Quarterlytics / Amicus Therapeutics

Amicus Therapeutics

fold · NASDAQ
Claim this profile
Ticker fold
Exchange NASDAQ
Sector
Industry
Employees 501-1000
← All annual reports
FY2023 Annual Report · Amicus Therapeutics
Sign in to download
Loading PDF…
An Extraordinary 
Story in Rare 
Disease

20 23  AN NUAL REP ORT

To Our Shareholders

Everyday Amicus is driven by a shared 
sense of purpose and commitment to 
people  around  the  world  living  with 
a rare disease. Our work is founded 
in the belief that every person living 
with a rare disease deserves access 
to  effective  treatments  and  that 
together we can be the difference. 

Our accomplishments in 2023 represent the dedication 
Amicus brings to the rare disease community as we 
continued  our  mission  of  transforming  the  lives  of 
people living with rare diseases. The accomplishments 
were  transformational  and  pillared  around  our  three 
value drivers:

•  Receiving  regulatory  approvals  of  our  second 
commercial  therapy,  Pombiliti™  +  Opfolda™,  in  the 
United  States,  European  Union,  and  the  United 
Kingdom

• 

Increasing  access  to  Galafold  with  over  2,400 
people living with Fabry disease around the world

Following  the  approval  of  our  second  commercial 
therapy,  we  are  committed  more  than  ever  to 
increasing  our  leadership  in  rare  diseases  and 
achieving our next level of growth. A growth defined 
by delivering our therapies to those in need, advancing 
our  ongoing  studies  to  enhance  our  medical  and 
scientific leadership in Fabry and Pompe disease, and 
leveraging  our  strong  infrastructure  to  create  long-
term  value.  I  am  confident  our  pursuit  of  excellence 
and  innovation  on  behalf  of  people  living  with  rare 
diseases will position us for success and create value 
for all our stakeholders.

As we reflect on the past year and set our sights on 
the  year  ahead,  I  would  like  to  recognize  the  many 
people who have made Amicus an extraordinary story 
in  rare  disease.  Thank  you  to  the  patients  and  their 
families  who  inspire  us,  to  our  employees  for  their 
passion and drive, and to you, our shareholders, for 
supporting our mission.

•  Delivering  on  our  commitment  of  non-GAAP 

Sincerely,

profitability in the fourth quarter of the year

Bradley Campbell 
President and Chief Executive Officer

Amicus Therapeutics    2023 Annual  Report    2

Bradley L. Campbell
President and Chief Executive Officer

Amicus Therapeutics    2023 Annual  Report    3

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, 2023

$399M 

Net Product Sales

500+ 

Dedicated  
Employees Globally

Focused Rare Disease

Pipeline

in Fabry Disease  
and Pompe Disease

2 Approved 
Therapies 

Galafold® and Pombiliti™ + Opfolda™

Global Footprint in 

20+ Countries

Non-GAAP 

Profitability

Achieved in Q4 20231

1.  Amicus defines non-GAAP Net (Loss) Income as GAAP Net (Loss) Income excluding the impact of share-based compensation expense, 

changes in fair value of contingent consideration, loss on impairment of assets, depreciation and amortization, acquisition related income 
(expense), loss on extinguishment of debt, restructuring charges and income taxes.

Amicus Therapeutics    2023 Annual  Report    4

lives of those living with devastating conditions 

2013

Entry into biologics through 
acquisition of Callidus and Pompe 
enzyme replacement therapy

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. Our 

company was founded by an entrepreneur who 

embarked on a life-long journey to transform the 

when two of his children were diagnosed 

with a rare disease. That spirit of empathy, 

compassion, and tenacity permeates our culture 

and influences all aspects of our approach to 

advancing cutting-edge technologies.

Amicus Therapeutics    2023 Annual  Report    5

2023

Pombiliti™ + Opfolda™ approved – first 
and only two-component therapy for 
Late-Onset Pompe disease 

2022

More than 2,000 patients 
on Galafold®

2016

Galafold® approved – first and 
only approved oral treatment 
option for Fabry disease

2007

Amicus initial public offering  
(NASDAQ: FOLD)

2006

First Fabry patient treated in 
an Amicus clinical trial

2002

Amicus is founded on the 
pharmacological chaperone technology 
from Mt. Sinai School of Medicine

Reaching Patients 
Across the Globe

Amicus is a global organization, united by a 
passion for making a difference. 

Our global footprint spans over 20 countries, including our global 

headquarters in Princeton, NJ and international headquarters in Marlow, U.K. 

Additional international office locations include Australia, Canada, France, 

Japan, Germany, Italy, the Netherlands, and Spain. 

Global HQ
Princeton, NJ

International HQ
Marlow, United Kingdom

Canada

Netherlands

Spain

Germany

Italy

France

Japan

Australia

Amicus Therapeutics    2023 Annual  Report    6

Core Value Drivers

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

2,400+ patients and $388M global sales in FY23

Projecting Galafold revenue growth of 11-16% at CER1 in 2024

Fastest growing treatment for Fabry disease globally 

Pombiliti + Opfolda: Resetting Treatment Expectations  
for People Living with Late-onset Pompe Disease

Approved and launched in the U.S., EU, and the U.K., the three largest Pompe markets

Growing patient and physician demand across all three markets

Focus on securing broad patient access and initiating multiple successful launches throughout 2024

Non-GAAP Profitability achieved in 4Q 2023: On-track to achieve first full year of  
non-GAAP profitability in 2024 

Continue to drive double-digit revenue growth for Galafold

Advance the ongoing commercial launch of Pombiliti + Opfolda

Targeted investment in next-generation therapies for Fabry disease and Pompe disease 

Leverage global commercial infrastructure to become a leader in rare diseases

1.  Constant Exchange Rates; 2024 Galafold revenue guidance utilizes actual exchange rate as of December 31, 2023.

Discovery

Preclinical

Phase 1/2

Phase 3

Regulatory

Commercial

Fabry Franchise

Galafold® (migalastat) 

Fabry Genetic Medicines

Next-Generation Chaperone

Pompe Franchise

Pombiliti™ (cipaglucosidase alfa-atga) + Opfolda™ (miglustat)

Pompe Genetic Medicines

Other

Discovery Programs

Amicus Therapeutics    2023 Annual  Report    7

Fabry Disease

Fabry disease is a rare, progressive genetic 
disorder characterized by a defective gene (GLA) 

that causes an enzyme deficiency. This enzyme is 

responsible for breaking down disease substrate 

that, when deficient in patients with Fabry disease, 

builds up in the kidneys, one of the organ systems 

impacted by Fabry disease.

Galafold® (migalastat) is an oral 
pharmacological chaperone of alpha-

Galactosidase A (alpha-Gal A) for the treatment 

of Fabry disease in adults who have amenable 

galactosidase alpha gene (GLA) variants.

40+

countries with 
regulatory approval

60-65%

market share of treated 
amenable patients

90%+

compliance and 
adherence rates

Amicus Therapeutics    2023 Annual  Report    8

Natalie
Living with Fabry Disease

Amicus Therapeutics    2023 Annual  Report    9

Jeff
Living with Late-Onset Pompe Disease

Amicus Therapeutics    2023 Annual  Report    10

Pompe Disease

Pompe disease is a progressive, debilitating, and life-
threatening rare Lysosomal Disorder 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. This leads to 

accumulation of glycogen in cells, which is believed to result 

in the clinical manifestations of Pompe disease.

Pombiliti™ (cipaglucosidase alfa-atga) + Opfolda™ (miglustat) 
is a two-component therapy that consists of cipaglucosidase 

alfa-atga, a bis-M6P-enriched rhGAA that facilitates high-

affinity uptake through the M6P receptor while retaining 

its capacity for processing into the most active form of the 

enzyme, and the oral enzyme stabilizer, miglustat, that’s 

designed to reduce loss of enzyme activity in the blood.  

Approved and 
launched in the  
three largest  
Pompe markets:  
U.S., EU, and U.K.

First and only two-
component therapy 
for the treatment of 
late-onset Pompe 
disease.

Resetting therapeutic 
expectations 
for Pompe with 
Pombiliti + Opfolda: 
Improvement is 
Possible

Amicus Therapeutics    2023 Annual  Report    11

Corporate Responsibility

Strengthening our corporate culture as we grow to positively 
impact as many people living with rare diseases as possible

Corporate Responsibility

At Amicus, we have a shared purpose of improving public health, patient experiences, 

and outcomes with a focus on educational, advocacy, and access initiatives related to 

the disease areas in which we focus our development and therapeutic programs.

Healing Beyond Disease

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.

Healing Beyond Disease is inspired by and adaptive 
to rare disease communities and reflects the existing 
generosity of our corporate culture.

Time

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

Talent 

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

Treasure

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

Pledge 

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

Bridges

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

Amicus Therapeutics    2023 Annual  Report    12

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, 2023

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)

47 Hulfish Street, Princeton, NJ
(Address of Principal Executive Offices)

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

08542
(Zip Code)

(609) 662-2000

(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  283,196,538  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, 2023) was $3,556,948,517. 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, 2024 was 

295,382,614 shares.

DOCUMENTS  INCORPORATED  BY  REFERENCE:  Portions  of  the  Proxy  Statement  for  the  registrant's  2024  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 1C. CYBERSECURITY
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

5

26

68

68

69

69

70

71

72

72

79

80

112

112

113

113

114

114

114

114

114

115

119

120

  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,  Galafold®  and  design, 
Pombiliti™ and design, Opfolda™ 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 Pombiliti™ (also referred to as "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 such therapies;

the costs, timing, and outcome of regulatory review of our product candidates;

any changes in regulatory standards relating to the review of our product candidates;

any  changes  in  laws,  rules  or  regulations  affecting  our  ability  to  manufacture,  transport,  test,  develop,  or 
commercialize our products, including Galafold®, Pombiliti™ + Opfolda™, or our product candidates;

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 products and product candidates; 

our ability to successfully commercialize Galafold® (also referred to as "migalastat HCl"); 

our ability to successfully commercialize Pombiliti™ + Opfolda™ (together, also referred to as "AT-GAA") in the E.U., 
U.K., and U.S., and elsewhere, if regulatory applications are approved;

our ability to manufacture or supply sufficient clinical or commercial products, including Galafold® and Pombiliti™ + 
Opfolda™;

our ability to obtain reimbursement for Galafold® and Pombiliti™ + Opfolda™;

our ability to satisfy post-marketing commitments or requirements for continued regulatory approval of Galafold® and 
Pombiliti™ + Opfolda™;

our ability to obtain market acceptance of Galafold® and Pombiliti™ + Opfolda™, or any other product developed or 
acquired that has received regulatory approval;

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  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;

-1-

 
 
Table of Contents

•

•

•

•

•

•

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

the costs associated with, and our ability to comply with, emerging environmental, social and governance standards, 
including climate reporting requirements at the local, state and national levels;

our ability to successfully protect our information technology systems and maintain our global operations and supply 
chain without interruption;

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.

-2-

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 products 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 products 
or, if approved, product candidates, their commercialization may suffer.

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

•

•

•

• Galafold®, Pombiliti™ + Opfolda™, 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, including the U.S. and China relations, could adversely affect 

our business, particularly as it relates to products or product candidates for which we have a sole supplier.

• Our products 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 products 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 products or product candidates may have side effects that could impact 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  anti-kickback,  fraud  and  abuse,  anti-bribery  and  corruption  and  other  laws  and 
regulations, which could expose us to criminal, civil, or contractual penalties, reputational harm and diminished 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  our  clinical  trials,  regulatory  approvals  could  be  delayed  or 
prevented.

Initial clinical trial results 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 be 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 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.

-3-

Table of Contents

• Our  use  of  third  parties  to  manufacture  our  products  or  product  candidates  may  increase  the  risk  that  we  will  not  have 
sufficient  quantities  of  our  products  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 distribute our products who may not perform satisfactorily. 

• 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 products 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 products 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®, Pombiliti™ + Opfolda™, 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, we could lose material license rights.

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

• 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.

• The  increased  focus  on  environmental,  social  and  governance  ("ESG")  matters  and  emission  reporting  by  investors, 
governmental bodies and other stakeholders, as well as existing and proposed laws related to these topics, may adversely 
affect our business and reputation. 

• 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. 

• Unfavorable global economic conditions such as global crises, health epidemics, military conflicts, geopolitical and trade 
disputes, including between the U.S. and China, or other factors, may adversely affect our business and financial results. 

-4-

Table of Contents

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  seek  to  deliver  the  highest  quality  therapies  that  have  the  potential  to  obsolete  current 
treatments, provide significant benefits to patients, and be first- or best-in-class. Our two marketed therapies are Galafold®, the 
first oral monotherapy for people living with Fabry disease who have amenable genetic variants, and Pombiliti™ + Opfolda™, a 
novel treatment designed to improve uptake of active enzyme into key disease relevant tissues for adults living with late-onset 
Pompe disease.

Galafold® (also referred to as "migalastat") is approved in over 40 countries around the world, including the United States 
("U.S."),  European  Union  ("E.U."),  United  Kingdom  ("U.K."),  and  Japan.  Additionally,  Galafold®  has  been  granted  orphan 
drug designation in the U.S., E.U., U.K., Japan, and several other countries.

Pombiliti™ + Opfolda™ (also referred to as "cipaglucosidase alfa-atga/miglustat") was approved in 2023 in the three largest 
Pompe  markets:  the  U.S.,  the  E.U.,  and  the  U.K.  Multiple  regulatory  submissions  and  reimbursement  processes  with  global 
health authorities are currently underway. Additionally, Pombiliti™ + Opfolda™ has been granted orphan drug designation in the 
U.S., E.U., U.K., Japan and several other countries.

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

Highlights of our progress include:

•

•

•

•

Commercial and regulatory success in Fabry disease. For the year ended December 31, 2023, Galafold® revenue was 
$387.8 million of consolidated revenue, which represented an increase of $58.7 million compared to the prior year. We 
continue to see strong commercial momentum and expansion into additional geographies. 

Pompe disease program milestones. For the year ended December 31, 2023 Pombiliti™ + Opfolda™ revenue was $11.6 
million of consolidated revenue. Pombiliti™ + Opfolda™ were approved by the European Commission ("EC") in June 
2023, the Medicines and Healthcare products Regulatory Agency ("MHRA)" of the United Kingdom in August 2023, 
and the U.S. Food and Drug Administration ("FDA") in September 2023.

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

Financial  strength.  Total  cash,  cash  equivalents,  and  marketable  securities  as  of  December  31,  2023  was  $286.2 
million. 

Our Commercial Products and Product Candidates

Galafold® (migalastat HCl) for Fabry Disease

Our oral precision medicine Galafold® was granted accelerated approval by the FDA in August 2018 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. 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). Marketing authorization approvals as well as approvals for adolescents aged 12 years and older weighing 45 kg or 
more have been granted in over 40 countries around the world. We plan to continue to launch Galafold® in additional countries, 
including for adolescents aged 12 years and older. 

-5-

Table of Contents

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. 

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 are also continuing discovery for next-generation genetic medicines and have an academic research collaboration agreement 
to explore next-generation pharmacological chaperones for Fabry disease. 

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  in  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 Journal 
of the American Medical Association 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,  three  other  products,  all  ERTs,  are  approved  for  the  treatment  of  Fabry  disease:  agalsidase  beta  by  Sanofi 
Aventis, pegunigalsidase alfa-iwxj by Chiesi Farmaceutici and agalsidase alfa by Takeda, the last of which is not approved in 
the U.S. 

-6-

Table of Contents

Pombiliti™ (cipaglucosidase alfa-atga) + Opfolda™ (miglustat) for Pompe Disease

We have leveraged our biologics capabilities to develop Pombiliti™ + Opfolda™, a novel treatment paradigm for late-onset 
Pompe disease. Pombiliti™ + Opfolda™ were approved by the EC in June 2023, the MHRA in August 2023, and the FDA in 
September 2023. Additional regulatory submissions and reimbursement processes with global health authorities are currently 
underway.

Pombiliti™  +  Opfolda™  consists  of  a  uniquely  engineered  rhGAA  enzyme,  cipaglucosidase  alfa-atga,  with  an  optimized 
carbohydrate structure to enhance lysosomal uptake, administered in combination with miglustat that functions as an enzyme 
stabilizer. Miglustat binds to and stabilizes cipaglucosidase alfa-atga reducing inactivation of rhGAA in circulation to improve 
the uptake of active enzyme into key disease relevant tissues. Miglustat is not an active ingredient that contributes directly to 
glycogen reduction. 

In addition, clinical studies are ongoing in pediatric patients for both the late-onset Pompe disease ("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 storage disorder 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. Pompe disease is a rare genetic disease with a traditionally used incidence rate of 1:40,000 (European Journal of 
Human  Genetics  1999).    However,  it’s  increasingly  recognized  that  the  incidence  rate  varies  among  different  ethnic  groups, 
forms of the disease (infantile onset vs late onset Pompe Disease) and countries (Molecular Genetics and Metabolism Reports 
2021).  With  the  advent  of  new-born  screening  and  adoption  by  several  states  in  the  U.S.  and  elsewhere,  more  definitive 
incidence  rate  data  is  beginning  to  be  gathered  with  rates  as  low  as  1:10,152  (Current  Treatment  Options  Neurology  2022).  
Based on a recent study of population genetic prevalence, the revised estimated incidence rate is now believed to be 1:23,232 
(Molecular  Genetics  and  Metabolism  Reports  2021).  As  additional  newborn  screening  data  is  gathered  worldwide,  a  clearer 
picture of the disease epidemiology will emerge.

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

avalglucosidase alfa-ngpt by Sanofi Aventis.

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  and  intellectual  property  necessary  to  develop  and 
market technologies or products with a focus on rare and orphan diseases. We are exploring potential collaborations, alliances, 
and  various  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.

-7-

Table of Contents

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 ingredient in Galafold®, in the 
treatment  of  Fabry  disease,  which  expire  between  2027  and  2042  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,  as  well  as  their  foreign  counterparts  covering  various  aspects  of  Galafold®, 
including  composition-of-matter  methods  of  treating  a  patient  diagnosed  with  Fabry  disease,  and  methods  of 
manufacturing. Any patents issuing from these applications will expire between 2036 and 2043. We anticipate listing 
these patents in the FDA Orange Book if issued.

• We  own  several  issued  U.S.  patents  that  cover  various  aspects  of  Opfolda™  and  Pombiliti™,  a  pharmacological 
chaperon/ERT combination in the treatment of Pompe disease, which expire between 2033 and 2037. Several of the 
issued U.S. patents are listed in the FDA Orange Book for Opfolda™.  Foreign counterparts to the issued patents are 
pending or issued in Europe, Japan, and certain other jurisdictions. We also have pending U.S. patent applications, as 
well as foreign counterpart applications, covering various aspects of compositions, methods of treatment, methods of 
manufacture,  and  formulations.  Any  patents  issuing  from  these  pending  applications  will  expire  between  2033  and 
2043.  We  also  filed  Patent  Term  Extension  application  at  the  U.S.  Patent  and  Trademark  Office  ("USPTO"), 
requesting  that  the  term  of  certain  issued  U.S.  patent  covering  cipaglucosidase  alfa,  the  active  pharmaceutical 
ingredient in Pombiliti™, be extended pursuant to 35 U.S.C. § 156.

•

From  our  agreement  with  the  University  of  Pennsylvania  ("Penn"),  we  have  a  license  to  Penn’s  patent  portfolio 
pertaining to vector and other platform technologies for treating Pompe disease and Fabry disease.

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:

•

•

•

Next-generation Fabry chaperones;

Gene therapy protein engineering technology;

Gene  therapy  (e.g.,  Pompe,  Fabry)  and  ERT  (e.g.,  CDKL5)  programs  and  their  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.

-8-

Table of Contents

•

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 
New  Drug  Application  ("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. Lupin, Aurobindo and Teva 
supplemented their Paragraph IV Certifications in 2023.  In the fourth quarter of 2023, a stipulation order to stay litigation with 
respect to Lupin was ordered. Additionally, in the first quarter of 2024, a stipulation was filed with the court and approved by 
the presiding judge, whereby the parties agreed to accept our definition of the terms that were in dispute. As such, the scheduled 
Markman hearing was deemed unneeded and cancelled. 

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.

-9-

Table of Contents

Collaboration and License Agreements

We have acquired rights to develop and commercialize our product candidates through licenses granted by various parties. 
We  have  certain  obligations  under  these  acquisitions  or  licensing  agreements,  including  diligence  obligations  and  payments, 
which are contingent upon achieving various development, regulatory and commercial milestones. Also, pursuant to the terms 
of  some  of  these  license  agreements,  when  and  if  commercial  sales  of  a  product  commence,  we  may  be  obligated  to  pay 
royalties to such third parties on net sales of the respective products.

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

University of Pennsylvania

In December 2022, 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.

-10-

Table of Contents

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.

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 lysosomal storage disorders. 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:

-11-

Table of Contents

Competitor (1)

Indication

Product

Class of Product

Status

Sanofi

Takeda (2)

Chiesi (3)

Idorsia

AceLink

Sangamo

4DMT

Bayer

Astellas

Roche

Maze

Fabry Disease

Fabrazyme®

Pompe Disease

Myozyme®/ Lumizyme®

Pompe Disease

Nexviazyme®/ Nexviadyme®

ERT

ERT

ERT

Fabry Disease

Venglustat

Fabry Disease

Fabry Disease

Fabry Disease

Fabry Disease

Replagal®

ELFABRIO®

Lucerastat

AL1211

Fabry Disease

Isaralgagene civaparvovec

Fabry Disease

Pompe Disease

Pompe Disease

Pompe Disease

Pompe Disease

4D-310

ACTUS-101

AT845

SPK-3006

MZE001

Oral glucosylceramide 
synthase ("GCS") 
Inhibitor

ERT

ERT

Oral GCS Inhibitor

Oral GCS Inhibitor

Gene Therapy

Gene Therapy

Gene Therapy

Gene Therapy

Gene Therapy

Oral glycogen synthase 
("GYS1") Inhibitor

Marketed

Marketed

Marketed

Phase 3

Marketed

Marketed

Phase 3

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

Phase 1/2

2023 Sales

(in millions)

€991 

€783 

€425 

N/A

¥71,300 

$14.7

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

_____________________________
(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, 2023, as Takeda's fiscal year ends on March 31, 2024.  
(3) Reflects sales through September 30, 2023. 

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.

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.

-12-

 
 
 
 
Table of Contents

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.

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.

-13-

Table of Contents

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.

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.

-14-

Table of Contents

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.

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.

-15-

Table of Contents

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.

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.

-16-

Table of Contents

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.

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.

-17-

Table of Contents

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; 

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; 

-18-

Table of Contents

•

•

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.

-19-

Table of Contents

To obtain regulatory approval of an orphan drug under the E.U. regulatory system, we are mandated to submit a marketing 
authorization  application  ("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  European 
Medicines  Agency  ("EMA"),  to  be  assessed  by  the  Committee  for  Medicinal  Products  for  Human  Use  ("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 
Marketing  Authorization  Holder  ("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.

-20-

Table of Contents

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.

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  ("grandfathered")  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 for Galafold® with 
an effective date of January 1, 2021. 

-21-

Table of Contents

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.  Galafold®  and  Pombiliti™  +  Opfolda™  have  been  granted  orphan 
designation by the MHRA.

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 early access to medicine scheme ("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  Securities  and 
Exchange  Commission  ("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 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. 

-22-

Table of Contents

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 products and product candidates, if approved, are the following: 

•

•

•

•

•

•

•

•

•

•

•

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 and adjusted 
the sequester to 1% for the period between April 1, 2022 and June 30, 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.

-23-

Table of Contents

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  products  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.  Orphan  drugs  that  treat  only  one  rare  disease  are 
exempt  from  the  IRA's  drug  negotiation  program.  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  global  employees  and  valuing  their 
differences 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 fostering an inclusive workplace 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 which 
is  evidenced  through  our  most  recent  engagement  survey  where  we  came  within  2%  of  the  global  benchmark  for  Justice/
Fairness. 

As of December 31, 2023, we had 517 full-time employees. As of December 31, 2023, 58% of our global workforce, 31% 
of our executive management team and 30% of our Board of Directors were women.  We are committed to ensuring a diverse, 
equitable, and inclusive culture where all employees are provided equal opportunities.

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,  and 
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. 

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 

-24-

Table of Contents

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  47  Hulfish  Street,  Princeton,  NJ  08542  and  our  telephone  number  is  609-662-2000.  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.

-25-

Table of Contents

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  and  maintain 
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 and maintain 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:

•

•

•

•

•

•

•

•

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;

-26-

Table of Contents

•

•

•

•

•

successfully identifying new patients who could benefit from Galafold®;

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; and

obtaining and maintaining a commercially viable price.

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 and debt covenants.

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 products or product candidates and our ability to generate revenue will be materially impaired.

Our  products,  Galafold®  and  Pombiliti™  +  Opfolda™,  and  product  candidates  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 products and product candidates will prevent us from commercializing 
our products 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, 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,  whether  those  currently  in  our  pipeline  or  those  we  acquire  or  in-
license in the future, 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:

•

•

•

•

•

•

•

our  failure  to  demonstrate  to  the  satisfaction  of  the  applicable  regulatory  authorities  that  any  of  our  product 
candidates, 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;

-27-

Table of Contents

•

•

•

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  products  or  product  candidates,  if  approved,  we  may  not  be  successful  in  commercializing 
Galafold®, Pombiliti™ + Opfolda™,  or any product candidate 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  have  leveraged 
these  resources  to  support  the  launch  of  Pombiliti™  +  Opfolda™  in  those  same  jurisdictions.  We  anticipate  using  these 
capabilities  to  support  other  product  candidates  if  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 products 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 products 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®,  Pombiliti™  +  Opfolda™,  or  our  product 

candidates if and when they are approved by regulatory authorities, on our own include:

•

•

•

•

•

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

-28-

Table of Contents

•

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  products  or  product  candidates,  if  approved,  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 products 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:

•

•

•

•

•

•

•

we  may  not  be  able  to  control  the  amount  and  timing  of  resources  that  our  distributors  may  devote  to  the 
commercialization of our products 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 products 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, meet our debt obligations, and may 
not ever become profitable.

If  the  market  opportunities  for  our  products  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 products and product candidates are being developed to address is rare and by definition has 
small patient populations. 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  products  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 products or product candidates prove to be incorrect, the market opportunities for our products 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.

-29-

Table of Contents

Galafold® and Pombiliti™ + Opfolda™, 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  Pombiliti™  +  Opfolda™,  as  well  as  any  of  our  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:

•

•

•

•

•

•

•

•

•

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 products 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®,  Pombiliti™  +  Opfolda™  and  any  of  our  product  candidates  that  receive  marketing 
approval, and we may fail to meet our revenue targets as a result.

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  products,  Galafold®,  Pombiliti™  +  Opfolda™  and  product  candidates,  as  well  as  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  and 
Pompe disease. These Fabry products include Sanofi Aventis' Fabrazyme®, Takeda’s Replagal®, and Chiesi's Elfabrio,  as well 
as other Fabry treatment products in development. As of 2022, Galafold® also faces potential generic competition, with Hatch-
Waxman  litigation  currently  on-going.  In  addition,  Sanofi  markets  and  sells  Myozyme®
  Lumizyme®,  Nexviazyme®,  and 
,
Nexviadyme®  for  the  treatment  of  Pompe  disease.  We  are  also  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.

-30-

Table of Contents

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.

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 products 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®,  Pombiliti™  +  Opfolda™,  and  any  of  our  product  candidates  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:

•

•

•

•

•

•

•

•

•

•

•

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, or 
natural disasters (including earthquakes, typhoons, floods and fires).

Moreover, 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.

-31-

Table of Contents

In addition, Pombiliti™ is currently manufactured in the People's Republic of China (“PRC”) by WuXi Biologics Co., Ltd. 
(“WuXi”).  The  PRC,  and  WuXi  specifically,  has  faced  increased  scrutiny  by  the  U.S.  government,  which  could  impact  our 
ability to supply Pombiliti™ to meet our forecasted future demand, as WuXi is our sole supplier. This risk is discussed in greater 
detail below under the heading “Risks Related to the Manufacture of our Products and Product Candidates and our Dependence 
on Third Parties”.

Following  the  receipt  of  marketing  approval  of  our  products  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 successfully commercialize Galafold®, Pombiliti™ + Opfolda™, or any product candidate if approved, will 
also  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®, Pombiliti™ + Opfolda™, or any product candidate 
that  we  commercialize  or  may  commercialize,  and  if  coverage  and  reimbursement  are  available,  what  the  level  of 
reimbursement will be. Reimbursement may impact the demand for, or the price of, Galafold®, Pombiliti™ + Opfolda™, or 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 
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. In the United States, 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.

-32-

Table of Contents

There  have  been  significant  ongoing  judicial,  administrative,  executive  and  legislative  efforts  to  modify  or  eliminate  the 

Affordable Care Act.

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  products  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.  

Recently,  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 products 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.

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®, 
Pombiliti™ + Opfolda™,or any of our product candidates may include restrictions on use, limit use to specific populations or 
include various 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  Risk  Evaluation  and  Mitigation  Strategies  ("REMS")  plan.  Physicians  may 
nevertheless  prescribe  such  products  to  their  patients  in  a  manner  that  is  inconsistent  with  the  approved  label  provided  the 
company did not promote such use. 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 use of our products and product candidates, including 
risks which may arise from misuse or malfunction of, or design flaws in, such products or product candidates, whether or not 
such  problems  directly  relate  to  the  products,  product  candidates  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 and potentially 
crippling liabilities. Regardless of merit or eventual outcome, liability claims may result in:

•

•

reduced resources of our management to pursue our business strategy;

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

-33-

Table of Contents

•

•

•

•

•

•

•

•

•

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. Insurance 
coverage is increasingly expensive and 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 including our ability to service our debt and comply with the liquidity and revenue covenants contained therein.

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

In the U.S., after an NDA is approved, 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  one  of  our 
products or product candidates 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 
because they do not need to conduct highly expensive clinical trials to support their ANDA filing. 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  products  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  had  received  Paragraph  4  certifications  from  three  ANDA  filers  for  Galafold®  and  had  initiated  Hatch-
Waxman  litigation  against  these  ANDA  filers.  That  litigation  remains  pending.  While  we  strongly  believe  in  our  patent 
protection  and  will  vigorously  defend  our  Galafold®  intellectual  property  rights,  there  is  no  guarantee  we  will  prevail  in  the 
Hatch-Waxman  litigation  or  any  other  challenges  to  our  intellectual  property.  Moreover,  we  may  be  compelled  to  settle  this 
litigation on unfavorable terms with a direct negative impact on our revenue and profitability projections.

The  Biologics  Price  Competition  and  Innovation  Act,  or  BPCIA,  was  enacted  as  part  of  the  Patient  Protection  and 
Affordable  Care  Act  of  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, to which Pombiliti™ is subject. 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.

Accordingly, other manufacturers potentially could develop and seek FDA approval of "biosimilar" products at some point 

in the future, including a biosimilar of Pombiliti™ or any other product we develop or acquire that is approved under a BLA.

-34-

Table of Contents

Our competitors may be able to develop and commercialize their products, including products identical to ours, in any ex-
U.S. jurisdiction in which we are unable to obtain, maintain, or enforce our patent claims. Furthermore, generic manufacturers 
may  develop,  seek  approval  for  and  launch  generic  versions  of  our  products,  and  may  challenge  the  scope,  validity  or 
enforceability of our patents, requiring us to possibly engage in complex, lengthy and costly litigation or other proceedings.

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.

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 other 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.

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

Our products 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  products,  Galafold®  and  Pombiliti™  +  Opfolda™,  or  product  candidates  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 products 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:

•

•

•

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, debt covenants or adversely affect our reputation.

-35-

Table of Contents

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  products  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:

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

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;

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.

-36-

Table of Contents

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 
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 products 
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 products 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:

•

•

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;

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. Moreover, the Office of Inspector General (“OIG”) issues guidance documents and Advisory 
Opinions on matters that could give rise to prosecutions, investigations, litigation and/or settlements under the 
False Claims Act.  For example, OIG issued an Advisory Opinion in April 2022 regarding manufacturer support 
of  genetic  testing  which  could  form  a  basis  for  government  scrutiny  in  certain  circumstances.  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;

-37-

Table of Contents

•

•

•

•

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.  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;

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;

-38-

Table of Contents

•

•

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®  or  Pombiliti™  +  Opfolda™,  as  well  as  our  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. While we have processes and controls to ensure that our business arrangements with third parties will comply with 
applicable  healthcare  laws  and  regulations,  it  is  nonetheless  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.

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, 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.

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  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:

-39-

Table of Contents

•

•

•

•

•

•

•

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  that  could  delay  or  prevent  our 

ability to receive regulatory approval or commercialize our product candidates, including:

•

•

•

•

•

•

•

•

•

•

•

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;

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.

-40-

Table of Contents

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:

•

•

•

•

•

•

•

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.

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.

-41-

Table of Contents

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.

We  may  not  be  able  to  obtain  or  maintain  orphan  drug  exclusivity  for  our  products  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. Pombiliti™ + Opfolda™ has also received this designation from the FDA in 2017, EMA in 2018, 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  our  product  candidates  obtains  orphan  drug  exclusivity  for  and  approval  of  a  product  with  the 
same indications as our product candidates 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.

-42-

Table of Contents

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  Pombiliti™  + 
Opfolda™ 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. Moreover, our therapy for the 
treatment  of  Pompe  disease  is  comprised  of  two  components,  an  ERT  (Pombiliti™)  and  a  small  molecule  (Opfolda™).  Full 
marketing approval is required for both components in each jurisdiction that we seek to commercialize in and a failure to secure 
marketing approval for either in a given target geography could materially harm our business and results of operations. 

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 potential 
gene therapies and have historically 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, that we will 
meet any projected timelines for development or that we will continue to pursue these therapies.

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

Use of third parties to manufacture our products or product candidates may increase the risk that we will not have 
sufficient quantities of our products 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  our  products  or 
product candidates. 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 products and 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 
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  products  or  product 
candidates.

-43-

Table of Contents

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 or 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:

•

•

•

•

•

•

•

•

•

•

•

reliance on the third-party for regulatory compliance and quality assurance, including with their own vendors 
with which we do not have a contractual relationship;

limitations  on  supply  availability  resulting  from  capacity,  scheduling  constraints,  and  geographic  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®, Pombiliti™ + Opfolda™, 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 
Pombiliti™  +  Opfolda™.  Different  geopolitical  situations  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  products  and  product  candidates.  Our  products  and  product 
candidates 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 and product candidates.

The majority of our preclinical, clinical and commercial products, including Galafold® and Pombiliti™, are manufactured 
by single source third-party manufacturers. 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 or in a timely fashion. 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 and commercialize our product candidates 
and compete effectively.

-44-

Table of Contents

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

We rely on third parties to distribute our products, and those third parties may not perform satisfactorily, including 
failing to deliver products to meet demand.

We do not distribute our products ourselves and rely on third parties for the delivery of clinical and commercial products to 
our customers and patients.  Any of these third parties may experience delays in the delivery of our products, may be unable to 
deliver the products or may not comply with the appropriate delivery conditions.  Failure to deliver our products may adversely 
affect  our  future  profit  margins,  our  ability  to  meet  our  obligations  under  our  credit  facility  and  our  ability  to  develop  and 
commercialize our products.

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. 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  or  acquire.  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.

-45-

Table of Contents

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.

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:

•

•

•

•

•

•

•

•

•

•

•

•

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 products 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.

-46-

Table of Contents

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.

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

We currently rely on the manufacturers of our products 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  products  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 materials 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  products  or,  after  regulatory 
approval has been obtained, our product candidates, the commercial launch of our products 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 products or product candidates.

Manufacturing 
commercialization.

issues  may  arise 

that  could 

increase  product  and  regulatory  approval  costs  or  delay 

Manufacturing  of  our  products  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 products, proceed with planned clinical 
trials,  or  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 products or product candidates.

We currently rely on WuXi Biologics Co., Ltd., a company based in the People's Republic of China, as the sole supplier of 
our biologic product, Pombiliti™. 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.,  including  but  not  limited  to  potential 
sanctions  imposed  by  the  U.S.  government  on  WuXi,  or  any  of  the  other  countries  in  which  our  products  are  marketed.  In 
addition, the out-breaks of illnesses in the PRC could impact operations at WuXi. Although currently there has been no impact 
on  our  ability  to  obtain  supply  of  Pombiliti™.,  and  we  and  Wuxi  have  robust  mitigation  plans  in  place  to  the  extent  feasible 
based  on  the  risk,  there  can  be  no  assurance  that  operations  would  not  be  impacted  in  the  future  with  a  negative  impact  on 
supply of our product.

-47-

Table of Contents

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 second therapy, Pombiliti™ 
+ Opfolda™,  as well as our pipeline 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, 
as  well  as  Pombiliti™  +  Opfolda™  for  the  treatment  of  adults  with  Pompe  disease,  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 not be profitable on a non-
GAAP or GAAP basis or achieve our year-to-year profitability guidance. 

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

•

•

•

•

•

•

•

continue our development and commercialization of our products and seek regulatory approvals for our product 
candidates 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® and Pombiliti™ + 
Opfolda™ 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 Pombiliti™ + Opfolda™, as well as our other product candidates in Europe, Japan 
and the U.S. or other territories in which we have received or may receive regulatory approval;

continue our next-generation product research; and

continue our rigorous prosecution and defense of our patent portfolio. 

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 potential future losses have had and will 
continue to have an adverse effect on our stockholders' equity and working capital.

-48-

Table of Contents

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. We began the commercial launch of our second therapy for the 
treatment of Pompe disease, Pombiliti™ + Opfolda™, in June 2023 in the E.U, August 2023 in the U.K. and September 2023 in 
the U.S. Our ability to generate material revenue and become profitable depends upon our ability to successfully commercialize 
our existing products 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,  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 products and product candidates depends on a number of 
factors, including our ability to:

•

•

•

•

•

•

•

•

•

•

•

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

complete  and  submit  regulatory  submissions  and  obtain  regulatory  approval  in  target  geographies  for 
Pombiliti™ + Opfolda™;

develop and maintain a commercial organization capable of sales, marketing, and distribution for Galafold® and 
Pombiliti™ + Opfolda™, and any product candidates we intend to market if approved, in the countries where we 
have chosen to commercialize the products ourselves, including the U.S., EU, UK, 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®,  Pombiliti™  +  Opfolda™,  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; 

successfully protect our intellectual property rights; and

successfully navigate the evolving geopolitical landscape and any adverse impacts arising therefrom, including 
actions by governments, our customers, our suppliers or other third parties.

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,  we  may  be  unable  to 
continue our operations at planned levels and be forced to reduce our operations.

If we require substantial additional capital to fund our operations and we fail to obtain necessary financing, we may 
the  development  and  commercialization  of  our  products  and  development  and 
be  unable 
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  products  and  product 
candidates for which we may receive regulatory approval, including continuing to maintain 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 global pandemics, government sanctions, future business 
development collaborations, pipeline expansion, and investment in manufacturing capabilities could impact our future capital 
requirements.  As  such,  we  may  require  substantial  additional  capital  for  the  development  and  commercialization  of  our 
products and further development and commercialization of our product candidates.

-49-

Table of Contents

If additional funding is needed, we cannot be certain that such 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:

•

•

•

•

•

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

seek  collaborators  for  Galafold®,  Pombiliti™  +  Opfolda™,  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, products 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 a 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:

•

•

•

•

•

•

•

•

•

•

•

•

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

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 Pombiliti™ + Opfolda™ 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 products 
and product candidates;

the activities of our competitors;

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 or prosecuting any claims we may assert against others;

the cost of complying with new laws, rules, regulations or executive orders in the geographies in which we or 
our key manufacturers, suppliers and customers operate;

the emergence of competing technologies and other adverse market developments;

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.

-50-

Table of Contents

Raising  additional  capital  may  cause  dilution  to  our  existing  stockholders,  restrict  our  operations,  or  require  us  to 
relinquish rights to our technologies, Galafold®, Pombiliti™ + Opfolda™, 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, warrants 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 2029 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®, Pombiliti™ + Opfolda™ or our 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 October 2023, we entered into the Senior Secured Term Loan due 2029 for a $400 million credit facility with Blackstone 
Alternative Credit Advisors LP and Blackstone Life Sciences Advisors L.L.C. (collectively, “Blackstone”), with an interest rate 
equal to a 3-month  adjusted Term SOFR, subject to a 2.5% floor, plus 6.25% per annum that requires interest-only payments 
until  late-2026  and  matures  in  2029.  We  received  net  proceeds  of  $387.4  million  in  October  2023,  after  deducting  fees  and 
expenses. There were no warrants or equity conversion features associated with the Senior Secured Term Loan due 2029, but 
Blackstone simultaneously made a $29.8 million investment in our common stock, net of offering costs. The Senior Secured 
Term  Loan  due  2029  contains  a  minimum  liquidity  covenant  tested  monthly  and  in  effect  at  all  times,  and  a  minimum 
consolidated revenue covenant measured as of the previous four consecutive fiscal quarters over the term of the loan. 

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 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.

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.  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.

-51-

Table of Contents

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,  2023,  we  had  U.S.  federal,  U.K.  and  state  net  operating  loss  carry  forwards  ("NOLs")  of 
approximately $1.2 billion, $28.4 million and $1.0 billion, 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. The U.K. carryforward period is unlimited. Most of the state net operating loss carry forwards generated 
prior to 2009 have expired through 2016. The remaining state net operating loss carry forwards including those generated in 
2009  through  2023  will  expire  in  2030  through  2042.  State  research  and  development  credits  will  expire  beginning  2024 
through 2033. 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 the NOLs for the tax year 2023 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 47% of our 
common stock as of December 31, 2023. 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.

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.

-52-

Table of Contents

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, products 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:

•

•

•

•

•

•

•

•

•

•

•

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;

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 any possible future 
litigation involving Pombiliti™ + Opfolda™, will demonstrate that our patents are valid and enforceable. 

-53-

Table of Contents

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  Pombiliti™  + 
Opfolda™, 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  Pombiliti™  +  Opfolda™.  We  also  have  several  pending 
applications covering Galafold®, Pombiliti™ + Opfolda™ 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  products.  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 
products that are identical to our products 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 competitive identical products for indications other than the one for which the 
products  have  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.

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.

-54-

Table of Contents

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.

-55-

Table of Contents

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.

-56-

Table of Contents

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  Pombiliti™ + Opfolda™, 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  products  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.

-57-

Table of Contents

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.

As  part  of  our  business,  we  have  historically  been  a  party  to  license  agreements  pursuant  to  which  we  license  key 
intellectual property relating to certain products or product candidates. We expect to enter into additional licenses in the future. 
Such licenses 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 or product candidate 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.

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,  and  Simon  Harford,  our 
Chief Financial Officer, both of whom has significant pharmaceutical industry experience. The loss of the services of either 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. 
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  without  increased  expense,  if  at  all,  or  continue  our  development  and  commercialization 
activities.

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.

-58-

Table of Contents

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, 2023, we had 517 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:

•

•

•

•

•

•

•

•

•

•

•

managing  the  development  and  commercialization  of  any  products  or  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 expertise in newly acquired or in-licensed technologies; 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, agents 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, agents 
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:

•

•

•

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;

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; 

-59-

Table of Contents

•

•

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

laws requiring the timely and accurate disclosure of material information to investors and analysts.

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,  have 
extensive Board of Directors oversight, 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  various  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, develops mitigation strategies for these risks, and reports 
material developments 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, reporting 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.

The  increased  focus  on  environmental,  social  and  governance  matters  and  emissions  reporting  by  investors, 
governmental bodies and other stakeholders, as well as existing and proposed laws related to these topics, may adversely 
affect our business and reputation.

Companies are being increasingly judged by not just their financial performance, but also by their performance on a variety 
of  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.

-60-

Table of Contents

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, the SEC has announced a proposal aimed at mandating the disclosure of certain greenhouse gas emissions 
and climate change-related risks for publicly traded U.S. companies, with similar laws and regulations related to the disclosure 
of greenhouse gas emissions and/or climate change-related risks enacted or proposed in California, the European Union, and 
various other jurisdictions. Compliance with any such new laws or regulations will be costly, time consuming, and, as a global 
commercial organization, require expenditure of our limited resources to be in compliance with the various standards across the 
jurisdictions in which we operate. Failure to adequately meet these new and upcoming disclosure requirements may affect the 
manner and locations in which we choose to conduct our business and could adversely affect our profitability and returns to our 
investors.

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  or  meet  the  evolving  regulatory 
requirements. Any failure or perceived failure by us in this regard could have a material adverse effect on our reputation with 
investors, 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.

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.

Our business could be adversely affected by the effects of health pandemics or epidemics, which could cause significant 
disruptions in our operations.

Health pandemics or epidemics have in the past and could again in the future result in quarantines, stay-at-home orders, 
remote  work  policies  or  other  similar  events  that  may  disrupt  businesses,  delay  our  research  and  development  programs  and 
timelines, negatively impact productivity and increase risks associated with cybersecurity, the future magnitude of which will 
depend, in part, on the length and severity of the restrictions and other limitations. More specifically, these types of events may 
negatively impact personnel at third-party manufacturing facilities or the availability or cost of materials, which could disrupt 
our supply chain. In addition, impact on the operations of the FDA or other regulatory authorities could negatively affect our 
planned  approval  processes.  Finally,  economic  conditions  and  business  activity  may  be  negatively  impacted  and  may  not 

-61-

Table of Contents

recover as quickly as anticipated. The effects of epidemics and pandemic are highly uncertain and subject to change. If we are 
not able to respond to and manage the impact of such events effectively, our business, operating results, financial condition and 
cash flows could be adversely affected.

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 to our operations, it could result in a 
material disruption to the commercialization of our products 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.

In  addition,  cybersecurity  threats  and  reported  incidents  are  increasing  in  their  frequency,  sophistication  and  intensity, 
including as a result of ongoing military conflicts, certain U.S. foreign relations, and increased remote work arrangements, and 
are  becoming  increasingly  difficult  to  detect,  particularly  when  they  impact  vendors,  customers  or  suppliers,  and  other 
companies in our supply chain. Cybersecurity threats or incidents may include the deployment of malware via emails disguised 
to look legitimate or the use of social engineering to obtain employee access credentials to the company’s computer network 
and systems, as well as various other schemes and approaches designed to breach company cyber defenses. Once access has 
been  obtained,  the  illegitimate  actor  can  steal  sensitive  information,  install  ransomware  requiring  a  large  financial  outlay  to 
recover company systems and files, or wreak havoc in a variety of different and creative ways. While we have robust detection, 
mitigation, response and recovery protocols in place, there is no guarantee that these will be effective in preventing disruptions 
to our operations and adequately safeguard confidential, propriety or sensitive information from misappropriation or corruption. 
Our key business partners, manufacturers and vendors face these same risks and a successful attack on their systems could have 
a  similar  negative  impact  to  our  business  and  operations.  Moreover,  new  SEC  reporting  requirements  now  mandate  specific 
disclosures in the event of a material cybersecurity incident. As such, we may have to report certain incidents that could result 
in  reputational  harm  and  loss  of  investor,  customer  and  patient  confidence  even  if  our  cybersecurity  defenses  are  ultimately 
effective  in  staving  off  such  incidents.  To  date  and  to  our  knowledge,  we  have  not  experienced  a  material  cybersecurity 
incident. 

 We may use artificial intelligence in our business, and challenges with properly managing its use could adversely affect 
our business.

We may incorporate artificial intelligence (“AI”) solutions into our business, and applications of AI may become important 
in  our  operations  over  time.  Our  competitors  or  other  third  parties  may  incorporate  AI  into  their  businesses  more  quickly  or 
more successfully than us, which could impair our ability to compete effectively and adversely affect our results of operations. 
Additionally, if the types of information that AI applications assist in producing are or are alleged to be deficient, inaccurate, or 
biased,  our  business,  financial  condition,  and  results  of  operations  may  be  adversely  affected.  The  rapid  evolution  of  AI, 
including  potential  government  regulation  of  AI,  may  require  significant  resources  to  develop,  test  and  maintain  our 
implementations of AI.

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.  We  may  not  identify  or  complete  these 
transactions  in  a  timely  manner,  on  a  cost-effective  basis,  or  at  all  despite  a  substantial  outlay  of  resources  in  pursuing  such 

-62-

Table of Contents

transactions,  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, issue equity,  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 
favorable to us, within the expected timeframes, or at all despite a substantial outlay of resources in pursuing such divesture or 
license.  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:

•

•

•

•

•

•

•

•

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.

-63-

Table of Contents

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  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,  climate  change  could  present  risks  to  our  operations,  including  an  adverse  impact  on  global  temperatures, 
weather patterns and the frequency and severity of extreme weather and natural disasters. Natural disasters and extreme weather 
conditions, such as a hurricane, tornado, earthquake, wildfire or flooding, may pose physical risks to our facilities, employees, 
customers, patients and disrupt the operation of our supply chain and increase operational costs.

Additionally,  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. 
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 our operations and supply chain. As these tensions continue to rise, more targeted approaches by the 
U.S. or PRC governments on certain products, industries or companies (including WuXi, a sole supplier of one of our products) 
could significantly impact our ability to effectively manufacture and distribute our products, including Pombiliti™ + Opfolda™, 
materially impacting our ability to meet patient demands or financial forecasts. 

Further,  recent  global  events  have  adversely  affected  and  are  continuing  to  adversely  affect  workforces,  organizations, 
economies, and financial markets globally, leading to economic downturns, inflation, and increased market volatility. Military 
conflicts and wars (such as the ongoing conflicts between Russia and Ukraine, Israel and Hamas, and the Red Sea crisis and its 
impact on shipping and logistics), terrorist attacks, instability in Venezuela, other geopolitical events, high inflation, increasing 
interest  rates,  bank  failures  and  associated  financial  instability  and  crises,  and  supply  chain  issues  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:

•

•

•

•

•

the success of competitive products or technologies;

regulatory  actions  with  respect  to  our  products  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  or  we  may  bring 
against others;

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

-64-

Table of Contents

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

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;

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.

-65-

Table of Contents

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 Form S-8 registration statements 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  with  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, some of which have been exercised, 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.  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.  
Finally,  in  October  2023,  we  entered  into  a  securities  purchase  agreement  with  Blackstone  for  the  private  placement  of 
2,467,104 shares of our common stock, at a purchase price of $12.16 per share.

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;

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.

-66-

Table of Contents

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 products 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 
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 

-67-

Table of Contents

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 1C.    CYBERSECURITY

The  Company’s  Board  of  Directors  (the  “Board”)  recognizes  the  critical  importance  of  maintaining  the  trust  and 
confidence  of  our  customers,  clients,  business  partners  and  employees.  The  Board  is  actively  involved  in  oversight  of  the 
Company’s  Enterprise  Risk  Management  Program  (“ERMP”),  and  cybersecurity  represents  an  important  component  of  the 
Company’s overall approach to enterprise risk management. The Company’s cybersecurity policies, standards, processes and 
practices  are  integrated  into  the  Company’s  ERMP  and  are  based  on  recognized  frameworks  established  by  the  National 
Institute  of  Standards  and  Technology  and  other  applicable  industry  standards.  In  general,  the  Company  seeks  to  address 
cybersecurity  risks  through  a  systematic,  cross-functional  approach  that  is  focused  on  preserving  the  confidentiality,  security 
and availability of the information that the Company collects and stores by identifying, preventing and mitigating cybersecurity 
threats and responding to cybersecurity incidents if they should occur.

Risk Management and Strategy

As one of the critical elements of the Company’s overall enterprise risk management approach, the Company’s cybersecurity 
program is focused on the following key areas:

•

•

Governance: As discussed in more detail under the heading “Governance,” the Board’s oversight of cybersecurity is 
delegated  to  the  Audit  and  Compliance  Committee  of  the  Board,  which  oversees  the  Company’s  entire  ERMP, 
reporting  up  to  the  full  board  on  a  periodic  basis.  The  Company’s  Chief  Information  Officer  (“CIO”),  the  Chief 
Compliance Officer and other members of management regularly report to the Audit and Compliance Committee, with 
cybersecurity representing a standing meeting agenda topic.

Collaborative  Approach:  The  Company  has  implemented  a  systematic,  cross-functional  approach  to  identifying, 
preventing  and  mitigating  cybersecurity  threats  and  incidents,  while  also  implementing  controls  and  procedures  that 
provide for the prompt escalation of certain cybersecurity incidents so that decisions regarding the public disclosure 
and reporting of such incidents can be made by management in a timely manner.

Technical  Safeguards:  The  Company  deploys  technical  safeguards  that  are  designed  to  protect  the  Company’s  information 
systems from cybersecurity threats, including firewalls, intrusion prevention and detection systems, anti-malware functionality 
and  access  controls,  24x7  security  monitoring,  and  other  controls  which  are  evaluated  and  improved  through  vulnerability 
assessments and cybersecurity threat intelligence.

•

•

•

Incident Response and Recovery Planning: The Company has established and maintains systematic incident response 
and  recovery  plans  that  address  the  Company’s  response  to  a  cybersecurity  incident,  and  such  plans  are  tested  and 
evaluated on a periodic basis.

Third-Party  Risk  Management:  The  Company  maintains  a  systematic,  risk-based  approach  to  identifying  and 
overseeing cybersecurity risks presented by third parties, including vendors, service providers and other external users 
of the Company’s systems, as well as the systems of third parties that could adversely impact our business in the event 
of a cybersecurity incident affecting those third-party systems.

Education  and  Awareness:  The  Company  provides  regular,  mandatory  cybersecurity  training  for  all  personnel  as  a 
means  to  equip  the  Company’s  workforce  with  effective  tools  to  recognize,  address  and  communicate  potential  or 
actual  threats  to  the  Company’s  cybersecurity  systems.  Moreover,  these  trainings  also  allow  Company  personnel  to 
remain up-to-date with evolving information security policies, standards, processes and best practices.

The Company engages in the periodic assessment and testing of the Company’s policies, standards, processes and practices that 
are designed to address cybersecurity threats and incidents. These efforts include a wide range of activities, including audits, 
assessments,  tabletop  exercises,  threat  modeling,  vulnerability  testing  and  other  exercises  focused  on  evaluating  the 

-68-

Table of Contents

effectiveness of our cybersecurity measures and planning. The Company has also engaged third parties to perform assessments 
on  our  cybersecurity  measures,  including  information  security  maturity  assessments,  audits  and  independent  reviews  of  our 
information security control environment and operating effectiveness. The results and findings of these exercises are reported to 
the  Audit  and  Compliance  Committee,  who  in  turn  updates  the  Board  as  appropriate.  Management  will  then  evaluate  such 
findings  and,  with  input  from  the  Audit  and  Compliance  Committee,  take  the  appropriate  steps  to  adjust  the  Company’s 
cybersecurity policies, standards, processes and practices, as may be applicable, to strengthen or address any weaknesses, gaps 
or findings as the case may be.

As  of  the  date  of  this  Annual  Report  on  Form  10-K,  we  are  not  aware  of  any  risks  from  the  cybersecurity  threats  that  have 
materially  affected  or  are  reasonably  likely  to  materially  affect  us,  including  our  business  strategy,  results  of  operations  and 
financial condition.

Governance

The Board has delegated their oversight of cybersecurity to the Company’s Audit and Compliance Committee which oversees 
the entire ERMP process. As detailed above, cybersecurity is a standing agenda topic for the Audit and Compliance Committee 
which receives regular presentations and reports from the Company’s CIO on cybersecurity risks, detection protocols, disaster 
recovery  readiness,  the  threat  environment,  recent  developments  in  the  cybersecurity  space  (including  known  incidents 
affecting the Company or key Company suppliers), evolving standards, vulnerability assessments, third-party and independent 
reviews,  technological  trends  and  information  security  considerations  arising  with  respect  to  the  Company’s  peers  and  third 
parties.  Under  the  current  cybersecurity  framework,  the  Audit  and  Compliance  Committee  receives  prompt  and  timely 
information  regarding  any  cybersecurity  incident  that  meets  established  reporting  thresholds,  as  well  as  ongoing  updates 
regarding any such incident. The Audit and Compliance Committee will keep the full board informed, as may be appropriate, 
until any such threat has been addressed to their satisfaction. Additionally, cybersecurity is also a standing agenda topic for the 
Global Risk Committee, with periodic updates to the Executive Committee and Senior Leadership Team.

The  CIO,  in  coordination  with  the  Chief  Executive  Officer,  Chief  Financial  Officer,  Chief  Compliance  Officer,  Chief  Legal 
Officer, and Chief People Officer works collaboratively across the Company to implement a program designed to protect the 
Company’s  information  systems  from  cybersecurity  threats  and  to  promptly  respond  to  any  cybersecurity  incidents  in 
accordance with the Company’s incident response and recovery plans. To facilitate the success of the Company’s cybersecurity 
risk management program, multidisciplinary teams throughout the Company are deployed to address cybersecurity threats and 
to respond to cybersecurity incidents. The CIO has served in various leadership roles in information technology and information 
security for over 24 years, including serving as the vice president of information technology, with direct responsibility over the 
cyber  security  program,  for  a  large  publicly-traded  company  and  as  the  chief  information  security  officer  of  several  large 
healthcare organizations. The CIO holds a Certified Information Systems Security Professional certification, an undergraduate 
degree in engineering, an MBA and a PhD in engineering.

Item 2.    PROPERTIES

The following table contains information about our current significant leased properties as of December 31, 2023. 

Location

Approximate
Square Feet

Use

Lease expiry date (1)

Philadelphia, Pennsylvania, U.S. 

50,816  Office and laboratory

September 2034

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

-69-

 
 
 
Table of Contents

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.

-70-

Table of Contents

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, 2024 was $12.80 per share. As of February 13, 2024, there were 17 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.

12/31/2018

12/31/2019

12/31/2020

12/31/2021

12/31/2022

12/31/2023

Amicus Therapeutics, Inc.

NASDAQ Composite

NASDAQ Biotechnology

$100

$100

$100

$102

$135

$124

$241

$194

$156

$121

$236

$155

$125

$157

$137

$149

$223

$146

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

-71-

Amicus Therapeutics, Inc.NASDAQ CompositeNASDAQ Biotechnology12/31/201812/31/201912/31/202012/31/202112/31/202212/31/202350100150200250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, 2023:

Period

October 1, 2023 through October 31, 2023

November 1, 2023 through November 30, 2023

December 1, 2023 through December 31, 2023

Total

Total Number 
of Shares 
Purchased (1)

Average 
Price Paid 
per Share

47,887  $ 

12,420  $ 

38,804  $ 

99,111  $ 

10.46 

10.66 

13.61 

11.72 

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  seek  to  deliver  the  highest  quality  therapies  that  have  the  potential  to  obsolete  current 
treatments, provide significant benefits to patients, and be first- or best-in-class. Our two marketed therapies are Galafold®, the 
first oral monotherapy for people living with Fabry disease who have amenable genetic variants, and Pombiliti™ + Opfolda™, a 
novel treatment designed to improve uptake of active enzyme into key disease relevant tissues for adults living with late-onset 
Pompe disease.

Galafold® (also referred to as "migalastat") is approved in over 40 countries around the world, including the United States 
("U.S."),  European  Union  ("E.U."),  United  Kingdom  ("U.K."),  and  Japan.  Additionally,  Galafold®  has  been  granted  orphan 
drug designation in the U.S., E.U., U.K., Japan and several other countries.

Pombiliti™ + Opfolda™ (also referred to as "cipaglucosidase alfa-atga/miglustat") was approved in 2023 in the three largest 
Pompe  markets:  the  U.S.,  the  E.U.,  and  the  U.K.  Multiple  regulatory  submissions  and  reimbursement  processes  with  global 
health authorities are currently underway. Additionally, Pombiliti™ + Opfolda™ has been granted orphan drug designation in the 
U.S., E.U., U.K., Japan and several other countries.

-72-

 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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 2023 and 2022 items and year-to-year comparisons 
between 2023 and 2022. Discussions of 2021 items and year-to-year comparisons between 2022 and 2021 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, 2022, which comparisons are hereby incorporated by reference.

Year Ended December 31, 2023 Compared to Year Ended December 31, 2022 

The following table provides selected financial information of our operations:

(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 (expense) income:

Interest income

Interest expense

Loss on extinguishment of debt

Other (expense) income

Income tax (expense) benefit

Years Ended December 31,

2023

2022

Change

$ 

399,356 

$ 

329,233 

$ 

70,123 

37,326 

 9.3 %

38,599 

 11.7 %

(1,273) 

 (2.4) %

152,381 

275,270 
2,583 

1,134 

7,873 

7,078 

(50,149) 

(13,933) 

(15,886) 

(1,483) 

276,677 

213,041 
1,078 

6,616 

5,342 

3,024 

(37,119) 

— 

4,176 

5,471 

(124,296) 

62,229 
1,505 

(5,482) 

2,531 

4,054 

(13,030) 

(13,933) 

(20,062) 

(6,954) 

Net loss attributable to common stockholders

$ 

(151,584) 

$ 

(236,568) 

$ 

84,984 

Net Product Sales. Net product sales increased $70.1 million during the year ended December 31, 2023 compared to the 
prior year. The increase was primarily due to continued growth of Galafold® in the U.S., Europe, and Japan markets as well as 
our commercial launch of Pombiliti™ + Opfolda™ in Europe and the U.S. 

Cost  of  goods  sold.  Cost  of  goods  sold  includes  manufacturing  costs  for  our  commercial  products  as  well  as  royalties 
associated with net product sales of Galafold®. Cost of goods sold as a percentage of net product sales decreased 2.4% primarily 
due  to  inventory  write-offs  in  the  prior  year.  A  portion  of  inventory  available  for  sale  was  expensed  as  research  and 
development costs prior to regulatory approval and as such, the cost of goods sold and related gross margins are not necessarily 
indicative of future costs of goods sold and gross margin.

-73-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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)
Pombiliti™ + Opfolda™ (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,

2023

2022

$ 

12,928  $ 

58,826 

872 

1,681 

74,307 

62,492 

15,582 

78,074 

$ 

152,381  $ 

15,012 

99,584 

48,948 

124 

163,668 

1

82,386 

30,623 

113,009 

276,677 

The $124.3 million decrease in research and development costs was primarily driven by the strategic deprioritization of our 
gene therapy portfolio, which resulted in the recognition of contract exit costs in the prior year. Additionally, Pompe disease 
program spend decreased due to reduced clinical manufacturing costs. Personnel and other costs decreased in connection with 
the reallocation of resources to support our Pombiliti™ + Opfolda™ commercial launch and continued growth of Galafold®.

Selling,  General,  and  Administrative  Expense.  Selling,  general,  and  administrative  expense  increased  $62.2  million, 
primarily  driven  by  personnel  costs  in  connection  with  the  reallocation  of  resources  to  support  our  Pombiliti™  +  Opfolda™ 
commercial launch and third-party professional fees.

Loss on Impairment of Assets. The $5.5 million decrease was primarily in connection with the strategic deprioritization of 

our gene therapy portfolio in the prior year, which resulted in us recognizing a loss on impairment of assets.

Loss  on  Extinguishment  of  Debt.  In  October  2023,  the  Company  voluntarily  prepaid  the  outstanding  principal  amount, 
accrued interest and prepayment premiums of the Senior Secured Term Loan due 2026. As a result of this early extinguishment, 
a loss on extinguishment of debt of $13.9 million was recognized in the Consolidated Statements of Operations.

Interest Expense. Interest expense increased $13.0 million during the year ended December 31, 2023. The increase was due 

to a higher variable interest rate on debt year over year. 

Other (Expense) Income. The $20.1 million variance was primarily related to movement in foreign exchange rates caused 

by remeasurement of foreign-denominated balances.

Income Tax Expense. The income tax expense for the year ended December 31, 2023 was $1.5 million. We are subject to 
income taxes in various jurisdictions. Our tax liabilities are largely dependent on the distributions of pre-tax earnings among the 
many jurisdictions in which we operate.

-74-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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 consist of sales of Galafold®

 for the treatment of Fabry disease and Pombiliti™ + Opfolda™ for the 
treatment of Pompe disease. We have recorded revenue on sales where our products are available either on a commercial basis 
or through a reimbursed early access program. Orders for our products are generally received from distributors and pharmacies 
with the ultimate payor often a government authority.

We recognize revenue when our performance obligations with our customers have been satisfied, which occurs at a point in 
time  when  the  pharmacies  or  distributors  obtain  control  of  our  products.  The  transaction  price  is  determined  based  on  fixed 
consideration  in  our  customer  contracts  net  of  estimates  for  variable  consideration.  Variable  consideration,  which  primarily 
consists of discounts and rebates due to foreign and U.S. government programs, is estimated based on contractual arrangements 
or statutory obligations, which may vary by product and payer and is recorded in the same period the related sales occur. 

Estimation  requires  evaluation  of  our  actual  historical  experience,  customer  mix,  current  contractual  and  statutory 
obligations,  and  inventory  channel  levels.  We  evaluate  our  customer  mix  to  estimate  which  sales  will  be  subject  to  which 
revenue dilutive items and consider changes to government program guidelines or contractual obligations that would impact the 
actual rebate or discount and/or our estimates of which sales qualify for such rebate or discount. 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.

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® and Pombiliti™ + Opfolda™, 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, 
product 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 
equity  program  ("ATM  program"),  pursuant  to  which  we  may  offer  to  sell  shares  of  our  common  stock  having  aggregate 
offering gross proceeds of up to $250.0 million. During the year ended December 31, 2023, we issued and sold an aggregate of 
5,244,936 shares through our ATM program at a weighted-average public offering price of $12.50 per share, resulting in net 
proceeds of $63.1 million. As of December 31, 2023, an aggregate of $184.4 million worth of shares remain available to be 
issued and sold under the ATM program. 

In  October  2023,  we  entered  into  the  Senior  Secured  Term  Loan  due  2029.  This  transaction  resulted  in  net  proceeds  of 
$387.4  million,  after  deducting  fees  and  expenses.  There  were  no  warrants  or  equity  conversion  features  associated  with  the 
Senior Secured Term Loan due 2029. Simultaneously, we also entered into a securities purchase agreement with funds managed 
by  Blackstone,  for  the  private  placement  of  an  aggregate  of  2,467,104  shares  of  our  common  stock,  at  a  purchase  price  of 
$12.16 per share. Proceeds from the private placement, net of offering costs, were $29.8 million. We used proceeds from the 
Senior Secured Term Loan due 2029 and the private placement to prepay the Senior Secured Term Loan due 2026, inclusive of 
the outstanding principal amount, accrued interest and prepayment premium.

-75-

Table of Contents

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, 2023, we had cash, cash equivalents, and marketable securities of $286.2 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, 2023 was $69.1 million. The components of net cash used in 
operations included the net loss for the year ended December 31, 2023 of $151.6 million and the net change in operating assets 
and liabilities of $48.0 million offset by $86.1 million of stock compensation and $44.4 million of other non-cash adjustments. 
The  change  in  operating  assets  was  primarily  due  to  an  increase  in  inventory  of  $44.6  million,  an  increase  in  accounts 
receivable of $20.1 million associated with increased commercial sales, and an increase in prepaid and other current assets of 
$8.1 million primarily associated with tax prepayments. The net cash used in operations was also impacted by an increase in 
accounts payable and accrued expenses of $49.2 million, associated with accrued interest due to timing, inventory purchases to 
support  our  continued  commercial  growth,  personnel  costs,  and  an  increases  in  sales  rebates  associated  with  increased 
commercial sales.

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 offset by $76.5 million of stock compensation and $33.4 million of other non-cash adjustments. 
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®.

-76-

Table of Contents

Net Cash Provided by Investing Activities

Net cash provided by investing activities for the year ended December 31, 2023 was $98.1 million. Our investing activities 
have  consisted  primarily  of  purchases,  sales,  and  maturities  of  investments  and  capital  expenditures.  Net  cash  provided  by 
investing activities reflects $197.2 million for the sale and redemption of marketable securities, partially offset by $91.7 million 
for the purchase of marketable securities and $7.4 million for capital expenditures.

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 (Used in) Financing Activities

Net cash provided by financing activities for the year ended December 31, 2023 was $61.7 million. Net cash provided by 
financing activities primarily reflects $387.4 million of net proceeds from the Senior Secured Loan due in 2029, $63.1 million 
of  net  proceeds  from  the  issuance  of  shares  in  connection  with  our  ATM  program,  $29.8  million  of  net  proceeds  from  our 
private  placement  with  Blackstone,  and  $10.3  million  in  proceeds  from  the  exercise  of  stock  options.  Net  cash  provided  by 
financing activities was partially offset by the $408.0 million repayment of our Senior Secured Loan due in 2026, and $17.9 
million for payments of employee withholding taxes related to restricted stock unit vesting.

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.

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:

•

•

•

•

•

•

•

•

•

•

•

•

•

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 Pombiliti™ (also referred to as "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 such therapies;

the costs, timing, and outcome of regulatory review of our product candidates;

any changes in regulatory standards relating to the review of our product candidates;

any  changes  in  laws,  rules  or  regulations  affecting  our  ability  to  manufacture,  transport,  test,  develop,  or 
commercialize our products, including Galafold®, Pombiliti™ + Opfolda™, or our product candidates; 

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 products and product candidates; 

our ability to successfully commercialize Galafold® (also referred to as "migalastat HCl"); 

our ability to successfully commercialize Pombiliti™ + Opfolda™ (together, also referred to as "AT-GAA") in the E.U., 
U.K., and U.S., and elsewhere, if regulatory applications are approved;

our ability to manufacture or supply sufficient clinical or commercial products, including Galafold® and Pombiliti™ + 
Opfolda™;

our ability to obtain reimbursement for Galafold® and Pombiliti™ + Opfolda™;

-77-

Table of Contents

•

•

•

•

•

•

•

•

•

•

•

•

our ability to satisfy post-marketing commitments or requirements for continued regulatory approval of Galafold® and 
Pombiliti™ + Opfolda™;

our  ability  to  obtain  market  acceptance  of  Galafold®  and  Pombiliti™  +  Opfolda™  or  any  other  product  developed  or 
acquired that has received regulatory approval;

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  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 economic benefits from any such collaborators; 

the costs associated with, and our ability to comply with, emerging environmental, social and governance standards, 
including climate reporting requirements at the local, state and national levels;

our ability to successfully protect our information technology systems and maintain our global operations and supply 
chain without interruption;

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 business development collaborations, pipeline 
expansion, and investment in manufacturing capabilities could impact our long-term capital requirements.

Contractual Obligations and Commitments

As  of  December  31,  2023,  remaining  maturities,  including  expected  interest  payments  through  maturity,  on  our  Senior 
Secured Term Loan due 2029 were $623.4 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, 2023, our undiscounted cash 
liabilities  for  operating  leases  were  $89.8  million,  with  maturities  ranging  up  through  fiscal  2034.  Refer  to  “—  Note  12. 
Leases,” to the Consolidated Financial Statements for more information.

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. As of December 31, 2023, remaining milestones under this agreement were $9.8 million. 
Refer to "— Note 14. Collaborative Agreements," 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,  2023,  these  purchase  and  manufacturing  obligations  totaled  $126.2  million,  of  which  $83.9  million  and 
$42.3 million are expected in 2024 and 2025, respectively. 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, 2023 Consolidated Balance Sheets.

We have no off-balance sheet arrangements as of December 31, 2023 and 2022. 

-78-

Table of Contents

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, 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 $0.1 million as of December 31, 2023. 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, 2023, we had a $400 million Senior 
Secured  Term  Loan  due  2029  that  bears  interest  at  a  rate  equal  to  the  3-month  Term  Secured  Overnight  Financing  Rate 
("SOFR"), subject to a 2.5% floor, plus a Term SOFR adjustment of 0.26161% and a margin of 6.25% per year. We entered 
into  this  loan  in  October  of  2023,  and  simultaneously  used  proceeds  from  the  Senior  Secured  Term  Loan  due  2029  and  the 
private placement to prepay the Senior Secured Term Loan due 2026. We do not currently hedge our variable interest rate debt. 
The annual average variable interest rate for our variable rate debts during the year ended December 31, 2023 was 11.7%. A 
hypothetical  100  basis  point  increase  or  decrease  in  the  average  interest  rate  on  our  variable  rate  debts  would  result  in  $4.1 
million change in the interest expense as of December 31, 2023. 

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.

-79-

Table of Contents

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:

•

•

•

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,  2023.  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, 2023, 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, 2023 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 February 28, 2024 

/s/ BRADLEY L. CAMPBELL

President and Chief Executive Officer

/s/ SIMON HARFORD

Chief Financial Officer

-80-

Table of Contents

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,  2023,  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, 2023, 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,  2023  and  2022,  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,  2023,  and  the  related  notes  and  our  report  dated  February  28,  2024  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
February 28, 2024 

-81-

Table of Contents

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, 2023 and 2022, 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, 2023, 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, 2023 and 2022, and the results of its operations and its cash 
flows for each of the three years in the period ended December 31, 2023, 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, 2023, 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 February 28, 2024 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.

-82-

Table of Contents

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.

Revenue recognition – Measurement of variable consideration
for Ex-U.S. third-party discounts and rebates

Description of the 
Matter

As described in Note 2 to the consolidated financial statements, the Company recognizes revenue 
net  of  estimates  for  variable  consideration,  which  are  primarily  third-party  discounts  and  rebates. 
The sales discounts and rebates are recorded as a reduction of revenue at the time revenue from the 
sale of the Company’s products is recognized, which occurs at a point in time when the customer 
obtains control of the product.

How We 
Addressed the 
Matter in Our 
Audit

Auditing  the  Ex-U.S.  sales  discounts  and  rebates  was  complex  because  of  the  volume  of  sales 
discounts  and  rebates  and  the  different  contractual  product  price,  discount  and/or  rebate  rate  for 
each country.

We identified, evaluated, and tested controls over management’s calculations of the discounts and 
rebates as well as the data input utilized in the calculations.

To  test  the  revenue  adjustments  related  to  sales  discounts  and  rebates  our  procedures  included, 
among others, assessing the terms of the arrangement, evaluating the methodology used, testing the 
significant  inputs,  and  the  completeness,  accuracy  and  relevance  of  the  underlying  data  used  by 
management in its calculations. We inspected significant sales contracts and agreements that include 
the contractual rights to discounts and rebates and tested credit memos issued during the year and 
subsequent to year end. In addition, we assessed the historical accuracy of management’s estimates 
against actual results.

/s/  Ernst & Young LLP

We have served as the Company's auditor since 2003.

Iselin, New Jersey
February 28, 2024 

-83-

 
Table of Contents

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 $25,429 and $22,281 at December 31, 
2023 and 2022, respectively

Intangible assets, less accumulated amortization of $2,510 and $0 at December 31, 2023 and 
December 31, 2022, respectively

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

Other non-current liabilities

Total liabilities

Commitments and contingencies

Stockholders' equity:

Common stock, $0.01 par value, 500,000,000 shares authorized, 293,594,209 and 281,108,273 shares 
issued and outstanding at December 31, 2023 and 2022, respectively

Additional paid-in capital

Accumulated other comprehensive gain (loss):

Foreign currency translation adjustment

Unrealized loss on available-for-sale securities

Warrants

Accumulated deficit

Total stockholders' equity

Total Liabilities and Stockholders' Equity

December 31,

2023

2022

$ 

246,994  $ 

39,206 

87,632 

59,696 

49,533 

483,061 

26,312 

31,667 

20,490 

197,797 

18,553 

$ 

777,880  $ 

$ 

15,120  $ 

144,245 

— 

8,324 

167,689 

387,858 

48,877 

13,282 

617,706 

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 

18,534 

601,120 

2,918 

2,815 

2,836,018 

2,664,744 

5,429 

(188) 

71 

(11,989) 

(116) 

83 

(2,684,074) 

(2,532,490) 

160,174 

$ 

777,880  $ 

123,047 

724,167 

See accompanying Notes to Consolidated Financial Statements

-84-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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 (expense) income:

Interest income

Interest expense

Loss on extinguishment of debt

Other (expense) income

Loss before income tax

Income tax (expense) benefit

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,

2023
399,356  $ 

2022
329,233  $ 

$ 

37,326 

362,030 

152,381 

275,270 

2,583 

1,134 

7,873 

38,599 

290,634 

276,677 

213,041 

1,078 

6,616 

5,342 

2021
305,514 

34,466 

271,048 

272,049 

192,710 

6,514 

— 

6,209 

439,241 

502,754 

477,482 

(77,211)   

(212,120)   

(206,434) 

7,078 

(50,149)   

(13,933)   

(15,886)   

3,024 

509 

(37,119)   

(32,471) 

— 

4,176 

(257) 

(2,901) 

(150,101)   

(242,039)   

(241,554) 

(1,483)   

5,471 

(8,906) 

(151,584)  $ 

(236,568)  $ 

(250,460) 

(0.51)  $ 

(0.82)  $ 

(0.92) 

$ 

$ 

  295,164,515 

  289,057,198 

  271,421,986 

See accompanying Notes to Consolidated Financial Statements

-85-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

Amicus Therapeutics, Inc.
Consolidated Statements of Comprehensive Loss
(in thousands)

Net loss

Other comprehensive gain (loss), net of tax:

Foreign currency translation adjustment gain (loss)

Unrealized (loss) gain on available-for-sale securities

Other comprehensive gain (loss)

Comprehensive loss

Years Ended December 31,

2023
(151,584)  $ 

2022
(236,568)  $ 

2021
(250,460) 

$ 

17,418 

(17,240)   

(72)   

154 

17,346 

(17,086)   

(3,161) 

(85) 

(3,246) 

$ 

(134,238)  $ 

(253,654)  $ 

(253,706) 

See accompanying Notes to Consolidated Financial Statements

-86-

 
 
 
 
 
 
Table of Contents

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, 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, 
net of offering costs

Vesting of restricted stock units, 
net of taxes

Stock-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

Stock-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 

— 

— 

— 

Balance at December 31, 2022

281,108,273 

2,815 

2,664,744 

Stock options exercised, net

1,357,945 

Issuance of shares in connection 
with at-the-market offering, net of 
issuance costs
Common stock issued from private 
placement, net of offering costs
Vesting of restricted stock units, 
net of taxes

Stock-based compensation

Warrants exercised

Unrealized loss on available-for-
sale securities
Foreign currency translation 
adjustment

Net loss

5,244,936 

2,467,104 

2,195,851 

— 

1,220,100 

— 

— 

— 

14 

52 

25 

— 

— 

12 

— 

— 

— 

10,247 

63,056 

29,802 

(17,920) 

86,077 

12 

— 

— 

— 

— 

83 

— 

— 

(12,387) 

— 

— 

— 

— 

83 

— 

— 

— 

— 

— 

— 

83 

— 

— 

— 

— 

— 

(12) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(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) 

(12,105) 

(2,532,490) 

123,047 

— 

— 

— 

— 

— 

— 

(72) 

17,418 

— 

— 

— 

— 

— 

— 

— 

— 

10,261 

63,108 

29,827 

(17,920) 

86,077 

12 

(72) 

17,418 

— 

(151,584) 

(151,584) 

Balance at December 31, 2023

293,594,209  $ 

2,918  $ 

2,836,018  $ 

71  $ 

5,241  $ 

(2,684,074)  $ 

160,174 

See accompanying Notes to Consolidated Financial Statements

-87-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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

Stock-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

Net cash provided by investing activities

Financing activities

Proceeds from the issuance of shares in connection with at-the-market offering, net of 
issuance costs

Proceeds from equity financing, net of issuance costs

Withholding taxes paid on vested restricted stock units

Proceeds from stock options exercised, net

Proceeds from warrants exercised, net

Payment of long-term debt

Proceeds from long-term debt, net of issuance costs

Payment of contingent consideration

Payment of finance leases

Net cash provided by (used in) financing activities

Effect of exchange rate changes on cash, cash equivalents, and restricted cash

Net increase (decrease) in cash, cash equivalents, and restricted cash

Cash, cash equivalents, and restricted cash at the beginning of the year

Years Ended December 31,

2023

2022

2021

$ 

(151,584)  $ 

(236,568)  $ 

(250,460) 

2,616 

7,873 

86,077 

13,933 

2,583 

19,613 

(4,939) 

2,727 

(20,108) 

(44,614) 

(8,062) 

49,195 

(3,054) 

(21,347) 

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) 

$ 

(69,091)  $ 

(166,575)  $ 

(202,491) 

197,227 

(91,723) 

(7,440) 

— 

335,926 

(243,255) 

(3,766) 

3,411 

$ 

98,064  $ 

92,316  $ 

63,108 

29,827 

(17,920) 

10,261 

12 

(408,043) 

387,360 

(2,653) 

(275) 

— 

— 

(11,490) 

4,310 

— 

— 

— 

— 

(283) 

424,043 

(341,398) 

(3,884) 
— 

78,761 

— 

199,750 

(15,009) 

10,228 

19,230 

— 

— 

(1,647) 

(479) 

61,677  $ 

(7,463)  $ 

212,073 

$ 

$ 

6,312  $ 

(14,619)  $ 

96,962 

153,115 

(96,341) 

249,456 

(5,049) 

83,294 

166,162 

249,456 

Cash, cash equivalents, and restricted cash at the end of the year

$ 

250,077  $ 

153,115  $ 

-88-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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,

2023

2022

2021

$ 

$ 

$ 

$ 

105  $ 

—  $ 

36,090  $ 

34,358  $ 

868  $ 

8,525  $ 

1,141  $ 

1,609  $ 

300 

30,468 

1,448 

20,032 

See accompanying Notes to Consolidated Financial Statements

-89-

Table of Contents

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 seeks to deliver the highest quality therapies that 
have  the  potential  to  obsolete  current  treatments,  provide  significant  benefits  to  patients,  and  be  first-  or  best-in-class.  The 
Company's  two  marketed  therapies  are  Galafold®,  the  first  oral  monotherapy  for  people  living  with  Fabry  disease  who  have 
amenable genetic variants, and Pombiliti™ + Opfolda™, a novel treatment designed to improve uptake of active enzyme into key 
disease relevant tissues for adults living with late-onset Pompe disease.

Galafold® (also referred to as "migalastat"), is approved in over 40 countries around the world, including the United States 
("U.S."),  European  Union  ("E.U."),  United  Kingdom  ("U.K."),  and  Japan.  Additionally,  Galafold®  has  been  granted  orphan 
drug designation in the U.S., E.U., U.K., Japan and several other countries. 

Pombiliti™ + Opfolda™ (also referred to as "cipaglucosidase alfa-atga/miglustat"), was approved in 2023 in the three largest 
Pompe  markets:  the  U.S.,  the  E.U.,  and  the  U.K.  Multiple  regulatory  submissions  and  reimbursement  processes  with  global 
health authorities are currently underway. Additionally, Pombiliti™ + Opfolda™ has been granted orphan drug designation in the 
U.S., E.U., U.K., Japan and several other countries.

The Company had an accumulated deficit of $2.7 billion as of December 31, 2023 and anticipates incurring losses through 
the fiscal year ending December 31, 2024. The Company has historically funded its operations through stock offerings, product 
revenues, debt issuances, collaborations, and other financing arrangements.

Based on its current operating model, the Company believes 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 business 
development opportunities, pipeline expansion, and investment in manufacturing capabilities could impact the Company's long-
term capital requirements.

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. Certain prior year amounts have been reclassified for comparative purposes. The 
reclassifications did not affect results of operations, net assets or cash flows.

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  weighted  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. Transactions which are not in the functional currency of the entity are remeasured 
into the functional currency with gains or losses resulting from the remeasurement recorded in other (expense) income.

-90-

Table of Contents

Use of Estimates

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

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.

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  gain  (loss)  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 as a component of other non-current assets on the Company's Consolidated Balance Sheets. 

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 primarily related to its product sales of Galafold®. The 
Company's accounts receivable at December 31, 2023 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,  2023,  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  expensed  as  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.

-91-

Table of Contents

Revenue Recognition

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

 The Company has recorded revenue on sales where its products are available either on a commercial basis or through a 
reimbursed  early  access  program.  Product  orders  are  generally  received  from  distributors  and  pharmacies,  with  the  ultimate 
payor  often  a  government  authority.  In  2023,  one  customer  accounted  for  28%  of  net  product  sales  and  16%  of  accounts 
receivable from product sales while another customer accounted for 17% of accounts receivable from product sales. In 2022, 
one customer accounted for 27% 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 the products. 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 
primarily  consist  of  third-party  discounts  and  rebates.  The  identified  variable  consideration  is  recorded  as  a  reduction  of 
revenue at the time revenue from the sale 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 product:

(in thousands)
Galafold®
Pombiliti™ + Opfolda™
Total net product sales

For the Year

2023
387,777  $ 
11,579 
399,356  $ 

2022
329,046  $ 
187 
329,233  $ 

2021
305,514 
— 
305,514 

$ 

$ 

The following table summarizes the Company's net product sales disaggregated by geographic area:

(in thousands)
U.S.

Ex-U.S.

Total net product sales

Inventories and Cost of Goods Sold

For the Year 

2023

2022

2021

$ 

$ 

146,937  $ 

115,946  $ 

95,387 

252,419 

213,287 

210,127 

399,356  $ 

329,233  $ 

305,514 

Until  regulatory  approval  of  Pombiliti™  +  Opfolda™,  the  Company  expensed  all  manufacturing  costs  as  research  and 
development expense. Upon regulatory approval, the Company began capitalizing costs related to the purchase and manufacture 
of Pombiliti™ + Opfolda™.

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  Company's 
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. A portion of inventory available for 
sale  was  expensed  as  research  and  development  costs  prior  to  regulatory  approval  and,  as  such,  the  cost  of  goods  sold  and 
related gross margins are not necessarily indicative of future costs of goods sold and gross margin.

-92-

 
 
 
 
 
 
Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

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.

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.

-93-

Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

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 Gain (Loss)

Components  of  other  comprehensive  gain  (loss)  include  unrealized  gains  and  losses  on  available-for-sale  securities  and 

gains and losses 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  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  interest  rate  implicit  in  lease  contracts  is  typically  not  readily 
determinable.  As  a  result,  the  Company  utilizes  its  incremental  borrowing  rate,  which  reflects  the  fixed  rate  at  which  the 
Company could borrow on a collateralized basis the amount of the lease payments in the same currency, for a similar term, in a 
similar economic environment. 

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. 

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, 2023, 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.

-94-

Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

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  and  unvested  restricted  stock  units  would  be  anti-dilutive. 
Therefore, the weighted average shares used to calculate both basic and diluted earnings per share are the same. 

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,  its  Chief 
Executive  Officer,  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.

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  payable,  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, 
with changes in fair value recorded on the Consolidated Statements of Operations. The payments made related to the settlement 
of  the  contingent  consideration  payable  recognized  at  fair  value  as  of  the  acquisition  date  (including  measurement-period 
adjustments) were disclosed as cash outflows for financing activities, whereas the payments related to the change in fair value 
of the contingent consideration payable were disclosed as cash outflows for operating activities in the Consolidated Statement 
of Cash Flows. 

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. Goodwill is 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  impairment  test  is  concluded.  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. 

Finite-lived intangible assets are recorded at cost, net of accumulated amortization, and, if applicable, impairment charges. 
Amortization of finite-lived intangible assets is recorded over the assets’ estimated useful lives on a straight-line basis or based 
on the pattern in which economic benefits are consumed, if reliably determinable. The Company reviews finite-lived intangible 
assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be 
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 asset over its estimated fair value in the period at which such a 
determination is made.

-95-

Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

No indicators of impairment were noted during the years ended December 31, 2023 and 2022.

Recent Accounting Developments -  Guidance Not Yet Adopted

In November 2023, the FASB issued the Accounting Standards Update ("ASU") No. 2023-07, Segment Reporting (Topic 
280): Improvements to Reportable Segment Disclosures. The amendments expand reportable segment disclosure requirements, 
primarily  through  enhanced  disclosures  about  significant  segment  expenses.  The  amendments  require,  among  other  things, 
disclosure of the title and position of the chief operating decision maker and require that public entities with a single reportable 
segment provide all disclosures required by this update and existing segment disclosures in Topic 280. Annual disclosures are 
required for fiscal years beginning after December 15, 2023 and interim disclosures are required for periods within fiscal years 
beginning  after  December  15,  2024.  Retrospective  application  is  required  unless  it  is  impracticable,  and  early  adoption  is 
permitted.  The adoption of this guidance is not expected to have a significant impact on the Company's consolidated financial 
statements.

In  December  2023,  the  FASB  issued  ASU  No.  2023-09,  Income  Taxes  (Topic  740):  Improvements  to  Income  Tax 
Disclosures.  The  ASU  requires  disclosure  of  disaggregated  income  taxes  paid,  prescribes  standard  categories  for  the 
components of the effective tax rate reconciliation, and modifies other income tax-related disclosures. ASU 2023-09 is effective 
for fiscal years beginning after December 15, 2024, must be applied prospectively with an option to apply retrospectively, and 
early  adoption  is  permitted.  The  adoption  of  this  guidance  is  not  expected  to  have  a  significant  impact  on  the  Company's 
consolidated financial statements.

3. Goodwill and Intangible Assets

Finite-lived Intangible Assets

As of December 31, 2023, the Company had intangible assets of $20.5 million. Intangible assets consist of lead enzyme 
replacement therapy assets acquired with the Callidus Biopharma, Inc. ("Callidus") acquisition in 2013, previously accounted 
for  as  in-process  research  and  development.  In  March  2023,  as  a  result  of  the  European  Commission's  ("EC")  approval  of 
Pombiliti™, the Company began amortizing the assets over the initial regulatory exclusivity period of 7 years. The Company 
completed an impairment assessment before changing the classification to finite-lived intangible asset noting no impairment. 
Amortization expense for finite-lived intangible assets was $2.5 million for the year ended December 31, 2023. There was no 
amortization  expense  for  finite-lived  intangible  asset  for  the  year  ended  December  31,  2022.  Total  estimated  amortization 
expense  for  the  finite-lived  intangible  assets  for  each  of  the  next  5  years  is  approximately  $3.3  million  and  has  a  remaining 
amortization period of 6.2 years.

Goodwill

As of December 31, 2023, in connection with the acquisition of Callidus in 2013 and Scioderm, Inc. in 2015, the Company 

had goodwill of $197.8 million. There has been no change to the balance of goodwill since the dates of acquisition. 

-96-

Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

4. Cash, Cash Equivalents, Marketable Securities, and Restricted Cash

As of December 31, 2023, the Company held $247.0 million in cash and cash equivalents and $39.2 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  gain  (loss)  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  the  Consolidated  Statements  of 
Operations 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 the Consolidated 
Statements of Operations.

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, in accordance with Company policy, securities are of high 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:

(in thousands)

Cash and cash equivalents

Commercial paper

Treasury bill

U.S. government agency bonds

Money market

Certificates of deposit

Included in cash and cash equivalents

Included in marketable securities 
Total cash, cash equivalents, and marketable securities

(in thousands)

Cash and cash equivalents

Commercial paper

Money market

Certificates of deposit

Included in cash and cash equivalents

Included in marketable securities

As of December 31, 2023

Gross
Unrealized
Gain

Gross
Unrealized
Loss

Fair
Value

Cost

$ 

246,994  $ 

—  $ 

—  $ 

246,994 

14,651 

12,944 

11,450 

100 

51 

$ 

$ 

$ 

286,190  $ 

246,994  $ 

39,196 
286,190  $ 

12 

2 

— 

— 

— 

14  $ 

—  $ 

14 
14  $ 

— 

— 

(4)   

— 

— 

14,663 

12,946 

11,446 

100 

51 

(4)  $ 

286,200 

—  $ 

246,994 

(4)   
(4)  $ 

39,206 
286,200 

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 

Total cash, cash equivalents, and marketable securities

$ 

293,513  $ 

-97-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

Amicus Therapeutics, Inc.

Notes To Consolidated Financial Statements — (Continued)

For the year ended December 31, 2023 and 2022, there were no realized gains or losses. The cost of securities sold is based 

on the specific identification method.

Unrealized loss positions in the marketable securities as of December 31, 2023 reflect temporary impairments and are not a 
result of credit loss. Additionally, as these positions have been in a loss position for less than twelve months and the Company 
does not intend to sell these securities before recovery, the losses are recognized in other comprehensive gain (loss) . The fair 
value of these marketable securities in unrealized loss positions are $11.4 million as of December 31, 2023. The Company had 
no marketable securities in an unrealized loss position as of December 31, 2022.

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, 2023

December 31, 2022

December 31, 2021

$ 

$ 

246,994  $ 

148,813  $ 

3,083 

4,302 

245,197 

4,259 

250,077  $ 

153,115  $ 

249,456 

5. Inventories

Inventories as of  December 31, 2023 and December 31, 2022 consisted of the following: 

(in thousands)

Raw materials

Work-in-process

Finished goods

Total inventories

December 31, 2023 December 31, 2022

$ 

$ 

30,230  $ 

22,597 

6,869 

59,696  $ 

10,054 

9,615 

4,147 

23,816 

The Company's reserve for inventory was $0.5 million and $0.4 million as of December 31, 2023 and 2022, respectively. 
The  Company  has  a  number  of  binding  minimum  purchase  and  manufacturing  commitments  due  to  the  third-party 
manufacturers.  As  of  December  31,  2023,  these  purchase  and  manufacturing  obligations  totaled  $126.2  million,  of  which 
$83.9 million and $42.3 million are expected in 2024 and 2025, respectively.

-98-

 
 
 
 
 
 
 
Table of Content

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

Gross property and equipment

Less accumulated depreciation

Net property and equipment

December 31,

2023

2022

$ 

28,032  $ 

16,220 

4,934 

3,810 

2,928 

1,106 

66 

24,162 

16,345 

4,486 

4,160 

2,734 

1,106 

66 

57,096 

53,059 

(25,429)   

(22,281) 

$ 

31,667  $ 

30,778 

For both the years ended December 31, 2023 and 2022, depreciation expense was $4.8 million. Additionally, during the 
year  ended  December  31,  2022,  in  connection  with  the  strategic  deprioritization  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 taxes

Accrued interest on debt

Accrued royalties

Accrued professional fees

Other

8. Stockholders' Equity

Common Stock and Warrants

December 31,

2023

2022

$ 

38,305  $ 

31,190 

13,607 

13,380 

12,434 

11,661 

8,238 

5,059 

10,371 

25,701 

21,886 

10,515 

8,230 

5,938 

125 

6,908 

6,868 

7,465 

$ 

144,245  $ 

93,636 

As  of  December  31,  2023,  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.

-99-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

In November 2022, the Company entered into a Sales Agreement with The Goldman Sachs & Co. LLC to create an at-the-
market equity program ("ATM 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.  During the year ended December 31, 2023, the Company issued 
and sold an aggregate of 5,244,936 shares through its ATM program at a weighted-average public offering price of $12.50 per 
share,  resulting  in  net  proceeds  of  $63.1  million.  During  the  year  ended  December  31,  2022,  no  shares  were  sold  under  this 
ATM program. As of December 31, 2023, an aggregate of $184.4 million worth of shares remain available to be issued and 
sold under the ATM program. 

In October 2023, the Company entered into a securities purchase agreement with funds managed by Blackstone Alternative 
Credit Advisors LP and Blackstone Life Sciences Advisors L.L.C. (collectively, “Blackstone”), for the private placement of an 
aggregate  of  2,467,104  shares  of  the  Company’s  common  stock,  at  a  purchase  price  of  $12.16  per  share.  Proceeds  from  the 
private placement, net of offering costs, were $29.8 million.

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. As of December 31, 2023, 
1,220,100 pre-funded warrants have been exercised. 

  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. 

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 $7.5 million and $5.5 million as of December 31, 2023 

and 2022, 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, 2023, the Company has reserved up to 12,413,532 
shares for issuance under the Plan.

-100-

Table of Content

9. Stock-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  historical  volatility  of  the  Company's  common  stock  over  the  look-back  period 
corresponding to the expected life of the options. 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 a historical analysis of actual option forfeitures.

The fair value of the stock options granted were 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,

2023

2022

2021

 59.2 %

 3.9 %

5.47

 62.1 %

 1.7 %

5.34

$ 

— 

$ 

— 

$ 

 65.4 %

 0.6 %

5.40

— 

The weighted average grant-date fair value per share of options granted during 2023, 2022, and 2021 were $6.75, $6.11, 

and $9.08, respectively.

-101-

 
Table of Content

A summary of the Company's stock options for the year ended December 31, 2023 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, 2020

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2021

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2022

Granted

Exercised

Forfeited

Expired

Options outstanding, December 31, 2023

Vested and unvested expected to vest, December 31, 2023  

Exercisable at December 31, 2023

14,032  $ 

3,262  $ 

(1,483)  $ 

(844)  $ 

(236)  $ 

14,731  $ 

5,733  $ 

(660)  $ 

(495)  $ 

(245)  $ 

19,064  $ 

5,733  $ 

(1,361)  $ 

(356)  $ 

(78)  $ 

23,002  $ 

21,215  $ 

13,431  $ 

9.54 

16.53 

7.05 

12.97 

13.28 

11.08 

11.53 

6.58 

12.57 

12.84 

11.31 

11.99 

7.54 

11.59 

15.09 

11.69 

11.64 

11.26 

6.5 $ 

6.3 $ 

5.0 $ 

70.8 

66.5 

49.0 

The  aggregate  intrinsic  value  of  options  exercised  during  the  years  ended  December  31,  2023,  2022  and  2021  was  $7.1 
million,  $2.5  million,  and  $8.5  million,  respectively.  Cash  proceeds  from  stock  options  exercised  during  the  years  ended 
December  31,  2023,  2022,  and  2021  were  $10.3  million,  $4.3  million,  and  $10.2  million,  respectively.  As  of  December  31, 
2023, the total unrecognized compensation cost related to non-vested stock options granted was $35.0 million and is expected 
to be recognized over a weighted average period of three years.

-102-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

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, 2023 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, 2020

Granted

Vested

Forfeited

Non-vested units as of December 31, 2021

Granted

Vested

Forfeited

Non-vested units as of December 31, 2022

Granted

Vested

Forfeited

Non-vested units as of December 31, 2023

7,080  $ 

3,191  $ 

(1,863)  $ 

(1,067)  $ 

7,341  $ 

5,048  $ 

(2,251)  $ 

(421)  $ 

9,717  $ 

4,762  $ 

(3,610)  $ 

(836)  $ 

10,033  $ 

11.35 

16.94 

15.77 

12.82 

13.90 

11.93 

12.48 

12.06 

13.07 

13.02 

12.21 

11.63 

13.37 

2.1 $ 

142.4 

As of December 31, 2023, there was $53.6 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 Company's 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,

2023

2022

2021

$ 

$ 

21,470  $ 

25,089  $ 

64,607 

51,423 

86,077  $ 

76,512  $ 

17,340 

40,498 

57,838 

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.

-103-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

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, 2023 are identified in the following tables:

(in thousands)
Assets:

Commercial paper

Treasury bill

U.S. government agency bonds

Money market

(in thousands)

Liabilities:

Deferred compensation plan liability

Level 1

Level 2

Total

$ 

—  $ 

14,663  $ 

— 

— 

7,631 

12,946 

11,446 

— 

14,663 

12,946 

11,446 

7,631 

$ 

7,631  $ 

39,055  $ 

46,686 

Level 1

Level 2

Total

$ 

$ 

7,531  $ 

7,531  $ 

—  $ 

—  $ 

7,531 

7,531 

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

$ 

$ 

—  $ 

5,458 
5,458  $ 

21,417  $ 
— 
21,417  $ 

21,417 
5,458 
26,875 

The Company's Senior Secured Term Loan due 2029 falls into the Level 2 category within the fair value level hierarchy 
and the fair value was determined using a discounted cash flow analysis that factors in current market yields for comparable 
borrowing  arrangements  under  the  Company's  credit  profile.  The  carrying  value  of  the  Senior  Secured  Term  Loan  due  2029 
approximates the fair value. Deferred compensation plan liability is recorded as a component of other non-current liabilities on 
the Company's Consolidated Balance Sheets.

The Company did not have any Level 3 assets as of December 31, 2023 or 2022. 

Cash, Money Market Funds and Marketable Securities

The Company classifies its cash and cash equivalents 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  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,  2023.  No  transfers  of  assets  between  Level  1  and  Level  2  of  the  fair  value 
measurement hierarchy occurred during the year ended December 31, 2023.

-104-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

Contingent Consideration Payable

The contingent consideration payable resulted from the acquisition of Callidus in November 2013. The Company reached 
regulatory  milestones  of  $9.0  million  in  March  2023  and  $15.0  million  in  September  2023  associated  with  the  approval  of 
Pombiliti™  by  the  EC  and  U.S.  Food  and  Drug  Administration  ("FDA"),  respectively.  The  $9.0  million  and  $15.0  million 
payments were paid in the second and fourth quarter of 2023, respectively.  

The following table shows the change in the balance of contingent consideration payable for the year ended December 31, 

2023 and 2022, 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 

11. Debt 

The Company's debt consists of the following: 

Years ended December 31,

2023

2022

$ 

21,417  $ 

20,339 

2,583 

(24,000)   

1,078 

— 

$ 

—  $ 

21,417 

(in thousands)
Senior Secured Term Loan due 2029:

Principal
Less: debt discount (1)
Less: deferred financing (1)

Net carrying value of Long-term debt

Senior Secured Term Loan due 2026(2):

Principal
Less: debt discount (1)
Less: deferred financing (1)

Net carrying value of Long-term debt

Net carrying value of Long-term debt

As of December 31,

2023

2022

400,000  $ 

(9,652) 

(2,490) 

387,858  $ 

— 

— 

— 

— 

—  $ 

400,000 

— 

— 

(4,571) 

(3,439) 

—  $ 

391,990 

387,858  $ 

391,990 

$ 

$ 

$ 

$ 

$ 

_____________________________
(1) Included in the Consolidated Balance Sheets within long-term debt and amortized to interest expense over the remaining life of the 
corresponding Senior Secured Term Loan using the effective interest rate method.
(2) The principal, accrued interest and prepayment premiums associated with the Senior Secured Term Loan due 2026 were fully paid in 
October 2023.

Senior Secured Term Loan due 2029

In October 2023, the Company entered into a $400 million loan agreement (the “Senior Secured Term Loan due 2029”) 
with  Blackstone  Alternative  Credit  Advisors  LP  and  Blackstone  Life  Sciences  Advisors  L.L.C.  (collectively,  “Blackstone”) 
with an interest rate equal to 3-month Term SOFR, subject to a 2.5% floor, plus a Term SOFR adjustment of 0.26161% and a 
margin of 6.25% that requires interest-only payments until early-2027. The Senior Secured Term Loan due 2029 will be repaid 
in  twelve  quarterly  payments  of  $33.3  million,  starting  on  January  2027  with  the  final  balance  due  on  the  maturity  date  in 
October 2029. This transaction resulted in net proceeds of $387.4 million, after deducting fees and expenses. There were no 
warrants or equity conversion features associated with the Senior Secured Term Loan due 2029. 

-105-

 
 
 
 
 
 
 
 
 
 
 
Table of Content

The Senior Secured Term Loan due 2029 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 2029. The Company may prepay the Senior Secured Term Loan due 2029 in 
whole  or  in  part,  at  its  option  at  any  time.  Any  prepayment  of  the  Senior  Secured  Term  Loan  due  2029  is  subject  to  certain 
make-whole premiums and prepayment premiums, the latter of which decrease until the fifth anniversary of the transaction date 
at which point no prepayment penalty shall exist. The obligations under the Senior Secured Term Loan due 2029 are secured by 
a  first  lien  security  interest  in  certain  assets  of  the  Company.  The  Senior  Secured  Term  Loan  due  2029  contains  certain 
customary representations and warranties, affirmative and negative covenants and events of default applicable to the Company. 
If an event of default occurs and is continuing, Blackstone may declare all amounts outstanding under the Senior Secured Term 
Loan due 2029 to be immediately due and payable.

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 was to 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. 
There were no warrants or equity conversion features associated with the Senior Secured Term Loan due 2026. 

In October of 2023, the Company used $408.9 million of the net proceeds from the Senior Secured Term Loan due 2029 
and the private placement to prepay the Senior Secured Term Loan due 2026, inclusive of the outstanding principal amount, 
$0.8 million in accrued interest and $8.0 million as a prepayment premium. In connection with the prepayment, the Company 
recorded a loss from early extinguishment of debt of  $13.9 million in the Company's Consolidated Statements of Operations.

Interest Expense

The following table sets forth interest expense recognized related to the Company's debt for the years ended December 31, 

2023 and 2022, 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 2029

Effective interest rate of the liability component, Senior Secured Term Loan due 2026

December 31, 
2023

December 31, 
2022

$  47,626 

$  34,446 

$ 

$ 

1,605 

1,011 
 12.8 %

 — %

$ 

$ 

1,503 

1,131 

 — %

 12.1 %

12. Leases

The  Company  currently  has  operating  leases  for  office  and  research  laboratory  space,  equipment,  and  vehicles  under 
agreements expiring at various dates through 2034, which include renewal options on leases which the Company is reasonably 
certain to exercise.

For the years ended December 31, 2023 and 2022, operating lease expense was $9.5 million and $9.8 million and variable 
lease expense was $2.1 million and $1.7 million, respectively. For the years ended December 31, 2023 and 2022, the Company 
paid  $9.5  million  and  $8.3  million,  respectively,  for  amounts  included  in  the  measurement  of  operating  lease  liabilities  and 
recorded right-of-use assets of $0.6 million and $8.9 million, respectively.

Commitments under finance leases are not significant for the year ended December 31, 2023.

-106-

Table of Content

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, 2023

December 31, 2022

$ 

$ 

$ 

26,312 

8,324 
48,877 
57,201 

$ 

$ 

$ 

29,534 

8,552 
51,578 
60,130 

9.4
 9.7 %

17.0
 12.2 %

At December 31, 2023, the future minimum operating lease payments were as follows:

(in thousands)

2024

2025

2026

2027

2028

Thereafter

Total lease payments

Less lease incentives

Less imputed interest

Total operating lease liability

Operating Lease

$ 

$ 

9,236 

9,157 

9,213 

9,351 

9,144 

43,715 

89,816 

(22,299) 

(10,316) 

57,201 

-107-

 
 
 
 
 
 
 
 
 
 
Table of Content

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,

2023

2022

2021

$ 

(234,482)  $ 

(343,424)  $ 

(333,571) 

84,381 

101,385 

92,017 

$ 

(150,101)  $ 

(242,039)  $ 

(241,554) 

Following were the components of income tax expense (benefit) for the years ended December 31, 2023, 2022, and 2021:

(in thousands)
Current

Federal
State
Foreign
Deferred
Federal
State
Foreign

Total

Years Ended December 31,

2023

2022

2021

$ 

$ 

—  $ 
14 
6,408 

—  $ 
6 

(5,760)   

(4,801)   
(138)   
— 
1,483  $ 

274 
9 
— 
(5,471)  $ 

— 
15 
8,857 

— 
34 
— 
8,906 

A reconciliation of the statutory tax rates and the effective tax rates for the years ended December 31, 2023, 2022, and 

2021 are as follows:

Statutory rate

Tax credits

Impact of foreign operations
Other
Valuation allowance

Net

Years Ended December 31,

2023

2022

2021

 (21) %

 (8) 

 (9) 
 8 
 31 

 (21) %

 (11) 

 18 
 3 
 9 

 (21) %

 (9) 

 3 
 3 
 28 

 1 %

 (2) %

 4 %

On December 22, 2017, the U.S. government enacted the Tax Cuts and Jobs Act ("Tax Act"). The Tax Act significantly 
revised  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. 

-108-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

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

Royalty payable

Other

Total net deferred tax assets

Less: valuation allowance

Net deferred tax liability

Years Ended
December 31,

2023

2022

$ 

—  $ 

68,567 

235,532 

34,425 

321,004 

17,314 

17,627 

10,567 

1,931 

20,858 

223,366 

29,317 

315,444 

16,417 

12,558 

11,428 

10,400 

20,109 

659,258 

707,606 

— 

(68,567) 

(10,004)   

(11,745) 

649,254 

627,294 

(649,254)   

(632,233) 

$ 

—  $ 

(4,939) 

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, 2023 and 2022, the Company recorded valuation allowances of 
$649.3 million and $632.2 million, respectively, representing an increase in the valuation allowance of $17.0 million in 2023, 
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 
intangible  assets  acquired  by  the  Company.  The  Company's  policy  is  to  record  a  deferred  tax  liability  related  to  acquired 
intangible assets 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.

-109-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Content

As of December 31, 2023, the Company had U.S. federal, U.K. and state net operating loss carry forwards ("NOLs") of 
approximately $1.2 billion, $28.4 million and $1.0 billion, 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. The U.K. carryforward period is unlimited. Most of the state net operating loss carry forwards generated 
prior to 2009 have expired through 2016. The remaining state net operating loss carry forwards including those generated in 
2009  through  2023  will  expire  in  2030  through  2042.  State  research  and  development  credits  will  expire  beginning  2024 
through 2033. 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  2023  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 U.S. federal research and experimentation and orphan drug credit carryforwards of approximately 
$18.4 million and $203.1 million, respectively, which will expire in the years 2030 through 2043. The Company also has state 
research and development tax credit carryforwards of $14.1 million. Deferred tax assets for these carryforwards are subject to a 
full valuation allowance.

The  Organization  Economic  Co-operation  and  Development  (“OECD”)  introduced  Base  Erosion  and  Profit  Shifting 
(“BEPS”)  Pillar  2  rules  that  impose  a  global  minimum  tax  rate  of  15%.  Numerous  countries,  including  European  Union 
member  states,  have  enacted  or  are  expected  to  enact  legislation  to  be  effective  as  early  as  January  1,  2024,  with  general 
implementation of a global minimum tax by January 1, 2025. The Company does not expect this new rule to apply until the 
Company meets the minimum global revenue threshold. 

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.

-110-

Table of Content

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. 

As of December 31, 2023, the contingent milestone payments due to GSK were $5.9 million and 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.

For  the  year  ended  December  31,  2023,  under  the  GSK  collaboration  agreement,  the  Company  incurred  approximately 
$27.7  million  of  royalty  expenses,  of  which  $8.2  million  is  recorded  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. In the fourth quarter of 2023, a stipulation order to stay litigation with respect to 
Lupin  was  ordered.  Additionally,  in  the  first  quarter  of  2024,  a  stipulation  was  filed  with  the  court  and  approved  by  the 
presiding judge, whereby the parties agreed to accept the Company’s definition of the terms that were in dispute. As such, the 
scheduled Markman hearing was deemed unneeded and cancelled. The Company has, and will continue to, 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:
Net loss attributable to common stockholders
Denominator:

Years Ended December 31,

2023

2022

2021

$ 

(151,584)  $ 

(236,568)  $ 

(250,460) 

Weighted average common shares outstanding — basic and diluted

  295,164,515 

  289,057,198 

  271,421,986 

Dilutive common stock equivalents would include the dilutive effect of outstanding common stock options and unvested 
RSUs.  Potentially  dilutive  common  stock  equivalents  were  excluded  from  the  diluted  earnings  per  share  denominator  for  all 
periods  because  of  their  anti-dilutive  effect.  Weighted  average  common  shares  outstanding  includes  outstanding  pre-funded 
warrants with an exercise price of $0.01.

-111-

Table of Content

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

Total number of potentially issuable shares

Years ended December 31,

2023

2022

2021

23,002 

10,033 

33,035 

19,064 

9,717 

28,781 

14,731 

7,341 

22,072 

Item 9.    CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL 
DISCLOSURE.

None.

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,  2023.  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, 2023, 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,  2023  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."

-112-

 
 
 
 
 
 
 
 
 
Table of Contents

Item 9B.    OTHER INFORMATION.

Rule 10b5-1 Trading Plans

The following table describes, for the quarterly period covered by this report, each director and officer (as defined in Rule 
16a-1(f) under the Exchange Act who has adopted, modified, or terminated a trading plan intended to satisfy the affirmative 
defense of Rule 10b5-1(c) under the Exchange Act (each plan, a “Rule 10b5-1 Trading Plan”). Each Rule 10b5-1 Trading Plan 
described below was adopted during an open insider trading window and in accordance with the Company’s policies regarding 
both insider trading and transactions relating to Company securities.

Name
(Title)

Action Taken
(Date of Action)

Rule 10b5-1 Trading 
Plan Provides for 
Purchase/Sale

Duration of the 
Trading Plan(1)

Aggregate Number of 
Securities

Margaret G. McGlynn
(Director)

Adoption
(November 10, 2023)

Sale

June 12, 2024

15,000(2)

____________________________

(1) The dates in this column represent the scheduled expiration date of each director or officer’s Rule 10b5-1 Trading Plan. Each Rule 
10b5-1 Trading Plan may terminate earlier than the date provided should all transactions contemplated thereunder occur prior to such 
date.
(2) Ms. McGlynn’s Rule 10b5-1 Trading Plan provides for the exercise of up to 15,000 stock options and the sale of up to 15,000 
underlying shares of common stock.

Item 9C.    DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS.

Not applicable. 

-113-

Table of Contents

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 2024 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.

-114-

Table of Contents

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, 2023 and 2022

Consolidated Statements of Operations for the years ended December 31, 2023, 2022, and 2021

Consolidated Statements of Comprehensive Loss for the years ended December 31, 2023, 2022, and 2021

Consolidated Statements of Changes in Stockholders' Equity for the years ended December 31, 2023, 2022, and 2021

Consolidated Statements of Cash Flows for the years ended December 31, 2023, 2022, and 2021

Notes To Consolidated Financial Statements

2. Consolidated Financial Statement Schedules

80

81

84

85

86

87

88

90

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 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.

+2.3 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 Second Amended and Restated By-laws of the 

Form 10-Q

8/8/2023

Registrant.

3.3 Certificate of Amendment to the Registrant's 

Restated Certificate of Incorporation.

Form 8-K

6/10/2015

3.4 Certificate of Amendment to the Restated Certificate 

of Incorporation

Form 8-K

6/8/2018

3.5 Certificate of Amendment to the Restated Certificate 

of Incorporation

Form 8-K

6/13/2023

3.1

3.2

3.1

3.1

3.1

-115-

 
 
 
 
 
 
 
 
Table of Contents

Incorporated by Reference
to SEC Filing

Exhibit
No.

Filed Exhibit Description

4.1 Specimen Stock Certificate evidencing shares of 

Form
S-1/A (333-141700)

Date
5/17/2007

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

4/24/2016

3/2/2020

9/29/2021

9/29/2021

10.1 Form of Director and Officer Indemnification 

8-K

12/28/2022

Agreement

*10.2 Amended and Restated 2007 Director Option Plan 

Form 8-K

6/18/2010

and form of option agreement

10.3 Securities Purchase Agreement, dated November 20, 
2013 by and among the Company and the purchasers 
identified therein

**10.4 Second Restated Agreement, dated November 19, 

2013 by and between the Registrant and Glaxo 
Group Limited

Form 8-K

11/20/2013

Exhibit 
No.

Filed with this
Form 10-K

4.1

4.7

4.8
4.1

10.3

10.1

10.2

10.1

X

*10.5 Amicus Therapeutics, Inc. Amended and Restated 

Form 8-K

12/28/2017

10.1

Restricted Stock Unit Deferral Plan

A

10.1

10.1

10.1

10.1

10.1

*10.6 Amended and Restated 2007 Equity Incentive Plan

DEF 14A

*10.7 Amicus Therapeutics, Inc. Cash Deferral Plan

Form 8-K

10.8 Form of Performance-Based Restricted Stock Unit 

Form 8-K

Award Agreement under the Amended and Restated 
2007 Equity Incentive Plan

4/26/2023

10/28/2016

12/30/2016

10.9 Amendment #1 to the Amicus Therapeutics, Inc. 

Form 8-K

10/26/2014

Cash Deferral Plan.

10.10 Amendment #2 to the Amicus Therapeutics, Inc. 

Form 8-K

12/19/2019

Cash Deferral Plan.

*10.11 Employment Agreement, dated August 1, 2022, by 
and between the Registrant and Bradley L. 
Campbell.

*10.12 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

*10.13 Employment Agreement dated February 18, 2020 

Form 10-K

3/2/2020

10.45

between the Registrant and Ellen S. Rosenberg 

*10.14 Employment Agreement dated February 18, 2020, 
between the Registrant and Daphne Quimi
*10.15 Employment Agreement, dated August 21, 2023, by 

and between Amicus Therapeutics, Inc. and Simon 
Harford

*10.16 Employment Agreement dated February 18, 2020 
between the Registrant and David Clark
*10.17 Employment Agreement dated February 18, 2020 
between the Registrant and Jeffrey Castelli

*10.18 Form of Board Restricted Stock Unit Award 

Agreement under the Amended and Restated 2007 
Equity Incentive Plan

Form 10-K

3/2/2020

10.48

Form 10-Q

11/8/2023

10.3

Form 10-K

3/2/2020

10.18

Form 10-K

3/2/2020

10.19

Form 10-K

3/1/2021

10.39

-116-

 
 
 
 
 
 
 
 
 
 
 
Table of Contents

Exhibit
No.
*10.19 Form of Board Stock Option Award Agreement 

Filed Exhibit Description

under the Amended and Restated 2007 Equity 
Incentive Plan

*10.20 Form of Stock Option Award Agreement under the 
Amended and Restated 2007 Equity Incentive Plan
*10.21 Form of Restricted Stock Unit Award Agreement 

under the Amended and Restated 2007 Equity 
Incentive Plan

Incorporated by Reference
to SEC Filing

Form

Form 10-K

Date
3/1/2021

Exhibit 
No.
10.41

Filed with this
Form 10-K

Form 10-K

3/1/2021

10.42

Form 10-K

2/24/2022

10.25

**10.22 License Agreement dated December 22, 2022, by 

Form 10-K

3/1/2023

10.25

and between Amicus Therapeutics, Inc. and the 
Trustees of the University of Pennsylvania

**10.23 Mutual Termination Agreement dated December 22, 
2022, by and between Amicus Therapeutics, Inc. and 
the Trustees of the University of Pennsylvania.

10.24 Loan Agreement, dated October 2, 2023 by and 
among Amicus Therapeutics, Inc., certain 
subsidiaries of Amicus Therapeutics, Inc. from time 
to time party thereto as Guarantors, Blackstone 
Alternative Credit Advisors LP, Blackstone Life 
Sciences Advisors L.L.C., certain lenders from time 
to time party thereto and Wilmington Trust, National 
Association, as Agent for the lenders.

Form 10-K

3/1/2023

10.26

Form 8-K

10/2/2023

10.1

10.25 Securities Purchase Agreement, dated October 2, 

Form 8-K

10/2/2023

10.2

2023, by and among Amicus Therapeutics, Inc. and 
the Purchasers identified on the signature pages 
thereto.

**10.26 Supply and Manufacturing Services Agreement, 

Form 10-Q

8/8/2023

10.2

dated as of March 31, 2023, by and among the 
Company, WuXi Biologics (Hong Kong) Limited, 
WuXi Biologics Ireland Limited and WuXi 
Biologics Germany GmbH

21.1 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.

97.1 Amicus Therapeutics, Inc. Clawback Policy

-117-

X

X

X

X

X

X

X

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents

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, 2023, 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, 2023 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.

Indicates management contract or compensatory plan.

** 

Portions of the exhibit have been omitted in accordance with 17 CFR § 229.601(b)(10)(iv).

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."

-118-

   
 
 
 
 
 
 
 
 
Table of Contents

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.

-119-

Table of Contents

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 February 28, 2024.
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/    Simon Harford

(Simon Harford)

/s/    Samantha L. Prout

(Samantha L. Prout)

/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)

President and Chief Executive Officer
(Principal Executive Officer)

February 28, 2024

Chief Financial Officer
(Principal Financial Officer)

February 28, 2024

Chief Accounting Officer and 
Controller 
(Principal Accounting Officer)

February 28, 2024

Executive Chairman

February 28, 2024

February 28, 2024

February 28, 2024

February 28, 2024

February 28, 2024

Director

Director

Director

Director

-120-

Table of Contents

Signature

Title

Date

/s/    Lynn Bleil

(Lynn Bleil)

/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

Director

February 28, 2024

February 28, 2024

February 28, 2024

February 28, 2024

-121-

Company Information

Executive Committee

BRADLEY CAMPBELL 
President and Chief Executive Officer

STEPHEN ARNOLD
Chief, Global Head of Rare Diseases

SIMON HARFORD
Chief Financial Officer

ELLEN ROSENBERG
Chief Legal Officer and 
Corporate Secretary

DAVID CLARK
Chief People Officer

JEFFREY CASTELLI, PH.D.
Chief Development Officer

Board of Directors

MICHAEL G. RAAB
President and Chief Executive Officer, 
Ardelyx, Inc. 
Chairman of the Board

LYNN D. BLEIL
Former Senior Partner, McKinesey & Co. 
Nominating and Governance (Chair)

BRADLEY CAMPBELL 
President and Chief Executive Officer

MICHAEL A. KELLY
Founder and President,  
Sentry Hill Partners, LLC

MARGARET G. MCGLYNN
Former President, Global Vaccines 
and Anti-Infectives, Merck 
Compensation and Leadership 
Development (Chair) 

JAYNE GERSHKOWITZ
Chief Patient Advocate

MITCHELL GOLDMAN, M.D., PH.D.
Chief Medical Officer

PATRIK FLORENCIO
Global Chief Compliance & Risk Officer

SÉBASTIEN MARTEL
Chief Business Officer

PAT O’SULLIVAN
Chief Technical Operations Officer

JILL WEIMER, PH.D.
Chief Science Officer

JULIE YU, PH.D.
Chief Program Officer

EIRY W. ROBERTS
Chief Medical Officer,  
Neurocrine Biosciences, Inc.

GLENN P. SBLENDORIO
Former Chief Executive Officer, 
IVERIC Bio, Inc. 
Audit and Compliance (Chair)

CRAIG A. WHEELER
Chief Executive Officer,  
Headwaters Biotech Advisors 
Science and Technology (Chair)

BURKE W. WHITMAN
Chief Executive Officer, Colmar Holdings; 
Retired Major General, U.S. Marine Corps

Headquarters

Amicus Therapeutics, Inc. 
47 Hulfish Street 
Princeton, NJ 08542

Transfer Agent

Equiniti Trust Company, LLC (“EQ”)

48 Wall Street, Floor 23 
New York, NY 10005 
800 937 5449

Independent Registered  
Public Accounting Firm
Ernst & Young LLP

Stockholder Inquiries
All stockholder 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., 
47 Hulfish St, Princeton, NJ, 08542 or via the 
Company’s website at www.amicusrx.com.

Annual Meeting
Amicus will hold its 2024 Annual Meeting of 
Stockholders in virtual format only. Our virtual 
meeting will be structured in a manner intended 
to provide our stockholders with a participation 
experience similar to an in-person meeting. 
The virtual annual meeting will be held at 9:00 
a.m. on Thursday, June 6, 2024. Stockholders 
can access the meeting via the Internet at 
www.virtualshareholdermeeting.com/FOLD2024

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 2023.

Amicus Therapeutics    2023 Annual  Report    

AMICUS THERAP EUTI CS, I NC. 

4 7 H ULF IS H STREET

PR I NCETON , NJ 08542

609-662-2 000

WWW.AMICU SRX .CO M