obtaining marketing approval or that prevent or limit commercial use.

Obtaining  approval  for  all  of  our  product  candidates,  including  AT-GAA,  is  highly  uncertain  and  we  may  fail  to  obtain 
regulatory approval in any or all jurisdictions. The review processes and the processes of regulatory authorities, including the 
FDA, EMA and PMDA, are extensive, lengthy, expensive, and uncertain, and such regulatory authorities may delay, limit, or 
deny the approval of any of our product candidates for many reasons, including, but not limited to:

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our  failure  to  demonstrate  to  the  satisfaction  of  the  applicable  regulatory  authorities  that  any  of  our  product 
candidates, including AT-GAA are safe and effective for a particular indication;

the  results  of  clinical  trials  may  not  meet  the  level  of  statistical  significance  or  other  efficacy  or  safety 
parameters required by the applicable regulatory authorities for approval;

the applicable regulatory authority may disagree with the number, design, size, conduct, or implementation of 
our clinical trials or conclude that the data fail to meet statistical or clinical significance;

the applicable regulatory authority may not find the data from preclinical studies and clinical trials sufficient to 
demonstrate that the product candidate's clinical and other benefits outweigh its safety risks;

the  applicable  regulatory  authority  may  disagree  with  our  interpretation  of  data  from  preclinical  studies  or 
clinical trials, and may reject conclusions from preclinical studies or clinical trials, or determine that primary or 
secondary endpoints from clinical trials were not met, or reject safety conclusions from such studies or trials;

the applicable regulatory authority may not accept data generated at one or more of our clinical trial sites;

the applicable regulatory authority may determine that we did not properly oversee our clinical trials or follow 
the regulatory authority's advice or recommendations in designing and conducting our clinical trials;

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an advisory committee, if convened by the applicable regulatory authority, may recommend against approval of 
our application or may recommend that the applicable regulatory authority require, as a condition of approval, 
additional  preclinical  studies  or  clinical  trials,  limitations  on  approved  labeling  or  distribution  and  use 
restrictions, or even if an advisory committee, if convened, makes a favorable recommendation, the respective 
regulatory authority may still not approve the product candidate;

the applicable regulatory authority may only approve a limited label for less than the full indicated population, 
as a second line or rescue therapy, or impose other label restrictions; and

the  applicable  regulatory  authority  may  identify  deficiencies  in  the  chemistry,  manufacturing,  and  control 
sections of our application, our manufacturing processes, facilities, or analytical methods or those of our third-
party  contract  manufacturers  or  be  unable  to  complete  any  necessary  manufacturing  inspections  of  our  third 
party  manufacturers  which  may  lead  to  significant  delays  in  the  approval  of  our  product  candidates  or  to  the 
rejection of our applications altogether.

The process of obtaining marketing approvals is expensive, may take many years, if approval is obtained at all, and can 
vary  substantially  based  upon  a  variety  of  factors,  including  the  type,  complexity,  and  novelty  of  the  product  candidates 
involved.  Changes  in  marketing  approval  policies  during  the  development  period,  changes  in  or  the  enactment  of  additional 
statutes  or  regulations,  or  changes  in  regulatory  review  for  each  submitted  product  application,  may  cause  delays  in  the 
approval  or  rejection  of  an  application.  Regulatory  authorities  have  substantial  discretion  in  the  approval  process  and  may 
refuse  to  accept  any  application  or  may  decide  that  our  data  are  insufficient  for  approval  and  require  additional  preclinical, 
clinical,  or  other  studies.  In  addition,  varying  interpretations  of  the  data  obtained  from  preclinical  and  clinical  testing  could 
delay, limit, or prevent marketing approval of a product candidate. Any marketing approval we ultimately obtain may be limited 
or subject to restrictions or post-approval commitments that render the approved product not commercially viable.

If we are unable to establish and maintain sales and marketing capabilities or enter into agreements with third parties 
to market and sell our product or product candidates, we may not be successful in commercializing Galafold®, or any 
product candidate, including AT-GAA, if and when they are approved.

To achieve commercial success for any approved product, we must continue to develop and maintain a sales and marketing 
organization or outsource commercialization to third parties. We have established our own sales and marketing capabilities to 
promote Galafold® in Europe, Japan, the U.S. and other foreign jurisdictions with a targeted sales force and anticipate using 
these  capabilities  to  support  other  product  candidates,  including  AT-GAA,  when  approved.  We  have  also  entered  into 
distribution agreements with third parties to market our products in jurisdictions in which we do not have our own sales and 
marketing capabilities. There are risks involved with establishing and maintaining our own sales and marketing capabilities and 
entering  into  arrangements  with  third  parties  to  perform  these  services  for  our  product  or  any  of  our  product  candidates,  if 
approved.  For  example,  recruiting  and  training  a  sales  force  is  expensive  and  time  consuming  and  could  delay  any  product 
launch. If the commercial launch of a product candidate, if approved, for which we recruit a sales force and establish marketing 
capabilities  is  delayed  or  does  not  occur  for  any  reason,  we  would  have  prematurely  or  unnecessarily  incurred  these 
commercialization expenses. This may be costly, and our investment would be lost if we cannot retain or reposition our sales 
and marketing personnel. Similarly, if we enter into agreements with third parties, including the out licensing of our product or 
product  candidates,  we  may  choose  to  reduce  or  eliminate  our  sales  and  marketing  operations  and  thereby  lose  our 
commercialization investment.

Factors  that  may  inhibit  our  efforts  to  successfully  commercialize  Galafold®,  or  our  product  candidates,  including  AT-

GAA, if and when they are approved by regulatory authorities, including the FDA, PMDA and EMA, on our own include:

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our inability to recruit, train and retain adequate numbers of effective sales and marketing personnel;

the  inability  of  sales  personnel  to  obtain  access  to  adequate  numbers  of  physicians  to  prescribe  any  future 
products;

the  lack  of  complementary  products  to  be  offered  by  sales  personnel,  which  may  put  us  at  a  competitive 
disadvantage relative to companies with more extensive product lines;

unforeseen costs and expenses associated with creating an independent sales and marketing organization;

misconduct  by  independent  sales  and  marketing  organizations  that  expose  us  to  fines,  penalties  and  other 
restrictions on our ability to effectively market and sell our products; and

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efforts by our competitors to commercialize products at or about the time when our product candidates would be 
coming to market.

We  may  also  co-promote  or  out  license  our  product  or  product  candidates  in  various  markets  with  pharmaceutical  and 
biotechnology companies in instances where we believe that a larger sales and marketing presence will expand the market or 
accelerate  penetration.  If  we  do  enter  into  co-promote  or  out  licensing  arrangements  with  third  parties,  our  product  revenues 
will  be  lower  than  if  we  directly  sold  and  marketed  our  products  and  any  revenues  received  under  such  arrangements  will 
depend on the skills and efforts of others.

We may not be successful in entering into distribution arrangements and marketing alliances with third parties. Our failure 
to enter into these arrangements on favorable terms could delay or impair our ability to commercialize our product and product 
candidates,  if  approved,  and  could  increase  our  costs  of  commercialization.  Dependence  on  distribution  arrangements  and 
marketing alliances to commercialize our products and product candidates will subject us to a number of risks, including:

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we  may  not  be  able  to  control  the  amount  and  timing  of  resources  that  our  distributors  may  devote  to  the 
commercialization of our product or product candidates, if approved;

our distributors may experience financial difficulties;

our distributors may experience compliance related issues and associated government investigations;

our distributors may require transfer of the marketing authorization for our product and product candidates, if 
approved, and may refuse to relinquish them at the end of the distribution relationship;

our  distributors  may  be  out  of  compliance  with  applicable  anti-bribery  and  corruption  laws  with  an  adverse 
effect on operations and expose us to liability;

business  combinations  or  significant  changes  in  a  distributor's  business  strategy  may  also  adversely  affect  a 
distributor's willingness or ability to complete its obligations under any arrangement; and

these arrangements are often terminated or allowed to expire, which could interrupt the marketing and sales of a 
product and decrease our revenue.

If we are unable to establish and maintain adequate sales, marketing and distribution capabilities, whether independently or 

with third parties, we may not be able to generate product revenue at our current guidance and may not ever become profitable.

If  the  market  opportunities  for  our  product  or  product  candidates  are  smaller  than  we  believe  they  are,  then  our 
revenues may be adversely affected, and our business may suffer.

Each of the diseases that our product and most advanced product candidates are being developed to address is rare. Our 
projections of both the number of people who have these diseases, as well as the subset of people with these diseases who have 
the potential to benefit from treatment with our product and product candidates, are based on estimates.

Currently,  most  reported  estimates  of  the  prevalence  of  these  diseases  are  based  on  studies  of  small  subsets  of  the 
population of specific geographic areas, which are then extrapolated to estimate the prevalence of the diseases in the broader 
world population. In addition, as new studies are performed the estimated prevalence of these diseases may change. There can 
be no assurance that the prevalence of Fabry disease, Pompe disease, or other rare diseases in the study populations, particularly 
in these newer studies, accurately reflects the prevalence of these diseases in the broader world population. If our estimates of 
the  prevalence  of  Fabry  disease,  Pompe  disease,  or  other  rare  diseases  or  of  the  number  of  patients  who  may  benefit  from 
treatment with our product or product candidates prove to be incorrect, the market opportunities for our product and product 
candidates, if approved, may be smaller than we believe they are, our prospects for generating revenue at our guidance levels 
may be adversely affected and our business may suffer.

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Galafold® or any of our product candidates that receive regulatory approval may fail to achieve the degree of market 
acceptance by physicians, patients, third-party payors and others in the medical community necessary for commercial 
success.

Galafold® and any of our other products or product candidates that receive regulatory approval may nonetheless fail to gain 
sufficient market acceptance by physicians, patients, third-party payors and others in the medical community. If these products 
do  not  achieve  an  adequate  level  of  acceptance,  we  may  not  generate  significant  product  revenues  or  any  profits  from 
operations.  The  degree  of  market  acceptance  of  our  product  candidates,  if  approved  for  commercial  sale,  will  depend  on  a 
number of factors, including:

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the efficacy and potential advantages compared to competitive or alternative treatments, including generics and 
gene therapies;

the prevalence and severity of any side effects;

the ability to offer our product and product candidates, if approved, for sale at competitive prices;

convenience and ease of administration compared to alternative treatments;

the  willingness  of  the  target  patient  population  to  try  new  therapies  and  of  physicians  to  prescribe  these 
therapies;

the strength of marketing and distribution support and timing of market introduction of competitive products;

publicity concerning our products or competing products and treatments;

competition from other products for the same or similar indications; and

sufficient third-party coverage or reimbursement.

Our  ability  to  negotiate,  secure  and  maintain  third-party  coverage  and  reimbursement  may  be  affected  by  political, 
economic and regulatory developments in the U.S., E.U., U.K. and other jurisdictions. Governments continue to impose cost 
containment  measures,  and  third-party  payors  are  increasingly  challenging  prices  charged  for  medicines  and  examining  their 
cost effectiveness, in addition to their safety and efficacy. These and other similar developments could significantly limit the 
degree of market acceptance of Galafold® and any of our product candidates that receive marketing approval and we may fail to 
meet our revenue targets.

We  face  substantial  competition,  which  may  result  in  others  discovering,  developing  or  commercializing  products 
before or more successfully than we do.

The development and commercialization of new drug products is highly competitive. We face competition with respect to 
our  current  product,  Galafold®,  and  product  candidates,  including  AT-GAA,  and  any  products  we  may  seek  to  develop  or 
commercialize  in  the  future  from  major  pharmaceutical  companies,  specialty  pharmaceutical  companies,  biotechnology  and 
gene therapy companies worldwide. For example, several large pharmaceutical and biotechnology companies currently market 
and  sell  products  for  the  treatment  of  lysosomal  storage  disorders,  including  Fabry  disease.  These  products  include  Sanofi 
Aventis' Fabrazyme® and Takeda’s Replagal®, as well as other Fabry treatment products in development. In addition, Sanofi 
 Lumizyme®, Nexviazyme®, and Nexviadyme® for the treatment of Pompe disease. We are also 
markets and sells Myozyme®
,
aware of other enzyme replacement and substrate reduction therapies in development by third parties for Fabry and Pompe, as 
well as potential gene therapies for both Fabry and Pompe and our other product candidates.

Potential  competitors  also  include  academic  institutions,  government  agencies  and  other  public  and  private  research 
organizations that conduct research, seek patent protection and establish collaborative arrangements for research, development, 
manufacturing and commercialization. Our competitors may develop products that are more effective, safer, more convenient or 
less  costly  than  any  that  we  are  developing  or  that  would  render  our  product  candidates  obsolete  or  noncompetitive.  Our 
competitors  may  also  obtain  FDA,  EMA,  or  other  regulatory  approval  for  their  products  more  rapidly  than  we  may  obtain 
approval for ours, could achieve regulatory exclusivity and block us from approval and marketing our products for a significant 
period of time. We may also face competition from off-label use of other approved therapies. There can be no assurance that 
developments  by  others  will  not  render  our  product  candidates  or  any  acquired  products  obsolete  or  noncompetitive  either 
during the research phase or once the products reach commercialization.

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Many  of  our  competitors  have  significantly  greater  financial  resources  and  expertise  in  research  and  development, 
manufacturing,  preclinical  testing,  conducting  clinical  trials,  obtaining  regulatory  approvals,  prosecuting  intellectual  property 
rights and marketing approved products than we do. Smaller and other early stage companies may also prove to be significant 
competitors, particularly through collaborative arrangements with large and established companies. These third parties compete 
with  us  in  recruiting  and  retaining  qualified  scientific  and  management  personnel,  establishing  clinical  trial  sites  and  patient 
registration  for  clinical  trials,  as  well  as  in  acquiring  technologies  complementary  to  or  necessary  for  our  programs  or 
advantageous  to  our  business.  In  addition,  if  we  obtain  regulatory  approvals  for  our  product  candidates,  manufacturing 
efficiency  and  marketing  capabilities  are  likely  to  be  significant  competitive  factors.  We  currently  rely  on  third-party 
manufacturers for our product and all of our product candidates. Further, many of our competitors have substantial resources 
and expertise in conducting collaborative arrangements, sourcing in-licensing arrangements, manufacturing and acquiring new 
business lines or businesses that are greater than our own.

A variety of risks associated with international operations could materially adversely affect our business.

Galafold®,  and  any  of  our  other  product  candidates,  including  AT-GAA,  that  may  be  approved  in  the  future  for 
commercialization in the E.U., U.K. or in other foreign countries are or will be subject to additional risks related to international 
operations or entering into international business relationships, including:

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different regulatory requirements for maintaining approval of drugs in foreign countries;

reduced protection for contractual and intellectual property rights in some countries;

unexpected changes in taxes, tariffs, trade barriers and regulatory requirements;

economic  weakness,  including  rising  interest  rates,  inflation  and  political  instability  in  particular  foreign 
economies and markets;

compliance with tax, employment, immigration and labor laws for employees living or traveling abroad;

our  ability,  and  our  commercialization  partners  ability,  to  comply  with  local  laws,  rules  and  regulations, 
including those relating to modern slavery;

foreign  currency  fluctuations,  which  could  result  in  increased  operating  expenses  and  reduced  revenue,  and 
other obligations incident to doing business in another country;

workforce uncertainty in countries where labor unrest is more common than in the U.S.;

noncompliance with the U.S. Foreign Corrupt Practices Act, the U.K. Bribery Act 2010 and similar anti-bribery 
and anti-corruption laws in other jurisdictions;

tighter restrictions on privacy and the collection and use of patient data; and

business  interruptions  resulting  from  geopolitical  actions  (including  war  and  terrorism),  pandemic  diseases 
(such as COVID-19), or natural disasters (including earthquakes, typhoons, floods and fires).

In addition, there are complex regulatory, tax, labor and other legal requirements imposed by the E.U., U.K., and many of 
the  individual  countries  in  Europe,  Asia  and  Latin  America  with  which  we  will  need  to  comply.  Many  U.S.-based 
biopharmaceutical  companies  have  found  the  process  of  marketing  their  own  products  in  Europe  and  other  international 
geographies to be very challenging.

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Following  the  receipt  of  marketing  approval  of  our  product  or  any  product  candidates,  the  products  may  become 
subject  to  unfavorable  pricing  regulations,  third-party  coverage  and  reimbursement  practices  or  healthcare  reform 
initiatives, which would harm our business.

The  regulations  and  practices  that  govern  marketing  approvals,  pricing,  commercialization,  coverage  and  reimbursement 
for  new  drug  products  vary  widely  from  country  to  country  and  product  to  product.  Current  and  future  legislation  may 
significantly  change  the  approval  requirements  in  ways  that  could  involve  additional  costs  and  cause  delays  in  obtaining 
approvals. Some countries, including almost all of the member states of the European Economic Area, require approval of the 
sale price of a drug before it can be marketed. In many countries, the pricing review period begins after marketing or product 
licensing  approval  is  granted.  In  some  foreign  markets,  including  the  European  market,  prescription  pharmaceutical  pricing 
remains subject to continuing governmental control even after initial approval is granted and approved products are subject to 
re-reviews, class reviews and other governmental controls which can negatively impact pricing originally approved. As a result, 
we might obtain marketing approval for a product in a particular country, but then be subject to price regulations that delay our 
commercial  launch  of  the  product,  possibly  for  lengthy  time  periods,  and  negatively  impact  any  revenues  we  are  able  to 
generate  from  the  sale  of  the  product  in  that  country.  Adverse  pricing  limitations  may  hinder  our  ability  to  recoup  our 
investment in one or more product candidates, even if our product candidates obtain marketing approval. This is particularly 
true in the case of gene therapies for which payors and manufacturers must develop different pricing models for this growing 
area.  Current  pricing  for  gene  therapies  may  not  be  sustainable  in  the  future  which  would  have  a  negative  impact  on  our 
revenues and business.

Our ability to commercialize Galafold® or any product candidate, including AT-GAA, if approved, successfully also will 
depend in part on the extent to which coverage and reimbursement for these products and related treatments will be available 
from government health administration authorities, private health insurers and other organizations. Government authorities and 
other third-party payors, such as private health insurers and health maintenance organizations, decide which medications they 
will pay for and establish reimbursement levels. A primary trend in the European and U.S. healthcare industries and elsewhere 
is cost containment. It is currently unknown what impact, if any proposed changes by the federal and state governments in the 
U.S. and similar changes in foreign countries may have on pricing and reimbursement, particularly with respect to government 
programs such as Medicare and Medicaid and Pharmacy Benefit Managers for commercial plans, and including reimportation, 
reference pricing and limitations on manufacturer price increases.

Prices at which we or our customers seek reimbursement for our products can be subject to challenge, reduction or denial 
by  the  government  and  other  payers.  Increasingly,  third-party  payors  are  requiring  that  drug  companies  provide  them  with 
predetermined discounts from list prices and are challenging the prices charged for pharmaceutical products. We cannot be sure 
that  coverage  and  reimbursement  will  continue  to  be  available  for  Galafold®  or  any  product  candidate  such  as  AT-GAA,  if 
approved, that we commercialize, and in particular gene therapies, and, if coverage and reimbursement are available, the level 
of reimbursement. Reimbursement may impact the demand for, or the price of, Galafold® and any product candidate for which 
we  obtain  marketing  approval.  Obtaining  reimbursement  for  our  product  candidates  when  approved  may  be  particularly 
difficult because of the higher prices typically associated with drugs directed at smaller orphan populations of patients and the 
pricing and reimbursement of competitive products. In addition, third-party payors are likely to impose strict requirements for 
reimbursement of a higher priced drug. If reimbursement is not available or is available only to limited levels, we may not be 
able to successfully commercialize any product for which we obtain marketing approval.

The United States and many foreign jurisdictions have enacted or proposed legislative and regulatory changes affecting the 
healthcare system, including implementing cost-containment programs to limit the growth of government-paid healthcare costs, 
including  price  controls,  restrictions  on  reimbursement  and  requirements  for  substitution  of  generic  products  for  branded 
prescription drugs. The Affordable Care Act was intended to broaden access to health insurance, reduce or constrain the growth 
of healthcare spending, enhance remedies against fraud and abuse, add transparency requirements for the healthcare and health 
insurance industries, impose new taxes and fees on the health industry and impose additional health policy reforms.

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There  have  been  significant  ongoing  judicial,  administrative,  executive  and  legislative  efforts  to  modify  or  eliminate  the 
Affordable  Care  Act.  For  example,  the  Tax  Cuts  and  Jobs  Act  enacted  on  December  22,  2017,  repealed  the  shared 
responsibility payment for individuals who fail to maintain minimum essential coverage under section 5000A of the Internal 
Revenue Code (the “Code”), commonly referred to as the individual mandate. The Budget Control Act of 2011, among other 
things, created the Joint Select Committee on Deficit Reduction to recommend proposals in spending reductions to Congress. 
The Joint Select Committee did not achieve its targeted deficit reduction of an amount greater than $1.2 trillion for the fiscal 
years 2012 through 2021, triggering the legislation’s automatic reductions to several government programs. These reductions 
included  aggregate  reductions  to  Medicare  payments  to  healthcare  providers  of  up  to  2.0%  per  fiscal  year,  which  went  into 
effect  in  April  2013.  Subsequent  litigation  extended  the  2%  reduction,  on  average,  to  2030  unless  additional  Congressional 
action is taken. In 2020 and 2021, during the COVID-19 pandemic, Congress passed several laws including the Coronavirus 
Aid,  Relief,  and  Economic  Security  Act  and  Consolidated  Appropriations  Act  of  2021,  that  temporarily  suspended  the  2% 
sequestration. At the end of 2021, Congress passed the Protecting Medicare and American Farmers from Sequester Cuts Act, 
which  extended  the  suspension  on  the  2%  sequestration  through  March  31,  2022,  and  adjusted  the  sequester  to  1%  for  the 
period between April 1, 2022 and June 30, 2022. On January 2, 2013, the American Taxpayer Relief Act was signed into law, 
which, among other things, reduced Medicare payments to several types of providers, including hospitals, imaging centers and 
cancer  treatment  centers,  and  increased  the  statute  of  limitations  period  for  the  government  to  recover  overpayments  to 
providers from three to five years.

The Affordable Care Act has also been subject to challenges in the courts. On December 14, 2018, a Texas U.S. District 
Court Judge ruled that the Affordable Care Act is unconstitutional in its entirety because the "individual mandate" was repealed 
by  Congress.  On  December  18,  2019,  the  Fifth  Circuit  U.S.  Court  of  Appeals  held  that  the  individual  mandate  is 
unconstitutional and remanded the case to the Texas District Court to reconsider its earlier invalidation of the entire Affordable 
Care Act. On June 17, 2021, the Supreme Court ruled that the plaintiffs lacked standing to challenge the law as they had not 
alleged  personal  injury  traceable  to  the  allegedly  unlawful  conduct.  As  a  result,  the  Supreme  Court  did  not  rule  on  the 
constitutionality of the ACA or any of its provisions.

Further changes to and under the Affordable Care Act remain possible but it is unknown what form any such changes or 
any law proposed to replace or revise the Affordable Care Act would take, and how or whether it may affect our business in the 
future. We expect that changes to the Affordable Care Act, the Medicare and Medicaid programs, changes allowing the federal 
government  to  directly  negotiate  drug  prices  and  changes  stemming  from  other  healthcare  reform  measures,  especially  with 
regard  to  healthcare  access,  financing  or  other  legislation  in  individual  states,  could  have  a  material  adverse  effect  on  the 
healthcare industry.  We also expect that the Affordable Care Act, as well as other healthcare reform measures that have and 
may be adopted in the future, may result in more rigorous coverage criteria and in additional downward pressure on the price 
that we receive for our product and product candidates, if approved. Any reduction in reimbursement from Medicare, Medicaid, 
or other government programs may result in a similar reduction in payments from private payers.  

The Inflation Reduction Act of 2022 (the "IRA") contains substantial drug pricing reforms, including the establishment of a 
drug price negotiation program within the U.S. Department of Health and Human Services that would require manufacturers to 
charge a negotiated "maximum fair price" for certain selected drugs or pay an excise tax for noncompliance, the establishment 
of  rebate  payment  requirements  on  manufacturers  of  certain  drugs  payable  under  Medicare  Parts  B  and  D  to  penalize  price 
increases that outpace inflation, and requires manufacturers to provide discounts on Part D drugs. Substantial penalties can be 
assessed for noncompliance with the drug pricing provisions in the IRA. Although the IRA exempts orphan drugs that treat only 
one  rare  disease  from  the  drug  pricing  negotiation  provisions,  we  do  not  know  if  additional  drug  pricing  reforms  could 
eliminate  this  exemption  and  therefore  affect  the  prices  we  can  charge  and  reimbursement  we  receive  for  our  product  and 
product candidates, if approved, thereby reducing our profitability. Any change to the exemption could have a material adverse 
effect  on  our  financial  condition,  results  of  operations,  and  growth  prospects.  The  effects  of  the  IRA  on  the  pharmaceutical 
industry in general are not yet known.

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The FDA and other regulatory agencies actively enforce the laws and regulations prohibiting the promotion of off-
label uses. If we are found to have promoted off-label uses, we may become subject to significant liability. 

The FDA and other regulatory agencies strictly regulate the promotional claims that may be made about prescription drug 
products. In particular, a product may not be promoted in the U.S. for uses that are not approved by the FDA as reflected in the 
product's approved labeling or prior to regulatory approval. Further, any labeling approved by the FDA for Galafold® or any of 
our other product candidates, including AT-GAA, may include restrictions on use, use limited to specific populations or other 
limitations.  The  FDA  may  impose  further  requirements  or  restrictions  on  the  distribution  or  use  of  any  of  our  other  product 
candidates as part of a REMS plan. Physicians may nevertheless prescribe such products to their patients in a manner that is 
inconsistent  with  the  approved  label.  If  we  are  found  to  have  promoted  such  off-label  uses,  we  may  become  subject  to 
significant liability. Similarly, the FDA strictly regulates the promotion of investigational products prior to approval, known as 
pre-approval  promotion.  The  federal  government  has  levied  large  civil  and  criminal  fines  and  /  or  other  penalties  against 
companies for alleged improper promotion and has investigated and / or prosecuted several companies in relation to off-label 
and/or  pre-approval  promotion.  The  FDA  has  also  requested  that  certain  companies  enter  into  consent  decrees  or  permanent 
injunctions  under  which  specified  promotional  conduct  is  changed,  curtailed  or  prohibited  or  have  delayed  approval  of 
investigational  products  due  to  pre-approval  conduct.  Inappropriate  promotional  activities  may  also  subject  a  company  to 
investigations, prosecutions and litigation by other government entities or private citizens.

Product liability lawsuits against us could cause us to incur substantial liabilities and to limit commercialization of 
any products that we may develop. 

We  face  an  inherent  risk  of  product  liability  exposure  related  to  the  testing  of  our  product  candidates  in  human  clinical 
trials and will face an even greater risk when we commercially sell any products that we develop, including those which may 
arise  from  misuse  or  malfunction  of,  or  design  flaws  in,  such  products,  whether  or  not  such  problems  directly  relate  to  the 
products and services we have provided. If we cannot successfully defend ourselves against claims that our product candidates 
or products caused injuries, we will incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may 
result in:

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reduced resources of our management to pursue our business strategy;

decreased demand for any product candidates or products that we may develop;

injury to our reputation and significant negative media attention;

regulatory  investigations,  prosecutions  or  enforcement  actions  that  could  require  costly  recalls  or  product 
modifications;

withdrawal of clinical trial participants;

regulatory authorities placing ongoing clinical trials on clinical hold;

significant costs to defend the related litigation;

increased insurance costs, or an inability to maintain appropriate insurance coverage;

substantial  monetary  awards  to  trial  participants  or  patients,  including  awards  that  substantially  exceed  our 
product liability insurance, which we would then be required to pay from other sources, if available, and would 
damage our ability to obtain liability insurance at reasonable costs, or at all, in the future;

loss of revenue; and

the inability to commercialize any products that we may develop.

The amount of insurance that we currently hold may not be adequate to cover all liabilities that we may incur. We have 
increased our insurance coverage for the commercialization of Galafold® and may increase insurance coverage when, and if, we 
begin  commercializing  any  other  product  candidate  that  receives  marketing  approval.  Insurance  coverage  is  increasingly 
expensive.  We  may  not  be  able  to  maintain  insurance  coverage  at  a  reasonable  cost  or  in  an  amount  adequate  to  satisfy  any 
liability that may arise. On occasion, large judgments have been awarded in lawsuits based on drugs that had unanticipated side 
effects. A successful product liability claim or a series of claims brought against us could cause our stock price to fall and, if 
judgments exceed our insurance coverage, could decrease our available cash and adversely affect our business.

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If the FDA or other applicable regulatory authorities approve generic or biosimilar products with claims that compete 
with  our  product  or  any  of  our  product  candidates,  it  could  reduce  our  sales  of  our  product  or  those  product 
candidates.

In the U.S., after an NDA is approved, such as Galafold®, the product covered thereby becomes a "listed drug" which can, 
in turn, be cited by potential competitors in support of approval of an abbreviated NDA, or ANDA. The Federal Food, Drug, 
and  Cosmetic  Act,  or  the  FD&C  Act,  FDA  regulations  and  other  applicable  regulations  and  policies  provide  incentives  to 
manufacturers to create modified, non-infringing versions of a drug to facilitate the approval of an ANDA or other application 
for generic substitutes. These manufacturers might only be required to conduct a relatively inexpensive study to show that their 
product  has  the  same  active  ingredients,  dosage  form,  strength,  route  of  administration,  and  conditions  of  use,  or  product 
labeling, as our product or product candidate and that the generic product is absorbed in the body at the same rate and to the 
same extent as, or is bioequivalent to, our product or product candidate. These generic equivalents would be significantly less 
costly than ours to bring to market and companies that produce generic equivalents are generally able to offer their products at 
lower prices. Thus, after the introduction of a generic competitor, a significant percentage of the sales of any branded product 
are  typically  lost  to  the  generic  product.  Accordingly,  competition  from  generic  equivalents  to  our  product  or  product 
candidates,  including  Galafold®,  would  substantially  limit  our  ability  to  generate  revenues  or  achieve  profitability  with  a 
negative impact on continued operations. As of the end of 2022, we received Para. 4 certifications from three ANDA filers for 
Galafold® and have initiated Hatch-Waxman litigation against these ANDA filers and will continue to vigorously defend our 
Galafold® intellectual property rights.

The  Biologics  Price  Competition  and  Innovation  Act,  or  BPCIA,  was  enacted  as  part  of  the  Patient  Protection  and 
Affordable  Care  Act  of  2010,  or  the  ACA,  Pub.  L.  No.  111-148  (2010).  The  BPCIA  authorizes  the  FDA  to  approve 
"abbreviated" BLAs for products whose sponsors demonstrate they are "biosimilar" to reference products previously approved 
under  BLAs,  including  AT-GAA,  if  approved.  The  FDA  may  also  separately  determine  whether  "biosimilar"  products  are 
"interchangeable"  with  their  reference  products.  However,  the  FDA  may  not  approve  an  "abbreviated"  BLA  for  a  biosimilar 
product until at least twelve years after the date on which the BLA for the reference product was approved. FDA approval of 
abbreviated BLAs could be further delayed if the reference products are subject to unexpired and otherwise valid patents.

Prior to the enactment of the BPCIA, information in approved BLAs could not be relied upon by other manufacturers to 
establish the safety and efficacy of their products for which they were seeking FDA approval. Accordingly, if our products such 
as AT-GAA are approved under a BLA, other manufacturers potentially could develop and seek FDA approval of "biosimilar" 
products at some point in the future, including a biosimilar of AT-GAA.

We  may  expend  our  limited  resources  to  pursue  a  particular  product,  product  candidate  or  indication  and  fail  to 
capitalize on a product, product candidates or indications that may be more profitable or for which there is a greater 
likelihood of success.

Because we have limited financial and managerial resources, we focus on research programs and product candidates for 
specific  indications.  As  a  result,  we  may  forego  or  delay  pursuit  of  opportunities  with  other  product  candidates  or  for  other 
indications  that  later  prove  to  have  greater  commercial  potential.  Our  resource  allocation  decisions  may  cause  us  to  fail  to 
capitalize on viable commercial products or profitable market opportunities. Our spending on current and future research and 
development programs and product candidates for specific indications may not yield any commercially viable products.

We  have  historically  been  focused  on  the  development  and  commercialization  of  Galafold®,  a  small  molecule  for  Fabry 
disease and a next generation ERT treatment for Pompe disease, ATB-200. In 2018, we also made a significant investment in 
potential gene therapies for Fabry, Pompe, and other LDs. Notwithstanding our large investment in gene therapies and Pompe 
ERT to date and anticipated future expenditures in related proprietary technologies, we have not yet developed, and may never 
successfully develop, any marketed drugs using ERT and gene therapy approaches. As a result of pursuing the development and 
commercialization  of  our  product  and  product  candidates  using  our  proprietary  and  licensed  technologies,  we  may  fail  to 
develop  products  or  product  candidates,  or  address  indications  based  on  other  scientific  approaches  that  may  offer  greater 
commercial  potential  or  for  which  there  is  a  greater  likelihood  of  success.  Research  programs  to  identify  new  product 
candidates require substantial technical, financial and human resources. These research programs may initially show promise in 
identifying potential product candidates yet fail to yield product candidates for clinical development.

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Risks Related to our Products and the Regulatory Approval and Clinical Development of our Product Candidates

Our  product  or  product  candidates  may  cause  undesirable  side  effects  or  have  other  properties  that  could  delay  or 
prevent their regulatory approval or commercialization.

Undesirable side effects caused by our product, Galafold® or product candidates including AT-GAA, could interrupt, delay 
or halt clinical trials and could result in the denial of regulatory approval by the FDA, EMA or other regulatory authorities for 
any or all targeted indications, and in turn prevent us from commercializing our product or product candidates, if approved, and 
generating  revenues  from  their  sale.  In  addition,  if  we  or  others  identify  undesirable  side  effects  caused  by  our  products  or 
product candidates after receipt of marketing approval:

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regulatory authorities may require the addition of restrictive labeling statements;

regulatory authorities may withdraw their approval of the product; and

we may be required to change the way the product is administered, or additional clinical trials are conducted.

Any of these events could prevent us from achieving or maintaining market acceptance of the affected product or product 
candidate  or  could  substantially  increase  the  costs  and  expenses  of  commercializing  the  product  or  product  candidate,  if 
approved, which in turn could delay or prevent us from generating significant revenues from its sale and limiting our ability to 
meet our financial guidance or adversely affect our reputation.

Any  product  or  product  candidate  for  which  we  obtain  marketing  approval  could  be  subject  to  restrictions  or 
withdrawal from the market and we may be subject to penalties or other enforcement actions if we fail to comply with 
regulatory  requirements  or  if  we  experience  unanticipated  problems  with  our  product  or  our  product  candidates, 
when and if any of them are approved.

Any product or product candidate for which we obtain marketing approval, along with the manufacturing processes, post-
approval  clinical  data,  labeling,  advertising  and  promotional  activities  for  such  product,  will  be  subject  to  continual 
requirements of and review by the FDA, EMA, PMDA and other regulatory authorities. For example, the FDA's requirements 
include  submissions  of  safety  and  other  post-marketing  information  and  reports,  registration  requirements,  Current  Good 
Manufacturing Practices, or cGMP, requirements relating to manufacturing, quality control, quality assurance and complaints 
and  corresponding  maintenance  of  records  and  documents,  requirements  regarding  the  distribution  of  samples  to  healthcare 
professionals and recordkeeping. Even if marketing approval of a product candidate is granted, the approval may be subject to 
limitations on the indicated uses for which the product may be marketed or may be subject to significant conditions of approval, 
including  the  requirement  of  a  REMS.  The  FDA  also  may  impose  requirements  for  costly  post-marketing  studies  or  clinical 
trials  and  surveillance  to  monitor  the  safety  or  efficacy  of  the  product.  The  labeling,  advertising,  promotion,  marketing  and 
distribution  of  a  drug,  biologic,  or  gene  therapy  product  also  must  be  in  compliance  with  FDA  requirements  which  include, 
among  others,  promotional  activities,  standards  and  regulations  for  direct-to-consumer  advertising,  promotional  activities 
involving the internet, and industry sponsored scientific and educational activities. In general, all product promotion must be 
consistent  with  the  labeling  approved  by  the  FDA  for  such  product,  contain  a  balanced  presentation  of  information  on  the 
product's uses, benefits, risks, and important safety information and limitations on use, and otherwise not be false or misleading. 
The FDA has very broad enforcement authority, and failure to abide by these regulations can result in penalties, including the 
issuance of a warning letter directing a company to correct deviations from regulatory standards and enforcement actions that 
can include seizures, injunctions and criminal prosecution. Failure to comply with applicable FDA requirements and restrictions 
also may subject a company to adverse publicity and enforcement action by the FDA, the U.S. Department of Justice ("DOJ") 
or  the  Office  of  the  Inspector  General  of  the  U.S.  Department  of  Health  and  Human  Services  ("HHS")  as  well  as  state 
authorities. This could subject us to a range of penalties that could have a significant commercial impact, including civil and 
criminal fines and agreements that materially restrict the manner in which a company promotes or distributes its products.

In addition, later discovery of previously unknown adverse events or other problems with our products, manufacturers or 

manufacturing processes, or failure to comply with regulatory requirements, may yield various results, including:

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restrictions on such products, manufacturers or manufacturing processes;

changes to or restrictions on the labeling or marketing of a product;

restrictions on product distribution or use;

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requirements to implement a REMS;

requirements to conduct post-marketing studies or clinical trials;

warning letters, untitled letters or Form 483s;

withdrawal of the products from the market;

refusal to approve pending applications or supplements to approved applications that we submit;

recall of products;

fines, restitution or disgorgement of profits or revenues;

suspension or withdrawal of marketing approvals;

refusal to permit the import or export of our products;

product seizure;

injunctions; or

the imposition of civil or criminal penalties.

Non-compliance  with  E.U.  and  U.K.  requirements  regarding  safety  monitoring  or  pharmacovigilance,  and  with 
requirements  related  to  the  development  of  products  for  the  pediatric  population,  can  also  result  in  significant  financial 
penalties. Similarly, failure to comply with the E.U.'s and U.K.'s requirements regarding the protection of personal information, 
which are effective as of May 25, 2018, can also lead to significant penalties and sanctions and business restrictions.

If  we,  or  our  suppliers,  third-party  contractors,  clinical  investigators  or  collaborators  are  slow  to  adapt,  or  are  unable  to 
adapt,  to  changes  in  existing  regulatory  requirements  or  adoption  of  new  regulatory  requirements  or  policies,  we  or  our 
collaborators  may  lose  marketing  approval  for  our  products  when  and  if  any  of  them  are  approved,  resulting  in  decreased 
revenue from milestones, product sales or royalties.

Our  relationships  with  customers,  healthcare  providers,  patients,  patient  organizations,  charitable  foundations  and 
third-party  payors  are  subject  to  applicable  anti-kickback,  fraud  and  abuse,  anti-bribery  and  corruption  and  other 
healthcare laws and regulations, which could expose us to criminal sanctions, civil penalties, contractual damages, 
reputational harm and diminished profits and future earnings.

Healthcare providers, physicians and payors play a primary role in the recommendation and prescription of our product and 
any product candidates for which we may obtain marketing approval. Increasingly, patients, patient organizations and charitable 
foundations  also  can  influence  selection  of  and  payment  for  therapies.  Our  current  and  future  arrangements  with  payors, 
healthcare providers, patient organizations, charitable foundations and patients may expose us to broadly applicable fraud and 
abuse,  anti-bribery  and  corruption,  and  other  healthcare  laws  and  regulations  that  may  constrain  the  business  or  financial 
arrangements and relationships through which we market, sell and distribute our product and any product candidates for which 
we may obtain marketing approval. Even though we do not and will not control referrals of healthcare services or bill directly to 
Medicare, Medicaid or other third-party payors, federal, state and foreign healthcare laws and regulations pertaining to fraud 
and abuse, anti-bribery and corruption, interaction with patient organizations, charitable foundations, and patients' rights are and 
will be applicable to our business. Restrictions under applicable federal, state and foreign healthcare laws and regulations may 
affect our ability to operate and expose us to areas of risk, including:

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the U.S. federal Anti-Kickback Statute, which prohibits, among other things, knowingly and willfully soliciting, 
offering,  receiving  or  providing  remuneration,  directly  or  indirectly,  in  cash  or  in  kind,  to  induce  or  reward 
either the referral of an individual for, or the purchase, order or recommendation of, any good or service, for 
which payment may be made under federal and state healthcare programs such as Medicare and Medicaid. A 
person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to 
have  committed  a  violation.  Several  other  countries,  including  the  U.K.,  have  enacted  similar  anti-kickback, 
fraud and abuse, and healthcare laws and regulations;

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the  U.S.  federal  False  Claims  Act,  which  imposes  criminal  and  civil  penalties,  including  through  civil 
whistleblower  or  qui  tam  actions,  against  individuals  or  entities  for  knowingly  presenting,  or  causing  to  be 
presented, to the federal government, claims for payment that are false or fraudulent or making a false statement 
to avoid, decrease or conceal an obligation to pay money to the federal government. In addition, the government 
may  assert  that  a  claim  including  items  and  services  resulting  from  a  violation  of  the  federal  Anti-Kickback 
Statute  constitutes  a  false  or  fraudulent  claim  for  purposes  of  the  False  Claims  Act.  In  addition,  charitable 
contributions to foundations for use in supporting patients may expose those foundations and us to additional 
penalties and prosecution under the False Claims Act. There is also a separate false claims provision imposing 
criminal  penalties.  Applicable  regulations  of  both  the  EMA  and  E.U.  member  states  also  impose  liability  for 
failing  to  comply  with  fraud  and  abuse  laws  or  improperly  using  information  obtained  in  in  the  course  of 
clinical trials with the EMA or other regulatory authorities;

The  U.S.  federal  Health  Insurance  Portability  and  Accountability  Act  of  1996  ("HIPAA")  which  imposes 
criminal  liability  and  amends  provisions  on  the  reporting,  investigation,  enforcement,  and  penalizing  of  civil 
liability for executing a scheme to defraud any healthcare benefit program or making false statements relating to 
healthcare matters. Similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual 
knowledge  of  the  statute  to  defraud  any  healthcare  benefit  program  or  specific  intent  to  violate  it  in  order  to 
have  committed  a  violation.  This  statute  also  may  impose  monetary  penalties  on  any  offers  or  transfers  of 
remuneration  to  Medicare  or  Medicaid  beneficiaries  (patients)  which  is  likely  to  influence  the  beneficiary's 
selection of particular supplier of government payable items. States, such as California have enacted their own 
privacy regulations and others may enact similar legislation. Similarly, the collection and use of personal health 
data  in  the  E.U.  is  governed  by  the  E.U.  General  Data  Protection  Regulation  (the  "GDPR"),  with  many 
requirements mandated by the GDPR for the consent of the individuals to whom the personal data relates, the 
information provided to the individuals, transfer of personal data within and outside of the E.U. and the security 
and  confidentiality  of  the  personal  data.  Enforcement  of  the  GDPR  began  on  May  25,  2018,  and  failure  to 
comply with the requirements of the GDPR may result in substantial fines and other administrative penalties. 
The GDPR increases our responsibility and liability in relation to personal data that we process, and we may be 
required to put in place additional mechanisms ensuring compliance with the GDPR. This may be onerous and 
adversely affect our business, financial condition, results of operations and prospects;

HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009, and 
its  implementing  regulations,  which  also  imposes  obligations  on  certain  covered  entity  healthcare  providers, 
health  plans,  and  healthcare  clearinghouses  as  well  as  their  business  associates  that  perform  certain  services 
involving the use or disclosure of individually identifiable health information, including mandatory contractual 
terms,  with  respect  to  safeguarding  the  privacy,  security  and  transmission  of  individually  identifiable  health 
information;

U.S. federal laws requiring drug manufacturers to report annually information related to certain payments and 
other  transfers  of  value  made  to  physicians  (defined  to  include  doctors,  dentists,  optometrists,  podiatrists 
chiropractors, physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists, and 
certified  nurse-midwives)  and  teaching  hospitals,  as  well  as  ownership  or  investment  interests  held  by 
physicians  and  their  immediate  family  members,  including  under  the  federal  Open  Payments  program, 
commonly known as the Sunshine Act, as well as other state and foreign laws regulating marketing activities 
and  requiring  manufacturers  to  report  marketing  expenditures,  payments  and  other  transfers  of  value  to 
physicians  and  other  healthcare  providers.  Similarly,  payments  made  to  physicians  in  certain  E.U.  member 
states  must  be  publicly  disclosed.  Moreover,  agreements  with  physicians  often  must  be  the  subject  of  prior 
notification and approval by the physician's employer, his or her competent professional organization and/or the 
regulatory  authorities  of  the  individual  E.U.  member  states.  These  requirements  are  provided  in  the  national 
laws,  industry  codes  or  professional  codes  of  conduct,  applicable  in  the  E.U.  member  states.  In  addition,  the 
provision  of  benefits  or  advantages  to  physicians  to  induce  or  encourage  the  prescription,  recommendation, 
endorsement, purchase, supply, order or use of medicinal products is prohibited in the E.U. Failure to comply 
with  these  requirements  could  result  in  reputational  risk,  public  reprimands,  administrative  penalties,  fines  or 
imprisonment;

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U.S. federal government price reporting laws, which require us to calculate and report complex pricing metrics 
to government programs, where such reported prices may be used in the calculation of reimbursement and/or 
discounts  on  our  marketed  drugs.  Participation  in  these  programs  and  compliance  with  the  applicable 
requirements may subject us to potentially significant discounts on our products, increased infrastructure costs, 
potential liability for the failure to report such prices in an accurate and timely manner, and potentially limit our 
ability to offer certain marketplace discounts;

U.S.  Foreign  Corrupt  Practices  Act,  which  prohibit  us  and  third  parties  working  on  our  behalf  from  making 
payments  to  foreign  government  officials  to  assist  in  obtaining  or  retaining  business.  Specifically,  the  anti-
bribery provisions of the FCPA prohibit the willful use of the mails or any means of instrumentality of interstate 
commerce corruptly in furtherance of any offer, payment, promise to pay, or authorization of the payment of 
money or anything of value to any person, while knowing that all or a portion of such money or thing of value 
will be offered, given or promised, directly or indirectly, to a foreign official to influence the foreign official in 
his or her official capacity, induce the foreign official to do or omit to do an act in violation of his or her lawful 
duty, or to secure any improper advantage in order to assist in obtaining or retaining business for or with, or 
directing business to, any person; enforcement actions may be brought by the Department of Justice or the SEC; 
legislation  has  expanded  the  SEC’s  power  to  seek  disgorgement  in  all  FCPA  cases  filed  in  federal  court  and 
extended the statute of limitations in SEC enforcement actions in intent-based claims, such as those under the 
FCPA, from five years to ten years; and 

state and foreign equivalents of each of the above laws, including foreign anti-bribery and corruption laws and 
state  anti-kickback  and  false  claims  laws,  which  may  apply  to  sales  or  marketing  arrangements  and  claims 
involving healthcare items or services reimbursed by non-governmental payors, including private insurers; state 
laws  which  require  pharmaceutical  companies  to  comply  with  the  pharmaceutical  industry's  voluntary 
compliance  guidelines  and  the  relevant  compliance  guidance  promulgated  by  the  federal  government  or 
otherwise restricting payments that may be made to healthcare providers; and state and foreign laws governing 
the privacy and security of health information in certain circumstances, many of which differ from each other in 
significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.

While we do not submit claims and our customers will make the ultimate decision on how to submit claims, in the U.S. we 
may provide reimbursement guidance and support regarding Galafold®, and our other product candidates for which we receive 
regulatory  approval,  to  our  customers  and  patients.  If  a  government  authority  were  to  conclude  that  we  provided  improper 
advice to our customers and patients and/or encouraged the submission of false claims for reimbursement, we could face action 
by government authorities. Similarly, if a government authority were to conclude that our patient support efforts or interactions 
with charitable foundations were improper, we could face action by government authorities. Efforts to ensure that our business 
arrangements  with  third  parties  will  comply  with  applicable  healthcare  laws  and  regulations  will  involve  substantial  costs. 
Nonetheless, it is possible that governmental authorities will conclude that our business practices may not comply with current 
or future statutes, regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations. If our 
operations are found to be in violation of any of these laws or any other governmental regulations that may apply to us, we may 
be subject to significant civil, criminal and administrative penalties, damages, fines, imprisonment, exclusion from participation 
in  government  funded  healthcare  programs,  such  as  Medicare  and  Medicaid,  and  the  curtailment  or  restructuring  of  our 
operations.

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If clinical trials of our product candidates fail to demonstrate safety and efficacy to the satisfaction of the FDA, EMA, 
PMDA  or  other  foreign  regulatory  authorities,  or  do  not  otherwise  produce  favorable  results,  we  may  experience 
delays  in  completing,  or  ultimately  be  unable  to  complete,  the  development  and  commercialization  of  our  product 
candidates.

In connection with seeking marketing approval from regulatory authorities for the sale of any product candidate, including 
AT-GAA, we must complete preclinical development and then conduct extensive clinical trials to demonstrate the safety and 
efficacy of our product candidates in humans. Clinical testing is expensive, difficult to design and implement, can take many 
years to complete, and is uncertain as to outcome. A failure of one or more clinical trials can occur at any stage of testing. The 
outcome of preclinical testing and early clinical trials may not be predictive of the success of later clinical trials, and interim 
results of a clinical trial do not necessarily predict final results. Moreover, preclinical and clinical data are often susceptible to 
varying interpretations and analyses, and many companies that have believed their product candidates performed satisfactorily 
in  preclinical  studies  and  clinical  trials  have  nonetheless  failed  to  obtain  marketing  approval  of  their  products.  This  is 
particularly the case with AT-GAA, as there can be no assurance that the Phase 3 PROPEL study results will meet regulatory 
standards for approval in every geography.

In addition, the regulatory pathways for gene therapies are evolving. In some cases, the FDA will approve gene therapies 
based on Phase 2 clinical trial data. If, however, the FDA decides we need to complete Phase 3 clinical trial(s), we may need to 
expend significantly more capital to pursue FDA approval of gene therapies. If we are required to conduct additional clinical 
trials or other testing of our product candidates, including AT-GAA, or any gene therapies, that we develop beyond those tests 
and trials that we contemplate; if we are unable to successfully complete our clinical trials or other testing; if the results of these 
trials or tests are not positive or are only modestly positive; or if there are safety concerns, we may:

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choose not to seek regulatory approval in the U.S., E.U., U.K. or other key jurisdictions;

be delayed in obtaining marketing approval for our product candidates;

not obtain marketing approval at all;

obtain approval for indications or patient populations that are not as broad as intended or desired;

obtain  approval  with  labeling  that  includes  significant  use  or  distribution  restrictions  or  safety  warnings, 
including boxed warnings;

be  subject  to  additional  post-marketing  testing  requirements,  safety  strategies  or  restrictions,  such  as  a 
requirement of a risk evaluation and mitigation strategy, or REMS; or

have the product removed from the market after obtaining regulatory approval.

If  we  experience  any  of  a  number  of  possible  unforeseen  events  in  connection  with  our  clinical  trials,  potential 
regulatory approval or commercialization of our product candidates, if approved, could be delayed or prevented.

We may experience numerous unforeseen events during, or as a result of, clinical trials including ongoing clinical trials of 
AT-GAA in additional study populations that could delay or prevent our ability to receive regulatory approval or commercialize 
our product candidates, including:

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•

•

•

•

clinical trials of our product candidates may produce negative or inconclusive results, and we may decide, or 
regulators may require us, to conduct additional clinical trials or abandon product development programs;

the number of patients required for clinical trials of our product candidates may be larger than we anticipate, 
enrollment in these clinical trials may be slower than we anticipate, or patients may drop out of these clinical 
trials at a higher rate than we anticipate;

we may be unable to enroll a sufficient number of patients in our trials to ensure adequate statistical power to 
detect any statistically significant treatment effects;

our third-party contractors may fail to comply with regulatory requirements or meet their contractual obligations 
to us in a timely manner, or at all;

regulators,  institutional  review  boards,  or  independent  ethics  committees  may  not  authorize  us  or  our 
investigators to commence a clinical trial or conduct a clinical trial at a prospective trial site;

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we may have delays in reaching or fail to reach agreement on acceptable clinical trial contracts or clinical trial 
protocols with prospective trial sites;

we may have to suspend or terminate clinical trials of our product candidates for various reasons, including a 
finding that the participants are being exposed to unacceptable health risks;

regulators,  institutional  review  boards,  or  independent  ethics  committees  may  require  that  we  or  our 
investigators  suspend  or  terminate  clinical  research  for  various  reasons,  including  noncompliance  with 
regulatory requirements or a finding that the participants are being exposed to unacceptable health risks;

the cost of clinical trials of our product candidates may be greater than we anticipate;

the  supply  or  quality  of  our  product  candidates  or  other  materials  necessary  to  conduct  clinical  trials  of  our 
product candidates may be insufficient or inadequate; or

our product candidates may have undesirable side effects or other unexpected characteristics, causing us or our 
investigators, regulators, institutional review boards or independent ethics committees to suspend or terminate 
the trials.

Our product development costs will increase if we experience delays in testing or regulatory approvals. We do not know 
whether  any  preclinical  tests  or  clinical  trials  will  begin  as  planned,  will  need  to  be  restructured  or  will  be  completed  on 
schedule, or at all. Significant preclinical study or clinical trial delays also could shorten any periods during which we may have 
the exclusive right to commercialize our product candidates, allow our competitors to bring products to market before we do, or 
impair  our  ability  to  successfully  commercialize  our  product  candidates,  and  so  may  harm  our  business  and  results  of 
operations.

If  we  experience  delays  or  difficulties  in  the  enrollment  of  patients  in  our  clinical  trials,  our  receipt  of  necessary 
regulatory approvals could be delayed or prevented.

We may not be able to initiate or continue clinical trials for our product candidates if we are unable to locate and enroll a 
sufficient  number  of  eligible  patients  to  participate  in  these  trials.  Each  of  the  diseases  that  our  lead  product  candidates  are 
intended  to  treat  are  characterized  by  small  patient  populations,  which  could  result  in  slow  enrollment  of  clinical  trial 
participants. In addition, our competitors have ongoing clinical trials for product candidates that could be competitive with our 
product candidates. As a result, potential clinical trial sites may elect to dedicate their limited resources to participation in our 
competitors' clinical trials and not ours, and patients who would otherwise be eligible for our clinical trials may instead enroll in 
clinical trials of our competitors' product candidates.

Patient enrollment is affected by other factors including:

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•

•

•

•

severity of the disease under investigation;

eligibility criteria for the clinical trial in question;

perceived risks and benefits of the product candidate under study;

efforts to facilitate timely enrollment in clinical trials;

patient referral practices of physicians;

the ability to monitor patients adequately during and after treatment; and

proximity and availability of clinical trial sites for prospective patients.

Enrollment delays in our clinical trials may result in increased development costs for our product candidates, which would 
cause the value of the Company to decline and limit our ability to obtain additional financing. Our inability to enroll a sufficient 
number  of  patients  in  any  of  our  clinical  trials  would  result  in  significant  delays  or  may  require  us  to  abandon  one  or  more 
clinical trials altogether.

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Initial results from a clinical trial do not ensure that the trial will be successful and success in preclinical or early 
stage clinical trials does not ensure success in later-stage clinical trials.

We will only obtain regulatory approval to commercialize a product candidate if we can demonstrate to the satisfaction of 
the  FDA  or  the  applicable  non-U.S.  regulatory  authority,  in  well-designed  and  conducted  clinical  trials,  that  the  product 
candidate is safe and effective and otherwise meets the appropriate standards required for approval for a particular indication. 
Clinical trials are lengthy, complex and extremely expensive processes with uncertain duration and results. A failure of one or 
more of our clinical trials may occur at any stage of testing.

Success in preclinical testing and early clinical trials does not ensure that later clinical trials will be successful. Our product 
candidates  may  fail  to  show  the  desired  safety  and  efficacy  in  clinical  development  despite  demonstrating  positive  results  in 
preclinical studies or having successfully advanced through initial clinical trials or preliminary stages of clinical trials. For some 
of  our  product  candidates,  we  have  no  safety  or  efficacy  data  in  humans.  There  can  be  no  assurance  that  the  results  seen  in 
preclinical studies for any product candidates will result in success in clinical trials. When administered in humans, the product 
candidates  may  perform  differently  than  in  preclinical  studies.  Product  candidates  may  demonstrate  different  chemical  and 
pharmacological  properties  in  patients  than  they  do  in  laboratory  studies  or  animal  studies,  and  may  interact  with  human 
biological systems in unforeseen, ineffective or harmful ways. We may be unable to generate sufficient preclinical, toxicology, 
or other in vivo or in vitro data to support the initiation or continuation of clinical trials.

Initial  results  from  a  clinical  trial  do  not  necessarily  predict  final  results.  We  cannot  be  assured  that  these  trials  will 
ultimately be successful. In addition, patients may not be compliant with their dosing regimen or trial protocols or they may 
withdraw from the clinical trial at any time for any reason. In addition, while the clinical trials of our product candidates are 
designed based on the available relevant information, in view of the uncertainties inherent in drug development, such clinical 
trials  may  not  be  designed  with  focus  on  indications,  patient  populations,  dosing  regimens,  safety  or  efficacy  parameters  or 
other  variables  that  will  provide  the  necessary  safety  or  efficacy  data  to  support  regulatory  approval  to  commercialize  the 
resulting  product  candidates.  This  is  particularly  the  case  for  emerging  gene  therapies  where  we  do  not  yet  have  a  defined 
regulatory pathway and there can be no assurance that regulators in the U.S., E.U., U.K., Japan or other jurisdictions will accept 
any gene therapy clinical data sets for approval and without additional clinical trials or that future trials will support approvals. 
In addition, individual patient responses to the dose administered of a product candidate may vary in a manner that is difficult to 
predict.  Also,  the  methods  we  select  to  assess  particular  safety  or  efficacy  parameters  may  not  yield  statistical  precision  in 
estimating our product candidates' effects on study participants. Even if we believe the data collected from clinical trials of our 
product  candidates  are  promising,  these  data  may  not  be  sufficient  to  support  approval  by  the  FDA  or  foreign  regulatory 
authorities.  Preclinical  and  clinical  data  can  be  interpreted  in  different  ways.  Accordingly,  the  FDA  or  foreign  regulatory 
authorities could interpret these data in different ways from us or our partners, which could delay, limit or prevent regulatory 
approval.

In  addition,  certain  of  our  product  candidates  are  based  on  emerging  gene  therapy  technologies.  The  FDA  may  require 
different  endpoints  than  the  endpoints  we  anticipate  using  or  have  used  in  our  clinical  trials,  or  a  different  analysis  of  those 
endpoints,  it  may  be  more  difficult  for  us  to  obtain,  or  we  may  be  delayed  in  obtaining,  FDA  approval  of  our  product 
candidates.  If  we  are  not  successful  in  commercializing  any  of  our  products  or  product  candidates,  if  approved,  or  are 
significantly delayed in doing so, our business will be materially harmed.

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We  may  not  be  able  to  obtain  or  maintain  orphan  drug  exclusivity  for  our  product  or  product  candidates.  If  our 
competitors  are  able  to  obtain  orphan  drug  exclusivity  for  their  products,  we  may  not  be  able  to  have  competing 
products approved by the applicable regulatory authority for a significant period of time.

Regulatory  authorities  in  some  jurisdictions,  including  the  E.U.,  U.K.,  and  the  U.S.,  may  designate  drugs  for  relatively 
small patient populations as orphan drugs. We obtained orphan drug designations from the FDA for Galafold® for the treatment 
of Fabry disease in February 2004. We also obtained orphan medicinal product designation in the E.U. and U.K. for Galafold® 
in May 2006. AT-GAA has also received this designation from the FDA, EMA, and, in 2020, from PMDA. Our competitors 
have also received orphan designations. However, these orphan designations may be retracted following regulatory review of 
our or our competitor’s marketing authorization and/or BLA submissions and may not be reflected in the final approval of a 
product.  Generally,  if  a  product  with  an  orphan  drug  designation  subsequently  receives  the  first  marketing  approval  for  the 
indication for which it has such designation, the product is entitled to a period of market exclusivity, which, subject to certain 
exceptions, precludes the EMA from approving another marketing application for a similar medicinal product or the FDA from 
approving another marketing application for the same drug for the same indication for that time period. The FDA defines “same 
drug”  as  a  drug  or  biologic  that  contains  the  same  active  moiety  and  is  intended  for  the  same  use.  The  applicable  market 
exclusivity period for orphan drugs is ten years in the E.U. and U.K. and seven years in the U.S. The E.U. and U.K. exclusivity 
period can be reduced to six years if a drug no longer meets the criteria for orphan drug designation, including if the drug is 
sufficiently profitable so that market exclusivity is no longer justified.

In  the  E.U.  and  U.K.,  a  "similar  medicinal  product"  is  a  medicinal  product  containing  a  similar  active  substance  or 
substances  as  contained  in  a  currently  authorized  orphan  medicinal  product,  and  which  is  intended  for  the  same  therapeutic 
indication. If a competitor to AT-GAA or our other product candidates obtains orphan drug exclusivity for and approval of a 
product with the same indications as our product candidates as before we do and if the competitor's product is the same drug or 
a similar medicinal product as ours, we could be excluded from the market for a certain period of time.

Even if we obtain orphan drug exclusivity for other product candidates in these indications, we may not be able to maintain 
it.  For  example,  if  a  competitive  product  that  is  the  same  drug  or  a  similar  medicinal  product  as  our  product  or  product 
candidate is shown to be clinically superior to our product or product candidate, as applicable, any orphan drug exclusivity we 
have obtained will not block the approval of such competitive product. In addition, orphan drug exclusivity will not prevent the 
approval  of  a  product  that  is  the  same  drug  as  our  product  or  product  candidate  if  the  FDA  finds  that  we  cannot  assure  the 
availability of sufficient quantities of the drug to meet the needs of the persons with the disease or condition for which the drug 
was designated.

The  FDA  Reauthorization  Act,  signed  into  law  in  August  2017,  authorizes  the  FDA  to  impose  additional  clinical  trial 
requirements  on  manufacturers  seeking  orphan  drug  designation  and/or  pediatric  indications.  Galafold®  and  AT-GAA  have 
obtained  orphan  drug  designations  from  the  FDA.  The  impact,  however,  of  future  regulations  on  other  product  candidates  is 
uncertain and could result in the need for additional clinical trials.

Failure  to  obtain  or  maintain  regulatory  approval  in  foreign  jurisdictions  would  prevent  us  from  marketing  our 
products abroad.

In  order  to  market  and  sell  our  products  in  Europe  and  many  other  jurisdictions,  we  must  obtain  separate  marketing 
approvals and comply with numerous and varying regulatory requirements. The approval procedure varies among countries and 
can involve additional testing. The time required to obtain approval may differ from that required to obtain FDA approval. The 
regulatory  approval  process  outside  the  U.S.  generally  includes  all  of  the  risks  associated  with  obtaining  FDA  approval.  In 
addition,  some  countries  outside  the  U.S.  require  approval  of  the  sales  price  of  a  drug  before  it  can  be  marketed.  In  many 
countries,  separate  procedures  must  be  followed  to  obtain  reimbursement.  We  may  not  obtain  marketing,  pricing  or 
reimbursement  approvals  outside  the  U.S.  on  a  timely  basis,  if  at  all.  Approval  by  the  FDA  does  not  ensure  approval  by 
regulatory  authorities  in  other  countries  or  jurisdictions,  and  approval  by  one  regulatory  authority  outside  the  U.S.  does  not 
ensure  approval  by  regulatory  authorities  in  other  countries  or  jurisdictions  or  by  the  FDA.  We  may  not  be  able  to  file  for 
marketing  approvals  and  may  not  receive  necessary  approvals  to  commercialize  our  products  in  any  market.  Regulatory 
approvals  in  countries  outside  the  U.S.  do  not  ensure  pricing  approvals  in  those  countries  or  in  any  other  countries,  and 
regulatory approvals and pricing approvals do not ensure that reimbursement will be obtained.

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In  December  2022,  the  Committee  for  Medicinal  Products  for  Human  Use  (CHMP)  of  the  European  Medicines  Agency 
(EMA)  adopted  a  positive  opinion  recommending  marketing  authorization  of  cipaglucosidase  alfa  used  in  combination  with 
miglustat for adults with late-onset Pompe disease (LOPD). A CHMP decision on miglustat is expected to follow. We do not 
know if both components of AT-GAA will be approved or, if approved, whether cipaglucosidase alfa and miglustat will receive 
favorable  pricing.  If  we  are  unable  to  secure  full  marketing  approval  for  both  components  of  AT-GAA,  EU  or  other 
geographies, our business and results of operations may be materially harmed.

Our  business  activities  involve  the  use  of  hazardous  materials,  which  require  compliance  with  environmental  and 
occupational  safety  laws  regulating  the  use  of  such  materials.  If  we  violate  these  laws,  we  could  be  subject  to 
significant fines, liabilities or other adverse consequences.

Our  research  and  development  programs  involve  the  controlled  use  of  hazardous  materials,  including  microbial  agents, 
corrosive,  explosive  and  flammable  chemicals  and  other  hazardous  compounds  in  addition  to  certain  biological  hazardous 
waste. Additionally, the activities of our third-party product manufacturers of our product, and of our product candidates if and 
when  they  reach  commercialization,  will  also  require  the  use  of  hazardous  materials.  Accordingly,  we  are  subject  to  federal, 
state and local laws governing the use, handling and disposal of these materials. Although we believe that our safety procedures 
for handling and disposing of these materials comply in all material respects with the standards prescribed by local, state and 
federal  regulations,  we  cannot  completely  eliminate  the  risk  of  accidental  contamination  or  injury  from  these  materials.  In 
addition,  although  our  collaborators  have  environmental  compliance  processes  in  place,  and  we  include  oversight  of  these 
processes  in  our  business  reviews,  they  may  not  ultimately  comply  with  these  laws.  In  the  event  of  an  accident  or  failure  to 
comply with environmental laws, we could be held liable for damages that result, and any such liability could exceed our assets 
and  resources  or  we  could  be  subject  to  limitations  or  stoppages  related  to  our  use  of  these  materials  which  may  lead  to  an 
interruption  of  our  business  operations  or  those  of  our  third-party  contractors.  While  we  believe  that  our  existing  insurance 
coverage is generally adequate for our normal handling of these hazardous materials, it may not be sufficient to cover pollution 
conditions or other extraordinary or unanticipated events. Furthermore, an accident could damage or force us to shut down our 
operations. Changes in environmental laws may impose costly compliance requirements on us or otherwise subject us to future 
liabilities and additional laws relating to the management, handling, generation, manufacture, transportation, storage, use and 
disposal of materials used in or generated by the manufacture of our products or related to our clinical trials. In addition, we 
cannot predict the effect that these potential requirements may have on us, our suppliers and contractors or our customers.

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If  we  are  unable  to  obtain  marketing  approval  for  AT-GAA,  or  if  it  is  approved  and  the  label  does  not  support 
reimbursement and we are unable to successfully commercialize AT-GAA, our business could be materially harmed.

Securing marketing approval requires the submission of extensive preclinical and clinical data and supporting information 
to regulatory authorities for each therapeutic indication to establish the product candidate's safety and efficacy. In September 
2021, the FDA accepted our AT-GAA BLA and NDA for review. Regulatory authorities, including FDA, may determine that 
AT-GAA  is  not  effective  or  only  moderately  effective,  have  effect  in  only  a  limited  population,  or  have  undesirable  or 
unintended side effects, toxicities, safety profiles or other characteristics that preclude us from obtaining marketing approval or 
that  prevent  or  limit  commercial  use.  In  October  2022,  FDA  informed  us  that  it  has  deferred  action  on  the  AT-GAA  BLA, 
pending inspection of the proposed manufacturing site in China. The inspection has been delayed due to restrictions related to 
the  COVID-19  pandemic  and  is  now  scheduled.  This  timing  is  subject  to  change  and  is  dependent  on  a  number  of  factors, 
including the evolving situation on the ground in China and the outcome of an inspection. There can be no assurance that an 
inspection  will  take  place  when  scheduled  or  that  an  inspection  will  be  successful  if  and  when  completed  all  of  which  may 
impact  timing  or  probability  of  any  approvals.  If  AT-GAA  fails  to  receive  marketing  approval,  is  significantly  delayed  in 
receiving marketing approval or if the approved labeling is not as expected, AT-GAA may fail to receive market acceptance, 
receive reimbursement or be able to generate material revenue, any of which could substantially harm our future business and 
impact our ability to meet our financial guidance. 

Risks Related to our Preclinical Product Candidates

Our gene therapy product candidates are based on novel technologies, which makes it difficult to predict the time and 
cost of product candidate development and subsequently obtaining regulatory approval.

Only a few gene therapy products have been approved in the U.S., E.U., and U.K. We have acquired the rights to many 
potential gene therapies and have focused a substantial amount of our research and development efforts on these gene therapy 
platforms. There can be no assurance that any development problems we experience in the future related to our gene therapies 
will  not  cause  significant  delays  or  unanticipated  costs,  or  that  such  development  problems  can  be  solved.  In  addition,  the 
clinical  study  requirements  of  the  FDA,  the  EMA,  and  other  regulatory  agencies  and  the  criteria  these  regulators  use  to 
determine  the  safety  and  efficacy  of  a  product  candidate  vary  substantially  according  to  the  type,  complexity,  novelty  and 
intended use and market of the potential products. The regulatory approval process for novel product candidates such as our 
gene therapies can be more expensive and take longer than for other, better known or more extensively studied pharmaceutical 
or other product candidates. There is no guarantee that our potential gene therapies will ever receive regulatory approval, that 
we will have the resources to develop these therapies, that we will recoup our investments made in gene therapies or that we 
will meet any projected timelines for development.

Risks Related to the Manufacture of our Product and Product Candidates and our Dependence on Third Parties

Use  of  third  parties  to  manufacture  Galafold®  or  AT-GAA  may  increase  the  risk  that  we  will  not  have  sufficient 
quantities of Galafold® or product candidates or such quantities at an acceptable cost, which could delay, prevent or 
impair our development or commercialization efforts.

We  do  not  currently  own  or  operate  manufacturing  facilities  for  clinical  or  commercial  production  of  Galafold®  or  AT-
GAA. We currently lack the resources and the capabilities to manufacture ourselves on a clinical or commercial scale. If we 
choose in the future to manufacture ourselves, we would face all of the risks and uncertainties of third-party manufacturers of 
our  products.  We  currently  outsource  all  manufacturing  and  packaging  of  our  product  and  preclinical  and  clinical  product 
candidates to third parties. The manufacture of pharmaceutical products requires significant expertise and capital investment, 
including the development of advanced manufacturing techniques and process controls. In particular, the manufacture of our 
biologic  product  candidate  ATB200  for  Pompe  is  highly  complex  and  we  may  encounter  difficulties  in  production.  These 
problems include difficulties with production costs and yields and quality control, including stability of the product or product 
candidate. The occurrence of any of these problems could significantly delay our clinical trials or the commercial availability of 
our product or product candidates.

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We may be unable to enter into agreements for commercial supply with third-party manufacturers or may be unable 
to do so on acceptable terms. Even if we enter into these agreements, the manufacturers of each product candidate 
will be single source suppliers to us for a significant period of time.

Even  if  we  are  able  to  establish  and  maintain  arrangements  with  third-party  manufacturers,  reliance  on  third-party 

manufacturers entails additional risks, including:

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reliance on the third party for regulatory compliance and quality assurance;

limitations on supply availability resulting from capacity and scheduling constraints of the third parties;

inability to manufacture product that meets the regulatory requirements for product approval;

inability to manufacture batches that meet specifications and quality standards; 

inability to hire and retain the skilled workers necessary to manufacture our products;

inability to meet environmental sustainability requirements;

impact on our reputation in the marketplace if manufacturers of our products, once commercialized, fail to meet 
the demands of our customers;

the possible breach of the manufacturing agreement by the third party;

the possible misappropriation of our proprietary information, including our trade secrets and know-how; 

the high cost of manufacturing processes and raw materials; and

the  possible  termination  or  nonrenewal  of  the  agreement  by  the  third  party  at  a  time  that  is  costly  or 
inconvenient for us. 

The failure of any of our contract manufacturers to maintain high manufacturing standards could result in injury or death of 
clinical trial participants or patients using products. Such failure could also result in product liability claims, product recalls, 
product seizures or withdrawals, delays or failures in testing or delivery, cost overruns or other problems that could seriously 
harm our business or profitability.

The  FDA  and  regulatory  authorities  in  other  jurisdictions  require  our  contract  manufacturers  to  comply  with  cGMP 
regulations. These regulations cover all aspects of the manufacturing, testing, quality control and recordkeeping relating to our 
product candidates and any products that we may commercialize, including Galafold®, AT-GAA, and our gene therapy product 
candidates. The FDA and other regulatory authorities may, and often will, require the inspection of our contract manufacturers 
in  order  to  approve,  or  maintain  the  approval  of,  our  products  or  product  candidates,  including  Galafold®  and  AT-GAA. 
Different  geopolitical  situations,  responses  to  COVID-19,  or  other  unforeseeable  events  could  impact  the  FDA,  or  other 
regulatory authorities, ability to timely inspect such contract manufacturers and such delays could materially harm our business 
and accuracy of our financial guidance projections.

Our contract manufacturers may not be able to comply with cGMP regulations or similar regulatory requirements outside 
the U.S. Our failure or the failure of our third-party manufacturers, to comply with applicable regulations could significantly 
and adversely affect regulatory approval and supplies of our product candidates. Our product candidates and any products that 
we may develop may compete with other product candidates and products for access to manufacturing facilities. There are a 
limited  number  of  manufacturers  that  operate  under  cGMP  regulations  and  that  might  be  capable  of  manufacturing  our 
products.

If  the  third  parties  that  we  engage  to  manufacture  product  for  our  preclinical  tests  and  clinical  trials  should  cease  to 
continue  to  do  so  for  any  reason,  we  likely  would  experience  delays  in  advancing  these  trials  while  we  identify  and  qualify 
replacement suppliers and we may be unable to obtain replacement supplies on terms that are favorable to us. In addition, if we 
are not able to obtain adequate supplies of our product candidates or the drug substances used to manufacture them, it will be 
more difficult for us to develop our product candidates and compete effectively.

Our current and anticipated future dependence upon others for the manufacture of our product candidates may adversely 
affect  our  future  profit  margins  and  our  ability  to  develop  product  candidates  and  commercialize  any  products  that  receive 
regulatory approval on a timely and competitive basis.

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We rely on third parties to conduct certain preclinical development activities and our clinical trials, and those third 
parties may not perform satisfactorily, including failing to meet deadlines for the completion of such trials.

We do not independently conduct clinical trials for our product candidates or certain preclinical development activities of 
our product candidates. We rely on third parties, such as CROs, clinical data management organizations, medical institutions 
and clinical investigators and collaboration partners, to perform these functions. Any of these third parties may terminate their 
engagements with us at any time. If we need to enter into alternative arrangements, it would delay our product development 
activities.

Our reliance on these third parties for certain preclinical and clinical development activities reduces our control over these 
activities  but  does  not  relieve  us  of  our  responsibilities.  For  example,  we  remain  responsible  for  ensuring  that  each  of  our 
clinical trials is conducted in accordance with the general investigational plan and protocols for the trial. Moreover, the FDA 
requires us to comply with standards, commonly referred to as Good Clinical Practices, or GCP, for conducting, recording and 
reporting  the  results  of  clinical  trials  to  assure  that  data  and  reported  results  are  credible  and  accurate  and  that  the  rights, 
integrity and confidentiality of trial participants are protected. We also are required to register certain ongoing clinical trials and 
post  the  results  of  completed  clinical  trials  on  a  government-sponsored  database,  ClinicalTrials.gov,  within  particular 
timeframes.  Failure  to  do  so  can  result  in  fines,  adverse  publicity  and  civil  and  criminal  sanctions.  Similar  GCP  and 
transparency  requirements  apply  in  the  E.U.  and  U.K.  Failure  to  comply  with  such  requirements,  including  with  respect  to 
clinical  trials  conducted  outside  the  E.U.,  U.K.  and  U.S.,  can  also  lead  regulatory  authorities  to  refuse  to  take  into  account 
clinical trial data submitted as part of an MAA.

Furthermore,  third  parties  that  we  rely  on  for  our  clinical  development  activities  may  also  have  relationships  with  other 
entities, some of which may be our competitors. If these third parties do not successfully carry out their contractual duties, meet 
expected deadlines or conduct our clinical trials in accordance with regulatory requirements or our stated protocols, we will not 
be able to obtain, or may be delayed in obtaining, marketing approvals for our product candidates and will not be able to, or 
may  be  delayed  in  our  efforts  to,  successfully  commercialize  our  product  candidates.  Our  product  development  costs  will 
increase if we experience delays in testing or obtaining marketing approvals.

We also rely on other third parties to obtain, store and distribute drug supplies for our preclinical development activities 
and clinical trials. In addition, in some instances we are required to purchase clinical supplies from our competitors, who may 
refuse to allow this purchase or do so at prohibitively high prices. Any performance failure on the part of our distributors or 
inability to secure supply from our competitors could delay preclinical and clinical development or marketing approval of our 
product  candidates  or  commercialization  of  our  products,  producing  additional  losses  and  depriving  us  of  potential  product 
revenue.

Extensions, delays, suspensions or terminations of our preclinical development activities or our clinical trials as a result of 
the performance of our independent clinical investigators and CROs will delay, and make more costly, regulatory approval for 
any  product  candidates  that  we  may  develop.  Any  change  in  a  CRO  during  an  ongoing  preclinical  development  activity  or 
clinical trial could seriously delay that trial and potentially compromise the results of the activity or trial.

We may not be successful in maintaining or establishing collaborations, which could adversely affect our ability to 
develop and, particularly in international markets, commercialize products.

We  are  collaborating  with  physicians,  academic  institutions,  hospitals,  patient  advocacy  groups,  foundations  and 
government agencies in order to assist with the development of our products and each of our product candidates. We plan to 
pursue similar activities in future programs and plan to evaluate the merits of retaining commercialization rights for ourselves 
or entering into selective collaboration arrangements with leading pharmaceutical or biotechnology companies. We also may 
seek to establish collaborations for the sales, marketing and distribution of our products in all or select geographies. If we elect 
to  seek  collaborators  in  the  future  but  are  unable  to  reach  agreements  with  suitable  collaborators,  we  may  fail  to  meet  our 
business objectives for the affected product or program. We face, and will continue to face, significant competition in seeking 
appropriate collaborators. Moreover, collaboration arrangements are complex and time consuming to negotiate, document and 
implement.  We  may  not  be  successful  in  our  efforts,  if  any,  to  establish  and  implement  collaborations  or  other  alternative 
arrangements. The terms of any collaboration or other arrangements that we establish, if any, may not be favorable to us.

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Any  collaboration  that  we  enter  into  may  not  be  successful.  The  success  of  our  collaboration  arrangements,  if  any,  will 
depend heavily on the efforts and activities of our collaborators. It is likely that any collaborators of ours will have significant 
discretion in determining the efforts and resources that they will apply to these collaborations. The risks that we may be subject 
to in possible future collaborations include the following:

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collaborators  have  significant  discretion  in  determining  the  efforts  and  resources  that  they  will  apply  to  these 
collaborations;

collaborators may not pursue development and commercialization of our product or product candidates or may 
elect  not  to  continue  or  renew  development  or  commercialization  programs,  based  on  clinical  trial  results, 
changes in the collaborators' strategic focus or available funding, or external factors such as an acquisition that 
diverts resources or creates competing priorities;

collaborators may delay clinical trials, provide insufficient funding for a clinical trial program, stop a clinical 
trial  or  abandon  a  product  candidate,  repeat  or  conduct  new  clinical  trials  or  require  a  new  formulation  of  a 
product candidate for clinical testing;

collaborators  could  independently  develop,  or  develop  with  third  parties,  products  that  compete  directly  or 
indirectly  with  our  products  or  product  candidates  if  the  collaborators  believe  that  competitive  products  are 
more  likely  to  be  successfully  developed  or  can  be  commercialized  under  terms  that  are  more  economically 
attractive than ours;

a  collaborator  with  marketing  and  distribution  rights  to  one  or  more  products  may  not  commit  sufficient 
resources to the marketing and distribution of such product or products;

collaborators  may  not  properly  maintain  or  defend  our  intellectual  property  rights  or  may  use  our  proprietary 
information in such a way as to invite litigation that could jeopardize or invalidate our intellectual property or 
proprietary information or expose us to potential liability;

collaborators may infringe the intellectual property rights of third parties, which may expose us to litigation and 
potential liability;

disputes may arise between the collaborator and us as to the ownership of intellectual property arising during 
the collaboration;

we may grant rights to our collaborators to be the holder of any marketing authorizations in a jurisdiction;

we may grant exclusive rights to our collaborators, which would prevent us from collaborating with others;

disputes  may  arise  between  the  collaborators  and  us  that  result  in  the  delay  or  termination  of  the  research, 
development  or  commercialization  of  our  products  or  product  candidates  or  that  result  in  costly  litigation  or 
arbitration that diverts management attention and resources; and

collaborations may be terminated and, if terminated, may result in a need for additional capital to pursue further 
development or commercialization of the applicable product candidates.

Collaboration agreements may not lead to development or commercialization of product candidates in the most efficient 
manner or at all. If a collaborator of ours were to be involved in a business combination, the continued pursuit and emphasis on 
our product development or commercialization program could be delayed, diminished or terminated.

Collaborations with pharmaceutical companies and other third parties often are terminated or allowed to expire by the other 
party. Such terminations or expirations may adversely affect us financially and could harm our business reputation in the event 
we elect to pursue collaborations that ultimately expire or are terminated.

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Materials  necessary  to  manufacture  our  product  or  product  candidates  may  not  be  available  on  commercially 
reasonable  terms,  or  at  all,  which  may  delay  the  development  and  commercialization  of  our  product  or  product 
candidates.

We currently rely on the manufacturers of our product and product candidates to purchase from third-party suppliers the 
materials necessary to produce the compounds for our preclinical studies, clinical trials, and commercial supply and we rely, or 
will  rely,  on  these  other  manufacturers  for  commercial  distribution  of  our  product  and,  if  and  when  we  obtain  marketing 
approval, for any of our product candidates. Suppliers may not sell these materials to our manufacturers at the time we need 
them  or  on  commercially  reasonable  terms  and  all  such  prices  are  susceptible  to  fluctuations  in  price  and  availability  due  to 
transportation costs, government regulations, price controls, geopolitical risk and changes in economic climate or other foreseen 
circumstances.  We  do  not  have  any  control  over  the  process  or  timing  of  the  acquisition  of  these  materials  by  our 
manufacturers. We may enter into agreements to purchase certain materials and provide them to our manufacturers, with all the 
risks  and  uncertainties  of  supply  associated  with  those  purchases.  If  we  or  our  manufacturers  are  unable  to  obtain  these 
materials  for  our  preclinical  studies  and  clinical  trials,  product  testing  and  potential  regulatory  approval  of  our  product 
candidates would be delayed, significantly impacting our ability to develop and commercialize our product candidates. If our 
manufacturers  or  we  are  unable  to  purchase  these  materials  for  commercial  distribution  of  our  product  or,  after  regulatory 
approval  has  been  obtained,  our  product  candidates,  the  commercial  launch  of  our  product  and  product  candidates  would  be 
delayed or there would be a shortage in supply, which would materially affect our ability to generate revenues from the sale of 
our product or product candidates.

Manufacturing 
commercialization.

issues  may  arise 

that  could 

increase  product  and  regulatory  approval  costs  or  delay 

Manufacturing  of  our  product  and  product  candidates  requires  us  or  our  manufacturing  partners  to  conduct  required 
stability and comparability testing. We or our partners may encounter product, packaging, equipment and process-related issues 
that  may  require  refinement  or  resolution  in  order  to  successfully  commercialize  our  product  and  proceed  with  our  planned 
clinical trials and obtain regulatory approval for commercial marketing of our product candidates. In the future, we may identify 
impurities,  which  could  result  in  increased  scrutiny  by  regulatory  authorities,  delays  in  our  clinical  programs  and  regulatory 
approval, increases in our operating expenses or failure to obtain or maintain approval for our product or product candidates.

We currently rely on WuXi Biologics Co., Ltd. ("Wuxi"), a company based in the People's Republic of China (the "PRC"), 
as  the  sole  supplier  of  our  biologic  product,  ATB200.  Accordingly,  there  is  a  risk  that  supplies  of  our  product  may  be 
significantly delayed by or may become unavailable as a result of manufacturing, equipment, process, regulatory or business-
related issues affecting that company. We may also face additional manufacturing and supply-chain risks due to the regulatory 
and political structure of the PRC, or as a result of the international relationship between the PRC and the U.S. or any of the 
other countries in which our products are marketed. In addition, the out-breaks of SARS, COVID-19 or other similar illnesses 
in the PRC could impact operations at Wuxi. Although currently there has been no impact on our ability to obtain supply of 
ATB200,  and  we  and  Wuxi  have  robust  mitigation  plans  in  place,  there  can  be  no  assurance  that  operations  would  not  be 
impacted in the future with a negative impact on supply of our product.

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We may encounter difficulties manufacturing our gene therapy which could impact timing and availability of clinical 
and commercial supply.

We  may  experience  delays  in  developing  a  sustainable,  reproducible  and  commercial-scale  manufacturing  process  or 
transferring  that  process  to  commercial  partners  for  our  gene  therapy  product  candidates.  There  is  intense  competition  for 
limited  commercial  manufacturing  capacity  in  gene  therapy  and  for  base  materials,  such  as  plasmids,  necessary  to  the 
manufacturing  of  gene  therapy  products.  We  do  not  currently  have  our  own  gene  therapy  manufacturing  capacity  and  rely 
instead on commercial manufacturing partners. These commercial manufacturing partners are expanding rapidly and there can 
be no assurance that needed capacity will be available or that these partners will continue to meet evolving regulatory standards. 
Any  delay  in  securing  supply  of  these  materials  and  the  manufacturing  slots  with  commercial  partners  may  prevent  us  from 
completing our clinical studies or commercializing our products on a timely or profitable basis, if at all. In addition, FDA and 
other  regulatory  bodies  are  continuing  to  evolve  their  guidance  for  gene  therapy  manufacturing  and  could  impose  rigorous 
requirements relating to the manufacturing and testing of clinical and commercial products that could add time, complexity and 
the risk that we or our manufacturing partners will be unable to meet these requirements.

Risks Related to our Financial Position

We  have  incurred  significant  losses  since  our  inception  and  anticipate  that  we  will  continue  to  incur  losses  in  the 
future.

To date, we have focused on developing and commercializing our first product, Galafold®, and our pipeline product AT-
GAA as well as our gene therapies. Investment in pharmaceutical product development is highly speculative because it entails 
substantial  upfront  capital  expenditures  and  significant  risk  that  a  product  candidate  will  fail  to  gain  regulatory  approval  or 
become commercially viable. Although the European Commission, PMDA and FDA have granted approval for Galafold®, for 
the  treatment  of  adults  with  a  confirmed  diagnosis  of  Fabry  disease  and  who  have  an  amenable  genetic  variant,  and  we  are 
generating product sales, we continue to incur significant research, development, commercialization and other expenses related 
to our ongoing operations. As a result, we are not profitable, have incurred losses in each period since our inception, and may 
never  be  profitable  on  a  non-GAAP  or  GAAP  basis.  For  the  year  ended  December  31,  2022,  we  have  a  net  loss  of  $236.6 
million, and we have an accumulated deficit of $2.5 billion at December 31, 2022.

We expect to continue to incur significant costs in the foreseeable future as we:

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continue  our  development  and  commercialization  of,  and  seek  regulatory  approvals  for,  product  candidates, 
including Galafold® and AT-GAA in the U.S., the E.U., U.K., Japan and other foreign countries, as applicable;

conduct  additional  clinical  trials  to  support  the  full  approval  of  Galafold®  in  the  U.S.  and  post-approval 
commitments or trials;

continue communicating with the EMA, as necessary, regarding post-marketing requirements and clinical trials 
for Galafold®;

continue to or initiate the regulatory submission process for marketing approval of Galafold® outside of the U.S. 
and E.U. and other foreign jurisdictions where approved, as applicable;

build and maintain our commercial infrastructure so that it is capable of supporting product sales, marketing and 
distribution of Galafold® and our other product candidates in Europe, Japan and the U.S. or other territories in 
which we have received or may receive regulatory approval;

prepare for launch of AT-GAA in the U.S., E.U., U.K. and other jurisdictions if approved by regulators;

continue our gene transfer discovery and next generation product research;

continue our preclinical studies of and potentially conduct clinical studies of ERT and gene therapy for CDD; 
and

continue our rigorous prosecution and defense of our patent portfolio. 

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We may encounter unforeseen expenses, difficulties, complications, delays, and other unknown factors that may adversely 
affect  our  business.  The  size  of  our  future  losses  will  depend,  in  part,  on  the  rate  of  future  growth  of  our  expenses  and  our 
ability to generate revenues. If any of our product candidates fails in clinical trials or does not gain regulatory approval, or if 
approved, fails to achieve market acceptance, we may never become profitable. Even if we achieve profitability in the future, 
we may not be able to sustain profitability in subsequent periods. Our prior losses and expected future losses have had and will 
continue to have an adverse effect on our stockholders' equity and working capital.

We may never become profitable even though we currently generate revenue from the sale of products.

We  began  the  commercial  launch  of  our  first  product,  Galafold®,  in  May  2016,  with  the  U.S.  and  Japan  commercial 
launches in 2018 and are now approved in over 40 countries. Our ability to generate material revenue and become profitable 
depends upon our ability to successfully commercialize our existing product and product candidates, or product candidates that 
we  may  in-license  or  acquire  in  the  future.  Even  if  we  are  able  to  successfully  achieve  regulatory  approval  for  our  product 
candidates, including AT-GAA, we do not know when any of these product candidates will generate revenue for us, if at all and 
we may not meet our current revenue, operating expense and profitability guidance. Our ability to generate revenue from our 
current or future product and product candidates depends on a number of factors, including our ability to:

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successfully  complete  development  activities  and  obtain  additional  regulatory  and  pricing  and  reimbursement 
approvals for, and continue to successfully commercialize, Galafold®;

complete  and  submit  regulatory  submissions  to  the  FDA,  EMA,  MHRA,  PDMA  and  others  and  obtain 
regulatory approval for AT-GAA;

develop and maintain a commercial organization capable of sales, marketing, and distribution for Galafold® and 
any product candidates we intend to market, including AT-GAA if approved, in the countries where we have 
chosen to commercialize the product candidates ourselves including the U.S. and Japan;

manufacture commercial quantities of our products at acceptable cost levels;

obtain a commercially viable price for our products;

obtain coverage and adequate reimbursement from third parties, including government payors;

successfully  satisfy  post-marketing  requirements  that  the  FDA,  EMA,  or  other  foreign  regulatory  authorities 
may  impose  for  Galafold®  or  any  of  our  other  product  candidates  that  may  receive  regulatory  approval, 
including pediatric trials and patient registries;

successfully develop or acquire new products and product candidates;

successfully complete development activities, including the necessary preclinical studies and clinical trials, with 
respect to product candidates; and

continue  to  navigate  any  adverse  impacts  of  the  COVID-19  outbreak,  including  due  to  actions  by  us, 
governments, our customers, our suppliers or other third parties to control the spread of COVID-19, or by other 
health epidemics or pandemics.

Even  if  we  are  able  to  generate  significant  revenues  from  the  sale  of  our  products  and  accurately  predict  and  control 
expenses, we may not reach our financial guidance or become profitable and may need to obtain additional funding to continue 
operations. If we fail to become profitable or are unable to sustain profitability on a continuing basis, then we may be unable to 
continue our operations at planned levels and be forced to reduce our operations.

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If we require substantial additional capital to fund our operations and we fail to obtain necessary financing, we may 
be  unable 
the  development  and  commercialization  of  our  product  and  development  and 
commercialization of our product candidates.

to  complete 

Our operations have consumed substantial amounts of cash. We expect to continue to spend substantial amounts to advance 
the  preclinical  and  clinical  development  of  our  product  candidates,  and  launch  and  commercialize  our  product  and  product 
candidates for which we may receive regulatory approval, including continuing to build our own commercial organization. We 
believe that our current cash position, including expected revenues, is sufficient to fund our operations and ongoing research 
programs  for  at  least  the  next  12  months.  Potential  impacts  of  the  COVID-19  pandemic,  future  business  development 
collaborations, pipeline expansion, and investment in manufacturing capabilities could impact our future capital requirements. 
However, we may require substantial additional capital for the development and commercialization of our product and further 
development and commercialization of our product candidates.

We  cannot  be  certain  that  additional  funding  will  be  available  on  acceptable  terms,  or  at  all.  If  we  are  unable  to  raise 

additional capital in sufficient amounts, when required or on acceptable terms, we could also be required to:

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significantly  delay,  scale  back,  or  discontinue  the  development  or  the  commercialization  of  our  product  or 
product candidates or one or more of our other research and development initiatives;

seek  collaborators  for  Galafold®,  AT-GAA  or  one  or  more  of  our  current  or  future  product  candidates  at  an 
earlier  stage  than  otherwise  would  be  desirable,  or  on  terms  that  are  less  favorable  than  might  otherwise  be 
available;

relinquish or license on unfavorable terms our rights to our technologies, product or product candidates that we 
otherwise would seek to develop or commercialize ourselves;

significantly curtail operations; or

enter into strategic partnerships on unfavorable terms, including sale of our assets for less than full value.

Our forecast of the period of time through which our financial resources will be adequate to support our operations is a 
forward-looking statement and involves risks and uncertainties, and actual results could vary as a result of a number of factors, 
including the factors discussed elsewhere in this "Risk Factors" section. We have based this estimate on assumptions that may 
prove  to  be  wrong,  and  we  could  utilize  our  available  capital  resources  sooner  than  we  currently  expect.  Our  future  funding 
requirements, both near and long-term, will depend on many factors, including, but not limited to:

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the  costs  of  commercialization  activities,  including  maintaining  sales,  marketing,  and  distribution  capabilities 
for Galafold® and any product candidates for which we may receive regulatory approval in regions where we 
choose to commercialize our products on our own, including AT-GAA;

the scope, progress, results, and costs of preclinical development, laboratory testing, and clinical trials for our 
product candidates and any other product candidates that we may in-license or acquire;

the  cost  of  manufacturing  drug  supply  for  our  preclinical  studies,  clinical  trials,  and  commercial  supply, 
including the significant cost of manufacturing AT-GAA and our gene therapies;

the outcome, timing, and cost of the regulatory approval process by the FDA, EMA, PMDA and other foreign 
regulatory  authorities,  including  the  potential  for  regulatory  authorities  to  delay  approvals  pending  site 
inspections or requiring that we perform more studies than those that we currently anticipate for our product and 
product candidates including AT-GAA;

the cost of filing, prosecuting, defending, and enforcing any patent claims and other intellectual property rights; 

the  cost  and  timing  of  completion  of  existing  or  expanded  commercial-scale  outsourced  manufacturing 
activities;

the cost of defending any claims asserted against us;

the cost of complying with new laws, rules or regulations in the geographies in which we operate;

the emergence of competing technologies and other adverse market developments;

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the impact of foreign exchange rates on our operating expenses and revenue projections; 

the extent to which we acquire or invest in additional businesses, products, and technologies.

Raising  additional  capital  may  cause  dilution  to  our  existing  stockholders,  restrict  our  operations,  or  require  us  to 
relinquish rights to our technologies, Galafold® or product candidates.

We may seek additional capital through a combination of private and public equity offerings, debt financings, receivables 
or  royalty  financings,  strategic  collaborations  and  alliances,  restructuring  and  licensing  arrangements.  We  have  an  effective 
“shelf” registration statement on Form S-3 that allows us to issue securities in registered offerings as well as an available at-the-
market financing facility that allows us to sell shares of our common stock through a placement agent at market prices.To the 
extent that we raise additional capital through the sale of equity or convertible debt securities, your ownership interest will be 
diluted,  and  the  terms  may  include  liquidation  or  other  preferences  that  adversely  affect  the  rights  of  existing  stockholders. 
Debt, receivables, and royalty financings may be coupled with an equity component, such as warrants to purchase stock, which 
could  also  result  in  dilution  of  our  existing  stockholders'  ownership.  The  incurrence  of  additional  indebtedness  beyond  our 
existing indebtedness with the Senior Secured Term Loan due 2026 could also result in increased fixed payment obligations and 
could also result in certain restrictive covenants, such as limitations on our ability to incur further debt, limitations on our ability 
to acquire or license intellectual property rights, and other operating restrictions that could have a material adverse effect on our 
ability to conduct our business and may result in liens being placed on our assets and intellectual property. If we were to default 
on any of our indebtedness, we could lose such assets and intellectual property. If we raise additional funds through strategic 
collaborations  and  alliances  and  licensing  arrangements  with  third  parties,  we  may  have  to  relinquish  valuable  rights  to 
Galafold®, AT-GAA or our other product candidates, or grant licenses on terms that are not favorable to us. If we are unable to 
raise additional funds through equity or debt financing when needed, we may be required to delay, limit, reduce or terminate 
our  product  development  or  commercialization  efforts  or  grant  rights  to  develop  and  market  our  technologies  that  we  would 
otherwise prefer to develop and market ourselves.

Servicing our debt requires a significant amount of cash, and we may not have sufficient cash flow from our business 
to pay our substantial debt.

In July 2020, we entered into the Senior Secured Term Loan due 2026 for a $400 million credit facility with Hayfin Capital 
Management, with an interest rate equal to 3-month LIBOR, subject to a 1% floor, plus 6.5% per annum that requires interest-
only payments until mid-2024 and matures in six years in 2026. We received net proceeds of $385.9 million in July 2020, after 
deducting fees and expenses. There were no warrants or equity conversion features associated with the Senior Secured Term 
Loan  due  2026.  The  Senior  Secured  Term  Loan  due  2026  contains  a  minimum  liquidity  covenant  of  $75  million,  tested 
monthly and in effect at all times, and an incremental minimum consolidated revenue covenant, measured as of the previous 
four consecutive fiscal quarters. The minimum consolidated revenue covenant ranges from $140 million, beginning March 31, 
2021, and peaks at $225 million by June 30, 2023, continuing at that level until the loan is repaid.

There  can  be  no  assurance  that  our  cash  and  cash  equivalents,  together  with  funds  generated  by  our  operations  and  any 
future financings, will be sufficient to satisfy our debt payment obligations or that we will have sufficient equity to satisfy these 
obligations.  Our  inability  to  generate  funds  obtain  financing  sufficient  to  satisfy  our  debt  payment  obligations  or  remain  in 
compliance with the debt covenants may result in such obligations being accelerated by our lenders, which would likely have a 
material adverse effect on our business, financial condition and results of operations.

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Foreign currency exchange rate fluctuations could harm our financial results.

We conduct operations in many countries involving transactions denominated in a variety of currencies other than the U.S. 
dollar.  The  majority  of  our  current  Galafold®  revenue  is  derived  from  outside  the  U.S.  Accordingly,  changes  in  the  value  of 
currencies  relative  to  the  U.S.  dollar  may  impact  our  consolidated  revenues  and  operating  results  due  to  transactional  and 
translational  remeasurement  that  is  reflected  in  our  earnings.  The  current  exposures  arise  primarily  from  cash,  accounts 
receivable,  intercompany  receivables  and  payables,  and  net  product  sales  denominated  in  foreign  currencies.  Fluctuations  in 
currency exchange rates have had, and will continue to have, an impact on our results as expressed in U.S. dollars. We are not 
currently  engaged  in  any  foreign  currency  hedging  activities  and  there  can  be  no  assurance  that  currency  exchange  rate 
fluctuations will not adversely affect our results of operations, financial condition and cash flows. In addition, our outlooks do 
not  assume  fluctuations  in  currency  exchange  rates.  Adverse  fluctuations  in  currency  exchange  rates  from  the  date  of  our 
outlooks  could  cause  our  actual  results  to  differ  materially  from  those  anticipated  in  our  outlooks  and  adversely  impact  our 
business, results of operations and financial condition.

We  also  face  risks  arising  from  the  imposition  of  exchange  controls  and  currency  devaluations.  Exchange  controls  may 
limit our ability to convert foreign currencies into U.S. dollars or to make payments by our foreign subsidiaries or businesses 
located  in  or  conducted  within  a  country  imposing  controls.  Currency  devaluations  result  in  a  diminished  value  of  funds 
denominated in the currency of the country instituting the devaluation.

Our ability to use our net operating loss carryforwards and certain other tax attributes may be limited.

As of December 31, 2022, we had federal and state net operating loss carry forwards ("NOLs") of approximately $1,183 
million and $992 million, respectively. The federal carry forward for losses generated prior to 2018 will expire in 2029 through 
2037. Federal net operating losses incurred in 2018 and onward have an indefinite expiration under the Tax Cuts and Jobs Act. 
Most  of  the  state  carry  forwards  generated  prior  to  2009  have  expired  through  2016.  The  remaining  state  carry  forwards 
including  those  generated  in  2009  through  2022  will  expire  in  2029  through  2040.  Utilization  of  NOLs  may  be  subject  to  a 
substantial  limitation  pursuant  to  Section  382  of  the  Internal  Revenue  Code  of  1986,  as  amended,  as  well  as  similar  state 
statutes in the event of an ownership change. Such ownership changes have occurred in the past, and could occur again in the 
future. Under Section 382 of the Internal Revenue Code of 1986, as amended, or Section 382, if a corporation undergoes an 
"ownership change," generally defined as a greater than 50% change (by value) in its equity ownership over a three-year period, 
the corporation's ability to use its pre-change NOLs and other pre-change tax attributes (such as research and development tax 
credits)  to  offset  its  post-change  income  may  be  limited.  We  may  experience  ownership  changes  in  the  future  as  a  result  of 
shifts in our stock ownership some of which are outside our control. We completed a detailed study of our NOLs for the tax 
year 2022 and determined that there was not an ownership change in excess of 50%. Ownership changes in future periods may 
place additional limits on our ability to utilize net operating loss and tax credit carry forwards. In addition, at the state level, 
there may be periods during which the use of NOLs is suspended or otherwise limited, which could accelerate or permanently 
decrease the amount of state attributes and increase state taxes owed.

Our  executive  officers,  directors  and  principal  stockholders  maintain  the  ability  to  exert  significant  influence  and 
control over matters submitted to our stockholders for approval.

Our executive officers, directors and affiliated stockholders beneficially own shares representing approximately 49% of our 
common stock as of December 31, 2022. As a result, if these stockholders were to choose to act together, they would be able to 
exert significant influence and control over matters submitted to our stockholders for approval, as well as our management and 
affairs. For example, these persons, if they choose to act together, could influence the election of directors and approval of any 
merger,  consolidation,  sale  of  all  or  substantially  all  of  our  assets  or  other  business  combination  or  reorganization.  This 
concentration  of  voting  power  could  delay  or  prevent  an  acquisition  of  us  on  terms  that  other  stockholders  may  desire.  The 
interests  of  this  group  of  stockholders  may  not  always  coincide  with  the  interests  of  other  stockholders,  and  they  may  act, 
whether by meeting or written consent of stockholders, in a manner that advances their best interests and not necessarily those 
of  other  stockholders,  including  obtaining  a  premium  value  for  their  common  stock,  and  might  affect  the  prevailing  market 
price for our common stock.

Because we do not anticipate paying any cash dividends on our capital in the foreseeable future, capital appreciation, 
if any, will be our stockholders sole source of gain.

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We have never declared or paid cash dividends on our capital stock. We currently intend to retain all of our future earnings, 
if  any,  to  finance  the  development  and  growth  of  our  business.  In  addition,  the  terms  of  any  future  debt  agreements  may 
preclude us from paying dividends. As a result, capital appreciation, if any, of our common stock will be our stockholders sole 
source of gain for the foreseeable future. 

Our disclosure controls and procedures may not prevent or detect all errors or acts of fraud.

We  are  subject  to  the  periodic  reporting  requirements  of  the  Exchange  Act.  Our  disclosure  controls  and  procedures  are 
designed to reasonably assure that information required to be disclosed by us in reports we file or submit under the Exchange 
Act is accumulated and communicated to management, recorded, processed, summarized and reported within the time periods 
specified  in  the  rules  and  forms  of  the  Securities  and  Exchange  Commission.  We  believe  that  any  disclosure  controls  and 
procedures, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives 
of the control system are met.

These inherent limitations reflect the reality that judgments can be faulty, and that breakdowns can occur because of simple 
error  or  mistake.  Additionally,  controls  can  be  circumvented  by  the  individual  acts  of  some  persons,  by  collusion  of  two  or 
more  people  or  by  an  unauthorized  override  of  the  controls.  Accordingly,  because  of  the  inherent  limitations  in  our  control 
system, misstatements due to error or fraud may occur and not be detected.

Risks Related to our Intellectual Property

If  we  are  unable  to  obtain  and  maintain  patent  protection  for  our  technology  and  products,  or  if  the  scope  of  the 
patent protection is not sufficiently broad, our competitors could develop and commercialize technology and products 
similar  or  identical  to  ours,  and  our  ability  to  successfully  commercialize  our  technology  and  products  may  be 
adversely affected.

Our success depends in large part on our ability to obtain and maintain patent protection in the U.S. and other countries 
with  respect  to  our  proprietary  technology  and  products.  We  seek  to  protect  our  proprietary  position  by  filing  patent 
applications in the U.S. and in certain foreign jurisdictions related to our novel technologies, product and product candidates 
that are important to our business. This process is expensive and time-consuming, and we may not be able to file and prosecute 
all necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that we will fail to 
identify patentable aspects of our research and development output before it is too late to obtain patent protection. Moreover, if 
we  license  technology  or  product  candidates  from  third  parties  in  the  future,  these  license  agreements  may  not  permit  us  to 
control  the  preparation,  filing  and  prosecution  of  patent  applications,  or  to  maintain  or  enforce  the  patents,  covering  this 
intellectual  property.  These  agreements  could  also  give  our  licensors  the  right  to  enforce  the  licensed  patents  without  our 
involvement, or to decide not to enforce the patents at all. Therefore, in these circumstances, these patents and applications may 
not be prosecuted and enforced in a manner consistent with the best interests of our business.

The patent position of biotechnology and pharmaceutical companies generally is highly uncertain, involves complex legal 
and factual questions and has in recent years been the subject of much litigation, including U.S. Hatch-Waxman litigation. As a 
result, the issuance, scope, validity, enforceability and commercial value of our patent rights are highly uncertain. Our pending 
and future patent applications may not result in patents being issued which protect our technology or products, in whole or in 
part, or which effectively prevent others from commercializing competitive technologies and products. Changes in either the 
patent laws or interpretation of the patent laws in the U.S. and other countries may diminish the value of our patents or narrow 
the scope of our patent protection.

The degree of future protection for our proprietary rights is uncertain, and we cannot ensure that:

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•

•

we or our licensors were the first to make the inventions covered by each of our pending patent applications;

we or our licensors were the first to file patent applications for these inventions;

others will not independently develop similar or alternative technologies or duplicate any of our technologies;

any patents issued to us or our licensors will provide a basis for commercially viable products, will provide us 
with any competitive advantages or will not be challenged by third parties;

licenses from other third parties will not be required to commercialize patented products;

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we will develop additional proprietary technologies that are patentable;

we will file patent applications for new proprietary technologies promptly or at all;

our patents will not expire prior to or shortly after commencing commercialization of a product;

the patents of others will not have a negative effect on our ability to do business;

patent authorities will not identify deficiencies in our patent applications and refuse to grant our patents; or

outcome  of  any  patent  litigation,  including  Hatch-Waxman  litigation  involving  Galafold®  or  AT-GAA,  will 
demonstrate that our patents are valid and enforceable. 

In addition, we cannot be assured that any of our pending patent applications will result in issued patents. In particular, we 
have filed patent applications in the U.S., the European Patent Office and other countries outside the U.S. that have not been 
issued as patents. These pending applications include, among others, some of the patent applications for AT-GAA, Galafold®, 
and our gene therapy platforms and product candidates. If patents are not issued in respect of our pending patent applications, 
we may not be able to stop competitors from marketing similar products in Europe and other countries in which we do not have 
issued patents.

In addition to patent protection outside of the U.S., we intend to seek orphan medicinal product designation of our product 
candidates  and  to  rely  on  statutory  data  exclusivity  provisions  in  jurisdictions  outside  the  U.S.  where  such  protections  are 
available, including Europe. The patent rights that we own or have licensed relating to our product candidates are limited in 
ways that may affect our ability to exclude third parties from competing against us if we obtain regulatory approval to market 
these product candidates. In particular:

•

•

We have multiple composition of matter patents covering Galafold® and multiple method of treatment patents 
issued  and  listed  in  the  Orange  Book.  We  have  composition  of  matter,  method  of  treatment,  method  of 
manufacture,  formulation  and  other  patents  issued  for  AT-GAA.  We  also  have  several  pending  applications 
covering  Galafold®,  AT-GAA  and  gene  therapy.  There  can  be  no  assurance  that  these  applications  will  be 
allowed  or  that  allowed  applications  will  be  issued  or  that  the  scope  of  such  patents,  if  they  issue,  will  be 
sufficient  to  protect  our  product.  Composition  of  matter  patents  can  provide  protection  for  pharmaceutical 
products to the extent that the specifically covered compositions are important. For our product candidates for 
which we do not hold composition of matter patents, competitors who obtain the requisite regulatory approval 
can  offer  products  with  the  same  composition  as  our  products  so  long  as  the  competitors  do  not  infringe  any 
method of use patents that we may hold.

For some of our product candidates the principal patent protection that covers or those we expect will cover our 
product candidate is a method of use patent. This type of patent only protects the product when used or sold for 
the specified method. However, this type of patent does not limit a competitor from making and marketing a 
product that is identical to our product that is labeled for an indication that is outside of the patented method, or 
for which there is a substantial use in commerce outside the patented method.

Moreover, physicians may prescribe such a competitive identical product for indications other than the one for which the 
product  has  been  approved,  or  off-label  indications,  that  are  covered  by  the  applicable  patents.  Although  such  off-label 
prescriptions may infringe or induce infringement of method of use patents, the practice is common and such infringement is 
difficult to prevent or prosecute.

The laws of foreign countries may not protect our rights to the same extent as the laws of the U.S. For example, European 
patent  law  restricts  the  patentability  of  methods  of  treatment  of  the  human  body  more  than  U.S.  law  does.  Certain  foreign 
jurisdictions may not recognize or enforce any patents granted or patent applications filed in those jurisdictions. In addition, we 
may  not  pursue  or  obtain  patent  protection  in  all  major  markets.  Assuming  the  other  requirements  for  patentability  are  met, 
currently, the first to file a patent application is generally entitled to the patent. However, prior to March 16, 2013, in the U.S., 
the first to invent was entitled to the patent. Publications of discoveries in the scientific literature often lag behind the actual 
discoveries, and patent applications in the U.S. and other jurisdictions are typically not published until 18 months after filing, or 
in some cases not at all. Therefore, we cannot know with certainty whether we were the first to make the inventions claimed in 
our patents or pending patent applications, or that we were the first to file for patent protection of such inventions.

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Moreover, we may be subject to a third-party pre-issuance submission of prior art to the U.S. Patent and Trademark Office 
or become involved in opposition, derivation, reexamination, inter partes review, post grant review, interference proceedings or 
other patent office proceedings or litigation, in the U.S. or elsewhere, challenging our patent rights or the patent rights of others, 
including  U.S.  Hatch-Waxman  litigation.  An  adverse  determination  in  any  such  submission,  proceeding  or  litigation  could 
reduce  the  scope  of,  or  invalidate,  our  patent  rights,  allow  third  parties  to  commercialize  our  technology  or  products  and 
compete directly with us, without payment to us, or result in our inability to manufacture or commercialize products without 
infringing  third-party  patent  rights.  In  addition,  if  the  breadth  or  strength  of  protection  provided  by  our  patents  and  patent 
applications is threatened, it could dissuade companies from collaborating with us to license, develop or commercialize current 
or future product candidates.

Even  if  our  patent  applications  issue  as  patents,  they  may  not  issue  in  a  form  that  will  provide  us  with  any  meaningful 
protection,  prevent  competitors  from  competing  with  us  or  otherwise  provide  us  with  any  competitive  advantage.  Our 
competitors  may  be  able  to  circumvent  our  owned  or  licensed  patents  by  developing  similar  or  alternative  technologies  or 
products in a non-infringing manner. In addition, other companies may attempt to circumvent any regulatory data protection or 
market  exclusivity  that  we  obtain  under  applicable  legislation,  which  may  require  us  to  allocate  significant  resources  to 
preventing such circumvention. Legal and regulatory developments in the E.U. and elsewhere may also result in clinical trial 
data  submitted  as  part  of  an  MAA  becoming  publicly  available.  Such  developments  could  enable  other  companies  to 
circumvent our intellectual property rights and use our clinical trial data to obtain marketing authorizations in the E.U. and in 
other jurisdictions. Such developments may also require us to allocate significant resources to prevent other companies from 
circumventing  or  violating  our  intellectual  property  rights.  Our  attempts  to  prevent  third  parties  from  circumventing  our 
intellectual property and other rights may ultimately be unsuccessful. We may also fail to take the required actions or pay the 
necessary fees to maintain our patents.

The  issuance  of  a  patent  is  not  conclusive  as  to  its  inventorship,  scope,  validity  or  enforceability,  and  our  owned  and 
licensed patents may be challenged in the courts or patent offices in the U.S. and abroad. Such challenges may result in loss of 
exclusivity or freedom to operate or in patent claims being narrowed, invalidated or held unenforceable, in whole or in part, 
which could limit our ability to stop others from using or commercializing similar or identical technology and products, or limit 
the duration of the patent protection of our technology and products. Given the amount of time required for the development, 
testing and regulatory review of new product candidates, patents protecting such candidates might expire before or shortly after 
such candidates are commercialized. As a result, our patent portfolio may not provide us with sufficient rights to exclude others 
from commercializing products similar or identical to ours.

Further,  litigation,  interferences,  oppositions,  inter  partes  reviews,  administrative  challenges  or  other  similar  types  of 
proceedings are, have been and may in the future be necessary in some instances to determine the validity and scope of certain 
of  our  proprietary  rights,  and  in  other  instances  to  determine  the  validity,  scope  or  non-infringement  of  certain  patent  rights 
claimed  by  third  parties  to  be  pertinent  to  the  manufacture,  use  or  sale  of  our  products.  We  may  also  face  challenges  to  our 
patent  and  regulatory  protections  covering  our  products  by  third  parties,  including  manufacturers  of  generics  and  biosimilars 
that  may  choose  to  launch  or  attempt  to  launch  their  products  before  the  expiration  of  our  patent  or  regulatory  exclusivity. 
Litigation,  interference,  oppositions,  inter  partes  reviews,  administrative  challenges  or  other  similar  types  of  proceedings  are 
unpredictable  and  may  be  protracted,  expensive  and  distracting  to  management.  The  outcome  of  such  proceedings  could 
adversely affect the validity and scope of our patent or other proprietary rights, hinder our ability to manufacture and market 
our  products,  require  us  to  seek  a  license  for  the  infringed  product  or  technology  or  result  in  the  assessment  of  significant 
monetary damages against us that may exceed amounts, if any, accrued in our financial statements. An adverse determination in 
a judicial or administrative proceeding or a failure to obtain necessary licenses could prevent us from manufacturing or selling 
our products. Furthermore, payments under any licenses that we are able to obtain would reduce our profits derived from the 
covered products and services.

Additionally, our products, or the technologies or processes used to formulate or manufacture those products may now, or 
in the future, infringe the patent rights of third parties. It is also possible that third parties will obtain patent or other proprietary 
rights  that  might  be  necessary  or  useful  for  the  development,  manufacture  or  sale  of  our  products.  We  may  need  to  obtain 
licenses for intellectual property rights from others and may not be able to obtain these licenses on commercially reasonable 
terms, if at all.

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We are currently and may become involved in lawsuits to protect or enforce our patents or other intellectual property, 
which could be expensive, time consuming and unsuccessful.

There  has  been,  and  we  expect  that  there  may  continue  to  be,  significant  litigation  in  the  industry  regarding  patents  and 
other intellectual property rights. Litigation, arbitrations, administrative proceedings and other legal actions with private parties 
and  governmental  authorities  concerning  patents  and  other  intellectual  property  rights  may  be  protracted,  expensive  and 
distracting to management. Competitors may sue us as a way of delaying the introduction of our drugs or to remove our drugs 
from the market. Any litigation, including litigation related to Abbreviated New Drug Applications, or ANDA, litigation related 
to  505(b)(2)  applications,  interference  proceedings  to  determine  priority  of  inventions,  derivations  proceedings,  inter  partes 
review, oppositions to patents in foreign countries, litigation against our collaborators or similar actions, may be costly and time 
consuming and could harm our business. We expect that litigation may be necessary in some instances to determine the validity 
and scope of certain of our proprietary rights. Litigation may be necessary in other instances to determine the validity, scope or 
non-infringement of certain patent rights claimed by third parties to be pertinent to the manufacture, use or sale of our products. 
Ultimately, the outcome of such litigation could adversely affect the validity and scope of our patent or other proprietary rights, 
hinder our ability to manufacture and market our products, or result in the assessment of significant monetary damages against 
us that may exceed amounts, if any, accrued in our financial statements.

To  the  extent  that  valid  present  or  future  third-party  patents  or  other  intellectual  property  rights  cover  our  drugs,  drug 
candidates or technologies, we or our strategic collaborators may seek licenses or other agreements from the holders of such 
rights in order to avoid or settle legal claims. Such licenses may not be available on acceptable terms, which may hinder our 
ability to, or prevent us from being able to, manufacture and market our drugs. Payments under any licenses that we are able to 
obtain would reduce our profits derived from the covered products.

As part of the approval process for Galafold®, FDA granted us a New Chemical Entity (“NCE”) exclusivity period during 
which  other  manufacturers’  applications  for  approval  of  generic  versions  of  our  product  will  not  be  approved.  Generic 
manufacturers may challenge the patents protecting products that have been granted NCE exclusivity one year prior to the end 
of  the  NCE  exclusivity  period.  Generic  manufacturers  have  sought  and  may  continue  to  seek  FDA  approval  for  a  similar  or 
identical drug through an abbreviated new drug application (“ANDA”), the application form typically used by manufacturers 
seeking approval of a generic drug. The sale of generic versions of Galafold® earlier than their patent expiration would have a 
significant negative effect on our revenues and results of operations. To seek approval for a generic version of a product having 
NCE status, a generic company may submit its ANDA to FDA four years after the branded product’s approval.

Starting  in  October  2022,  we  received  letters  from  Aurobindo  Pharma  Ltd.,  Lupin  Ltd.,  and  Teva  Pharmaceutical,  Inc. 
(collectively,  “generic  manufacturers”)  indicating  that  they  have  submitted  ANDAs  to  FDA  requesting  permission  to  market 
and manufacture generic versions of Galafold®. They have challenged the validity of all or some of the patents listed on the 
Orange  Book  associated  with  Galafold®.  We  filed  lawsuits  against  the  generic  manufacturers,  and  we  intend  to  enforce  and 
defend our intellectual property. Although we cannot predict with certainty the ultimate outcome of the foregoing actions, or 
any other litigation that we may have with generic manufacturers in the future, an adverse judgment could result in substantial 
monetary damages, including Galafold®’s lost revenues, and we may spend significant resources enforcing and defending our 
patents.  If  we  are  unsuccessful  in  these  lawsuits,  some  or  all  of  our  original  claims  in  the  patents  may  be  narrowed  or 
invalidated,  and  the  patent  protection  for  Galafold®  in  the  United  States  may  be  shortened.    Further,  if  all  the  patents  are 
invalidated, the FDA could approve the requests to manufacture a generic version of Galafold® in the United States prior to the 
expiration date of those patents.  Moreover, we may be forced to settle litigation on terms that are unfavorable and result in 
sales of generic versions of Galafold® prior to expiration of our patents.  The sale of generic version of Galafold® earlier than 
the  patent  expiration  would  have  a  significant  negative  effect  on  our  revenues,  projections  of  profitability  and  results  of 
operations.

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Third  parties  may  initiate  legal  proceedings  alleging  that  we  are  infringing  their  intellectual  property  rights,  the 
outcome of which would be uncertain and could have a material adverse effect on the success of our business.

Our research, development and commercialization activities, as well as any product candidates or products resulting from 
these  activities,  including  Galafold®  or  AT-GAA,  may  infringe  or  be  accused  of  infringing  one  or  more  claims  of  an  issued 
patent or may fall within the scope of one or more claims in a published patent application that may subsequently issue and to 
which we do not hold a license or other rights. 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 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, 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.

No  assurance  can  be  given  that  patents  do  not  exist,  have  not  been  filed,  or  could  not  be  filed  or  issued,  which  contain 
claims  covering  our  product  candidates,  technology  or  methods.  Because  of  the  number  of  patents  issued  and  patent 
applications filed in our field, we believe there is a risk that third parties may allege they have patent rights encompassing our 
product candidates, technology or methods.

If any of these patents were to be asserted against us, while we do not believe that our product candidates would be found 
to infringe any valid claim of such patents, there is no assurance that a court would find in our favor. If we were to challenge 
the  validity  of  any  issued  U.S.  patent  in  court,  we  would  need  to  overcome  a  presumption  of  validity  that  attaches  to  every 
patent. This burden is high and would require us to present clear and convincing evidence as to the invalidity of the patent's 
claims. There is no assurance that a court would find in our favor on infringement or validity. Furthermore, during the course of 
litigation,  confidential  information  may  be  disclosed  in  the  form  of  documents  or  testimony  in  connection  with  discovery 
requests, depositions or trial testimony. Disclosure of our confidential information and our involvement in intellectual property 
litigation could materially adversely affect our business.

In order to avoid or settle potential claims with respect to any patent rights of third parties, we may choose or be required to 
seek a license from a third party and be required to pay license fees or royalties or both. These licenses may not be available on 
acceptable terms, or at all. Even if we or our collaborators were able to obtain a license, the rights may be nonexclusive, which 
could  result  in  our  competitors  gaining  access  to  the  same  intellectual  property.  Ultimately,  we  could  be  prevented  from 
commercializing a product, or be forced to cease some aspect of our business operations, if, as a result of actual or threatened 
patent infringement claims, we are unable to enter into licenses on acceptable terms. This could harm our business significantly. 

There  has  been  substantial  litigation  and  other  proceedings  regarding  patent  and  other  intellectual  property  rights  in  the 
pharmaceutical  and  biotechnology  industries.  In  addition  to  infringement  claims  against  us,  we  may  become  a  party  to  other 
patent litigation and other proceedings, including interference proceedings declared by the U.S. Patent and Trademark Office 
and opposition proceedings in the European Patent Office, regarding intellectual property rights with respect to our products 
and technology. Even if we prevail, the cost to us of any patent litigation or other proceeding could be substantial.

Some of our competitors may be able to sustain the costs of complex patent litigation more effectively than we can because 
they have substantially greater resources. In addition, any uncertainties resulting from any litigation could significantly limit our 
ability to continue our operations. Patent litigation and other proceedings may also absorb significant management time.

We  may  be  subject  to  claims  by  third  parties  asserting  that  we  or  our  employees  have  misappropriated  their 
intellectual property, or claiming ownership of what we regard as our own intellectual property.

Many  of  our  employees  were  previously  employed  at  universities  or  other  biotechnology  or  pharmaceutical  companies, 
including  our  competitors  or  potential  competitors.  Although  we  try  to  ensure  that  our  employees  do  not  use  the  proprietary 
information or know-how of others in their work for us, we may be subject to claims that we or these employees have used or 
disclosed  intellectual  property,  including  trade  secrets  or  other  proprietary  information,  of  any  such  employee's  former 
employer. Litigation may be necessary to defend against these claims.

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In  addition,  while  we  typically  require  our  employees  and  contractors  who  may  be  involved  in  the  development  of 
intellectual property to execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such 
an agreement with each party who in fact develops intellectual property that we regard as our own. Our and their assignment 
agreements may not be self-executing or may be breached, and we may be forced to bring claims against third parties, or defend 
claims they may bring against us, to determine the ownership of what we regard as our intellectual property.

If  we  fail  in  prosecuting  or  defending  any  such  claims,  in  addition  to  paying  monetary  damages,  we  may  lose  valuable 
intellectual property rights or personnel. Even if we are successful in prosecuting or defending against such claims, litigation 
could result in substantial costs and be a distraction to management.

If we fail to comply with our obligations in our intellectual property licenses with third parties, we could lose license 
rights that are important to our business.

We  are  a  party  to  license  agreements  with  Nationwide  Children’s  Hospital  ("Nationwide  Children’s")  and  University  of 
Pennsylvania ("Penn") pursuant to which we license key intellectual property relating to our gene therapy product candidates. 
We expect to enter into additional licenses in the future. Our existing licenses impose, and we expect that future licenses will 
impose, various diligences, milestone payment, royalty, insurance and other obligations on us. If we fail to comply with these 
obligations, the licensor may have the right to terminate the license, in which event we might not be able to market any product 
that is covered by the licensed patents.

We have not yet registered our trademarks in all of our potential markets, and failure to secure those registrations 
could adversely affect our business.

Our trademark applications may not be allowed for registration, and our registered trademarks may not be maintained or 
enforced.  During  trademark  registration  proceedings,  we  may  receive  rejections.  Although  we  are  given  an  opportunity  to 
respond  to  those  rejections,  we  may  be  unable  to  overcome  such  rejections.  In  addition,  in  the  U.S.  Patent  and  Trademark 
Office  and  in  comparable  agencies  in  many  foreign  jurisdictions,  third  parties  are  given  an  opportunity  to  oppose  pending 
trademark applications and to seek to cancel registered trademarks. Opposition or cancellation proceedings may be filed against 
our trademarks, and our trademarks may not survive such proceedings. If we do not secure registrations for our trademarks, we 
may encounter more difficulty in enforcing them against third parties than we otherwise would.

Our  rights  to  develop  and  commercialize  our  gene  therapy  product  candidates  are  subject,  in  part,  to  the  terms  and 
conditions of licenses granted to us by others.

The  biotechnology  and  pharmaceutical  industries,  especially  in  the  gene  therapy  field,  are  characterized  by  rapidly 
changing technologies, significant competition and a strong emphasis on intellectual property. We face substantial competition 
from  many  different  sources,  including  large  and  specialty  pharmaceutical  and  biotechnology  companies,  academic  research 
institutions,  government  agencies  and  public  and  private  research  institutions.  We  are  aware  of  companies  focused  on 
developing  gene  therapies  in  various  indications  as  well  as  several  companies  addressing  other  methods  for  delivering  or 
modifying genes and regulating gene expression. Any advances in gene therapy technology made by a competitor may be used 
to develop therapies that could compete against any of our product candidates.

Many of our potential competitors, alone or with their strategic partners, have substantially greater financial, technical and 
other  resources  than  we  do,  such  as  larger  research  and  development,  clinical,  marketing  and  manufacturing  organizations. 
Mergers  and  acquisitions  in  the  biotechnology  and  pharmaceutical  industries  may  result  in  even  more  resources  being 
concentrated  among  a  smaller  number  of  competitors.  Our  commercial  opportunity  could  be  reduced  or  eliminated  if 
competitors develop and commercialize products that are safer, more effective, have fewer or less severe side effects, are more 
convenient or are less expensive than any products that we may develop. Competitors also may obtain FDA or other regulatory 
approval  for  their  products  more  rapidly  than  we  may  obtain  approval  for  ours,  which  could  result  in  our  competitors 
establishing  a  strong  market  position  before  we  are  able  to  enter  the  market.  Additionally,  technologies  developed  by  our 
competitors may render our potential product candidates uneconomical or obsolete, and we may not be successful in marketing 
our product candidates against competitors.

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In  addition  to  our  own  patents,  we  have  acquired  licenses  to  certain  patent  rights  and  proprietary  technology  from  third 
parties, including our current partners at Nationwide Children’s and Penn, that are important or necessary to the development of 
our  technology  and  products,  including  technology  related  to  our  manufacturing  process  and  our  gene  therapy  product  and 
product candidates. These and other licenses may not provide exclusive rights to use such intellectual property and technology 
in all relevant fields of use and in all territories in which we may wish to develop or commercialize our technology and products 
in  the  future.  As  a  result,  we  may  not  be  able  to  prevent  competitors  from  developing  and  commercializing  competitive 
products in territories included in all of our licenses. Licenses to additional third-party technology that may be required for our 
development programs may not be available in the future or may not be available on commercially reasonable terms, or at all, 
which could have a material adverse effect on our business, financial condition, results of operations and prospects.

Risks Related to the COVID-19 Pandemic

The  novel  coronavirus  ("COVID-19")  pandemic  and  efforts  to  reduce  its  spread  may  negatively  impact  our  business 
and operations.

The COVID-19 pandemic has substantially burdened healthcare systems worldwide which may impact progression of our 
clinical  trials,  development  and  manufacturing  of  our  product  and  product  candidates  and  continued  commercialization  of 
Galafold®.  Required  inspections  and  reviews  by  regulatory  agencies  may  also  be  delayed  due  to  the  focus  of  resources  on 
COVID-19 as well as travel and other restrictions. In October 2022, FDA informed us that it has deferred action on the AT-
GAA BLA, pending inspection of the proposed manufacturing site in China. The inspection has been delayed due to restrictions 
related  to  the  COVID-19  pandemic  and  although  now  scheduled,  we  do  not  know  whether  the  FDA  will  inspect  when 
scheduled, whether the situation on the ground in China will change, nor the outcome of those inspections. Significant delays in 
the timing of our clinical trials and in regulatory reviews could adversely affect our ability to commercialize some assets in our 
product pipeline. Lack of normal access by patients to the healthcare system, along with concern about the continued supply of 
medications, may result in changes in buying patterns throughout the supply chain, including by patients, which could increase 
or  decrease  demand  for  our  products.  COVID-19  could  also  have  an  adverse  impact  on  our  supply  chain  and  distribution 
systems, which could impact our ability to distribute our products and the ability of third parties on which we rely to fulfill their 
obligations to us, increase our expenses and have a material adverse effect on our ability to generate revenue. In addition, the 
conditions  created  by  the  pandemic  may  intensify  other  risks  inherent  in  our  business,  including,  among  other  things,  risks 
related to drug pricing and access, intellectual property protection, product safety and efficacy concerns, product liability and 
other litigation, and the impact of adverse global and local economic conditions.

Risks Related to Employment, Environmental, Social and Governance Matters

Our future success depends on our ability to retain our Chief Executive Officer and other key personnel and to attract, 
retain and motivate qualified personnel.

We are highly dependent on Bradley L. Campbell, our President and Chief Executive Officer, Daphne Quimi, our Chief 
Financial  Officer,  and  John  F.  Crowley,  our  Executive  Chairman,  each  of  whom  has  significant  pharmaceutical  industry 
experience. The loss of the services of any of these individuals might impede the achievement of our research, development and 
commercialization  objectives  and  materially  adversely  affect  our  business  and  we  may  not  be  able  to  replace  them  with 
candidates with similar background and experience in the event of the loss of their services. We do not maintain "key person" 
insurance on Mr. Campbell or on any of our other key personnel.

Recruiting and retaining qualified scientific, clinical and sales and marketing personnel will also be critical to our success, 
including for our Global Headquarters in Philadelphia. In addition, maintaining a qualified finance and legal department is key 
to our ability to meet our regulatory obligations as a public company and important in any potential capital raising activities. 
Our industry has experienced a high rate of turnover in recent years. We may not be able to attract and retain these personnel on 
acceptable terms given the competition among numerous pharmaceutical and biotechnology companies for similar personnel, 
particularly in New Jersey and Philadelphia and their surrounding areas. Although we believe we offer competitive salaries and 
benefits, we may have to increase spending in order to retain personnel. If we fail to retain our remaining qualified personnel or 
replace them when they leave, we may be unable to recruit replacements nor continue our development and commercialization 
activities.

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In addition, we rely on consultants and advisors, including scientific and clinical advisors, to assist us in formulating our 
research and development and commercialization strategy. Our consultants and advisors may be employed by employers other 
than us and may have commitments under consulting or advisory contracts with other entities that may limit their availability to 
us.

We  expect  to  expand  our  development,  regulatory  and  sales  and  marketing  capabilities,  and  as  a  result,  we  may 
encounter difficulties in managing our growth, which could disrupt our operations.

As of December 31, 2022, we had 484 full-time employees. As our development and commercialization strategies develop, 
we  will  need  additional  managerial,  operational,  sales,  marketing,  financial,  technical  operations  and  other  resources.  Our 
management, personnel and systems currently in place may not be adequate to support this future growth. We may not be able 
to  effectively  manage  the  expansion  of  our  operations,  which  may  result  in  weaknesses  in  our  infrastructure,  give  rise  to 
operational mistakes, loss of business opportunities, loss of employees and reduced productivity among remaining employees. 
Future growth could require significant capital expenditures and may divert financial resources from other projects, such as the 
development  of  our  existing  or  future  product  candidates  and  we  may  not  be  able  to  replace  key  personnel  in  the  event  of 
turnover. Future growth would impose significant added responsibilities on members of management, including:

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managing the development and commercialization of any product candidates approved for marketing;

overseeing our ongoing preclinical studies and clinical trials effectively;

identifying,  recruiting,  maintaining,  motivating  and  integrating  additional  employees,  including  any  sales  and 
marketing personnel engaged in connection with the commercialization of any approved product;

managing  our  internal  development  efforts  effectively  while  complying  with  our  contractual  obligations  to 
licensors, licensees, contractors and other third parties;

managing our collaboration partners and associated joint steering committees;

managing any clinical or commercial collaborations with third parties;

improving our managerial, development, operational and financial systems and procedures;

monitoring and improving diversity, inclusion and pay-equity initiatives;

developing  our  compliance  infrastructure  and  processes  to  ensure  compliance  with  regulations  applicable  to 
public companies;

developing biologics and gene therapy manufacturing expertise; and

expanding our facilities.

As our operations expand, we will need to manage additional relationships with various strategic collaborators, suppliers 
and  other  third  parties.  Our  future  financial  performance  and  our  ability  to  commercialize  our  product  candidates  and  to 
compete effectively will depend, in part, on our ability to manage any future growth effectively. To that end, we must be able to 
manage  our  development  efforts  and  clinical  trials  effectively  and  hire,  train  and  integrate  additional  management, 
administrative and sales and marketing personnel. We may not be able to accomplish these tasks, and our failure to accomplish 
any of them could prevent us from successfully growing our company.

Our  employees,  independent  contractors,  principal  investigators,  CROs,  consultants  and  vendors  may  engage  in 
misconduct or other improper activities, including noncompliance with regulatory standards and requirements, which 
could cause significant liability for us and harm our reputation.

We  are  exposed  to  the  risk  that  our  employees,  independent  contractors,  principal  investigators,  CROs,  consultants  and 
vendors  may  engage  in  fraudulent  conduct,  harassment  or  other  illegal  activity.  Misconduct  by  these  parties  could  include 
intentional, reckless and/or negligent conduct or disclosure of unauthorized activities to us that violates:

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FDA or similar regulations of foreign regulatory authorities, including those laws requiring the reporting of true, 
complete and accurate information to such authorities;

manufacturing standards;

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federal  and  state  healthcare  fraud  and  abuse  laws  and  regulations,  anti-bribery  and  corruption  laws,  anti-
discrimination  and  harassment  laws,  privacy  and  similar  laws  and  regulations  established  and  enforced  by 
foreign regulatory authorities; or

laws that require the reporting of financial information or data accurately.

In  particular,  sales,  marketing  and  business  arrangements  in  the  healthcare  industry  are  subject  to  extensive  laws  and 
regulations intended to prevent fraud, kickbacks, self-dealing, bribery and corruption and other abusive practices. These laws 
and  regulations  may  restrict  or  prohibit  a  wide  range  of  pricing,  discounting,  marketing  and  promotion,  sales  commission, 
customer incentive programs and other business arrangements. Activities subject to these laws also involve the improper use of 
information  obtained  in  the  course  of  clinical  trials,  which  could  result  in  regulatory  sanctions  and  serious  harm  to  our 
reputation.  We  have  adopted  a  Code  of  Business  Conduct  and  Ethics,  a  robust  Enterprise  Risk  Management  Program,  and 
conduct  comprehensive  training,  but  it  is  not  always  possible  to  identify  and  deter  misconduct  by  employees  and  other  third 
parties,  and  the  precautions  we  take  to  detect  and  prevent  this  activity  may  not  be  effective  in  controlling  unknown  or 
unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a 
failure to be in compliance with such laws or regulations. If any such actions are instituted against us, and we are not successful 
in defending ourselves or asserting our rights, those actions could have a material adverse effect on our business and results of 
operations, including the imposition of civil, criminal and administrative penalties, damages, monetary fines, possible exclusion 
from participation in healthcare programs, contractual damages, reputational harm, diminished profits and future earnings, and 
curtailment of our operations, any of which could have a material adverse effect on our ability to operate our business and our 
results of operations.

If  our  enterprise  risk  program,  global  risk  committee  and  other  compliance  methods  are  not  effective,  our  business, 
financial condition and operating results may be adversely affected

Our  ability  to  identify,  manage  and  respond  to  the  various  risks  related  to  our  business  is  largely  dependent  on  our 
established and maintained compliance, risk, audit and reporting systems and procedures. The Board of Directors has ultimate 
responsibility for risk oversight of the Company and carries out this duty through its Committees. Our Audit and Compliance 
Committee,  Nominating  and  Corporate  Governance  Committee,  Compensation  and  Leadership  Development  Committee  and 
Science  and  Technology  Committee  have  each  been  delegated  oversight  authority  by  the  Board  of  Directors  with  respect  to 
issues in their applicable areas of expertise. These committees are responsible for identifying, monitoring and reporting areas of 
concern to the full Board of Directors. At the Company level, our senior management team similarly monitors risk through the 
Global Risk Committee. Membership of the Global Risk Committee consists primarily of key department heads who are asked 
to bring to such committee relevant items for discussion that they or their teams have identified at the numerous sub-committees 
these  individuals  chair  or  attend.  The  Global  Risk  Committee  then  uses  this  information  to  develop  an  Enterprise  Risk 
Management  Program,  which  identifies  key  risks  and  mitigation  strategies  and  which  is  reported  directly  to  the  Audit  and 
Compliance  Committee  on  a  quarterly  basis,  and  to  the  full  Board  of  Directors  on  a  yearly  basis.  Our  international  business 
segment also has its own companion committee which operates in substantially the same way as the Global Risk Committee 
and reports key risks to the Global Risk Committee for inclusion in the Enterprise Risk Management Program.

If our policies, procedures, and compliance systems, including our Enterprise Risk Management Program and the Global 
Risk Committee are not effective, or if we are not successful in monitoring or evaluating the risks to which we are or may be 
exposed, our business, reputation, financial condition and operating results could be materially adversely affected. We cannot 
provide  assurance  that  our  policies  and  procedures  will  always  be  effective,  or  that  our  management,  the  Enterprise  Risk 
Management Program or the Global Risk Committee would be able to identify any such ineffectiveness. If our compliance and 
risk management strategies are not effective, our business, financial condition and operating results may be adversely affected.

Our business and reputation may be adversely affected by environmental, social and governance matters.

Companies are being increasingly judged by not just their financial performance, but also by their performance on a variety 
of environmental, social and governance (“ESG”) matters. These matters include, among others, (i) the company’s efforts and 
contributions to or impacts on climate change and human rights matters, (ii) ethics and compliance with law, (iii) diversity and 
inclusion, and (iv) the role of the company’s board of directors in supervising various sustainability issues. Additionally, in the 
healthcare, pharmaceutical and life sciences industries, the public’s ability to access our medicines is of particular importance.

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Investment in funds that specialize in companies that perform well in ESG assessments are increasingly popular, and major 
institutional  investors  and  advisors  have  publicly  emphasized  the  importance  of  ESG  measures  to  their  investment  decisions 
and recommendations. Investors who are focused on ESG matters may seek enhanced ESG disclosures or to implement policies 
adverse  to  our  business,  and  there  can  be  no  assurances  that  stockholders  will  not  advocate,  via  proxy  contests,  media 
campaigns  or  other  public  or  private  means,  for  us  to  make  corporate  governance  changes  or  engage  in  certain  corporate 
actions. 

Additionally, there can be no certainty that we will successfully navigate or manage ESG issues or that we will successfully 
meet society’s expectations as to our proper role in the economy at large or as a global citizen. Any failure or perceived failure 
by us in this regard could have a material adverse effect on our reputation with governments, customers, employees, other third 
parties and the communities and industries in which we operate and on our business, share price, financial condition, access to 
capital or results of operations, including the sustainability of our business over time.

General Risk Factors

Our business and operations would suffer in the event of computer system failures or security breaches.

Despite  the  implementation  of  security  measures,  our  internal  computer  systems,  and  those  of  our  CROs,  contract 
manufacturing  organizations  and  other  third  parties  on  which  we  rely,  are  vulnerable  to  damage  from  computer  viruses, 
unauthorized access, ransomware attacks and other security breaches, natural disasters, terrorism, war and telecommunication 
and  electrical  failures.  System  failures,  accidents  or  security  breaches  could  cause  interruptions  in  our  operations  and  could 
result  in  a  material  disruption  of  our  clinical  activities  and  business  operations,  in  addition  to  possibly  requiring  substantial 
expenditures of resources to remedy. If such an event were to occur and cause interruptions in our operations, it could result in a 
material disruption of our commercialization of our product and our product candidate development programs. For example, the 
loss of clinical trial data from completed or ongoing clinical trials could result in delays in our regulatory approval efforts and 
significantly increase our costs to recover or reproduce the data. To the extent that any disruptions or security breach were to 
result in a loss or damage to our data or applications, or inappropriate disclosure of confidential or proprietary information, we 
could incur significant unexpected losses, expenses and liabilities, we could face litigation or suffer reputational harm and the 
further development of our product candidates could be delayed.

We  may  acquire  or  divest  assets  or  businesses,  or  form  collaborations  or  make  investments  in  other  companies  or 
technologies that could harm our operating results, dilute our stockholders' ownership, increase our debt, or cause us to 
incur significant expense.

As part of our business strategy, we may continue to pursue acquisitions or licenses of assets or businesses, or strategic 
alliances and collaborations, to expand our existing technologies and operations, such as our acquisition of Celenex in 2018 and 
license  agreement  with  Penn  in  2022.  We  may  not  identify  or  complete  these  transactions  in  a  timely  manner,  on  a  cost-
effective  basis,  or  at  all,  and  we  may  not  realize  the  anticipated  benefits  of  any  such  transaction,  any  of  which  could  have  a 
detrimental  effect  on  our  financial  condition,  results  of  operations,  and  cash  flows.  We  may  not  be  able  to  find  suitable 
acquisition  or  licensing  candidates,  and  if  we  make  any  acquisitions,  we  may  not  be  able  to  integrate  these  acquisitions 
successfully  into  our  existing  business  and  we  may  incur  additional  debt  or  assume  unknown  or  contingent  liabilities  in 
connection therewith. Integration of an acquired company or assets may also disrupt ongoing operations, require the hiring of 
additional  personnel  and  the  implementation  of  additional  internal  systems  and  infrastructure,  especially  the  acquisition  of 
commercial assets, and require management resources that would otherwise focus on developing our existing business. We may 
not  be  able  to  find  suitable  collaboration  partners  or  identify  other  investment  opportunities,  and  we  may  experience  losses 
related to any such investments.

To  finance  any  acquisitions,  licenses  or  collaborations,  we  may  choose  to  issue  debt  or  shares  of  our  common  stock  as 
consideration. Any such issuance of shares would dilute the ownership of our stockholders. If the price of our common stock is 
low or volatile, we may not be able to acquire other assets or companies or fund a transaction using our stock as consideration. 
Alternatively,  it  may  be  necessary  for  us  to  raise  additional  funds  for  acquisitions  through  public  or  private  financings. 
Additional funds may not be available on terms that are favorable to us, or at all.

In addition, we may divest or license all or a portion of certain businesses and/or facilities, joint venture or minority equity 
investment interests, subsidiaries, distributorships, or product categories, which could cause a decline in revenue or profitability 
and  may  make  our  financial  results  more  volatile.  We  may  be  unable  to  complete  any  such  divestiture  or  license  on  terms 

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favorable to us, within the expected timeframes, or at all. We may have continued financial exposure to divested or licensed 
businesses  following  the  completion  of  any  such  transaction,  including  increased  costs  due  to  potential  litigation,  contingent 
liabilities  and  indemnification  of  the  buyer  or  licensee  related  to,  among  other  things,  lawsuits,  regulatory  matters  or  tax 
liabilities. Such divestitures or licenses may also divert management’s attention from our core businesses and lead to potential 
issues with employees, customers or suppliers.

Provisions in our corporate charter documents and under Delaware law could make an acquisition of us, which may be 
beneficial  to  our  stockholders,  more  difficult  and  may  prevent  attempts  by  our  stockholders  to  replace  or  remove  our 
current management.

Provisions in our corporate charter and our bylaws may discourage, delay or prevent a merger, acquisition or other change 
in  control  of  us  that  stockholders  may  consider  favorable,  including  transactions  in  which  our  stockholders  might  otherwise 
receive  a  premium  for  their  shares.  These  provisions  could  also  limit  the  price  that  investors  might  be  willing  to  pay  in  the 
future for shares of our common stock, thereby depressing the market price of our common stock. In addition, these provisions 
may  frustrate  or  prevent  any  attempts  by  our  stockholders  to  replace  or  remove  our  current  management  by  making  it  more 
difficult  for  stockholders  to  replace  members  of  our  board  of  directors.  Because  our  board  of  directors  is  responsible  for 
appointing  the  members  of  our  management  team,  these  provisions  could  in  turn  affect  any  attempt  by  our  stockholders  to 
replace current members of our management team. Among others, these provisions:

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establish a classified board of directors, and, as a result, not all directors are elected at one time;

allow the authorized number of our directors to be changed only by resolution of our board of directors;

limit the manner in which stockholders can remove directors from our board of directors;

establish  advance  notice  requirements  for  stockholder  proposals  that  can  be  acted  on  at  stockholder  meetings 
and nominations to our board of directors;

require that stockholder actions must be effected at a duly called stockholder meeting and prohibit actions by 
our stockholders by written consent;

limit who may call stockholder meetings;

authorize our board of directors to issue preferred stock, without stockholder approval, which could be used to 
institute a "poison pill" that would work to dilute the stock ownership of a potential hostile acquirer, effectively 
preventing acquisitions that have not been approved by our board of directors; and

require the approval of the holders of at least 67% of the outstanding voting stock to amend or repeal certain 
provisions of our charter or bylaws.

Moreover, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware 
General Corporation Law, which prohibits a person who owns in excess of 15% of our outstanding voting stock from merging 
or combining with us for a period of three years after the date of the transaction in which the person acquired in excess of 15% 
of our outstanding voting stock, unless the merger or combination is approved in a prescribed manner.

Unfavorable  global  economic  conditions,  whether  brought  about  by  material  global  crises,  health  epidemics,  military 
conflicts or war, geopolitical and trade disputes or other factors, may adversely affect our business and financial results.

Our business is sensitive to global economic conditions, which can be adversely affected by public health crises (including 
the  COVID-19  pandemic)  and  epidemics,  political  and  military  conflict,  trade  and  other  international  disputes,  significant 
natural disasters (including as a result of climate change) or other events that disrupt macroeconomic conditions.

For  example,  trade  policies  and  geopolitical  disputes  (including  as  a  result  of  China-Taiwan  relations)  and  other 
international  conflicts  can  result  in  tariffs,  sanctions  and  other  measures  that  restrict  international  trade,  and  can  materially 
adversely affect our business, particularly if these measures occur in regions where we source our components or raw materials. 
For example, tensions between the United States and China have led to a series of tariffs being imposed by the United States on 
imports  from  China  mainland,  as  well  as  other  business  restrictions.  Tariffs  increase  the  costs  of  the  components  and  raw 
materials we source. Countries may also adopt other measures, such as controls on imports or exports of goods, technology or 
data, that could adversely impact the Company’s operations and supply chain. 

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Further,  military  conflicts  or  wars  (such  as  the  ongoing  conflict  between  Russia  and  Ukraine)  can  cause  exacerbated 
volatility and disruptions to various aspects of the global economy. The uncertain nature, magnitude, and duration of hostilities 
stemming from such conflicts, including the potential effects of sanctions and counter-sanctions, or retaliatory cyber-attacks on 
the world economy and markets, have contributed to increased market volatility and uncertainty, which could have an adverse 
impact on macroeconomic factors that affect our business and operations.

The price of our common stock may be volatile and fluctuate substantially, which could result in substantial losses for 
purchasers of our common stock.

The market price of our common stock is highly volatile and may be subject to wide fluctuations in response to numerous 
factors, some of which are beyond our control. In addition to the factors discussed in this Annual Report on Form 10-K, these 
factors include:

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the success of competitive products or technologies;

regulatory  actions  with  respect  to  our  product  or  product  candidates  or  our  competitors'  products  or  product 
candidates;

actual or anticipated changes in our growth rate relative to our competitors;

the outcome of any patent infringement or other litigation that may be brought against us;

announcements  by  us  or  our  competitors  of  significant  acquisitions,  strategic  collaborations,  joint  ventures, 
collaborations or capital commitments;

results of clinical trials of our product candidates or those of our competitors;

regulatory or legal developments in the E.U., U.K., U.S. and other countries;

developments or disputes concerning patent applications, issued patents or other proprietary rights;

the recruitment or departure of key personnel;

the level of expenses related to our product or any of our product candidates or clinical development programs;

actual or anticipated variations in our quarterly operating results;

the number and characteristics of our efforts to in-license or acquire additional product candidates or products;

introduction of new products or services by us or our competitors;

failure to meet the estimates and projections of the investment community or that we may otherwise provide to 
the public;

actual or anticipated changes in estimates as to financial results, development timelines or recommendations by 
securities analysts;

variations in our financial results or those of companies that are perceived to be similar to us;

fluctuations in the valuation of companies perceived by investors to be comparable to us;

share price and volume fluctuations attributable to inconsistent trading volume levels of our shares;

announcement or expectation of additional financing efforts;

sales of our common stock by us, our insiders or our other stockholders;

changes in accounting practices;

lawsuits and other claims asserted against us;

changes in the structure of healthcare payment systems;

market conditions in the pharmaceutical and biotechnology sectors;

general economic, industry and market conditions;

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publication  of  research  reports  about  us,  our  competitors  or  our  industry,  or  positive  or  negative 
recommendations or withdrawal of research coverage by securities or industry analysts;

other events or factors, many of which are beyond our control; and

the other factors described in this "Risk Factors" section.

In addition, the stock market in general, and pharmaceutical and biotechnology companies in particular, have experienced 
extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance of these 
companies. Broad market and industry factors may negatively affect the market price of our common stock, regardless of our 
actual operating performance. The realization of any of the above risks or any of a broad range of other risks stated above could 
have a material adverse effect on the market price of our common stock.

As we operate in the pharmaceutical and biotechnology industry, we are especially vulnerable to these factors to the extent 
that  they  affect  our  industry  or  our  products.  In  the  past,  securities  class  action  litigation  has  often  been  initiated  against 
companies following periods of volatility in their stock price. This type of litigation could result in substantial costs and divert 
our management's attention and resources, and could also require us to make substantial payments to satisfy judgments or to 
settle litigation.

A significant portion of our total outstanding shares may be sold into the market. This could cause the market price of 
our common stock to drop significantly, even if our business is doing well.

Sales of a substantial number of shares of our common stock in the public market could occur at any time. These sales, or 
the perception in the market that the holders of a large number of shares intend to sell shares, could reduce the market price of 
our  common  stock.  Certain  holders  of  our  common  stock  have  rights,  subject  to  some  conditions,  to  require  us  to  file 
registration statements covering their shares or to include their shares in registration statements that we may file for ourselves or 
other stockholders. We also have registered on a Form S-8 registration statement all shares of common stock that we may issue 
under our equity compensation plans. As a result, these shares can be freely sold in the public market upon issuance, subject to 
volume limitations applicable to affiliates. In addition, certain of our employees, executive officers and directors have entered 
into,  or  may  enter  into,  Rule  10b5-1  plans  providing  for  sales  of  shares  of  our  common  stock  from  time  to  time.  Under  a 
Rule  10b5-1  plan,  a  broker  executes  trades  pursuant  to  parameters  established  by  the  employee,  director  or  officer  when 
entering into the plan, without further direction from the employee, officer or director. A Rule 10b5-1 plan may be amended or 
terminated  in  some  circumstances.  Our  employees,  executive  officers  and  directors  may  also  buy  or  sell  additional  shares 
outside  of  a  Rule  10b5-1  plan  when  they  are  not  in  possession  of  material,  nonpublic  information.  In  September  2021,  we 
entered into a securities purchase agreement an investor for the private placement of, among other things, pre-funded warrants 
to purchase an aggregate of 8,349,705 shares of common stock, at a purchase price of $10.17 per pre-funded warrant. Each pre-
funded warrant has an initial exercise price of $0.01 per share and is exercisable at any time after its original issuance at the 
option of each holder, in such holder’s discretion, by (i) payment in full in immediately available funds of the initial exercise 
price  for  the  number  of  shares  of  common  stock  purchased  upon  such  exercise  or  (ii)  a  cashless  exercise,  in  which  case  the 
holder would receive upon such exercise the net number of shares of common stock determined according to the formula set 
forth in the pre-funded warrant. Finally, in November 2022, we announced an "at the market offering" under which we may 
offer and sell shares of our common stock having an aggregate offering amount of up to $250,000,000.

We  may  fail  to  qualify  for  continued  listing  on  The  NASDAQ  Global  Market  which  could  make  it  more  difficult  for 
investors to sell their shares.

Our  common  stock  is  listed  on  The  NASDAQ  Global  Market,  or  NASDAQ.  As  a  NASDAQ  listed  company,  we  are 
required to satisfy the continued listing requirements of NASDAQ for inclusion in the Global Market to maintain such listing, 
including, among other things, the maintenance of a minimum closing bid price of $1.00 per share and stockholders' equity of at 
least  $10.0  million.  There  can  be  no  assurance  that  we  will  be  able  to  maintain  compliance  with  the  continued  listing 
requirements or that our common stock will not be delisted from NASDAQ in the future. If our common stock is delisted by 
NASDAQ, we could face significant material adverse consequences, including:

•

•

a limited availability of market quotations for our securities;

reduced liquidity with respect to our securities;

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•

•

•

a determination that our shares are a "penny stock," which will require brokers trading in our shares to adhere to 
more stringent rules, possibly resulting in a reduced level of trading activity in the secondary trading market for 
our shares;

a limited amount of news and analyst coverage for our company; and

a decreased ability to issue additional securities or obtain additional financing in the future.

If securities or industry analysts do not publish research or reports or publish unfavorable research about our business, 
the price of our common stock and trading volume could decline.

The trading market for our common stock depends in part on the research and reports that securities or industry analysts 
publish about us or our business. If securities or industry analysts do not initiate or continue coverage of us, the trading price for 
our common stock would be negatively affected. In the event we obtain securities or industry analyst coverage, if one or more 
of the analysts who covers us downgrades our common stock, the price of our common stock would likely decline. If one or 
more of these analysts ceases to cover us or fails to publish regular reports on us, interest in the purchase of our common stock 
could decrease, which could cause the price of our common stock or trading volume to decline.

We have broad discretion in the use of our cash and cash equivalents and may not use them effectively.

We  have  broad  discretion  in  the  use  of  our  cash  and  cash  equivalents,  and  investors  must  rely  on  the  judgment  of  our 
management regarding the use of our cash and cash equivalents. Our management may not use cash and cash equivalents in 
ways that ultimately increase the value of your investment. Our failure to use our cash and cash equivalents effectively could 
result  in  financial  losses  that  could  have  a  material  adverse  effect  on  our  business,  cause  the  price  of  our  common  stock  to 
decline and delay the development of our product and product candidates. Pending their use, we may invest our cash and cash 
equivalents in short-term or long-term, investment-grade, interest-bearing securities. These investments may not yield favorable 
returns.  If  we  do  not  invest  or  apply  our  cash  and  cash  equivalents  in  ways  that  enhance  stockholder  value,  we  may  fail  to 
achieve expected financial results, which could cause the price of our common stock to decline.

If  we  are  unable  to  protect  the  confidentiality  of  our  trade  secrets,  our  business  and  competitive  position  would  be 
harmed.

In addition to seeking patents for some of our technology and products, we also rely on trade secrets, including unpatented 
know-how, technology and other proprietary information, to maintain our competitive position. We seek to protect these trade 
secrets, in part, by entering into non-disclosure and confidentiality agreements with parties who have access to them, such as 
our employees, corporate collaborators, outside scientific collaborators, contract manufacturers, consultants, advisors and other 
third  parties.  We  also  enter  into  confidentiality  and  invention  or  patent  assignment  agreements  with  our  employees  and 
consultants. However, we cannot guarantee that we have executed these agreements with each party that may have or have had 
access to our trade secrets or that the agreements we have executed will provide adequate protection. Any party with whom we 
have  executed  such  an  agreement  may  breach  that  agreement  and  disclose  our  proprietary  information,  including  our  trade 
secrets, and we may not be able to obtain adequate remedies for such breaches. Enforcing a claim that a party illegally disclosed 
or  misappropriated  a  trade  secret  is  difficult,  expensive  and  time-consuming,  and  the  outcome  is  unpredictable.  In  addition, 
some courts inside and outside the U.S. are less willing or unwilling to protect trade secrets. If any of our trade secrets were to 
be lawfully obtained or independently developed by a competitor, we would have no right to prevent them, or those to whom 
they  communicate  it,  from  using  that  technology  or  information  to  compete  with  us.  If  any  of  our  trade  secrets  were  to  be 
obtained or independently developed by a competitor, our competitive position would be harmed.

Litigation may adversely affect our business, financial condition, results of operations or liquidity.

Our business is subject to the risk of litigation by employees, consumers, vendors, competitors, intellectual property rights 
holders,  stockholders,  government  agencies  and  others  through  private  actions,  class  actions,  administrative  proceedings, 
regulatory  actions,  Hatch-Waxman  or  other  litigation.  For  example,  we  and  certain  of  our  current  and  former  officers  have 
previously been parties to securities class action lawsuits against us, all of which have been settled or dismissed, and we are 
currently involved in Hatch-Waxman litigation. The outcome of litigation, particularly class action lawsuits, regulatory actions 
and intellectual property claims, is difficult to assess or quantify. Plaintiffs in these types of lawsuits may seek recovery of very 
large  or  indeterminate  amounts,  and  the  magnitude  of  the  potential  loss  relating  to  these  lawsuits  may  remain  unknown  for 
substantial periods of time. In addition, certain of these lawsuits, if decided against us or settled by us, may result in liability 

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material to our Consolidated Financial Statements as a whole or may negatively affect our operating results if changes to our 
business  operation  are  required.  The  cost  to  prosecute  or  defend  litigation  may  be  significant.  There  also  may  be  adverse 
publicity associated with litigation that could negatively affect customer perception of our business, regardless of whether the 
allegations  are  valid  or  whether  we  are  ultimately  found  liable.  As  a  result,  litigation  may  adversely  affect  our  business, 
financial condition, results of operations or liquidity.

We may be exposed to employment-related claims and losses which could have an adverse effect on our business.

As we continue to increase the size of our workforce, the risk of potential employment-related claims will also increase. As 
such, we may be subject to claims, allegations or legal proceedings related to employment matters including, but not limited to, 
discrimination, harassment (sexual or otherwise), wrongful termination or retaliation, local, state or federal labor law violations, 
injury,  and  wage  violations.  In  the  event  we  are  subject  to  one  or  more  employment-related  claims,  allegations  or  legal 
proceedings,  we  may  incur  substantial  costs,  losses  or  other  liabilities  in  the  defense,  investigation,  settlement  or  other 
disposition of such claims. In addition to the economic impact, we may also suffer reputational harm as a result of such claims, 
allegations  and  legal  proceedings  and  the  investigation,  defense  and  prosecution  of  such  claims,  allegations  and  legal 
proceedings  could  cause  substantial  disruption  in  our  business  and  operations.  While  we  do  have  policies  and  procedures  in 
place to reduce our exposure to these risks, there can be no assurance that such policies and procedures will be effective or that 
we will not be exposed to such claims, allegations or legal proceedings.

Item 1B.    UNRESOLVED STAFF COMMENTS

None.

Item 2.    PROPERTIES

The following table contains information about our current significant leased properties as of December 31, 2022. 

Location

Approximate
Square Feet

Use

Lease expiry date (1)

Philadelphia, Pennsylvania, U.S. 

50,816  Office and laboratory

September 2044

Marlow, United Kingdom
Princeton, New Jersey, U.S.

36,796  Office

29,972  Office

August 2028

January 2034

______________________________
(1) Includes renewal options on leases which we are reasonably certain to exercise.

In  addition  to  the  above,  we  also  maintain  offices  in  other  U.S.  and  international  jurisdictions  in  which  we  operate.  We 
believe  that  our  current  office  and  laboratory  facilities  are  adequate  and  suitable  for  our  current  and  anticipated  needs.  We 
believe that, to the extent required, we will be able to lease or buy additional facilities at commercially reasonable rates.

Item 3.    LEGAL PROCEEDINGS

The information called for by this item is incorporated herein by reference to the information set forth in Note 15 “Legal 

Proceedings” of the Notes to Consolidated Financial Statements included in Item 8 of this Report.

Item 4.    MINE SAFETY DISCLOSURES

None.

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Item 5.    MARKET FOR THE REGISTRANT'S COMMON EQUITY, RELATED STOCKHOLDER MATTERS, 
AND ISSUER PURCHASES OF EQUITY SECURITIES

PART II

Market for Our Common Stock

Our common stock has been traded on the NASDAQ Global Market under the symbol "FOLD" since May 31, 2007. Prior 
to  that  time,  there  was  no  public  market  for  our  common  stock.  The  closing  price  for  our  common  stock  as  reported  by  the 
NASDAQ Global Market on February 13, 2023 was $12.64 per share. As of February 13, 2023, there were 19 holders of record 
of our common stock.

Dividends

We have never declared or paid any dividends on our capital stock. We currently intend to retain any future earnings to 
finance the development and growth of our business. We do not intend to declare or pay cash dividends to our stockholders in 
the foreseeable future.

Recent Sales of Unregistered Securities

None.

Performance Graph

The  following  performance  graph  compares  the  cumulative  total  return  on  our  common  stock  during  the  last  five  fiscal 
years with the NASDAQ Composite Index (U.S.) and the NASDAQ Biotechnology Index during the same period. The graph 
shows the value at the end of each of the last five fiscal years, of $100 invested in our common stock. Pursuant to applicable 
SEC rules, all values assume reinvestment of the full amount of all dividends, however no dividends have been declared on our 
common stock to date. The stockholder return shown on the graph below is not necessarily indicative of future performance, 
and we do not make or endorse any predictions as to future stockholder returns.

12/31/2017

12/31/2018

12/31/2019

12/31/2020

12/31/2021

12/31/2022

Amicus Therapeutics, Inc.

NASDAQ Composite

NASDAQ Biotechnology

$100

$100

$100

$67

$96

$91

$68

$130

$113

$160

$187

$142

$80

$227

$141

$83

$150

$124

The stock price performance included in this graph is not necessarily indicative of future stock price performance.

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Amicus Therapeutics, Inc.NASDAQ CompositeNASDAQ Biotechnology12/31/201712/31/201812/31/201912/31/202012/31/202112/31/202250100150200250Table of Contents

Issuer Purchases of Equity Securities

The following table provides certain information with respect to purchase of our common stock during the three months 

ended December 31, 2022:

Period

October 1, 2022 through October 31, 2022

November 1, 2022 through November 30, 2022

December 1, 2022 through December 31, 2022

Total

Total Number 
of Shares 
Purchased (1)

Average 
Price Paid 
per Share

21,092  $ 

11,920  $ 

3,090  $ 

36,102  $ 

10.56 

11.45 

12.13 

10.99 

Total Number of 
Shares Purchased as 
Part of Publicly 
Announced Plans or 
Programs

Maximum Number (or 
Approximate Dollar Value) 
of Shares That May Yet Be 
Purchased Under the Plans 
or Programs

— 

— 

— 

— 

— 

— 

— 

— 

______________________________
(1) Represents shares of common stock withheld to satisfy taxes associated with the vesting of restricted stock awards.

Item 6.    [RESERVED]

Item 7.    MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF 
OPERATIONS

Overview

We  are  a  global,  patient-dedicated  biotechnology  company  focused  on  discovering,  developing,  and  delivering  novel 
medicines  for  rare  diseases.  We  have  a  portfolio  including  the  first,  oral  monotherapy  for  Fabry  disease  that  has  achieved 
widespread global approval and a differentiated biologic for Pompe disease that is under review with the U.S. Food and Drug 
Administration  ("FDA"),  the  European  Medicines  Agency  ("EMA"),  and  the  United  Kingdom  ("U.K.")  Medicines  and 
Healthcare products Regulatory Agency ("MHRA"). We are committed to discovering and developing next generation therapies 
in Fabry and Pompe diseases.

The cornerstone of our portfolio is Galafold® (also referred to as "migalastat"), the first and only approved oral precision 
medicine for people living with Fabry disease who have amenable genetic variants. Migalastat is currently approved under the 
trade  name  Galafold®  in  the  United  States  ("U.S."),  European  Union  ("E.U."),  U.K.,  and  Japan,  with  multiple  additional 
approvals granted and applications pending in several geographies around the world. 

The lead biologics program of our pipeline is Amicus Therapeutics GAA ("AT-GAA", also known as ATB200/AT2221, or 
cipaglucosidase alfa/miglustat), a novel, two-component, potential best-in-class treatment for Pompe disease. In February 2019, 
the  FDA  granted  Breakthrough  Therapy  designation  ("BTD")  to  AT-GAA  for  the  treatment  of  late  onset  Pompe  disease.  In 
September 2021, the FDA set the Prescription Drug User Fee Act ("PDUFA") target action date of May 29, 2022 for the New 
Drug Application ("NDA") for miglustat and July 29, 2022 for the Biologics License Application ("BLA") for cipaglucosidase 
alfa. The EMA validated the Marketing Authorization Application (“MAA”) in the fourth quarter of 2021. In May 2022, the 
FDA extended the review period for the NDA for miglustat and the BLA for cipaglucosidase alfa resulting in revised PDUFA 
action dates of August 29, 2022 and October 29, 2022, respectively. In October 2022, the FDA deferred action on the BLA for 
cipaglucosidase alfa, citing the inability to complete the manufacturing facility inspection prior to the PDUFA action date.  We 
are  actively  engaged  with  the  FDA  and  an  inspection  has  been  scheduled.  In  December  2022,  the  Committee  for  Medicinal 
Products  for  Human  Use  ("CHMP")  of  the  EMA  adopted  a  positive  opinion  recommending  market  authorization  of 
cipaglucosidase  alfa,  or  Pombiliti™.  The  regulatory  submission  process  for  AT-GAA  in  the  U.K.  was  initiated  in  December 
2022.

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We  continue  to  monitor  the  novel  coronavirus  ("COVID-19")  pandemic.  Our  commercial  operations  have  not  been 
significantly impacted by the COVID-19 pandemic and we gradually continue to see an improvement in patient identification 
and Galafold® initiation. We have maintained operations in all geographies, secured our global supply chain for our commercial 
and clinical products, as well as maintained the operational integrity of our clinical trials, with minimum disruptions. We have 
been able to continue to meet required commercial demand for Galafold® as well as supply our ongoing Pompe disease clinical 
studies and access programs including the Early Access to Medicines Scheme ("EAMS") without interruption. In regard to our 
regulatory  operations,  the  FDA  deferred  action  on  the  pending  BLA  for  cipaglucosidase  alfa,  as  a  facility  inspection  was 
necessary,  however,  could  not  be  completed  by  the  PDUFA  action  date  due  to  COVID-19  related  travel  restrictions.  The 
facility  inspection  has  subsequently  been  scheduled.  Per  FDA  guidance  relating  to  pre-approval  inspections  during  the 
COVID-19 pandemic, receipt of a deferral action indicates no deficiencies have been identified and the application otherwise 
satisfies the requirements for approval.

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Consolidated Results of Operations

The  following  discussion  should  be  read  in  conjunction  with  the  Consolidated  Financial  Statements  and  related  notes 
included elsewhere in this report. The following section generally discusses 2022 and 2021 items and year-to-year comparisons 
between 2022 and 2021. Discussions of 2020 items and year-to-year comparisons between 2021 and 2020 that are not included 
in this Form 10-K can be found in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended 
December 31, 2021, which comparisons are hereby incorporated by reference.

Year Ended December 31, 2022 Compared to Year Ended December 31, 2021 

The following table provides selected financial information for the Company:

(in thousands)

Net product sales

Cost of goods sold

Cost of goods sold as a percentage of net product sales

Operating expenses:

Research and development

Selling, general, and administrative

Changes in fair value of contingent consideration payable

Loss on impairment of assets

Depreciation and amortization

Other income (expense):

Interest income

Interest expense

Loss on extinguishment of debt

Other income (expense)

Income tax benefit (expense)

Years Ended December 31,

2022

2021

Change

$ 

329,233 

$ 

305,514 

$ 

23,719 

38,599 

 11.7 %

34,466 

 11.3 %

4,133 

 0.4 %

276,677 

213,041 
1,078 

6,616 

5,342 

3,024 

(37,119) 

— 

4,176 

5,471 

272,049 

192,710 
6,514 

— 

6,209 

509 

(32,471) 

(257) 

(2,901) 

(8,906) 

4,628 

20,331 
(5,436) 

6,616 

(867) 

2,515 

(4,648) 

257 

7,077 

14,377 

13,892 

Net loss attributable to common stockholders

$ 

(236,568) 

$ 

(250,460) 

$ 

Net Product Sales. Net product sales increased $23.7 million during the year ended December 31, 2022 compared to the 
prior year. The increase was primarily due to continued growth in the U.S., Europe, and Japan markets, partially offset by the 
$26.1 million unfavorable impact of foreign currency exchange.

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Research  and  Development  Expense.  The  following  table  summarizes  our  principal  product  development  programs  for 
each  product  candidate  in  development,  and  the  out-of-pocket,  third-party  expenses  incurred  with  respect  to  each  product 
candidate:

(in thousands)
Projects
Third-party direct project expenses

Galafold® (Fabry Disease)
AT-GAA (Pompe Disease)

Gene therapy programs

Pre-clinical and other programs

Total third-party direct project expenses

Other project costs

Personnel costs

Other costs

Total other project costs

Total research and development costs

Years Ended December 31,

2022

2021

$ 

15,012  $ 

99,584 

48,948 

124 

163,668 

82,386 

30,623 

113,009 

$ 

276,677  $ 

10,694 

108,969 

47,817 

872 

168,352 

1

73,082 

30,615 

103,697 

272,049 

The $4.6 million increase in research and development expense was primarily due to an increase in personnel share-based 
compensation  and  Fabry  disease  clinical  research.  These  costs  were  partially  offset  by  a  decrease  in  Pompe  disease  clinical 
research due to active studies nearing completion and the timing of manufacturing costs.

Selling,  General,  and  Administrative  Expense.  Selling,  general,  and  administrative  expense  increased  $20.3  million, 
primarily driven by the strategic prioritization of our gene therapy portfolio that resulted in the write-off of cloud computing 
costs  and  software  licensing  fees,  as  well  as  increases  in  share-based  compensation,  marketing,  and  travel  to  support  our 
organizational growth. These costs were partially offset by a reduction in third-party professional fees.

Changes  in  Fair  Value  of  Contingent  Consideration  Payable.  Changes  in  fair  value  of  contingent  consideration  payable 
decreased $5.4 million, primarily due to achievement of two regulatory milestones during the year ended December 31, 2021, 
as well as changes to certain valuation inputs resulting from the strategic prioritization of our gene therapy portfolio during the 
year ended December 31, 2022.

Loss on Impairment of Assets. In connection with the strategic prioritization of our gene therapy portfolio, the Company 

performed an assessment of its assets and recognized a $6.6 million loss on impairment of assets.

Interest Expense. Interest expense increased $4.6 million during the year ended December 31, 2022. The increase was due 

to a higher LIBOR year over year. 

Other  Income  (Expense).  The  $7.1  million  variance  was  primarily  related  to  foreign  exchange  gains  caused  by  local 

currency remeasurement of U.S. dollar balances.

Income Tax Benefit. The income tax benefit for the year ended December 31, 2022 was $5.5 million. We are subject to 
income  taxes  in  various  jurisdictions  but  due  to  the  offset  of  taxable  income  with  net  operating  losses  and  full  valuation 
allowance, there is nominal tax expense in 2022 for taxes in U.S. federal and state jurisdictions.

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Critical Accounting Policies and Significant Judgments and Estimates

The  discussion  and  analysis  of  our  financial  condition  and  results  of  operations  are  based  on  our  financial  statements, 
which we have prepared in accordance with U.S. generally accepted accounting principles ("U.S. GAAP"). The preparation of 
these  financial  statements  requires  us  to  make  estimates  and  assumptions  that  affect  the  reported  amounts  of  assets  and 
liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements, as well as the reported 
revenues and expenses during the reporting periods. On an ongoing basis, we evaluate our estimates and judgments, including 
those  described  in  greater  detail  below.  We  base  our  estimates  on  historical  experience  and  on  various  other  factors  that  we 
believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying 
value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates 
under different assumptions or conditions. We believe that the following discussion represents our critical accounting policies.

Revenue Recognition

Our net product sales primarily consist of sales of Galafold®

 for the treatment of Fabry disease. We have recorded revenue 
 is available either on a commercial basis or through a reimbursed early access program. Orders for 

 are generally received from distributors and pharmacies with the ultimate payor often a government authority.

on sales where Galafold®
Galafold®

We recognize revenue when our performance obligation with our customers have been satisfied, which occurs at a point in 
time  when  the  pharmacies  or  distributors  obtain  control  of  Galafold®.  The  transaction  price  is  determined  based  on  fixed 
consideration in our customer contracts and is recorded net of estimates for variable consideration, which are primarily third-
party discounts and rebates. The identified variable consideration is recorded as a reduction of revenue at the time revenue from 
the sale of Galafold®
 is recognized. We recognize revenue to the extent that it is probable that a significant revenue reversal will 
not occur in a future period. These estimates may differ from actual consideration received. We evaluate these estimates each 
reporting period to reflect known changes.

Research and Development Expenses

As  part  of  the  process  of  preparing  our  Consolidated  Financial  Statements,  we  are  required  to  estimate  and  accrue  our 
research and development expenses, including those related to clinical studies and drug manufacturing. This process involves 
reviewing contracts and purchase orders, identifying 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 costs.

Costs  for  preclinical  studies,  clinical  studies  and  manufacturing  activities  are  recognized  based  on  an  evaluation  of  our 
vendors’ progress towards completion of specific tasks, using data such as clinical site activations, clinical site maintenance, 
clinical site close out, patient out of pocket cost reimbursements, or information provided to us by our vendors regarding their 
actual costs incurred. Payments for these activities are based on the terms of individual contracts and payment timing may differ 
significantly from the period in which the services were performed. We determine accrual estimates through reports from and 
discussions with applicable personnel and outside service providers as to the progress or state of completion of studies, or the 
services completed. Our estimates of accrued expenses as of each balance sheet date are based on the facts and circumstances 
known  at  the  time.  Costs  that  are  paid  in  advance  of  performance  are  deferred  as  a  prepaid  expense  and  amortized  over  the 
service period as the services are provided.

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Share-based Compensation

Stock Option Grants

In accordance with the applicable accounting guidance, we estimate the fair value of each equity award on the day of grant. 
We chose the "straight-line" attribution method for allocating compensation costs and recognized the fair value of each stock 
option on a straight-line basis over the vesting period of the related awards.

We use the Black-Scholes option pricing model when estimating the grant date fair value for share-based awards. Use of a 
valuation model requires management to make certain assumptions with respect to selected model inputs. Expected volatility is 
based on our historical volatility since our initial public offering in May 2007. We determine the average expected life using our 
actual historical data. The risk-free interest rate is based on U.S. Treasury, zero-coupon issues with a remaining term equal to 
the expected life assumed at the date of grant. Forfeitures are estimated based on historical analysis of actual option forfeitures.

Restricted Stock Units and Performance-Based Restricted Stock Units (collectively "RSUs")

RSUs  awarded  under  the  plan  are  generally  subject  to  graded  vesting  and  are  contingent  on  an  employee's  continued 
service  on  such  date.  RSUs  are  generally  subject  to  forfeiture  if  employment  terminates  prior  to  the  release  of  vesting 
restrictions. We expense the cost of the RSUs, which is determined to be the fair market value of the shares of common stock 
underlying the RSUs at the date of grant, ratably over the period during which the vesting restrictions lapse. In addition, certain 
of our share-based awards are market- and performance-based and dependent upon achieving certain goals. The related share-
based compensation expense is determined based on the estimated fair value of the underlying shares on the date of grant and is 
recognized on a straight-line basis over the vesting term. With respect to performance-based awards, we estimate the probability 
that the performance conditions will be achieved. 

Intangible Assets and Goodwill

We record goodwill in a business combination when the total consideration exceeds the fair value of the net tangible and 
identifiable  intangible  assets  acquired.  Purchased  in-process  research  and  development  ("IPR&D")  is  accounted  for  as  an 
indefinite lived intangible asset until the underlying project is completed, at which point the intangible asset will be accounted 
for as a definite lived intangible asset, or abandoned, at which point the intangible asset will be written off or partially impaired. 
Goodwill  and  indefinite  lived  intangible  assets  are  assessed  annually  for  impairment  on  October  1  and  whenever  events  or 
circumstances  indicate  that  the  carrying  amount  of  an  asset  may  not  be  recoverable.  A  goodwill  impairment  loss,  if  any,  is 
measured  as  the  amount  by  which  our  single  reporting  unit's  carrying  value,  including  goodwill,  exceeds  its  fair  value.    An 
IPR&D impairment loss, if any, is measured as the amount by which the carrying amount of the asset exceeds its fair value.

Valuation of Contingent Consideration Payable

Consideration for the Company’s acquisitions may include future payments that are contingent upon the occurrence of a 
particular event. For example, milestone payments might be based on the achievement of various regulatory approvals or future 
sales milestones. Contingent consideration payments in asset acquisitions are recognized when the contingency is resolved, and 
the consideration is paid or becomes payable.  Contingent consideration obligations in business acquisitions are recorded at fair 
value on the acquisition date. 

The Company estimates the fair value of contingent consideration obligations through a probability weighted discounted 
cash flow valuation approach based on various assumptions and incorporating estimated success rates. Estimated payments are 
discounted using present value techniques to arrive at an estimated fair value at the balance sheet date. Each period we reassess 
the fair value of the contingent consideration payable and recognize changes within the Consolidated Statements of Operations. 
Changes in the fair value of the contingent consideration payable can result from changes in estimated probability adjustments 
with respect to regulatory approval, changes in the assumed timing of when milestones are likely to be achieved and changes in 
assumed discount periods and rates. Significant judgment is employed in determining the appropriateness of these assumptions 
each period. Accordingly, future business and economic conditions, as well as changes in any of the assumptions described in 
the accounting for business combinations above can materially impact the amount of contingent consideration expense that we 
record and, therefore, our results of operations in any given period.

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Liquidity and Capital Resources

As  a  result  of  our  significant  research  and  development  expenditures,  as  well  as  expenditures  to  build  a  commercial 
organization to support the launch of Galafold®, we have not been profitable and have generated operating losses since we were 
incorporated in 2002. We have historically funded our operations through stock offerings, Galafold® revenues, debt issuance, 
collaborations, and other financing arrangements.

Sources of Liquidity

In November 2022, we entered into a Sales Agreement with The Goldman Sachs & Co. LLC to create an at-the-market 
("ATM")  equity  program,  pursuant  to  which  we  may  offer  to  sell  shares  of  our  common  stock  having  an  aggregate  offering 
gross proceeds of up to $250.0 million. At December 31, 2022, no shares have been issued under the ATM equity program.

In September 2021, we entered into securities purchase agreements with certain investors for the private placement of an 
aggregate  of  11,296,660  shares  of  our  common  stock,  at  a  purchase  price  of  $10.18  per  share,  and  pre-funded  warrants  to 
purchase  an  aggregate  of  8,349,705  shares  of  common  stock,  at  a  purchase  price  of  $10.17  per  pre-funded  warrant.  The  net 
proceeds from these private placements were approximately $199.8 million.

Cash Flow Discussion

As of December 31, 2022, we had cash, cash equivalents, and marketable securities of $293.6 million. We invest cash in 
excess of our immediate requirements in regard to liquidity and capital preservation in a variety of interest-bearing instruments, 
including obligations of U.S. government agencies and money market accounts. Wherever possible, we seek to minimize the 
potential effects of concentration and degrees of risk. Although we maintain cash balances with financial institutions in excess 
of  insured  limits,  we  do  not  anticipate  any  losses  with  respect  to  such  cash  balances.  For  more  details  on  the  cash,  cash 
equivalents,  and  marketable  securities,  refer  to  "—  Note  4.  Cash,  Cash  Equivalents,  Marketable  Securities,  and  Restricted 
Cash," in our Notes to Consolidated Financial Statements.

Net Cash Used in Operating Activities

Net cash used in operations for the year ended December 31, 2022 was $166.6 million. The components of net cash used in 
operations included the net loss for the year ended December 31, 2022 of $236.6 million and the net change in operating assets 
and liabilities of $39.9 million. The change in operating assets was primarily due to increases in accounts receivable of $17.3 
million  due  to  increased  commercial  sales  of  Galafold®,  an  increase  in  prepaid  and  other  current  assets  of  $6.2  million  to 
support commercial activities for Galafold®, and an increase in inventory of $5.3 million. The net cash used in operations was 
also impacted by a decrease in accounts payable and accrued expenses of $6.4 million, associated with payments of contract 
manufacturing and third party development services partially offset by increases in sales rebates and royalties associated with 
increased commercial sales of Galafold®.

Net cash used in operations for the year ended December 31, 2021 was $202.5 million. The components of net cash used in 
operations included the net loss for the year ended December 31, 2021 of $250.5 million, and the net change in operating assets 
and liabilities of $28.9 million. The change in operating assets was primarily due to increases in accounts receivable of $8.2 
million due to increased commercial sales of Galafold®, an increase in inventory of $7.8 million, and increase in prepaid and 
other current assets of $5.9 million to support commercial activities for Galafold®. The net cash used in operations was also 
impacted  by  an  increase  in  accounts  payable  and  accrued  expenses  of  $7.4  million,  mainly  related  to  program  expenses  and 
support for the commercial activities of Galafold®, and a decrease due to payment of contingent consideration of $10.4 million 
associated with meeting certain regulatory milestones during the year.

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Net Cash Provided by Investing Activities

Net cash provided by investing activities for the year ended December 31, 2022 was $92.3 million. Our investing activities 
have  consisted  primarily  of  purchases,  sales,  and  maturities  of  investments  and  capital  expenditures.  Net  cash  provided  by 
investing  activities  reflects  $335.9  million  for  the  sale  and  redemption  of  marketable  securities  and  $3.4  million  of  proceeds 
from the sale of our property and equipment, partially offset by $243.3 million for the purchase of marketable securities and 
$3.8 million for capital expenditures.

Net cash provided by investing activities for the year ended December 31, 2021 was $78.8 million. Our investing activities 
have  consisted  primarily  of  purchases,  sales,  and  maturities  of  investments  and  capital  expenditures.  Net  cash  provided  by 
investing  activities  reflects  $424.0  million  for  the  sale  and  redemption  of  marketable  securities,  partially  offset  by  $341.4 
million for the purchase of marketable securities and $3.9 million for capital expenditures.

Net Cash (Used in) Provided by Financing Activities

Net cash used in financing activities for the year ended December 31, 2022 was $7.5 million. Net cash used in financing 
activities primarily reflects $11.5 million from payments of employee withholding taxes related to restricted stock unit vesting, 
partially offset by $4.3 million from the exercise of stock options.

Net cash provided by financing activities for the year ended December 31, 2021 was $212.1 million. Net cash provided by 
financing activities primarily reflects $199.8 million in net proceeds from the September 2021 private placement of securities, 
$19.2  million  from  the  exercise  of  warrants  and  $10.2  million  from  the  exercise  of  stock  options,  partially  offset  by  $15.0 
million from payments of employee withholding taxes related to restricted stock unit vesting.

Funding Requirements

We  expect  to  continue  to  incur  significant  costs  in  the  foreseeable  future  primarily  due  to  research  and  development 
expenses, including expenses related to conducting clinical trials. Our future capital requirements will depend on a number of 
factors, including:

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the scope, progress, results and costs of clinical trials for our drug candidates;

the  cost  of  manufacturing  drug  supply  for  our  commercial,  clinical  and  preclinical  studies,  including  the  cost  of 
manufacturing Pompe Enzyme Replacement Therapy ("ERT" or "ATB200" or "cipaglucosidase alfa");

the  future  results  of  preclinical  research  and  subsequent  clinical  trials  for  pipeline  candidates  we  may  identify  from 
time to time, including our ability to obtain regulatory approvals and commercialize these therapies and obtain market 
acceptance for such therapies;

the costs, timing, and outcome of regulatory review of our product candidates, including AT-GAA;

any changes in regulatory standards relating to the review of our product candidates, including AT-GAA;

the number and development requirements of other product candidates that we pursue;

the costs of commercialization activities, including product marketing, sales, and distribution;

the emergence of competing technologies and other adverse market developments;

the estimates regarding the potential market opportunity for our product and product candidates, including AT-GAA; 

our  ability  to  successfully  commercialize  Galafold®  (also  referred  to  as  "migalastat  HCl")  and,  if  our  regulatory 
applications are approved, AT-GAA;

our ability to manufacture or supply sufficient clinical or commercial products, including Galafold® and AT-GAA;

our ability to obtain reimbursement for Galafold® and, if our regulatory applications are approved, AT-GAA;

our  ability  to  satisfy  post-marketing  commitments  or  requirements  for  continued  regulatory  approval  of  Galafold®, 
and, if approved and applicable, AT-GAA;

our ability to obtain market acceptance of Galafold® and, if our regulatory applications are approved, AT-GAA;

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the  costs  of  preparing,  filing,  and  prosecuting  patent  applications  and  maintaining,  enforcing,  and  defending 
intellectual property-related claims, including Hatch-Waxman litigation;

the impact of litigation that has been or may be brought against us or of litigation that we are pursuing or may pursue 
against others, including Hatch-Waxman litigation;

the extent to which we acquire or invest in businesses, products, and technologies;

our ability to successfully integrate our acquired products and technologies into our business, or successfully divest or 
license existing products and technologies from our business, including the possibility that the expected benefits of the 
transactions will not be fully realized by us or may take longer to realize than expected;

our ability to establish licensing agreements, collaborations, partnerships or other similar arrangements and to obtain 
milestone, royalty, or other payments from any such collaborators; 

the extent to which our business could be adversely impacted by the effects of the novel coronavirus ("COVID-19") 
outbreak,  including  actions  by  us,  governments,  our  customers,  our  suppliers,  or  other  third  parties  to  control  the 
spread of COVID-19, or by other health epidemics or pandemics;

the costs associated with, and our ability to comply with, emerging environmental, social and governance standards;

our ability to accurately forecast revenue, operating expenditures, or other metrics impacting profitability;

fluctuations in foreign currency exchange rates; and

changes in accounting standards.

We  may  seek  additional  funding  through  public  or  private  financings  of  debt  or  equity.  Based  on  our  current  operating 
model,  we  believe  that  the  current  cash  position,  which  includes  expected  revenues,  is  sufficient  to  fund  our  operations  and 
ongoing  research  programs  for  at  least  the  next  12  months.  Potential  impacts  of  the  COVID-19  pandemic,  business 
development collaborations, pipeline expansion, and investment in manufacturing capabilities could impact our future capital 
requirements.

Contractual Obligations and Commitments

As  of  December  31,  2022,  remaining  maturities,  including  interest,  on  our  Senior  Secured  Term  Loan  due  2026  was 

$517.7 million. Refer to "— Note 11. Debt," to the Consolidated Financial Statements for more information.

We are lessees to various operating leases for facilities and equipment. As of December 31, 2022, our undiscounted cash 
liabilities  for  operating  leases  were  $168.8  million,  with  maturities  ranging  up  through  fiscal  2044.  Refer  to  “—  Note  12. 
Leases,” to the Consolidated Financial Statements for more information.

We have a number of binding minimum purchase and manufacturing commitments due to our third-party manufacturers. 
As  of  December  31,  2022,  these  purchase  and  manufacturing  obligations  totaled  $62.4  million.  Contracts  for  which  our 
commitment  is  variable,  based  on  volumes,  with  no  fixed  minimum  quantities,  and  contracts  that  can  be  canceled  without 
payment penalties have been excluded. These purchase obligations are in addition to amounts recorded on our December 31, 
2022 Consolidated Balance Sheets.

We have no off-balance sheet arrangements as of December 31, 2022 and 2021. 

Milestone Payments / Royalties

Callidus  -  In  connection  with  our  acquisition  of  Callidus  Biopharma,  Inc.  ("Callidus"),  we  may  be  obligated  to  make 
additional  payments  to  the  former  stockholders  of  Callidus  upon  the  achievement  of  certain  clinical  milestones  of  up  to  $35 
million and regulatory milestones of up to $80 million set forth in the merger agreement, provided that the aggregate merger 
consideration  shall  not  exceed  $130  million.  As  of  December  31,  2022,  $20  million  and  $68  million  remain  outstanding, 
respectively. Refer to “— Note 10. Assets and Liabilities Measured at Fair Value,” to the Consolidated Financial Statements. 

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Celenex - In connection with our acquisition of Celenex, Inc. ("Celenex"), we may be obligated to pay up to an additional 
$10  million  in  connection  with  the  achievement  of  certain  development  milestones,  $220  million  in  connection  with  the 
achievement of certain regulatory approval milestones across multiple programs and up to $75 million in tiered sales milestone 
payments. Celenex has an exclusive license agreement with Nationwide Children’s Hospital ("Nationwide Children’s"). Under 
this  license  agreement,  Nationwide  Children’s  is  eligible  to  receive  development  and  sales-based  milestones  of  up  to  $7.8 
million for each product.

University of Pennsylvania -  In connection with our license agreement with the University of Pennsylvania ("Penn"), Penn 
is eligible to receive up to an aggregate of $86.5 million for the achievement of certain milestones and royalty payments with 
respect  to  licensed  products  for  each  indication.  Royalty  payments  are  based  on  net  sales  of  licensed  products  on  a  licensed 
product-by-licensed product and country-by-country basis.

GlaxoSmithKline - In connection with our collaboration agreement with GlaxoSmithKline ("GSK"), pursuant to which we 
obtained  global  rights  to  develop  and  commercialize  Galafold®  as  a  monotherapy  and  in  combination  with  ERT  for  Fabry 
disease, GSK is eligible to receive post-approval and sales-based milestones up to $40 million, as well as tiered royalties in the 
mid-teens in eight major markets outside the U.S. 

Recent Accounting Pronouncements

Please  refer  to  "—  Note  2.  Summary  of  Significant  Accounting  Policies,"  in  our  Notes  to  the  Consolidated  Financial 

Statements.

Item 7A.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

Market  risk  is  the  risk  of  change  in  fair  value  of  a  financial  instrument  due  to  changes  in  interest  rates,  equity  prices, 
creditworthiness,  financing,  exchange  rates  or  other  factors.  Our  primary  market  risk  exposure  relates  to  changes  in  interest 
rates in our cash, cash equivalents, and marketable securities. We place our investments in high-quality financial instruments, 
primarily  money  market  funds,  corporate  debt  securities,  asset  backed  securities,  and  U.S.  government  agency  notes  with 
maturities  of  less  than  one  year,  which  we  believe  are  subject  to  limited  interest  rate  and  credit  risk.  The  securities  in  our 
investment  portfolio  are  not  leveraged,  are  classified  as  available-for-sale  and,  due  to  the  short-term  nature,  are  subject  to 
minimal  interest  rate  risk.  We  believe  that  a  1%  (100  basis  points)  change  in  average  interest  rates  would  either  increase  or 
decrease  the  market  value  of  our  investment  portfolio  by  $0.5  million  as  of  December  31,  2022.  We  currently  do  not  hedge 
interest  rate  exposure  and  consistent  with  our  investment  policy,  we  do  not  use  derivative  financial  instruments  in  our 
investment portfolio. 

We are exposed to interest rate risk with respect to variable rate debt. At December 31, 2022, we had a $400 million Senior 
Secured Term Loan due 2026 that bears interest at a rate equal to the 3-month LIBOR, subject to a 1% floor, plus 6.5% per 
year. We do not currently hedge our variable interest rate debt. The annual average variable interest rate for our variable rate 
debt as of December 31, 2022 was 8.5%. A hypothetical 100 basis point increase or decrease in the average interest rate on our 
variable rate debt would result in $4.1 million change in the interest expense as of December 31, 2022. 

The  Financial  Conduct  Authority  has  announced  the  intent  to  phase  out  the  use  of  LIBOR  by  mid-2023.  If  LIBOR  is 
discontinued, we may need to renegotiate the terms of the Senior Secured Term Loan due 2026 in order to replace LIBOR with 
an alternative standard. As a result, we may incur incremental costs in transitioning to a new standard, and interest rates on our 
current or future indebtedness may be adversely affected by the new standard. The potential effect of any such event on our cost 
of capital cannot yet be determined, but we do not expect it to have a material impact on our consolidated financial condition, 
results of operations, or cash flows.

We face foreign exchange risk as a result of entering into transactions denominated in currencies other than U.S. dollars. 
We  are  not  currently  engaged  in  any  foreign  currency  hedging  activities.  The  current  exposures  arise  primarily  from  cash, 
accounts  receivable,  intercompany  receivables  and  payables,  and  net  product  sales  denominated  in  foreign  currencies.  Both 
positive  and  negative  impacts  to  our  international  product  sales  from  movements  in  foreign  currency  exchange  rates  may  be 
partially  mitigated  by  the  natural,  opposite  impact  that  foreign  currency  exchange  rates  have  on  our  international  operating 
expenses.  A  hypothetical  10%  change  in  foreign  exchange  rates  during  any  of  the  periods  presented  would  not  have  had  a 
material impact on our Consolidated Financial Statements.

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Item 8.    FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

Management's Report on Consolidated Financial Statements and
Internal Control over Financial Reporting

The management of Amicus Therapeutics, Inc. has prepared, and is responsible for the Company's Consolidated Financial 
Statements  and  related  footnotes.  These  Consolidated  Financial  Statements  have  been  prepared  in  conformity  with  U.S. 
generally accepted accounting principles ("U.S. GAAP").

We are responsible for establishing and maintaining adequate internal control over financial reporting. Internal control over 
financial  reporting  is  defined  in  Rule  13a-15(f)  or  15d-15(f)  promulgated  under  the  Securities  Exchange  Act  of  1934  as  a 
process designed by, or under the supervision of the Company's principal executive and principal financial officers and effected 
by  the  Company's  board  of  directors,  management,  and  other  personnel,  to  provide  reasonable  assurance  regarding  the 
reliability  of  financial  reporting  and  the  preparation  of  financial  statements  for  external  purposes  in  accordance  with 
U.S. GAAP and includes those policies and procedures that:

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pertain to the maintenance of records that in reasonable detail accurately and fairly reflect the transactions and 
dispositions of the assets of Amicus Therapeutics, Inc.;

provide  reasonable  assurance  that  transactions  are  recorded  as  necessary  to  permit  preparation  of  financial 
statements in accordance with generally accepted accounting principles, and that receipts and expenditures of 
Amicus therapeutics, Inc. are being made only in accordance with authorizations of management and directors 
of Amicus therapeutics, Inc.; and

provide  reasonable  assurance  regarding  prevention  or  timely  detection  of  unauthorized  acquisition,  use  or 
disposition  of  the  assets  of  Amicus  Therapeutics,  Inc.  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.

We  assessed  the  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December  31,  2022.  In  making  this 
assessment, we used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (2013 
framework) ("COSO") in Internal Control — Integrated Framework. Based on our assessment we believe that, as of December 
31, 2022, our internal control over financial reporting is effective based on those criteria.

The effectiveness of the Company's internal control over financial reporting as of December 31, 2022 has been audited by 
Ernst  &  Young  LLP,  an  independent  registered  public  accounting  firm,  as  stated  in  their  report.  This  report  appears  on  the 
following page.

Dated March 1, 2023 

/s/ BRADLEY L. CAMPBELL

President and Chief Executive Officer

/s/ DAPHNE QUIMI

Chief Financial Officer

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Report of Independent Registered Public Accounting Firm

To the Stockholders and the Board of Directors of Amicus Therapeutics, Inc.

Opinion on Internal Control Over Financial Reporting

We  have  audited  Amicus  Therapeutics,  Inc.’s  internal  control  over  financial  reporting  as  of  December  31,  2022,  based  on 
criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the 
Treadway  Commission  (2013  framework)  (the  COSO  criteria).  In  our  opinion,  Amicus  Therapeutics,  Inc.  (the  Company) 
maintained, in all material respects, effective internal control over financial reporting as of December 31, 2022, based on the 
COSO criteria.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) 
(PCAOB),  the  consolidated  balance  sheets  of  the  Company  as  of  December  31,  2022  and  2021,  the  related  consolidated 
statements of operations, comprehensive loss, changes in stockholders’ equity and cash flows for each of the three years in the 
period ended December 31, 2022, and the related notes and our report dated March 1, 2023 expressed an unqualified opinion 
thereon.

Basis for Opinion

The  Company’s  management  is  responsible  for  maintaining  effective  internal  control  over  financial  reporting  and  for  its 
assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s Report 
on Consolidated Financial Statements and Internal Control over Financial Reporting. Our responsibility is to express an opinion 
on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with 
the 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  effective  internal  control  over  financial  reporting  was  maintained  in  all 
material respects.

Our  audit  included  obtaining  an  understanding  of  internal  control  over  financial  reporting,  assessing  the  risk  that  a  material 
weakness exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and 
performing  such  other  procedures  as  we  considered  necessary  in  the  circumstances.  We  believe  that  our  audit  provides  a 
reasonable basis for our opinion.

Definition and Limitations of Internal Control Over Financial Reporting

A  company’s  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 generally 
accepted  accounting  principles.  A  company’s  internal  control  over  financial  reporting  includes  those  policies  and  procedures 
that  (1)  pertain  to  the  maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and 
dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit 
preparation  of  financial  statements  in  accordance  with  generally  accepted  accounting  principles,  and  that  receipts  and 
expenditures  of  the  company  are  being  made  only  in  accordance  with  authorizations  of  management  and  directors  of  the 
company;  and  (3)  provide  reasonable  assurance  regarding  prevention  or  timely  detection  of  unauthorized  acquisition,  use,  or 
disposition of the company’s 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.

/s/  Ernst & Young LLP

Iselin, New Jersey
March 1, 2023 

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Report of Independent Registered Public Accounting Firm

To the Stockholders and the Board of Directors of Amicus Therapeutics, Inc.

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Amicus Therapeutics, Inc. (the Company) as of December 
31, 2022 and 2021, the related consolidated statements of operations, comprehensive loss, changes in stockholders’ equity and 
cash flows for each of the three years in the period ended December 31, 2022, 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 at December 31, 2022 and 2021, and the results of its operations and its cash 
flows for each of the three years in the period ended December 31, 2022, in conformity with U.S. generally accepted accounting 
principles.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) 
(PCAOB), the Company’s internal control over financial reporting as of December 31, 2022, based on criteria established in 
Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission 
(2013 framework), and our report dated March 1, 2023 expressed an unqualified opinion thereon.

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 audits. We are a public accounting firm registered with the 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 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.  Our  audits  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 financial statements. We believe that our audits provide a reasonable basis for our opinion.

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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 the 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 matter below, providing a separate opinion on the critical audit 
matter or on the accounts or disclosures to which it relates.

Fair Value Measurement of the Contingent Consideration

Description of the 
Matter

As described in Note 10 to the consolidated financial statements, the Company has a $21.4 million 
contingent consideration liability recorded as of December 31, 2022 representing the fair value of 
additional  amounts  that  management  believes  are  likely  to  be  paid  to  the  former  stockholders  of 
Callidus Biopharma, Inc. The determination of the recorded amount of the contingent consideration 
liabilities requires the Company to make significant estimates and assumptions.

We  identified  the  measurement  of  the  contingent  consideration  liability  as  a  critical  audit  matter 
because  auditing  the  Company’s  valuation  of  the  contingent  consideration  liability  involved 
complex  and  challenging  auditor  judgment  as  the  inputs  to  such  valuation,  such  as  the  estimated 
probability  of  achieving  milestones,  the  assumed  timing  of  milestones  and  the  discount  rates,  are 
largely unobservable. 

How We 
Addressed the 
Matter in Our 
Audit

To  test  the  estimated  fair  value  of  the  contingent  consideration  liability,  we  performed  audit 
procedures  that  included  testing  the  operating  effectiveness  of  internal  controls  relating  to 
management’s  fair  value  measurement  of  the  contingent  consideration  liability  including  controls 
over the Company’s model, significant assumptions, and data. 

Our procedures also included, among others, assessing the terms of the arrangement, evaluating the 
methodology  used,  testing  the  significant  assumptions  discussed  above  and  the  completeness, 
accuracy  and  relevance  of  the  underlying  data  used  by  management  in  its  analysis.  We  also 
performed analyses of certain assumptions to assess the impact of changes in certain assumptions on 
the Company’s determination of the fair value of the contingent consideration liability. Evaluating 
the  assumptions  also  involved  evaluating  whether  the  assumptions  used  by  management  were 
consistent with external market data and evidence obtained in other areas of the audit.

/s/  Ernst & Young LLP

We have served as the Company's auditor since 2003.

Iselin, New Jersey
March 1, 2023 

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Amicus Therapeutics, Inc.
Consolidated Balance Sheets
(in thousands, except share and per share amounts)

Assets

Current assets:

Cash and cash equivalents

Investments in marketable securities

Accounts receivable

Inventories

Prepaid expenses and other current assets

Total current assets

Operating lease right-of-use assets, net

Property and equipment, less accumulated depreciation of $22,281 and $19,882 at December 31, 
2022 and 2021, respectively

In-process research & development

Goodwill

Other non-current assets

Total Assets

Liabilities and Stockholders' Equity

Current liabilities:

Accounts payable

Accrued expenses and other current liabilities

Contingent consideration payable

Operating lease liabilities

Total current liabilities

Long-term debt

Operating lease liabilities

Deferred income taxes

Deferred reimbursements

Other non-current liabilities

Total liabilities

Commitments and contingencies

Stockholders' equity:

Common stock, $0.01 par value, 500,000,000 shares authorized, 281,108,273 and 278,912,800 shares 
issued and outstanding at December 31, 2022 and 2021, respectively

Additional paid-in capital

Accumulated other comprehensive (loss) gain:

Foreign currency translation adjustment

Unrealized loss on available-for-sale securities

Warrants

Accumulated deficit

Total stockholders' equity

Total Liabilities and Stockholders' Equity

December 31,

2022

2021

$ 

148,813  $ 

144,782 

66,196 

23,816 

40,209 

423,816 

29,534 

30,778 

23,000 

197,797 

19,242 

$ 

724,167  $ 

$ 

15,413  $ 

93,636 

21,417 

8,552 

139,018 

391,990 

51,578 

4,939 

4,656 

8,939 

245,197 

237,299 

52,672 

26,818 

34,848 

596,834 

20,586 

42,496 

23,000 

197,797 

24,427 

905,140 

21,513 

98,153 

18,900 

7,409 

145,975 

389,357 

43,363 

4,930 

5,906 

8,240 

601,120 

597,771 

2,815 

2,808 

2,664,744 

2,595,419 

(11,989) 

(116) 

83 

5,251 

(270) 

83 

(2,532,490) 

(2,295,922) 

123,047 

$ 

724,167  $ 

307,369 

905,140 

See accompanying Notes to Consolidated Financial Statements

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Net product sales

Cost of goods sold

Gross profit

Operating expenses:

Amicus Therapeutics, Inc.
Consolidated Statements of Operations
(in thousands, except share and per share amounts)

Research and development

Selling, general, and administrative

Changes in fair value of contingent consideration payable

Loss on impairment of assets

Depreciation and amortization

Total operating expenses

Loss from operations

Other income (expense):

Interest income

Interest expense

Loss on extinguishment of debt

Other income (expense)

Loss before income tax

Income tax benefit (expense)

Net loss attributable to common stockholders

Net loss attributable to common stockholders per common share — basic 
and diluted
Weighted-average common shares outstanding — basic and diluted

Years Ended December 31,

2022
329,233  $ 

2021
305,514  $ 

$ 

38,599 

290,634 

276,677 

213,041 

1,078 

6,616 

5,342 

34,466 

271,048 

272,049 

192,710 

6,514 

— 

6,209 

2020
260,886 

31,044 

229,842 

308,443 

156,407 

3,144 

— 

8,846 

502,754 

477,482 

476,840 

(212,120)   

(206,434)   

(246,998) 

3,024 

509 

(37,119)   

(32,471)   

— 

4,176 

(257)   

(2,901)   

3,226 

(22,425) 

(7,276) 

(781) 

(242,039)   

(241,554)   

(274,254) 

5,471 

(8,906)   

(2,598) 

(236,568)  $ 

(250,460)  $ 

(276,852) 

(0.82)  $ 

(0.92)  $ 

(1.07) 

$ 

$ 

  289,057,198 

  271,421,986 

  258,867,380 

See accompanying Notes to Consolidated Financial Statements

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Amicus Therapeutics, Inc.
Consolidated Statements of Comprehensive Loss
(in thousands)

Net loss

Other comprehensive (loss) gain:

Foreign currency translation adjustment (loss) gain

Unrealized gain (loss) on available-for-sale securities

Other comprehensive (loss) gain

Comprehensive loss

Years Ended December 31,

2022
(236,568)  $ 

2021
(250,460)  $ 

2020
(276,852) 

$ 

(17,240)   

(3,161)   

154 

(85)   

(17,086)   

(3,246)   

5,627 

(225) 

5,402 

$ 

(253,654)  $ 

(253,706)  $ 

(271,450) 

See accompanying Notes to Consolidated Financial Statements

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Amicus Therapeutics, Inc.
Consolidated Statements of Changes in Stockholders' Equity
(in thousands, except share amounts)

Common Stock

Shares

Amount

Additional
Paid-In
Capital

Warrants

Other
Comprehensive
Gain (Loss)

Accumulated
Deficit

Total
Stockholders'
Equity

Balance at December 31, 2019

255,417,869  $ 

2,598  $ 

2,227,225  $ 

12,387  $ 

2,825  $ 

(1,768,610)  $ 

476,425 

Stock options exercised, net

Vesting of restricted stock units, 
net of taxes

Share-based compensation

Unrealized loss on available-for-
sale securities

Foreign currency translation 
adjustment

Net loss

5,233,672 

1,411,920 

— 

— 

— 

— 

52 

— 

— 

— 

— 

— 

42,230 

(10,028) 

49,151 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(225) 

5,627 

— 

— 

— 

— 

— 

42,282 

(10,028) 

49,151 

(225) 

5,627 

— 

(276,852) 

(276,852) 

Balance at December 31, 2020

262,063,461 

2,650 

2,308,578 

12,387 

8,227 

(2,045,462) 

286,380 

Stock options exercised, net

1,461,189 

Common stock issued from equity 
financing and pre-funded warrants

Vesting of restricted stock units, 
net of taxes

Share-based compensation

Warrants exercised

Equity component of the 
convertible notes 

Unrealized loss on available-for-
sale securities
Foreign currency translation 
Adjustment

Net loss

11,296,660 

1,064,135 

— 

2,554,999 

472,356 

— 

— 

— 

15 

112 

— 

— 

26 

5 

— 

— 

— 

10,213 

199,552 

(15,009) 

57,838 

31,591 

2,656 

— 

— 

— 

Balance at December 31, 2021

278,912,800 

2,808 

2,595,419 

Stock options exercised, net

Vesting of restricted stock units, 
net of taxes

Share-based compensation

Unrealized gain on available-for-
sale securities

Foreign currency translation 
adjustment

Net loss

656,377 

1,539,096 

— 

— 

— 

— 

7 

— 

— 

— 

— 

— 

4,303 

(11,490) 

76,512 

— 

— 

— 

— 

83 

— 

— 

(12,387) 

— 

— 

— 

— 

83 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(85) 

(3,161) 

— 

— 

— 

— 

— 

— 

— 

— 

10,228 

199,747 

(15,009) 

57,838 

19,230 

2,661 

(85) 

(3,161) 

— 

(250,460) 

(250,460) 

4,981 

(2,295,922) 

307,369 

— 

— 

— 

154 

(17,240) 

— 

— 

— 

— 

— 

4,310 

(11,490) 

76,512 

154 

(17,240) 

— 

(236,568) 

(236,568) 

Balance at December 31, 2022

281,108,273  $ 

2,815  $ 

2,664,744  $ 

83  $ 

(12,105)  $ 

(2,532,490)  $ 

123,047 

See accompanying Notes to Consolidated Financial Statements

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Amicus Therapeutics, Inc.
Consolidated Statements of Cash Flows
(in thousands)

Operating activities

Net loss

Adjustments to reconcile net loss to net cash used in operating activities:

Amortization of debt discount and deferred financing

Depreciation and amortization

Share-based compensation

Loss on extinguishment of debt

Non-cash changes in the fair value of contingent consideration payable

Foreign currency remeasurement loss

Non-cash deferred taxes

Asset impairment charges and other asset write-offs

Changes in operating assets and liabilities:

Accounts receivable

Inventories

Prepaid expenses and other current assets

Accounts payable, accrued expenses, and other current liabilities

Other non-current assets and liabilities

Payment of contingent consideration

Net cash used in operating activities

Investing activities

Sale and redemption of marketable securities

Purchases of marketable securities

Capital expenditures

Proceeds from sale of assets

Years Ended December 31,

2022

2021

2020

$ 

(236,568)  $ 

(250,460)  $ 

(276,852) 

2,634 

5,342 

76,512 

— 

1,078 

6,121 

9 

18,177 

(17,330) 

(5,343) 

(6,194) 

(6,377) 

(4,636) 

— 

2,490 

6,209 

57,838 

257 

6,514 

3,565 

34 

— 

(8,189) 

(7,790) 

(5,919) 

7,430 

(4,117) 

(10,353) 

1,794 

8,846 

49,151 

7,276 

3,144 

5,471 

(155) 

99 

(11,219) 

(4,639) 

(8,766) 

(10,610) 

3,170 

— 

$ 

(166,575)  $ 

(202,491)  $ 

(233,290) 

335,926 

(243,255) 

(3,766) 

3,411 

424,043 

(341,398) 

(3,884) 

— 

354,826 

(365,178) 

(3,227) 
— 

Net cash provided by (used in) investing activities

$ 

92,316  $ 

78,761  $ 

(13,579) 

Financing activities

Proceeds from issuance of common stock from equity financing and pre-funded 
warrants, net of issuance costs

Payment of long-term debt

Proceeds from long-term debt, net of issuance costs

Payment of finance leases

Purchase of vested restricted stock units, net of taxes

Proceeds from stock options exercised, net

Proceeds from warrants exercised, net

Payment of contingent consideration

Net cash (used in) provided by financing activities

Effect of exchange rate changes on cash, cash equivalents, and restricted cash

Net increase in cash, cash equivalents, and restricted cash

Cash, cash equivalents, and restricted cash at the beginning of the year

$ 

$ 

— 

— 

— 

(283) 

(11,490) 

4,310 

— 

— 

199,750 

— 

— 

(479) 

(15,009) 

10,228 

19,230 

(1,647) 

— 

(155,249) 

385,929 

(76) 

(10,028) 

42,282 

— 

— 

(7,463)  $ 

212,073  $ 

262,858 

(14,619)  $ 

(5,049)  $ 

(96,341) 

249,456 

83,294 

166,162 

3,830 

19,819 

146,343 

166,162 

Cash, cash equivalents, and restricted cash at the end of the year

$ 

153,115  $ 

249,456  $ 

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Supplemental disclosures of cash flow information

Tenant improvements paid through lease incentive

Cash paid during the period for interest

Capital expenditures unpaid at the end of period

Cash paid for income taxes

Years Ended December 31,

2022

2021

2020

$ 

$ 

$ 

$ 

—  $ 

300  $ 

470 

34,358  $ 

30,468  $ 

24,683 

1,141  $ 

1,609  $ 

1,448  $ 

985 

20,032  $ 

10,371 

See accompanying Notes to Consolidated Financial Statements

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1. Description of Business

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements

Amicus Therapeutics, Inc. (the "Company") is a global, patient-dedicated biotechnology company focused on discovering, 
developing,  and  delivering  novel  medicines  for  rare  diseases.  The  Company  has  a  portfolio  including  the  first,  oral 
monotherapy for Fabry disease that has achieved widespread global approval and a differentiated biologic for Pompe disease, 
that  is  under  review  with  the  U.S.  Food  and  Drug  Administration  ("FDA"),  European  Medicines  Agency  ("EMA"),  and  the 
United Kingdom ("U.K.") Medicines and Healthcare products Regulatory Agency ("MHRA"). The Company is committed to 
discovering and developing next generation therapies in Fabry and Pompe diseases.

The cornerstone of the Company's portfolio is Galafold® (also referred to as "migalastat"), the first and only approved oral 
precision medicine for people living with Fabry disease who have amenable genetic variants. Migalastat is currently approved 
under  the  trade  name  Galafold®  in  the  United  States  ("U.S."),  European  Union  ("E.U."),  U.K.,  and  Japan,  with  multiple 
additional approvals granted and applications pending in several geographies around the world. 

The lead biologics program of the Company's pipeline is Amicus Therapeutics GAA ("AT-GAA", also known as ATB200/
AT2221,  or  cipaglucosidase  alfa/miglustat),  a  novel,  two-component,  potential  best-in-class  treatment  for  Pompe  disease.  In 
February 2019, the FDA granted Breakthrough Therapy designation ("BTD") to AT-GAA for the treatment of late onset Pompe 
disease. In September 2021, the FDA set the Prescription Drug User Fee Act ("PDUFA") target action date of May 29, 2022 for 
the  New  Drug  Application  ("NDA")  for  miglustat  and  July  29,  2022  for  the  Biologics  License  Application  ("BLA")  for 
cipaglucosidase alfa. The EMA validated the Marketing Authorization Application (“MAA”) in the fourth quarter of 2021. In 
May 2022, the FDA extended the review period for the NDA for miglustat and the BLA for cipaglucosidase alfa resulting in 
revised PDUFA action dates of August 29, 2022 and October 29, 2022, respectively. In October 2022, the FDA deferred action 
on the BLA for cipaglucosidase alfa, citing the inability to complete the manufacturing facility inspection prior to the PDUFA 
action date.  The Company is actively engaged with the FDA and an inspection has been scheduled. In December 2022, the 
Committee for Medicinal Products for Human Use ("CHMP") of the EMA adopted a positive opinion recommending market 
authorization of cipaglucosidase alfa, or Pombiliti™. The regulatory submission process for AT-GAA in the U.K. was initiated 
in December 2022.

The  Company  continues  to  monitor  the  novel  coronavirus  (“COVID-19”)  pandemic.  The  Company's  commercial 
operations have not been significantly impacted by the COVID-19 pandemic and the Company gradually continues to see an 
improvement  in  patient  identification  and  Galafold®  initiation.  The  Company  has  maintained  operations  in  all  geographies, 
secured its global supply chain for its commercial and clinical products, as well as maintained the operational integrity of its 
clinical  trials,  with  minimum  disruptions.  The  Company  has  been  able  to  continue  to  meet  required  commercial  demand  for 
Galafold®  as  well  as  supply  its  ongoing  Pompe  disease  clinical  studies  and  access  programs  including  the  Early  Access  to 
Medicines Scheme ("EAMS") without interruption. In regard to the Company’s regulatory operations, the FDA deferred action 
on the pending BLA for cipaglucosidase alfa, as a facility inspection was necessary, however, could not be completed by the 
PDUFA action date due to COVID-19 related travel restrictions. The facility inspection has subsequently been scheduled. Per 
FDA  guidance  relating  to  pre-approval  inspections  during  the  COVID-19  pandemic,  receipt  of  a  deferral  action  indicates  no 
deficiencies have been identified and the application otherwise satisfies the requirements for approval.

The Company had an accumulated deficit of $2.5 billion as of December 31, 2022 and anticipates incurring losses through 
the  fiscal  year  ending  December  31,  2023.  The  Company  has  historically  funded  its  operations  through  stock  offerings, 
Galafold® revenues, debt issuances, collaborations, and other financing arrangements.

Based  on  its  current  operating  model,  the  Company  believes  that  the  current  cash  position,  which  includes  expected 
revenues,  is  sufficient  to  fund  the  Company's  operations  and  ongoing  research  programs  for  at  least  the  next  12  months. 
Potential  impacts  of  the  COVID-19  pandemic,  business  development  collaborations,  pipeline  expansion,  and  investment  in 
manufacturing capabilities could impact the Company's future capital requirements.

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

2. Summary of Significant Accounting Policies

Basis of Presentation

The  Company  has  prepared  the  accompanying  Consolidated  Financial  Statements  in  accordance  with  U.S.  generally 
accepted accounting principles ("U.S. GAAP") and include all adjustments necessary for the fair presentation of the Company's 
financial position for the periods presented.

Consolidation

The Consolidated Financial Statements include the accounts of the Company and its subsidiaries. Intercompany accounts 

and transactions are eliminated in consolidation.

Foreign Currency Transactions

The functional currency for most of the Company's foreign subsidiaries is their local currency. For non-U.S. subsidiaries 
that transact in a functional currency other than the U.S. dollar, assets and liabilities are translated at current rates of exchange 
at  the  balance  sheet  date.  Income  and  expense  items  are  translated  at  the  average  foreign  exchange  rates  for  the  period. 
Adjustments resulting from the translation of the financial statements of the Company's foreign operations into U.S. dollars are 
excluded  from  the  determination  of  net  income  and  are  recorded  in  accumulated  other  comprehensive  income,  a  separate 
component of stockholders' equity.

Use of Estimates

The  preparation  of  financial  statements  in  conformity  with  U.S.  GAAP  requires  management  to  make  estimates  and 
assumptions  that  affect  the  reported  amounts  of  assets  and  liabilities,  the  disclosure  of  contingent  assets  and  liabilities  at  the 
date of the financial statements, and the reported amounts of revenues and expenses during the reporting periods. Actual results 
could differ from those estimates.

Additionally, the Company assessed the impact the COVID-19 pandemic had on its operations and financial results as of 
December 31, 2022 and through the issuance of these financial statements. The Company’s analysis was informed by the facts 
and  circumstances  as  they  were  known  to  the  Company.  This  assessment  considered  the  impact  COVID-19  may  have  on 
financial estimates and assumptions that affect the reported amounts of assets and liabilities and revenue and expenses.

Cash, Cash Equivalents, Marketable Securities, and Restricted Cash

The  Company  considers  all  highly  liquid  investments  purchased  with  a  maturity  of  three  months  or  less  at  the  date  of 
acquisition  to  be  cash  equivalents.  Marketable  securities  consist  of  fixed  income  investments  with  a  maturity  of  greater  than 
three  months  and  other  highly  liquid  investments  that  can  be  readily  purchased  or  sold  using  established  markets.  These 
investments are classified as available-for-sale and are reported at fair value on the Company's Consolidated Balance Sheets. 
Unrealized  holding  gains  and  losses  are  reported  within  other  comprehensive  (loss)  gain  in  the  Company's  Consolidated 
Statements of Comprehensive Loss. Fair value is based on available market information including quoted market prices, broker 
or dealer quotations, or other observable inputs.

Restricted cash consists primarily of funds held to satisfy the requirements of certain agreements that are restricted in their 

use and is included in other current assets and other non-current assets on the Company's Consolidated Balance Sheets. 

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

Concentration of Credit Risk

The  Company's  financial  instruments  that  are  exposed  to  concentration  of  credit  risk  consist  primarily  of  cash,  cash 
equivalents, and marketable securities. The Company maintains its cash and cash equivalents in bank accounts, which, at times, 
exceed  federally  insured  limits.  The  Company  invests  its  marketable  securities  in  high-quality  commercial  financial 
instruments.  The  Company  has  not  recognized  any  losses  from  credit  risks  on  such  accounts  during  any  of  the  periods 
presented.  The  Company  believes  it  is  not  exposed  to  significant  credit  risk  on  its  cash,  cash  equivalents,  or  marketable 
securities.

The Company is subject to credit risk from its accounts receivable related to its product sales of Galafold®. The Company's 
accounts  receivable  at  December  31,  2022  have  arisen  from  product  sales  primarily  in  Europe,  the  U.S.,  and  Japan.  The 
Company will periodically assess the financial strength of its customers to establish allowances for anticipated losses, if any. 
For  accounts  receivable  that  have  arisen  from  named  patient  sales,  the  payment  terms  are  predetermined,  and  the  Company 
evaluates  the  creditworthiness  of  each  customer  on  a  regular  basis.  As  of  December  31,  2022,  the  Company's  allowance  for 
doubtful accounts was $0.2 million.

Property and Equipment

Property  and  equipment  are  stated  at  cost,  less  accumulated  depreciation.  Depreciation  is  calculated  over  the  estimated 
useful lives of the respective assets, which range from three to five years, or the lesser of the related initial term of the lease or 
useful life for leasehold improvements.

The initial cost of property and equipment consists of its purchase price and any directly attributable costs of bringing the 
asset to its working condition and location for its intended use. Expenditures incurred after the fixed assets have been put into 
operation,  such  as  repairs  and  maintenance,  are  charged  to  income  in  the  period  in  which  the  costs  are  incurred.  Major 
replacements, improvements, and additions are capitalized in accordance with Company policy.

The  Company  evaluates  long-lived  assets  for  impairment  whenever  events  or  changes  in  circumstances  indicate  that  the 
carrying  amount  of  an  asset  group  may  not  be  recoverable.  If  indications  of  impairment  exist,  projected  future  undiscounted 
cash flows associated with the asset or asset group are compared to the carrying value of the asset to determine whether the 
asset or asset group's value is recoverable. If impairment is determined, the Company writes down the asset to its estimated fair 
value and records an impairment loss equal to the excess of the carrying value of the long-lived asset over its estimated fair 
value in the period at which such a determination is made.

Revenue Recognition

The Company’s net product sales consist primarily of sales of Galafold® for the treatment of Fabry disease. Galafold® sales 
for the years ended December 31, 2022, 2021 and 2020 were $329.0 million, $305.5 million and $260.9 million, respectively. 
The Company has recorded revenue on sales where Galafold® is available either on a commercial basis or through a reimbursed 
early  access  program.  Orders  for  Galafold®  are  generally  received  from  distributors  and  pharmacies,  with  the  ultimate  payor 
often a government authority. In 2022, one customer accounted for 27% of net product sales and 14% of accounts receivable 
from product sales. In 2021, one customer accounted for 24% of net product sales and 14% of accounts receivable from product 
sales.

The Company recognizes revenue when its performance obligations to its customers have been satisfied, which occurs at a 
point  in  time  when  the  pharmacies  or  distributors  obtain  control  of  Galafold®.  The  transaction  price  is  determined  based  on 
fixed consideration in the Company's customer contracts and is recorded net of estimates for variable consideration, which are 
third party discounts and rebates. The identified variable consideration is recorded as a reduction of revenue at the time revenue 
from the sale of Galafold® is recognized. The Company recognizes revenue to the extent that it is probable that a significant 
revenue reversal will not occur in a future period. These estimates may differ from actual consideration received. The Company 
evaluates these estimates each reporting period to reflect known changes.

The following table summarizes the Company's net product sales disaggregated by geographic area:

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

(in thousands)
U.S.

Ex-U.S.

Total net product sales

Inventories and Cost of Goods Sold

For the Year 

2022

2021

2020

$ 

$ 

115,946  $ 

95,387  $ 

80,046 

213,287 

210,127 

180,840 

329,233  $ 

305,514  $ 

260,886 

Inventories are stated at the lower of cost and net realizable value, determined by the first-in, first-out method. Inventories 
are  reviewed  periodically  to  identify  slow-moving  or  obsolete  inventory  based  on  projected  sales  activity  as  well  as  product 
shelf-life. In evaluating the recoverability of inventories produced, the probability that revenue will be obtained from the future 
sale of the related inventory is considered and inventory value is written down for inventory quantities in excess of expected 
requirements. Expired inventory is disposed of and the related costs are recognized as cost of goods sold in the Consolidated 
Statements of Operations.

Cost  of  goods  sold  includes  the  cost  of  inventory  sold,  manufacturing  and  supply  chain  costs,  product  shipping  and 

handling costs, provisions for excess and obsolete inventory, as well as royalties payable. 

Fair Value Measurements

The Company records certain asset and liability balances under the fair value measurements as defined by the Financial 
Accounting  Standard  Board  ("FASB")  guidance.  Current  FASB  fair  value  guidance  emphasizes  that  fair  value  is  a  market-
based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on 
the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant 
assumptions in fair value measurements, current FASB guidance establishes a fair value hierarchy that distinguishes between 
market  participant  assumptions  based  on  market  data  obtained  from  sources  independent  of  the  reporting  entity  (observable 
inputs  that  are  classified  within  Levels  1  and  2  of  the  hierarchy)  and  the  reporting  entity's  own  assumptions  that  market 
participant's  assumptions  would  use  in  pricing  assets  or  liabilities  (unobservable  inputs  classified  within  Level  3  of  the 
hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has 
the  ability  to  access  at  measurement  date.  Level  2  inputs  are  inputs  other  than  quoted  prices  included  in  Level  1  that  are 
observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and 
liabilities  in  active  markets,  as  well  as  inputs  that  are  observable  for  the  asset  or  liability  (other  than  quoted  prices),  such  as 
interest  rates,  foreign  exchange  rates,  and  yield  curves  that  are  observable  at  commonly  quoted  intervals.  Level  3  inputs  are 
unobservable inputs for the asset or liability, which is typically based on an entity's own assumptions, as there is little, if any, 
related market activity. In instances where the determination of the fair value measurement is based on inputs from different 
levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is 
based on the lowest level input that is significant to the fair value measurement in its entirety. The Company's assessment of the 
significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to 
the asset or liability.

Contingent Liabilities

On  an  ongoing  basis,  the  Company  may  be  involved  in  various  claims  and  legal  proceedings.  On  a  quarterly  basis,  the 
Company reviews the status of each significant matter and assesses its potential financial exposure. If the potential loss from 
any claim, asserted or unasserted, or legal proceeding is considered probable and the amount can be reasonably estimated, the 
Company will accrue a liability for the estimated loss. Because of uncertainties related to claims and litigation, accruals will be 
based on the Company's best estimates based on available information. On a periodic basis, as additional information becomes 
available, or based on specific events such as the outcome of litigation or settlement of claims, the Company may reassess the 
potential liability related to these matters and may revise these estimates, which could result in material adverse adjustments to 
the Company's operating results.

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

Research and Development Costs

Research and development costs are expensed as incurred. Research and development expense consist primarily of costs 
related  to  personnel,  including  salaries  and  other  personnel  related  expenses,  consulting  fees,  and  the  cost  of  facilities  and 
support  services  used  in  drug  development.  Assets  acquired  that  are  used  for  research  and  development  and  have  no  future 
alternative use are expensed as in-process research and development.

Interest Income and Interest Expense

Interest  income  consists  of  interest  earned  on  the  Company's  cash,  cash  equivalents,  and  marketable  securities.  Interest 

expense consists of interest incurred on debt and finance leases.

Income Taxes

The Company accounts for income taxes under the liability method. Under this method deferred income tax liabilities and 
assets  are  determined  based  on  the  difference  between  the  financial  statement  carrying  amounts  and  tax  basis  of  assets  and 
liabilities  and  for  operating  losses  and  tax  credit  carry  forwards,  using  enacted  tax  rates  in  effect  in  the  years  in  which  the 
differences are expected to reverse. A valuation allowance is recorded if it is "more likely than not" that a portion or all of a 
deferred tax asset will not be realized.

The Company’s tax returns are subject to examination by U.S. Federal, state, and foreign taxing jurisdictions. The impact 
of  an  uncertain  tax  position  taken  or  expected  to  be  taken  on  an  income  tax  return  must  be  recognized  in  the  financial 
statements  at  the  largest  amount  that  is  more  likely  than  not  to  be  sustained.  An  uncertain  income  tax  position  will  not  be 
recognized in the financial statements unless it is more likely than not to be sustained.

Other Comprehensive (Loss) Gain

Components  of  other  comprehensive  (loss)  gain  include  unrealized  gains  and  losses  on  available-for-sale  securities  and 

(loss) gain on foreign currency transactions and are included in the Consolidated Statements of Comprehensive Loss.

Leases

The Company primarily enters into lease agreements for office space, equipment, and vehicles. The leases have varying 
terms, some of which could include options to renew, extend, and early terminate. The Company determines if an arrangement 
is  a  lease  at  contract  inception.  Operating  leases  are  included  in  right-of-use  ("ROU")  assets  and  lease  liabilities  on  the 
Consolidated Balance Sheets. 

ROU assets represent the Company's right to control the use of an explicitly or implicitly identified fixed asset for a period 
of time and lease liabilities represent the Company's obligation to make lease payments arising from the lease. Control of an 
underlying asset is conveyed to the Company if the Company obtains the rights to direct the use of and to obtain substantially 
all of the economic benefits from using the underlying asset. ROU assets and liabilities are recognized at commencement date 
based on the present value of lease payments over the lease term. The Company uses its incremental borrowing rate based on 
the information available at commencement date in determining the present value of lease payments. 

Lease  payments  included  in  the  measurement  of  the  lease  liability  are  comprised  of  fixed  payments.  Variable  lease 
payments are excluded from the ROU asset and lease liability and are recognized in the period in which the obligation for those 
payments is incurred. Variable lease payments are presented in the Consolidated Statements of Operations in the same line item 
as expenses arising from fixed lease payments for operating leases. The Company has lease agreements that include lease and 
non-lease components, which the Company accounts for as a single lease component for all underlying asset categories. 

The lease term for all of the Company's leases includes the non-cancellable period of the lease plus any additional periods 
covered by either a Company option to extend (or not to terminate) the lease that the Company is reasonably certain to exercise, 
or an option to extend (or not to terminate) the lease controlled by the lessor. 

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

Leases  with  an  initial  term  of  12  months  or  less  are  not  recorded  on  the  Consolidated  Balance  Sheets.  The  Company 
recognizes lease expense for these leases on a straight-line basis over the lease term. The Company applies this policy to all 
underlying asset categories.

Nonqualified Cash Deferral Plan

The  Company's  Cash  Deferral  Plan  (the  "Deferral  Plan"),  provides  certain  key  employees  and  members  of  the  Board  of 
Directors  as  selected  by  the  Compensation  Committee  of  the  Board  of  Directors  of  the  Company  (the  "Compensation 
Committee"), with an opportunity to defer the receipt of such participant's base salary, bonus, and director's fees, as applicable. 
The  Deferral  Plan  is  intended  to  be  a  nonqualified  deferred  compensation  plan  that  complies  with  the  provisions  of 
Section 409A of the Internal Revenue Code. All of the investments held in the Deferral Plan are classified as trading securities 
and  recorded  at  fair  value  with  changes  in  the  investments'  fair  value  recognized  as  earnings  in  the  period  they  occur.  The 
corresponding liability for the Deferral Plan is included in other non-current liability in the Consolidated Balance Sheets.

Equity-based Compensation

At December 31, 2022, the Company had one equity-based employee compensation plan, which is described more fully in 
"— Note 8. Stockholders' Equity." The Company applies the fair value method of measuring equity-based compensation, which 
requires a public entity to measure the cost of employee services received in exchange for an award of equity instruments based 
on the grant-date fair value of the award.

Loss per Common Share

The  Company  calculates  net  loss  per  share  as  a  measurement  of  the  Company's  performance  while  giving  effect  to  all 
dilutive potential common shares that were outstanding during the reporting period. The Company had a net loss for all periods 
presented; accordingly, the inclusion of common stock options, unvested restricted stock units, and certain warrants would be 
anti-dilutive. Therefore, the weighted average shares used to calculate both basic and diluted earnings per share are the same. 
See "— Note 15. Basic and Diluted Net Loss per Common Share" for further discussion on net loss per share.

Segment Information

The Company currently operates in one business segment focused on the discovery, development, and commercialization 
of advanced therapies to treat a range of devastating rare and orphan diseases. The Company is not organized by market and is 
managed  and  operated  as  one  business.  A  single  management  team  reports  to  the  chief  operating  decision  maker  who 
comprehensively  manages  the  entire  business.  The  Company  does  not  operate  any  separate  lines  of  business  or  separate 
business  entities  with  respect  to  its  products.  Accordingly,  the  Company  does  not  accumulate  discrete  financial  information 
with respect to separate service lines, and thus there is one reporting unit.

Business Combinations

The  Company  assigns  fair  value  to  the  tangible  and  intangible  assets  acquired  and  liabilities  assumed  based  upon  their 
estimated  fair  values  on  the  acquisition  date  from  acquired  businesses.  The  purchase  price  allocation  process  requires 
management to make significant estimates and assumptions, especially at the acquisition date with respect to intangible assets 
and  in-process  research  and  development  ("IPR&D").  In  connection  with  the  purchase  price  allocations  for  acquisitions,  the 
Company  estimates  the  fair  value  of  contingent  payments  utilizing  a  probability-based  income  approach  inclusive  of  an 
estimated discount rate.

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

Contingent Consideration Payable

Contingent  consideration  payments  in  asset  acquisitions  are  recognized  when  the  contingency  is  resolved  and  the 
consideration is paid or becomes payable. This does not apply in circumstances when the contingent consideration meets the 
definition of a derivative, in which case the amount becomes part of the basis in the asset acquired. Upon recognition of the 
contingent consideration payment, the amount is included in the cost of the acquired asset or group of assets. For contingent 
consideration  payments  in  business  combinations,  the  Company  determines  the  fair  value  of  contingent  acquisition 
consideration payable on the acquisition date using a probability-based income approach utilizing an appropriate discount rate. 
The  short  term  and  long  term  portions  of  the  contingent  consideration  payable  is  shown  on  the  Company's  Consolidated 
Balance  Sheets.  The  fair  value  of  the  contingent  consideration  payable  will  be  determined  each  period  end  and  the  resulting 
change will be recorded on the Consolidated Statements of Operations.

Intangible Assets and Goodwill

The Company records goodwill in a business combination when the total consideration exceeds the fair value of the net 
tangible and identifiable intangible assets acquired. Purchased IPR&D is accounted for as an indefinite lived intangible asset 
until the underlying project is completed, at which point the intangible asset will be accounted for as a definite lived intangible 
asset, or abandoned, at which point the intangible asset will be written off or partially impaired. Goodwill and indefinite lived 
intangible  assets  are  assessed  annually  for  impairment  on  October  1  and  whenever  events  or  circumstances  indicate  that  the 
carrying  amount  of  an  asset  may  not  be  recoverable.  The  Company  first  assesses  the  qualitative  factors  to  determine  if  a 
quantitative test is necessary.  If required, or if the Company elects to bypass the qualitative assessment, a quantitative goodwill 
or  IPR&D  impairment  test  is  conducted.  If  it  is  determined  the  full  carrying  amount  of  IPR&D  is  not  recoverable,  an 
impairment loss is recorded in the amount by which the carrying amount of the asset exceeds its fair value. If it is determined 
the Company's single reporting unit's carrying value, including goodwill, exceeds its fair value, an impairment loss is recorded 
for the difference. No indicators of impairment were noted during the years ended December 31, 2022 and 2021.

Recent Accounting Developments 

The Company has evaluated recent accounting pronouncements and believes that none of them will have a material effect 

on the Company's Consolidated Financial Statements or related disclosures.

3. Goodwill and Intangible Assets

As of December 31, 2022, in connection with the acquisitions, the Company had goodwill of $197.8 million and IPR&D of 
$23.0  million,  which  are  reported  at  fair  value  on  the  Company's  Consolidated  Balance  Sheets.  Intangible  assets  related  to 
IPR&D  assets  are  considered  to  be  indefinite-lived  until  the  completion  or  abandonment  of  the  associated  research  and 
development efforts. During the period the assets are considered indefinite-lived, they will not be amortized but will be tested 
for impairment on an annual basis and between annual tests if the Company becomes aware of any events occurring or changes 
in circumstances that would indicate a reduction in the fair value of the IPR&D assets below their respective carrying amounts.

Goodwill and intangible assets are assessed annually for impairment on October 1 and whenever events or circumstances 
indicate that the carrying amount of an asset may not be recoverable. A goodwill impairment loss, if any, is measured as the 
amount by which the Company's single reporting unit's carrying value, including goodwill, exceeds its fair value. An IPR&D 
impairment loss, if any, is measured as the amount by which the carrying amount of the asset exceeds its fair value. 

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

The following table represents the changes in IPR&D for the years ended December 31, 2022 and 2021, respectively:

Balance at December 31, 2020

Change in IPR&D

Balance at December 31, 2021

Change in IPR&D

Balance at December 31, 2022

(in millions)

$ 

$ 

$ 

23.0 

— 

23.0 

— 

23.0 

The following table represents the changes in Goodwill for the years ended December 31, 2022 and 2021, respectively:

Balance at December 31, 2020

Change in goodwill

Balance at December 31, 2021

Change in goodwill

Balance at December 31, 2022

(in millions)

$ 

$ 

$ 

197.8 

— 

197.8 

— 

197.8 

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

4. Cash, Cash Equivalents, Marketable Securities, and Restricted Cash

As of December 31, 2022, the Company held $148.8 million in cash and cash equivalents and $144.8 million of marketable 
securities which are reported at fair value on the Company's Consolidated Balance Sheets. Unrealized holding gains and losses 
are  generally  reported  within  other  comprehensive  (loss)  gain  in  the  Consolidated  Statements  of  Comprehensive  Loss.  If  a 
decline in the fair value of a marketable security below the Company's cost basis is determined to be other-than-temporary or if 
an available-for-sale debt security’s fair value is determined to be less than the amortized cost and the Company intends or is 
more than likely to sell the security before recovery and it is not considered a credit loss, such security is written down to its 
estimated fair value as a new cost basis and the amount of the write-down is included in earnings as an impairment charge. If 
the unrealized loss of an available-for-sale debt security is determined to be a result of credit loss the Company would recognize 
an allowance and the corresponding credit loss would be included in earnings.

The Company regularly invests excess operating cash in deposits with major financial institutions, money market funds, 
notes issued by the U.S. government, as well as fixed income investments and U.S. bond funds, both of which can be readily 
purchased  and  sold  using  established  markets.  The  Company  believes  that  the  market  risk  arising  from  its  holdings  of  these 
financial  instruments  is  mitigated  as  many  of  these  securities  are  either  government  backed  or  of  the  highest  credit  rating. 
Investments that have original maturities greater than three months but less than one year are classified as current.

Cash, cash equivalents, and marketable securities are classified as current unless mentioned otherwise below and consisted 

of the following:

Total cash, cash equivalents, and marketable securities

$ 

293,513  $ 

(in thousands)

Cash and cash equivalents

Commercial paper

Money market

Certificate of deposit

Included in cash and cash equivalents

Included in marketable securities 

(in thousands)

Cash and cash equivalents

Commercial paper

Corporate debt securities

Asset-backed securities

Money market

Certificate of deposit

Included in cash and cash equivalents

Included in marketable securities

As of December 31, 2022

Gross
Unrealized
Gain

Gross
Unrealized
Loss

Fair
Value

Cost

$ 

148,813  $ 

—  $ 

—  $ 

148,813 

144,299 

350 

51 

$ 

$ 

293,513  $ 

148,813  $ 

144,700 

82 

— 

— 

82  $ 

—  $ 

82 

82  $ 

— 

— 

— 

144,381 

350 

51 

—  $ 

293,595 

—  $ 

148,813 

— 

144,782 

—  $ 

293,595 

As of December 31, 2021

Gross
Unrealized
Gain

Gross
Unrealized
Loss

Fair
Value

Cost

$ 

245,197  $ 

—  $ 

—  $ 

245,197 

174,578 

32,322 

30,070 

350 

51 

$ 

$ 

482,568  $ 

245,197  $ 

237,371 

7 

— 

— 

— 

— 

7  $ 

—  $ 

7 

7  $ 

(54)   

(11)   

(14)   

— 

— 

174,531 

32,311 

30,056 

350 

51 

(79)  $ 

482,496 

—  $ 

245,197 

(79)   

237,299 

(79)  $ 

482,496 

Total cash, cash equivalents, and marketable securities

$ 

482,568  $ 

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Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

For both the years ended December 31, 2022 and 2021, there were no realized gains or losses. The cost of securities sold is 

based on the specific identification method.

The  Company  had  no  marketable  securities  in  an  unrealized  loss  position  as  of  December  31,  2022.  Unrealized  loss 
positions in the marketable securities as of December 31, 2021 reflect temporary impairments and were not a result of credit 
loss. Additionally, as these positions were in a loss position for less than twelve months and the Company did not intend to sell 
these  securities  before  recovery,  the  losses  were  recognized  in  other  comprehensive  (loss)  gain.  The  fair  value  of  these 
marketable securities in unrealized loss positions was $173.4 million as of December 31, 2021.  

The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the Consolidated 

Balance Sheets that sum to the total of the same such amounts shown in the Consolidated Statements of Cash Flows.

(in thousands)

Cash and cash equivalents

Restricted cash
Cash, cash equivalents, and restricted cash shown in 
the Consolidated Statements of Cash Flows

December 31, 2022

December 31, 2021

December 31, 2020

$ 

$ 

148,813  $ 

245,197  $ 

4,302 

4,259 

163,240 

2,922 

153,115  $ 

249,456  $ 

166,162 

5. Inventories

Inventories  consist  of  raw  materials,  work  in  process,  and  finished  goods  related  to  the  manufacture  of  Galafold®.  The 

following table summarizes the components of inventories: 

(in thousands)

Raw materials

Work-in-process

Finished goods

Total inventories

December 31, 2022 December 31, 2021

$ 

$ 

10,054  $ 

9,615 

4,147 

23,816  $ 

12,289 

10,699 

3,830 

26,818 

The Company's reserve for inventory was $0.4 million and $1.1 million as of December 31, 2022 and 2021, respectively.

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6. Property and Equipment

Property and equipment consist of the following:

(in thousands)

Leasehold improvements

Research equipment

Computer equipment

Construction in progress

Furniture and fixtures

Computer software

Vehicles

Land

Gross property and equipment

Less accumulated depreciation

Net property and equipment

December 31,

2022

2021

$ 

24,162  $ 

16,345 

4,486 

4,160 

2,734 

1,106 

66 

— 

53,059 

24,168 

16,663 

5,720 

8,229 

3,163 

1,174 

71 

3,190 

62,378 

(22,281)   

(19,882) 

$ 

30,778  $ 

42,496 

Depreciation expense was $4.8 million and $5.7 million for the years ended December 31, 2022 and 2021, respectively. 
Additionally,  during  the  year  ended  December  31,  2022,  in  connection  with  the  strategic  prioritization  of  its  gene  therapy 
portfolio, the Company performed an assessment of its fixed assets. As a result, the Company recognized an impairment charge 
of $6.6 million.

7. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consist of the following: 

(in thousands)

Accrued compensation and benefits

Accrued sales rebates and discounts

Accrued program fees

Accrued contract manufacturing & contract research costs

Accrued royalties

Accrued professional fees

Accrued taxes

Other

8. Stockholders' Equity

Common Stock and Warrants

December 31,

2022

2021

$ 

25,701  $ 

21,886 

10,515 

8,230 

6,908 

6,868 

5,938 

7,590 

24,258 

15,989 

13,294 

20,361 

4,522 

9,377 

6,154 

4,198 

$ 

93,636  $ 

98,153 

As  of  December  31,  2022,  the  Company  was  authorized  to  issue  500  million  shares  of  common  stock.  Dividends  on 
common stock will be paid when, and if, declared by the board of directors. Each holder of common stock is entitled to vote on 
all matters that are appropriate for stockholder voting and is entitled to one vote for each share held.

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In November 2022, the Company entered into a Sales Agreement with The Goldman Sachs & Co. LLC to create an at-the-
market  ("ATM")  equity  program,  pursuant  to  which  the  Company  may  offer  to  sell  shares  of  its  common  stock  having  an 
aggregate offering gross proceeds of up to $250.0 million.  At December 31, 2022, no shares have been issued under the ATM 
equity program.

In  September  2021,  the  Company  entered  into  a  securities  purchase  agreement  with  certain  entities,  the  (“Purchase 
Agreements”) for the private placement of an aggregate of 11,296,660 shares of the Company’s common stock, at a purchase 
price  of  $10.18  per  share,  and  pre-funded  warrants  to  purchase  an  aggregate  of  8,349,705  shares  of  common  stock,  at  a 
purchase  price  of  $10.17  per  pre-funded  warrant.  Proceeds  from  the  private  placement,  net  of  offering  costs,  were  $199.8 
million. Each pre-funded warrant has an initial exercise price of $0.01 per share and is exercisable at any time after its original 
issuance, subject generally to the lock-up period, at the option of each holder, in such holder’s discretion, by (i) payment in full 
in  immediately  available  funds  of  the  initial  exercise  price  for  the  number  of  shares  of  common  stock  purchased  upon  such 
exercise  or  (ii)  a  cashless  exercise,  in  which  case  the  holder  would  receive  upon  such  exercise  the  net  number  of  shares  of 
common stock determined according to the formula set forth in the pre-funded warrant. Certain of the Purchase Agreements 
provide for a lock-up period of either 60 days or nine months based on the individual agreements. 

  During  the  first  quarter  of  2021,  1,294,999  and  1,260,000  warrants  were  exercised  at  $7.98  and  $7.06  per  share  of 

common stock, respectively, resulting in gross cash proceeds of $19.2 million. 

 During the first and third quarters of 2021, the Company entered into separate, privately negotiated exchange agreements 
with the holders of the Convertible Notes (the "Holders"). Under the terms of the exchange agreements, the Holders agreed to 
exchange  the  remaining  aggregate  principal  amount  of  $2.8  million  of  Convertible  Notes  held  by  them  in  exchange  for  an 
aggregate of approximately 472,356 shares of Company common stock, par value $0.01 per share. This transaction resulted in 
an increase of $2.7 million and five thousand dollars to additional paid-in-capital and common stock, respectively.

Nonqualified Cash Deferral Plan

The Company's Deferral Plan provides certain key employees and members of the Board of Directors, as selected by the 
Compensation Committee, with an opportunity to defer the receipt of such participant's base salary, bonus, and director's fees, 
as applicable. The Deferral Plan is intended to be a nonqualified deferred compensation plan that complies with the provisions 
of Section 409A of the Internal Revenue Code of 1986 as amended.

The Company had a deferred compensation investment balance of $5.5 million and $4.8 million as of December 31, 2022 

and 2021, respectively, with corresponding approximate amounts of liability. 

Deferral  Plan  investment  assets  are  classified  as  trading  securities  and  recorded  at  fair  value  with  changes  in  the 
investments'  fair  value  recognized  as  earnings  in  the  period  they  occur.  Deferred  compensation  liability  amounts  under  the 
Deferral Plan are included in other long-term liabilities.

Equity Incentive Plan 

The Company's Amended and Restated 2007 Equity Incentive Plan (the "Plan") provides for the granting of restricted stock 
units and options to purchase common stock in the Company to employees, directors, advisors, and consultants at a price to be 
determined  by  the  Company's  Board  of  Directors.  The  Plan  is  intended  to  encourage  ownership  of  stock  by  employees  and 
consultants of the Company and to provide additional incentives for them to promote the success of the Company's business. 
Under the provisions of the Plan, no option will have a term in excess of 10 years. The Board of Directors, or its committee, is 
responsible for determining the individuals to be granted options, the number of options each individual will receive, the option 
price per share, and the exercise period of each option. Options granted pursuant to the Plan generally vest 25% on the first year 
anniversary date of grant plus an additional 1/48th for each month thereafter and may be exercised in whole or in part for 100% 
of the shares vested at any time after the date of grant. As of December 31, 2022, the Company has reserved up to 15,472,672 
shares for issuance under the Plan.

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9. Share based Compensation 

The  Plan  provides  for  the  granting  of  restricted  stock  units  and  options  to  purchase  common  stock  in  the  Company  to 
employees, directors. advisors, and consultants at a price to be determined by the Company’s Board of Directors. The Plan is 
intended to encourage ownership of stock by employees and consultants of the Company and to provide additional incentives 
for  them  to  promote  the  success  of  the  Company’s  business.  The  Board  of  Directors,  or  its  committee,  is  responsible  for 
determining the individuals to be granted options, the number of options each individual will receive, the option price per share, 
and the exercise period of each option.

The Plan provides for certain benefits to qualifying Plan participants who separate from service with the Company due to 
death, disability or "retirement" (as such term is defined under the Plan) ("Qualified Participants"). Options granted under the 
Plan to a Qualified Participant shall continue to vest until the 2nd anniversary of the Qualified Participant’s separation and all 
vested  options  held  by  such  Qualified  Participant  shall  remain  exercisable  until  the  earlier  of  the  4th  anniversary  of  the 
Qualified  Participant’s  separation  or  the  original  expiration  date  of  the  option.  Options  that  are  not  exercised  during  this 
exercise period shall be forfeited. Time-based restricted stock units and restricted stock granted to a Qualified Participant under 
the Plan that was scheduled to vest within the two year period following the Qualified Participant's separation shall accelerate 
and be delivered upon such separation. Any time-based restricted stock units or restricted stock that would have vested after 
such two year period will be forfeited upon the Qualified Participant's separation. Also, per the Amendment, any performance-
based restricted stock units under the Plan ("PRSUs") received by the Qualified Participant, shall remain eligible to vest after 
the  Qualified  Participant’s  separation  based  on  the  actual  performance  of  the  Company  through  the  end  of  the  performance 
period applicable to any such PRSUs.

Stock Option Grants

The Company uses the fair value method of measuring share-based compensation, using the fair value of each equity award 
granted. The Company chose the ‘‘straight-line’’ attribution method for allocating compensation costs and recognized the fair 
value of each stock option on a straight-line basis over the vesting period of the related awards. 

The  Company  uses  the  Black-Scholes  option  pricing  model  when  estimating  the  grant  date  fair  value  for  share-based 
awards.  Use  of  a  valuation  model  requires  management  to  make  certain  assumptions  with  respect  to  selected  model  inputs. 
Expected volatility is based on the Company's historical volatility. The average expected life is determined using the Company's 
actual historical data. The risk-free interest rate is based on U.S. Treasury, zero-coupon issues with a remaining term equal to 
the expected life assumed at the date of grant. Forfeitures are estimated based on voluntary termination behavior, as well as a 
historical analysis of actual option forfeitures.

The fair value of the stock options granted was estimated on the date of grant using a Black-Scholes option pricing model 

with the following weighted-average assumptions:

Expected stock price volatility

Risk free interest rate

Expected life of options (years) 

Expected annual dividend per share

Years Ended December 31,

2022

2021

2020

 62.1 %

 1.7 %

5.34

 65.4 %

 0.6 %

5.40

$ 

— 

$ 

— 

$ 

 75.1 %

 1.6 %

5.67

— 

The weighted average grant-date fair value per share of options granted during 2022, 2021, and 2020 were $6.11, $9.08, 

and $6.40, respectively.

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A summary of the Company's stock options for the year ended December 31, 2022 were as follows:

Number of
Shares

(in thousands)

Weighted
Average
Exercise
Price

Weighted
Average
Remaining
Years

Aggregate
Intrinsic
Value

(in millions)

Options outstanding, December 31, 2019

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2020

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2021

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2022

Vested and unvested expected to vest, December 31, 2022  

Exercisable at December 31, 2022

16,724  $ 

4,362  $ 

(5,243)  $ 

(1,376)  $ 

(435)  $ 

14,032  $ 

3,262  $ 

(1,483)  $ 

(844)  $ 

(236)  $ 

14,731  $ 

5,733  $ 

(660)  $ 

(495)  $ 

(245)  $ 

19,064  $ 

17,492  $ 

10,938  $ 

9.15 

9.98 

8.11 

10.42 

13.33 

9.54 

16.53 

7.05 

12.97 

13.28 

11.08 

11.53 

6.58 

12.57 

12.84 

11.31 

11.22 

10.59 

6.6 $ 

6.4 $ 

5.0 $ 

36.7 

35.1 

29.0 

The  aggregate  intrinsic  value  of  options  exercised  during  the  years  ended  December  31,  2022,  2021  and  2020  was  $2.5 
million,  $8.5  million,  and  $40.9  million,  respectively.  Cash  proceeds  from  stock  options  exercised  during  the  years  ended 
December  31,  2022,  2021,  and  2020  were  $4.3  million,  $10.2  million,  and  $42.3  million,  respectively.  As  of  December  31, 
2022, the total unrecognized compensation cost related to non-vested stock options granted was $31.1 million and is expected 
to be recognized over a weighted average period of three years.

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Restricted Stock Units and Performance-Based Restricted Stock Units (collectively "RSUs")

RSUs  awarded  under  the  Plan  are  generally  subject  to  graded  vesting  and  are  contingent  on  an  employee's  continued 
service.  RSUs  are  generally  subject  to  forfeiture  if  employment  terminates  prior  to  the  release  of  vesting  restrictions.  The 
Company  expenses  the  cost  of  the  RSUs,  which  is  determined  to  be  the  fair  market  value  of  the  shares  of  common  stock 
underlying the RSUs at the date of grant, ratably over the period during which the vesting restrictions lapse. A summary of non-
vested RSU activity under the Plan for the year ended December 31, 2022 is as follows:

Number of
Shares

(in thousands)

Weighted
Average Grant
Date Fair
Value

Weighted
Average
Remaining
Years

Aggregate
Intrinsic
Value

(in millions)

Non-vested units as of December 31, 2019

Granted

Vested

Forfeited

Non-vested units as of December 31, 2020

Granted

Vested

Forfeited

Non-vested units as of December 31, 2021

Granted

Vested

Forfeited

Non-vested units as of December 31, 2022

5,792  $ 

4,692  $ 

(2,164)  $ 

(1,240)  $ 

7,080  $ 

3,191  $ 

(1,863)  $ 

(1,067)  $ 

7,341  $ 

5,048  $ 

(2,251)  $ 

(421)  $ 

9,717  $ 

11.18 

11.29 

10.70 

11.14 

11.35 

16.94 

15.77 

12.82 

13.90 

11.93 

12.48 

12.06 

13.07 

2.1 $ 

118.6 

As of December 31, 2022, there was $50.4 million of total unrecognized compensation cost related to unvested RSUs with 

service-based vesting conditions. These costs are expected to be recognized over a weighted average period of two years.

Compensation Expense Related to Equity Awards

The following table summarizes information related to compensation expense recognized in the Consolidated Statements of 

Operations related to the equity awards:

(in thousands)

Research and development expense

Selling, general, and administrative expense

Total equity compensation expense

10. Assets and Liabilities Measured at Fair Value

Years Ended December 31,

2022

2021

2020

$ 

$ 

25,089  $ 

17,340  $ 

51,423 

40,498 

76,512  $ 

57,838  $ 

20,817 

28,334 

49,151 

The  Company's  financial  assets  and  liabilities  are  measured  at  fair  value  and  classified  within  the  fair  value  hierarchy 

which is defined as follows:

Level 1 — Quoted prices in active markets for identical assets or liabilities that the Company has the ability to 
access at the measurement date.

Level 2 — Inputs other than quoted prices in active markets that are observable for the asset or liability, either 
directly or indirectly.

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Level 3 — Inputs that are unobservable for the asset or liability.

A  summary  of  the  fair  value  of  the  Company's  recurring  assets  and  liabilities  aggregated  by  the  level  in  the  fair  value 

hierarchy within which those measurements fall as of December 31, 2022 are identified in the following tables:

(in thousands)
Assets:

Commercial paper

Money market

(in thousands)

Liabilities:

Contingent consideration payable

Deferred compensation plan liability

Level 2

Total

$ 

144,381  $ 

144,381 

5,808 

5,808 

$ 

150,189  $ 

150,189 

Level 2

Level 3

Total

$ 

$ 

—  $ 

21,417  $ 

21,417 

5,458 

— 

5,458 

5,458  $ 

21,417  $ 

26,875 

A  summary  of  the  fair  value  of  the  Company's  recurring  assets  and  liabilities  aggregated  by  the  level  in  the  fair  value 

hierarchy within which those measurements fall as of December 31, 2021 are identified in the following tables:

(in thousands)
Assets:

Commercial paper

Corporate debt securities

Asset-backed securities

Money market

(in thousands)
Liabilities:
Contingent consideration payable
Deferred compensation plan liability

Level 2

Total

$ 

174,531  $  174,531 

32,311 

30,056 

5,150 

32,311 

30,056 

5,150 

$ 

242,048  $  242,048 

Level 2

Level 3

Total

$ 

$ 

—  $ 

4,800 

20,339  $ 
— 

4,800  $ 

20,339  $ 

20,339 
4,800 

25,139 

The Company's Senior Secured Term Loan due 2026 falls into the Level 2 category within the fair value level hierarchy 
and  the  fair  value  was  determined  using  quoted  prices  for  similar  liabilities  in  active  markets,  as  well  as  inputs  that  are 
observable for the liability (other than quoted prices), such as interest rates that are observable at commonly quoted intervals. 
The carrying value of the Senior Secured Term Loan due 2026 approximates the fair value.

The Company did not have any Level 3 assets as of December 31, 2022 or 2021.

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Cash, Money Market Funds and Marketable Securities

The Company classifies its cash within the fair value hierarchy as Level 1 as these assets are valued using quoted prices in 
an active market for identical assets at the measurement date. The Company considers its investments in marketable securities 
as available-for-sale and classifies these assets and the money market funds within the fair value hierarchy as Level 2 primarily 
utilizing broker quotes in a non-active market for valuation of these securities. No changes in valuation techniques or inputs 
occurred  during  the  year  ended  December  31,  2022.  No  transfers  of  assets  between  Level  1  and  Level  2  of  the  fair  value 
measurement hierarchy occurred during the year ended December 31, 2022.

Contingent Consideration Payable

The contingent consideration payable resulted from the acquisition of Callidus Biopharma, Inc. ("Callidus") in November 
2013. The most recent valuation was determined using a probability weighted discounted cash flow valuation approach. Gains 
and losses are included in the Consolidated Statements of Operations.

The  contingent  consideration  payable  for  Callidus  has  been  classified  as  a  Level  3  recurring  liability  as  its  valuation 
requires substantial judgment and estimation of factors that are not currently observable in the market. If different assumptions 
were used for the various inputs to the valuation approach, the estimated fair value could be significantly higher or lower than 
the fair value the Company determined. 

The  following  significant  unobservable  inputs  were  used  in  the  valuation  of  the  contingent  consideration  payable  of 

Callidus for the ATB200 Pompe disease program:

Contingent Consideration 
Liability

Fair Value as of 
December 31, 2022

(in thousands)

Valuation Technique

Unobservable Input

Range

Clinical and regulatory 
milestones

$ 

21,417 

Probability weighted 
discounted cash flow

Discount rate
Probability of achievement 
of milestones
Projected year of payments

10.2%

88%-98%

2023

Contingent consideration liabilities are remeasured to fair value each reporting period using discount rates, probabilities of 
payment,  and  projected  payment  dates.  Projected  contingent  payment  amounts  related  to  clinical  and  regulatory  based 
milestones are discounted back to the current period using a discounted cash flow model. Increases in discount rates and the 
time  to  payment  may  result  in  lower  fair  value  measurements.  Increases  or  decreases  in  any  of  those  inputs  together,  or  in 
isolation, may result in a significantly lower or higher fair value measurement. There is no assurance that any of the conditions 
for the milestone payments will be met.

The Company reached a regulatory milestone in September 2021 associated with FDA approval of the first BLA and in 
November 2021 associated with EMA validation of the MAA, both related to the contingent consideration of Callidus for the 
ATB200  Pompe  disease  program.  The  satisfaction  of  these  milestones  resulted  in  the  collective  milestone  payment  of  $12.0 
million.

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The following table shows the change in the balance of contingent consideration payable for the year ended December 31, 

2022 and 2021, respectively:  

(in thousands)

Balance, beginning of the period
Changes in fair value during the period, included in the Consolidated Statements 
of Operations 

Payment of contingent consideration in cash
Balance, end of the period(1) 

Years ended December 31,

2022

2021

$ 

20,339  $ 

25,825 

1,078 

— 

6,514 

(12,000) 

$ 

21,417  $ 

20,339 

______________________________
(1) As certain milestones are expected to be reached within the next twelve months, the December 31, 2022 balance was recorded as a current 
liability in the Consolidated Balance Sheets.

11. Debt 

The Company's debt consists of the following: 

(in thousands)
Senior Secured Term Loan due 2026:

Principal
Less: debt discount (1)
Less: deferred financing (1)

Net carrying value of Long-term debt

December 31, 2022

December 31, 2021

$ 

$ 

400,000  $ 

400,000 

(4,571) 

(3,439) 

(6,074) 

(4,569) 

391,990  $ 

389,357 

_____________________________
(1) Included in the Consolidated Balance Sheets within long-term debt and amortized to interest expense over the remaining life of the 
Senior Secured Term Loan using the effective interest rate method.

Senior Secured Term Loan due 2026

In  July  2020,  the  Company  entered  into  a  definitive  agreement  for  a  $400  million  credit  facility  with  Hayfin  Capital 
Management (“Senior Secured Term Loan due 2026”) with an interest rate equal to 3-month LIBOR, subject to a 1% floor, plus 
6.5% per annum and requires interest-only payments until mid-2024. The Senior Secured Term Loan due 2026 will be repaid in 
nine quarterly payments of $44.4 million, starting on July 2024 with the final balance due on the maturity date in July 2026. 
This transaction resulted in net proceeds of $385.9 million, after deducting fees and expenses. There were no warrants or equity 
conversion features associated with the Senior Secured Term Loan due 2026. The Company used the proceeds to voluntarily 
settle  the  Senior  Secured  Term  Loan  with  BioPharma  Credit  PLC,  which  included  the  $150  million  principal,  $1.1  million 
accrued  interest,  and  $5.2  million  in  early  settlement  premiums.  As  a  result  of  this  early  extinguishment,  the  Company 
recognized a loss on extinguishment of debt of $7.3 million in the Consolidated Statements of Operations.

The Senior Secured Term Loan due 2026 is subject to mandatory prepayment provisions that require prepayment upon a 
change of control, the incurrence of certain additional indebtedness, asset sale, or an event of loss, subject to certain conditions 
set forth in the Senior Secured Term Loan due 2026. The Company may prepay the Senior Secured Term Loan due 2026 in 
whole, at its option at any time. Any prepayment of the Senior Secured Term Loan due 2026 is subject to certain make-whole 
premiums and prepayment premiums, the latter of which decrease until the fourth anniversary of the transaction date at which 
point no prepayment penalty shall exist. The obligations under the Senior Secured Term Loan due 2026 are secured by a first 
lien  security  interest  in  certain  assets  of  the  Company.  The  Senior  Secured  Term  Loan  due  2026  contains  certain  customary 
representations and warranties, affirmative and negative covenants and events of default applicable to the Company. The Senior 
Secured  Term  Loan  due  2026  also  contains  a  minimum  liquidity  covenant  of  $75  million,  and  an  incremental  minimum 
consolidated  revenue  covenant,  measured  as  of  the  previous  four  consecutive  fiscal  quarters.  The  minimum  consolidated 
revenue covenant ranges from $140 million, beginning March 31, 2021, and peaks at $225 million by June 30, 2023, continuing 
at  that  level  until  the  Senior  Secured  Term  Loan  due  2026  is  repaid.  If  an  event  of  default  occurs  and  is  continuing,  Hayfin 
Capital Management may declare all amounts outstanding under the Senior Secured Term Loan due 2026 to be immediately 
due and payable.

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Interest Expense

The following table sets forth interest expense recognized related to the Company's debt for the years ended December 31, 

2022 and 2021, respectively:

(in thousands, except interest rate amounts)

Contractual interest expense

Amortization of debt discount

Amortization of deferred financing
Effective interest rate of the liability component, Senior Secured Term Loan due 2026

December 31, 
2022

December 31, 
2021

$  34,446 

$  30,473 

$ 

$ 

1,503 

1,131 
 12.1 %

$ 

$ 

1,462 

1,028 

 8.4 %

12. Leases

The  Company  currently  has  operating  leases  for  office  and  research  laboratory  space,  equipment,  and  vehicles  under 
agreements expiring at various dates through 2044, which include renewal options on leases which the Company is reasonably 
certain to exercise.

For  the  years  ended  December  31,  2022,  and  2021,  operating  lease  expense  was  $9.8  million  and  $10.0  million  and 
variable lease expense was $1.7 million and $2.1 million, respectively. For the years ended December 31, 2022, and 2021, the 
Company  paid  $8.3  million  and  $8.4  million,  respectively,  for  amounts  included  in  the  measurement  of  operating  lease 
liabilities  and  recorded  $8.9  million  and  $0.3  million,  respectively,  of  right-of-use  assets.  For  the  year  ended  December  31, 
2022, there were no tenant improvements paid through lease incentives in exchange for new operating lease liabilities.  For the 
year ended December 31, 2021, there were $0.3 million of tenant improvements paid through lease incentives in exchange for 
new operating lease liabilities. 

Commitments under finance leases are not significant for the year ended December 31, 2022.

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Supplemental balance sheet information related to operating leases were as follows:

(in thousands, except year and discount rate amounts)
Operating lease ROU assets, net

Current portion of the operating lease liabilities
Non-current portion of the operating lease liabilities
Total operating lease liability

Weighted-average remaining lease terms (years)
Weighted-average discount rate

December 31, 2022

December 31, 2021

$ 

$ 

$ 

29,534 

8,552 
51,578 
60,130 

$ 

$ 

$ 

20,586 

7,409 
43,363 
50,772 

17.0
 12.2 %

19.6
 13.1 %

At December 31, 2022, the future minimum operating lease payments were as follows:

(in thousands)

2023

2024

2025

2026

2027

Thereafter

Total lease payments

Less lease incentives

Less imputed interest

Total operating lease liability

Operating Lease

$ 

$ 

9,466 

8,624 

8,419 

8,571 

8,754 

124,979 

168,813 

(22,299) 

(86,384) 

60,130 

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13. Income Taxes

For financial reporting purposes, income (loss) before income taxes includes the following components:

(in thousands)

United States

Foreign

Total

Years Ended December 31,

2022

2021

2020

$ 

(343,424)  $ 

(333,571)  $ 

(365,332) 

101,385 

92,017 

91,078 

$ 

(242,039)  $ 

(241,554)  $ 

(274,254) 

Following were the components of income tax expense (benefit) for the years ended December 31, 2022, 2021, and 2020:

(in thousands)
Current

Federal
State
Foreign
Deferred
Federal
State
Foreign

Total

Years Ended December 31,

2022

2021

2020

$ 

$ 

—  $ 
6 

(5,760)   

274 
9 
— 
(5,471)  $ 

—  $ 
15 
8,857 

— 
34 
— 
8,906  $ 

— 
11 
4,163 

(1,421) 
(155) 
— 
2,598 

A reconciliation of the statutory tax rates and the effective tax rates for the years ended December 31, 2022, 2021, and 

2020 are as follows:

Statutory rate

Tax credits

Impact of foreign operations
Other
Valuation allowance

Net

Years Ended December 31,

2022

2021

2020

 (21) %

 (11) 

 18 
 3 
 9 

 (21) %

 (21) %

 (9) 

 3 
 3 
 28 

 (7) 

 4 
 2 
 23 

 (2) %

 4 %

 1 %

On December 22, 2017, the U.S. government enacted the Tax Cuts and Jobs Act ("Tax Act"). The Tax Act significantly 
revises  U.S.  tax  law  by,  among  other  provisions,  lowering  the  U.S.  federal  statutory  income  tax  rate  to  21%,  imposing  a 
mandatory  one-time  transition  tax  on  previously  deferred  foreign  earnings,  and  eliminating  or  reducing  certain  income  tax 
deductions. The Tax Act also introduced an additional U.S. tax on certain non-U.S. subsidiaries’ earnings which are considered 
to  be  Global  Intangible  Low  Taxed  Income  (referred  to  as  "GILTI").  After  consideration  of  the  relevant  guidance  and 
completing the accounting for the tax effects of the Tax Act, the Company has elected to treat GILTI as a period cost. 

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Beginning in 2022, the Tax Act eliminated the right to deduct research and development expenditures for tax purposes in 
the period the expenses were incurred and instead requires all U.S. and foreign research and development expenditures to be 
amortized over five and fifteen tax years, respectively.

Tax  returns  for  years  2017  through  2022  are  open  to  examination  by  tax  authorities.  The  Company  is  also  subject  to 

examination in any period for which it has net operating losses. 

Deferred income taxes reflect the net effect of temporary difference between the carrying amounts of assets and liabilities 
for financial reporting purposes and the amounts used for income tax purposes. The significant components of the deferred tax 
assets and liabilities are as follows:

(in thousands)

Deferred tax assets

Intellectual property

Research tax credit

Capitalized research and development costs

Net operating loss carry forwards

Share-based compensation

Interest carry forward limitation

Lease liability

Inventory

Other

Gross deferred tax assets

Deferred tax liabilities

Business acquisition

Royalty payable

Other

Total net deferred tax assets

Less: valuation allowance

Net deferred tax liability

Years Ended
December 31,

2022

2021

$ 

68,567  $ 

105,453 

223,366 

29,317 

315,444 

16,417 

12,558 

11,428 

10,400 

20,109 

707,606 

205,095 

— 

334,762 

11,779 

8,285 

9,105 

— 

17,748 

692,227 

(4,939)   

(4,930) 

(68,567)   

(105,453) 

(6,806)   

(4,932) 

627,294 

576,912 

(632,233)   

(581,842) 

$ 

(4,939)  $ 

(4,930) 

The  Company  records  a  valuation  allowance  for  temporary  differences  for  which  it  is  more  likely  than  not  that  the 
Company will not receive future tax benefits. At December 31, 2022 and 2021, the Company recorded valuation allowances of 
$632.2 million and $581.8 million, respectively, representing an increase in the valuation allowance of $50.4 million in 2022, 
due  to  the  uncertainty  regarding  the  realization  of  such  deferred  tax  assets,  to  offset  the  benefits  of  net  operating  losses 
generated  during  those  years.  The  deferred  tax  liability  related  to  business  acquisitions  pertains  to  the  basis  difference  in 
IPR&D acquired by the Company. The Company's policy is to record a deferred tax liability related to acquired IPR&D that 
may eventually be realized either upon amortization of the asset when the research is completed, and a product is successfully 
launched or the write-off of the asset if it is abandoned or unsuccessful.

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As of December 31, 2022, the Company had federal and state net operating loss carry forwards ("NOLs") of approximately 
$1,183 million and $992 million, respectively. The federal carry forward for losses generated prior to 2018 will expire in 2029 
through 2037. Federal net operating losses incurred in 2018 and onward have an indefinite expiration under the Tax Act. Most 
of the state carry forwards generated prior to 2009 have expired through 2016. The remaining state carry forwards including 
those generated in 2009 through 2022 will expire in 2029 through 2040. Utilization of NOLs may be subject to a substantial 
limitation  pursuant  to  Section  382  of  the  Internal  Revenue  Code  of  1986,  as  amended  as  well  as  similar  state  statutes  in  the 
event of an ownership change. Such ownership changes have occurred in the past and could occur again in the future. Under 
Section  382  of  the  Internal  Revenue  Code  of  1986,  as  amended,  or  Section  382,  if  a  corporation  undergoes  an  "ownership 
change,"  generally  defined  as  a  greater  than  50%  change  (by  value)  in  its  equity  ownership  over  a  three-year  period,  the 
corporation's  ability  to  use  its  pre-change  NOLs  and  other  pre-change  tax  attributes  (such  as  research  and  development  tax 
credits) to offset its post-change income may be limited. The Company may experience ownership changes in the future as a 
result of shifts in the stock ownership some of which are outside the Company's control. The Company completed a detailed 
study of the NOLs for the tax year 2022 and determined that there was not an ownership change in excess of 50%. Ownership 
changes in future periods may place additional limits on the Company's ability to utilize net operating loss and tax credit carry 
forwards. In addition, at the state level, there may be periods during which the use of NOLs is suspended or otherwise limited, 
which could accelerate or permanently decrease the amount of state attributes and increase state taxes owed. 

The Company also has research and experimentation and orphan drug credit carryforwards of approximately $36.4 million 
and $187.0 million, respectively, which will expire in the years 2030 through 2040. Deferred tax assets for these carryforwards 
are subject to a full valuation allowance.

14. Collaborative Agreements

University of Pennsylvania

In  October  2018,  as  amended,  the  Company  entered  into  a  collaboration  agreement  with  the  University  of  Pennsylvania 
("Penn") to pursue research and development of novel gene therapies. The Company's gene therapy portfolio pipeline expanded 
to include Pompe disease, Fabry disease and other rare diseases.

In December 2022, the Company entered into a mutual termination agreement (the "Termination Agreement") pursuant to 
which the Company and Penn mutually agreed to terminate the collaboration agreement, as amended. In connection with the 
Termination Agreement, the Company agreed to pay Penn an aggregate of $23.7 million in connection with an unpaid portion 
of the discovery support payments, research program wind-down activities, and outstanding patent costs which was recorded as 
a component of research and development expense within the Consolidated Statements of Operations. 

Concurrently, the Company entered into a license agreement with Penn pursuant to which it obtained a license with respect 
to the pre-clinical research and development of next generation parvovirus gene therapy products for the treatment of Pompe 
disease  and  Fabry  disease.  Under  the  agreement,  the  Company  will  be  responsible  for  clinical  development  and 
commercialization  of  the  licensed  products  for  the  indications  and  Penn  is  eligible  to  receive  certain  milestone  and  royalty 
payments  with  respect  to  licensed  products  for  each  indication,  up  to  an  aggregate  of  $86.5  million  per  indication.  Royalty 
payments are based on net sales of licensed products on a licensed product-by-licensed product and country-by-country basis.

GlaxoSmithKline

In  July  2012,  as  amended  in  November  2013,  the  Company  entered  into  an  agreement  with  GlaxoSmithKline  ("GSK"), 
pursuant to which Amicus obtained global rights to develop and commercialize Galafold® as a monotherapy and in combination 
with ERT for Fabry disease (“Collaboration Agreement”). Under the terms of the Collaboration Agreement, GSK is eligible to 
receive post-approval and sales-based milestones up to $40 million, as well as tiered royalties in the mid-teens in eight major 
markets outside the U.S. 

The  contingent  milestone  payments  due  to  GSK  are  recorded  within  the  other  current  and  other  non-current  liabilities 
accounts on the Consolidated Balance Sheets. Sales based tiered royalties due to GSK are recorded within the cost of goods 
sold within the Consolidated Statements of Operations.

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For  the  year  ended  December  31,  2022,  under  the  GSK  collaboration  agreements,  the  Company  incurred  approximately 
$25.1 million of royalty expenses. As of December 31, 2022, $7.4 million was recorded as deferred reimbursements and the 
Company recognized a liability of $6.9 million related to royalties payable to GSK within accrued expenses in the Consolidated 
Balance Sheets.

15. Legal Proceedings 

In the fourth quarter of 2022, the Company received Paragraph IV Certification Notice Letters from Teva Pharmaceuticals 
USA, Inc. ("Teva"), Aurobindo Pharma Limited ("Aurobindo"), and Lupin Limited ("Lupin") in connection with Abbreviated 
New Drug Applications (“ANDA”) filed with the FDA requesting approval to market generic Galafold®. In November 2022, 
the Company filed four lawsuits against Teva, Lupin, and Aurobindo in the U.S. District Court for the District of Delaware for 
infringement of its Orange Book-listed patents and will vigorously enforce its Galafold® intellectual property rights.

16. Basic and Diluted Net Loss per Common Share

The following table provides a reconciliation of the numerator and denominator used in computing basic and diluted net 

loss attributable to common stockholders per common share:

(in thousands, except per share amounts)

Numerator:

Years Ended December 31,

2022

2021

2020

Net loss attributable to common stockholders

$ 

(236,568)  $ 

(250,460)  $ 

(276,852) 

Denominator:

Weighted average common shares outstanding — basic and diluted

  289,057,198 

  271,421,986 

  258,867,380 

Dilutive  common  stock  equivalents  would  include  the  dilutive  effect  of  outstanding  common  stock  options,  unvested 
RSUs,  outstanding  warrants  for  common  stock  equivalents,  and  convertible  debt  units.  Potentially  dilutive  common  stock 
equivalents were excluded from the diluted earnings per share denominator for all periods because of their anti-dilutive effect. 

The  table  below  presents  potential  shares  of  common  stock  that  were  excluded  from  the  computation  as  they  were  anti-

dilutive using the treasury stock method:

(in thousands)

Options to purchase common stock

Unvested restricted stock units
Outstanding warrants, convertible to common stock

Convertible notes

Years ended December 31,

2022

2021

2020

19,064 

14,731 

14,032 

9,717 
— 

— 

7,341 
— 

— 

7,080 
2,555 

462 

Total number of potentially issuable shares

28,781 

22,072 

24,129 

Item 9.    CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL 
DISCLOSURE.

None.

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Item 9A.    CONTROLS AND PROCEDURES.

Evaluation of Disclosure Controls and Procedures

Our  management,  with  the  participation  of  our  principal  executive  officer  and  principal  financial  officer,  evaluated  the 
effectiveness  of  our  disclosure  controls  and  procedures  as  of  December  31,  2022.  The  term  "disclosure  controls  and 
procedures," as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act, means controls and other procedures of a 
company that are designed to ensure that information required to be disclosed by us in the reports that we file or submit under 
the  Exchange  Act  is  recorded,  processed,  summarized  and  reported  within  the  time  periods  specified  in  the  SEC  rules  and 
forms.  Disclosure  controls  and  procedures  include,  without  limitation,  controls  and  procedures  designed  to  ensure  that 
information required to be disclosed by a company in the reports that it files or submits under the Exchange Act is accumulated 
and  communicated  to  the  Company's  management,  including  its  principal  executive  and  principal  financial  officers,  as 
appropriate to allow timely decisions regarding required disclosure. Management recognizes that any controls and procedures, 
no  matter  how  well  designed  and  operated,  can  provide  only  reasonable  assurance  of  achieving  their  objectives  and 
management  necessarily  applies  its  judgment  in  evaluating  the  cost-benefit  relationship  of  possible  controls  and  procedures. 
Based on the evaluation of our disclosure controls and procedures as of December 31, 2022, our principal executive officer and 
principal  financial  officer  concluded  that,  as  of  such  date,  our  disclosure  controls  and  procedures  were  effective  at  the 
reasonable assurance level.

There have been no changes in our internal controls over financial reporting during the fourth quarter of the year ended 
December  31,  2022  that  have  materially  affected,  or  are  reasonably  likely  to  materially  affect,  our  internal  controls  over 
financial reporting.

Management's Report on Internal Control Over Financial Reporting

The information required by this section which includes the "Management's Report on Consolidated Financial Statements 
and  Internal  Control  over  Financial  Reporting"  and  the  "Report  of  Independent  Registered  Public  Accounting  Firm"  are 
incorporated by reference from "Item 8. Financial Statements and Supplementary Data."

Item 9B.    OTHER INFORMATION.

None.

Item 9C.    DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS.

Not applicable. 

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PART III

Certain  information  required  by  Part  III  is  omitted  from  this  Annual  Report  on  Form  10-K  as  we  intend  to  file  our 
definitive proxy statement for our 2023 annual meeting of stockholders, pursuant to Regulation 14A of the Securities Exchange 
Act,  not  later  than  120  days  after  the  end  of  the  fiscal  year  covered  by  this  Annual  Report  on  Form  10-K,  and  certain 
information to be included in the proxy statement is incorporated herein by reference.

Item 10.    DIRECTORS, EXECUTIVE OFFICERS OF THE REGISTRANT AND CORPORATE GOVERNANCE.

The information required by this item is incorporated by reference from the Proxy Statement under the caption "Executive 

Officers," "Section 16(a) Reports," "Proposal No. 1 — Election of Directors," "Committees of the Board and Meetings."

We have adopted a Code of Business Ethics and Conduct for Employees, Executive Officers and Directors that applies to 
our  employees,  officers  and  directors,  including  the  principal  executive  officer,  principal  financial  officer,  and  principal 
accounting officer, and incorporates guidelines designed to deter wrongdoing and to promote the honest and ethical conduct and 
compliance with applicable laws and regulations. In addition, the code of ethics incorporates our guidelines pertaining to topics 
such as conflicts of interest and workplace behavior. We have posted the text of our code on our website, where it is accessible 
for  free,  at  www.amicusrx.com  in  connection  with  "Investors/Corporate  Governance"  materials.  In  addition,  we  intend  to 
promptly disclose (1) the nature of any amendment to our code of ethics that applies to our principal executive officer, principal 
financial officer, principal accounting officer or controller, or persons performing similar functions and (2) the nature of any 
waiver, including an implicit waiver, from provision of our code of ethics that is granted to one of these specified officers, the 
name of such person who is granted the waiver and the date the waiver on our website in the future.

Item 11.    EXECUTIVE COMPENSATION.

The  information  required  by  this  item  is  incorporated  by  reference  from  the  Proxy  Statement  under  the  caption 
"Compensation  Discussion  and  Analysis,"  "Compensation  and  Leadership  Development  Committee  Report,"  and 
"Compensation and Leadership Development Committee Interlocks and Insider Participation."

Item 12.    SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED 
STOCKHOLDER MATTERS.

The information required by this item is incorporated by reference from the Proxy Statement under the captions "Security 
Ownership  of  Certain  Beneficial  Owners  and  Management  and  Related  Stockholder  Matters"  and  "Securities  Authorized  for 
Issuance under our Equity Compensation Plan."

Item 13.    CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS AND DIRECTOR INDEPENDENCE.

The information required by this item is incorporated by reference from the Proxy Statement under the captions "Policies 

and Procedures for Related Party Transactions," and "Director Independence."

Item 14.    PRINCIPAL ACCOUNTING FEES AND SERVICES.

The information required by this item is incorporated by reference from the Proxy Statement.

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Item 15.    EXHIBITS, FINANCIAL STATEMENT SCHEDULE

1. Index to Consolidated Financial Statements

PART IV

The following Consolidated Financial Statements are filed as part of this report:

Management's Report on Consolidated Financial Statements and Internal Control over Financial Reporting

Report of Independent Registered Public Accounting Firm (PCAOB ID: 42)

Consolidated Balance Sheets as of December 31, 2022 and 2021

Consolidated Statements of Operations for the years ended December 31, 2022, 2021, and 2020

Consolidated Statements of Comprehensive Loss for the years ended December 31, 2022, 2021, and 2020

Consolidated Statements of Changes in Stockholders' Equity for the years ended December 31, 2022, 2021, and 2020

Consolidated Statements of Cash Flows for the years ended December 31, 2022, 2021, and 2020

Notes To Consolidated Financial Statements

2. Consolidated Financial Statement Schedules

83

84

87

88

89

90

91

93

All schedules are omitted because they are not required or because the required information is included in the Consolidated 

Financial Statements or notes thereto.

3. Exhibits 

Exhibit
No.

Filed Exhibit Description

Form

1.1 Equity Distribution Agreement, dated November 7, 

Form 8-K

2022, by and between Amicus Therapeutics, Inc. and 
Goldman Sachs & Co. LLC

Incorporated by Reference
to SEC Filing

Date
11/7/2022

Exhibit 
No.

Filed with this
Form 10-K

1.1

2.1 Agreement and Plan of Merger, dated November 19, 
2013, by and among Amicus Therapeutics, Inc., CB 
Acquisition Corp., Callidus BioPharma, Inc., and 
Cuong Do

Form 8-K

2/12/2014

2.1

2.2 Amendment to Agreement and Plan of Merger, dated 

Form 8-K

9/30/2015

2.2

September 30, 2015, by and among the Registrant, 
Titan Merger Sub Corp. and Scioderm, Inc.

+2.3 Agreement and Plan of Merger, dated July 5, 2016, 

Form 8-K

7/6/2016

2.1

by and among MiaMed, Inc., the Registrant and 
Minervas Merger Sub, Inc.

+2.4 Agreement and Plan of Merger, dated as of 
September 19, 2018, by and among Amicus 
Therapeutics, Inc., Columbus Merger Sub Corp., 
Celenex, Inc. and Shareholder Representative 
Services LLC, solely in its capacity as the 
Shareholders’ Representative

Form 8-K

9/25/2018

2.1

3.1 Restated Certificate of Incorporation of the 

Form 10-K

2/28/2012

Registrant.

3.2 Restated By-laws of the Registrant.
3.3 Certificate of Amendment to the Registrant's 

Restated Certificate of Incorporation, as amended.
3.4 Certificate of Amendment to the Restated Certificate 

of Incorporation

S-1/A (333-141700)
Form 8-K

4/27/2007
6/10/2015

Form 8-K

6/8/2018

3.1

3.4
3.1

3.1

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Incorporated by Reference
to SEC Filing

Exhibit
No.

Filed Exhibit Description

Form

4.1 Specimen Stock Certificate evidencing shares of 

S-1 (333-141700)

common stock
4.2 Form of Indenture

4.3 Description of the Registrant's securities

4.4 Form of Pre-Funded Warrant

4.5 Securities Purchase Agreement, dated September 29, 
2021, by and between the Company and Redmile 
Group LLC

Form S-3ASR

Form 10-K
Form 8-K

Form 8-K

Date
3/30/2007

4/24/2016

3/2/2020

9/29/2021

9/29/2021

Exhibit 
No.

Filed with this
Form 10-K

4.1

4.7

4.8
4.1

10.3

4.6 Securities Purchase Agreement, dated September 29, 

Form 8-K

9/29/2021

10.4

2021, by and between the Company and Perceptive 
Life Sciences Master Fund, Ltd.

4.7 Securities Purchase Agreement, dated September 29, 

Form 8-K

9/29/2021

10.5

2021, by and among the Company and the 
Purchasers identified on the signature pages thereto
*10.1 2002 Equity Incentive Plan, as amended, and forms 

of option agreements thereunder

S-1/A (333-141700)

4/27/2007

10.2 Form of Director and Officer Indemnification 

8-K

12/28/2022

Agreement

*10.3 Amended and Restated 2007 Director Option Plan 

Form 8-K

6/18/2010

and form of option agreement

10.4 Securities Purchase Agreement, dated November 20, 
2013 by and among the Company and the purchasers 
identified therein

Form 8-K

11/20/2013

10.1

10.1

10.2

10.1

+10.5 Second Restated Agreement, dated November 19, 

Form 10-K

3/3/2014

10.46

2013 by and between the Registrant and Glaxo 
Group Limited

*10.6 Amicus Amicus Therapeutics, Inc. Amended and 

Form 8-K

12/28/2017

10.1

Restated Restricted Stock Unit Deferral Plan

A

10.1

10.1

10.1

10.1

10.1

*10.7 Amended and Restated 2007 Equity Incentive Plan

DEF 14A

*10.8 Amicus Therapeutics, Inc. Cash Deferral Plan

Form 8-K

10.9 Form of Performance-Based Restricted Stock Unit 

Form 8-K

Award Agreement under the Amended and Restated 
2007 Equity Incentive Plan

4/27/2021

10/28/2016

12/30/2016

10.10 Amendment #1 to the Amicus Therapeutics, Inc. 

Form 8-K

10/26/2014

Cash Deferral Plan.

10.11 Amendment #2 to the Amicus Therapeutics, Inc. 

Form 8-K

12/19/2019

Cash Deferral Plan.

*10.12 Employment Agreement, dated August 1, 2022, by 
and between the Registrant and Bradley L. 
Campbell.

*10.13 Employment Agreement, dated February 23, 2022, 
by and between the Registrant and John F. Crowley.

Form 8-K

8/1/2022

Form 8-K

2/24/2022

10.2

*10.14 Employment Agreement dated February 18, 2020 

Form 10-K

3/2/2020

10.45

between the Registrant and Ellen S. Rosenberg 

*10.15 Employment Agreement dated February 18, 2020, 
between the Registrant and Daphne Quimi
*10.16 Employment Agreement dated February 18, 2020 

between the Registrant and Hung Do

Form 10-K

3/2/2020

10.48

Form 10-K

3/2/2020

10.49

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Exhibit
No.
*10.17 Amendment to Employment and Confidentiality 

Filed Exhibit Description

Agreements dated September 28, 2021 by and 
between the Registrant and Hung Do.

*10.18 Employment Agreement dated February 18, 2020 
between the Registrant and David Clark
*10.19 Employment Agreement dated February 18, 2020 
between the Registrant and Jeffrey Castelli
10.20 Loan Agreement, dated as of July 17, 2020, by and 
among Amicus Therapeutics International Holding 
Ltd, as Borrower, Amicus Therapeutics, Inc. as 
Parent and a Guarantor, certain subsidiaries of Parent 
as additional Guarantors, and Hayfin Services LLP 
as Agent for certain lenders

Incorporated by Reference
to SEC Filing

Form

Form 8-K

Date
9/29/2021

Exhibit 
No.

Filed with this
Form 10-K

10.8

Form 10-Q

8/10/2020

10.2

*10.21 Form of Board Restricted Stock Unit Award 

Form 10-K

3/1/2021

10.39

Agreement under the Amended and Restated 2007 
Equity Incentive Plan

*10.22 Form of Board Stock Option Award Agreement 

Form 10-K

3/1/2021

10.41

Form 10-K

3/1/2021

10.42

Form 10-K

2/24/2022

10.25

under the Amended and Restated 2007 Equity 
Incentive Plan

*10.23 Form of Stock Option Award Agreement under the 
Amended and Restated 2007 Equity Incentive Plan
*10.24 Form of Restricted Stock Unit Award Agreement 

under the Amended and Restated 2007 Equity 
Incentive Plan

++10.25 License Agreement dated December 22, 2022, by 

and between Amicus Therapeutics, Inc. and the 
Trustees of the University of Pennsylvania

++10.26 Mutual Termination Agreement dated December 22, 
2022, by and between Amicus Therapeutics, Inc. and 
the Trustees of the University of Pennsylvania.

21 List of Subsidiaries

23.1 Consent of Independent Registered Public 

Accounting Firm.

31.1 Certification of Principal Executive Officer Pursuant 
to Rule 13a-14(a) of the Securities Exchange Act of 
1934.

31.2 Certification of Principal Financial Officer Pursuant 
to Rule 13a-14(a) of the Securities Exchange Act of 
1934.

32.1 Certificate of Principal Executive Officer pursuant to 
18 U.S.C. Section 1350 and Section 906 of the 
Sarbanes-Oxley Act of 2002.

32.2 Certificate of Principal Financial Officer pursuant to 
18 U.S.C. Section 1350 and Section 906 of the 
Sarbanes-Oxley Act of 2002.

-121-

X

X

X

X

X

X

X

X

X

X

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Exhibit
No.

Filed Exhibit Description

Form

Date

Exhibit 
No.

Filed with this
Form 10-K

Incorporated by Reference
to SEC Filing

101   The following financial information from this 

Annual Report on Form 10-K for the year ended 
December 31, 2021, formatted in Inline XBRL 
(Extensible Business Reporting Language) and filed 
electronically herewith: (i) the Consolidated Balance 
Sheets; (ii) the Consolidated Statements of 
Operations; (iii) the Consolidated Statements of 
Comprehensive Loss; (iv) the Consolidated 
Statements of Cash Flows; (v) and the Notes to the 
Consolidated Financial Statements.

104 The cover page from the Annual Report on Form 10-

K for the year ended December 31, 2021 formatted 
in Inline XBRL (included in Exhibit 101).

X

X

____________________________________________________________________

+ 

Confidential treatment has been granted as to certain portions of the document, which portions have been omitted and 
filed separately with the Securities and Exchange Commission.

++ 

Subject to confidential treatment request.

* 

** 

Indicates management contract or compensatory plan.

Certain confidential portions of this exhibit were omitted in accordance with Item 601(b)(10) of Regulation S-K.

The information required by this item is incorporated by reference from the Proxy Statement under the captions "Certain 
Relationships and Related Transactions," "Director Independence," "Committee Compensation and Meetings of the Board of 
Directors," and "Compensation Committee Interlock and Insider Participation."

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Item 16.    FORM 10-K SUMMARY.

Registrants may voluntarily include a summary of information required by Form 10-K under this Item 16. The Company 

has elected not to include such summary information.

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SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused 

this report to be signed on its behalf by the undersigned, thereunto duly authorized on March 1, 2023.
AMICUS THERAPEUTICS, INC.
(Registrant)
By:

/s/    Bradley L. Campbell
Bradley L. Campbell
Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this Report has been signed below by the following 

persons on behalf of the Registrant and in the capacities and on the dates indicated.

Signature

Title

Date

/s/    Bradley L. Campbell

(Bradley L. Campbell)

/s/    Daphne Quimi

(Daphne Quimi)

/s/    John F. Crowley

(John F. Crowley)

/s/    Margaret G. McGlynn

(Margaret G. McGlynn)

/s/    Michael G. Raab

(Michael G. Raab)

/s/    Glenn Sblendorio

(Glenn Sblendorio)

/s/    Craig Wheeler

(Craig Wheeler)

/s/    Lynn Bleil

(Lynn Bleil)

President and Chief Executive Officer
(Principal Executive Officer)

March 1, 2023

Chief Financial Officer
(Principal Financial Officer and 
Principle Accounting Officer)

March 1, 2023

Executive Chairman

March 1, 2023

March 1, 2023

March 1, 2023

March 1, 2023

March 1, 2023

March 1, 2023

Director

Director

Director

Director

Director

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Signature

Title

Date

/s/    Burke Whitman

(Burke Whitman)

/s/    Michael A. Kelly

(Michael A. Kelly)

/s/    Eiry W. Roberts, M.D.

(Eiry W. Roberts, M.D.)

Director

Director

Director

March 1, 2023

March 1, 2023

March 1, 2023

-125-

Company Information

Headquarters

Amicus Therapeutics, Inc. 
3675 Market Street 
Philadelphia, PA 19104

Transfer Agent

American Stock Transfer  
& Trust Company, LLC

6201 15th Avenue 
Brooklyn, NY 11219 
718 921 8200

Independent Registered  
Public Accounting Firm
Ernst & Young LLP

Stockholder Inquiries
All shareholder inquiries related to the 
Company’s stock should be directed to: 

Amicus Therapeutics Inc.  
Investor Relations 
ir@amicusrx.com

Common Stock
NASDAQ Symbol: FOLD

SEC Form 10-K
A copy of the Company’s annual report to the 
Securities and Exchange Commission on Form 
10-K will be available without charge upon 
written request to Amicus Therapeutics, Inc., 
3675 Market Street, Philadelphia, PA 19104 or via 
the Company’s website at www.amicusrx.com.

Annual Meeting
Amicus will hold its Annual General Meeting of 
Shareholders virtually on June 8, 2023,  
at 9:00 a.m. ET.

Safe Harbor
This annual report contains certain forward-
looking statements. For a discussion of forward-
looking statements, please see Part 1, Item 1 of 
our annual report on Form 10-K for 2022.

Executive Committee

BRADLEY L. CAMPBELL 
President and Chief Executive Officer

DAPHNE QUIMI
Chief Financial Officer

DAVID CLARK
Chief People Officer

JAYNE GERSHKOWITZ
Chief Patient Advocate

MITCHELL GOLDMAN, M.D., PH.D.
Chief Medical Officer

JILL WEIMER, PH.D.
Chief Science Officer

JULIE YU, PH.D.
Chief Program Officer

Board of Directors

JOHN F. CROWLEY
Executive Chairman

BRADLEY L. CAMPBELL 
President and  
Chief Executive Officer

MICHAEL G. RAAB
President and Chief Executive Officer, 
Ardelyx, Inc.

Lead Independent Director 
Nominating and Governance (Chair) 
Audit and Compliance

MICHAEL A. KELLY
Founder and President,  
Sentry Hill Partners, LLC

Audit and Compliance 
Science and Technology

LYNN D. BLEIL
Former Senior Partner,   
McKinesey & Co.

Compensation and  
Leadership Development 
Nominating and Governance 
Science and Technology

ELLEN S. ROSENBERG
Chief Legal Officer and  
Corporate Secretary

JEFFREY CASTELLI, PH.D.
Chief Development Officer

SÉBASTIEN MARTEL
Chief Business Officer

PATRIK FLORENCIO
Senior Vice President, Global Chief 
Compliance & Risk Officer

SIMON JORDAN
Chief, Global Head of Rare Diseases

PAT O’SULLIVAN
Chief Technical Operations Officer

CRAIG A. WHEELER
Chief Executive Officer,  
Headwaters Biotech Advisors

Science and Technology (Chair) 
Compensation and  
Leadership Development

GLENN P. SBLENDORIO
Chief Executive Officer, IVERIC Bio, Inc.

Audit and Compliance (Chair)

MARGARET G. MCGLYNN
Former President, Global Vaccines  
and Anti-Infectives, Merck

Compensation and Leadership 
Development (Chair) 
Nominating and Governance

BURKE W. WHITMAN
Chief Executive Officer, Colmar Holdings 
Retired Major General, U.S. Marine Corps

Audit and Compliance 
Nominating and Governance

EIRY W. ROBERTS
Chief Medical Officer,  
Neurocrine Biosciences, Inc.

Compensation and  
Leadership Development 
Science and Technology

A M I C U S   T H E R A P E U T I C S ,   I N C .

3675 Market Street 

Philadelphia, PA 19104 

+1 215-921-7600

www.amicusrx.com