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Anika Therapeutics, Inc.

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FY2018 Annual Report · Anika Therapeutics, Inc.
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A N N U A L   R E P O R T   2 0 1 8

PERFORMANCE

Driving growth and profitability to maximize value for  
our shareholders.

PRODUCTS

Innovative therapies developed and commercialized to meet the 
needs of our patients across the continuum of orthopedic and 
regenerative therapies.

PEOPLE

High-end talent driving innovation and a culture of achievement.

Dear Fellow Shareholders,

Since taking over as President and Chief Executive Officer in 
March of last year, my driving vision has been the transformation of 
Anika Therapeutics into a global commercial company delivering 
a continuum of innovative orthopedic and regenerative medicine 
therapies to fuel our next phase of growth and drive enduring 
shareholder value. In 2018, we prioritized and advanced this 
goal. We made the important decision to develop and deploy 
our hybrid commercial business model in the United States 
for orthopedic surgical product candidates. We onboarded 
experienced new talent on the management team and across other 
key functions to ensure we have the right winning team in place 
to drive growth and enhance efficiencies. We also progressed 
our broad and deep pipeline that we see as the leading edge 
of a cascade of new product launches to propel us forward.

The last year also brought certain headwinds both with regards 
to external circumstances, such as pricing pressure in the U.S. 
market and disappointing clinical trial results, as well as internal 
elements, such as our voluntary recall of certain HYAFF-based 
products. We persevered through these setbacks, and we 
believe that we have stabilized the company’s operations and 
overall foundation. We have made strong progress on our 5-year 
strategic plan to guide our continued transformation, and we are 
confident in the long-term growth potential for our company.

We believe we have a strong platform, both from a financial and 
technology standpoint, from which to launch our future. We 
believe that our 2018 performance highlights our ability to capably 
manage the elements of our business over which we can exert 
control and that 2019 will be a year of execution and accelerated 
performance as we drive forward into the next phase of growth. 
We are focused on growing our business responsibly, ethically 
and in a sustainable manner, while maintaining our strong culture 
of innovation, operational excellence and financial discipline. 
Finally, we remain committed to delivering long-term value to our 
shareholders through the development and commercialization 
of innovative orthopedic and regenerative therapies and smart 
investment of our resources. Change will not occur immediately, 
but we believe we can rapidly advance our strategic objectives.

On behalf of the management team and our Board of Directors, I 
thank you for your continued trust and confidence in our company, and 
I look forward to the future as we work tirelessly to drive innovation 
and transform Anika Therapeutics into a global commercial company.

Sincerely,

Joseph Darling 

President and Chief Executive Officer

Joseph Darling,
President & CEO

2019 is a 
transformational 
year for Anika, 
as we build our 
hybrid commercial 
business model 
in the U.S. and 
strengthen our 
international 
commercial 
infrastructure to 
drive the next phase 
of our growth.

ANNUAL REPORT 2 018

2

FY 2018 
HIGHLIGHTS

A NEW DAY FOR ANIKA

TRANSFORMING INTO A GLOBAL COMMERCIAL COMPANY 

Today is a new day for Anika Therapeutics. In 2018, we took important steps to 
transition the company for its next phase of growth, as we evolve into a global 
commercial company. From expanding our leadership team and Board of Directors to 
advancing our deep product pipeline and progressing toward the deployment of our 
hybrid commercial model in the U.S., we further solidified our strong foundation built 
over the past decade. 

In 2019, we plan to approach the 
market proactively and directly to 
gain greater visibility and control 
of our future. We are investing 
in commercial expansion efforts 
through our U.S. hybrid commercial 
model and the optimization of our 
distribution model outside of the 
United States. 

This is a very exciting time for Anika 
as we build and strengthen our 
global commercial infrastructure 
and capabilities to drive the next 
phase of our growth and evolution. 
Fundamentally, we believe our 
company and future growth are 
powered by a strategy focused 
around our people, our products, 
and our performance. Throughout 
this annual report, we will highlight 
our 2018 achievements and near- 
and long-term growth drivers within 
the context of these foundational 
strategic pillars.

We are committed 
to transforming 
Anika into a 
global commercial 
company with an 
innovative portfolio 
of orthopedic 
and regenerative 
medicine solutions 
spanning a broad 
continuum of care

27%

Vitality Index for New 
Products Launched 
Since 2014

11%

Orthobiologics  
5-Year CAGR

#1

Market Share in the 
U.S. Viscosupplement 
Market

34%

CINGAL Revenue Growth

$35M

Cash from Operations

$30M

Accelerated Share 
Repurchase Program

$

$159M$159M

Cash and Investments; 
No Debt

4  

ANNUAL REPORT 2 018

PEOPLE

HIGH-END TALENT DRIVING INNOVATION 
AND A CULTURE OF ACHIEVEMENT 

Over the course of 2018, we prioritized a shift in our culture and sought to energize the 
human element of our organization to focus on the many growth drivers we see for the 
company. This focus extended from our Board of Directors, where we added two new 
directors to broaden our overall knowledge base, to every function within the company 
with the goal of increasing our sophistication, efficiency, and overall level of expertise. 

With our U.S. headquarters located in the Boston area, a life science innovation 
hotbed, and our European headquarters located in Padova, Italy, a historic 
university town rich with culture and progressive thought, we intend to leverage 
our physical locations to recruit and retain the strongest talent available. Our Chief 
Human Resources Officer and the leader of our talent management function, 
Thomas Finnerty, has been tasked with aggressively recruiting talented individuals 
across the organization to maximize our performance, while empowering our 
employees to continuously seek innovative solutions in all areas of our business.

Since mid-2018, we have added executive leadership to our operations, commercial 
and research and development functions. These bright and ambitious industry veterans 
are already making positive contributions toward achieving our strategic objectives. 
Our Vice President of Operations, Alex Goraltchouk, has enhanced and galvanized 
our operational teams with his energy and commitment to continuous improvement 
and sustainable business practices. We have seen the beginnings of the expected 
financial benefits through expanded operating margins, and we anticipate even greater 
improvements as the team further integrates his innovative thinking into our operations.

We increased our focus on international expansion with the appointment of James Chase 
as our Vice President of International Sales and our first European-based commercial lead. 
We are increasing our attention on the markets outside of the United States and building 
a team of experts to support international growth through direct interaction with all key 
stakeholders. We plan to create an organization optimally positioned to maximize the global 
potential of our current and future product portfolio and product development activities. 

In the first quarter of 2019, we appointed Robert Richard, Ph.D. to the newly created 
position of Vice President of Research and Development (R&D). Dr. Richard’s extensive 
leadership and product development experience will help us accelerate and advance 
our orthopedic and regenerative medicine pipeline to deliver a cascade of innovative 
treatments to patients over the next several years. He will also enable us to leverage the 
broad utility of our technology platform, with a renewed focus on regenerative medicine. 
We are empowering our R&D team to step outside our traditional development paradigms, 
including through interaction with physicians and other external stakeholders to understand 
current unmet needs in the market, where we feel we can drive innovation in our portfolio.

In addition, we are currently structuring the internal programs and hiring the expert 
resources necessary to successfully deploy our U.S.-based hybrid commercial organization. 
We believe in ourselves, in our culture, and in our product offerings, both present and 
future, and our employees hard work and passion are at the heart of our organization.

We are committed 

to transforming 

Anika into a 

global commercial 

company with an 

innovative portfolio 

of orthopedic 

and regenerative 

medicine solutions 

spanning a broad 

continuum of care

“Efficiency,innovation,andafocus

onexecutionisatthecoreof
ourorganization.Thiswillenable
ustodrivesustainabilityand
maximizevalueforpatientsandour
shareholders.Withourfocusonthe
keyoperationalfundaments,we
believethatefficiencyimprovements
willalsoyieldenhancedquality
andasaferworkplace,aswellas
improvedontimedeliveryand
overallcompliance.”

—AlexeiGoraltchouk, 
VicePresidentofOperations

“Aswetransformintoaglobal
commercialorganization,itis
criticalforustobeengagedinthe
marketsinwhichweparticipate.
Wearebuildingourinternational
commercialinfrastructureto
strengthenourbrand,accelerate
internationalpenetrationanddrive
adoption,andimportantlybring
usclosertothepatientsweserve
throughenhancedrelationshipswith
keycliniciansandourdistributors.”

—JamesChase,
VicePresidentofInternationalSales

ANNUAL REPORT 2 018 

5

PEOPLEHIGH-END TALENT DRIVING INNOVATION AND A CULTURE OF ACHIEVEMENTDRIVING INNOVATION IN 
ORTHOPEDIC THERAPIES

PRODUCTS

MONOVISC 
Single Injection 
Osteoarthritis Treatment

CINGAL
Next Generation 
Osteoarthritis Therapy; 
Combination Hyaluronic 
Acid and Steroid

INNOVATIVE TREATMENTS DEVELOPED AND 
COMMERCIALIZED TO MEET THE NEEDS OF OUR PATIENTS 
ACROSS THE CONTINUUM OF ORTHOPEDIC THERAPIES

While our strategic focus has historically been centered on our strong viscosupplement 
portfolio anchored by MONOVISC and CINGAL, we believe that our future lies in 
regenerative medicine and other potential areas leveraging the broad utility of our 
HYAFF technology platform. There are over 4 million sports-related injuries per year, and 
the cartilage repair market represents an approximate $2 billion opportunity in the U.S. 
Based on feedback from physicians and other stakeholders, it is clear there is an urgent 
and growing global need for solutions that delay surgery and heal patients naturally 
while maintaining and supporting overall cost control initiatives. We believe we are well-
positioned to meet this global need through innovation utilizing our HYAFF technology 
platform, as well as potential synergistic acquisitions. Our goal is to transform into a market 
leader in orthopedic and regenerative medicine with a product portfolio spanning a broad 
continuum of care.

We expect our surgically-delivered bone repair and rotator cuff repair therapies to be 
the first two pipeline products launched under our hybrid commercial model. The first, 
our bone repair treatment, is scheduled to make its debut in the second half of 2019. 
We continue to believe in the U.S. commercial potential of HYALOFAST, and we are 
advancing initiatives to accelerate enrollment in the ongoing Phase III trial required for U.S. 
approval. We have refreshed our approach to more directly align our commercial and R&D 
functions to engage with external stakeholders to proactively analyze and seek to address 
unmet clinical needs. Additionally, we are continually exploring synergistic acquisition 
opportunities and targeted partnerships to augment our organic growth.

EXPANDING REGENERATIVE 
MEDICINE PORTFOLIO

HYBRID COMMERCIAL BUSINESS MODEL

Improving 

Operational 

Efficiency

As we develop and launch products with a different call point than our current portfolio 
in palliative pain management, we intend to utilize a hybrid commercial business model 
in the United States. This approach will pair a small in-house team of elite and highly-
skilled business development specialists with a strategic partner or regional distribution 
partnerships. We intend to 
structure any new partnership 
contracts to provide more 
favorable economics and greater 
control over market access, sales 
and marketing, minimum annual 
growth objectives, and pricing 
than our previous commercial 
partnerships have had historically. 
We intend to continue with 
our existing distribution model 
outside of the United States and 
expect the development of our 
international commercial team 
to drive similar benefits as well 
as a greater ability to hold our 
commercial partners accountable 
for their performance. We are 
pleased with the progress we are 
collectively making across our 
organization as we evolve into a 
global commercial company and 
gain greater visibility and control 
of our future.  

“ As an Orthopedic Surgeon and Sports 
Medicine Physician, I am constantly 
scanning the horizon to identify new 
therapies and technologies with the 
potential to be the best possible 
treatment option for my patients. I have 
been following the Anika story for a 
number of years now and successfully 
utilized certain of their offerings, and I 
am very excited about their next 
generation of products and the potential 
benefits that they may one day provide 
to my patients to help them recover from 

injury and restore their active lifestyles.”

Plancher Orthopaedics & Sports Medicine

– Kevin D. Plancher, MD 

HYALOFAST
A Hyaluronic Acid Based 
Matrix Supports Regeneration 
of Hyaline-like Cartilage

BONE REPAIR TREATMENT 
Commercial Launch Planned 
for 2H 2019

6  

ANNUAL REPORT 2 018

PERFORMANCE

DRIVING PROFITABLE GROWTH TO MAXIMIZE VALUE FOR OUR 
SHAREHOLDERS 

Our ongoing evolution into a global commercial company, which is supported by our 
people and products, is focused on maximizing value for our shareholders. In 2018, 
we effectively managed and stabilized the company’s operations following significant 
organizational change and business challenges. Our focus on operational excellence 
enabled us to continue to deliver strong profitability and cash flow for the year. We 
believe that this work has positioned us to accelerate our growth in the years ahead. 

CORPORATE SOCIAL 
RESPONSIBILITY

Anika is committed to creating a 
sustainable and diverse workplace, 
while ensuring we operate with the 
highest standards of quality, ethics and 
corporate governance. We are pleased 
to highlight our environmental, social 
and corporate governance progress and 
achievements in 2018. 

In 2019, we will take advantage of the multiple levers we have to drive growth 
throughout our business. We remain committed to achieving our long-term goal of 
delivering sustained double-digit revenue growth. 

Environmental

Developing Hybrid 
Commercial Model 

Improving 
Operational 
Efficiency

$

Disciplined & 
Balanced Capital 
Allocation

Advancing Orthopedic 
and Regenerative 
Medicine Pipeline

International Expansion 
of Orthobiologics 
Franchise

We look forward to completing the development of our hybrid commercial organization 
in 2019 and launching multiple new and innovative orthopedic and regenerative therapies 
over the next several years to fuel our growth. We have carefully considered the paths in 
front of us as we near completion of our 5-year strategic plan, and we are confident we 
have the right people, products and strategies to drive sustained growth and value for our 
shareholders. 

•   Material Recycling - Redundant 
component waste elimination

•   Emissions and other environmental data 

tracking initiative from company processes

•  Ozone depleting substance program
•  Heat recovery projects
•  Lighting upgrade - LED lights on automatic 

timers/dimmers

Social

•  UMASS Amherst iCons program annual 

contribution

•  Charitable contributions - Meals for Kids; 

Cradles to Crayons 

•  Employee health and wellness initiatives

Corporate Governance

•  Commitment to diversity 
•  Expansion of Board of Directors

– Cheryl R. Blanchard, Ph.D. - President 
and Chief Executive Officer, Keratin 
Biosciences, Inc.

– Susan N. Vogt - Formerly President 
and Chief Executive Officer, Aushon 
Biosystems, Inc.

– Joseph Darling - President and Chief 
Executive Officer, Anika Therapeutics

•  Risk management programs

ANNUAL REPORT 2 018 

7

EXECUTIVE OFFICERS 

BOARD OF DIRECTORS

SHAREHOLDER MEETING

Joseph Darling 
President and Chief Executive Officer

Joseph L. Bower, D.B.A. 
Chairman - Independent

Sylvia Cheung 
Chief Financial Officer

Cheryl R. Blanchard, Ph.D. 
Keratin Biosciences, Inc.

Edward Ahn, Ph.D. 
Chief Technology and Strategy Officer

Joseph G. Darling 
President and Chief Executive Officer

Thomas Finnerty 
Chief Human Resources Officer

Raymond J. Land 
Formerly of Clarient, Inc.

Glenn R. Larsen, Ph.D. 
Aquinnah Pharmaceuticals, Inc.

Jeffery S. Thompson 
HealthEdge Investment Partners, LLC

Susan N. Vogt 
Formerly of Aushon Biosystems, Inc.

June 18, 2019 
11:30 a.m. EDT 
Anika Therapeutics 
Corporate Headquarters

HEADQUARTERS

32 Wiggins Avenue 
Bedford, MA 01730 USA

EMPLOYEES

133 (as of December 31, 2018)

STOCK LISTING

NASDAQ: ANIK

INVESTOR RELATIONS

Sylvia Cheung 
Chief Financial Officer 
Phone: 781.457.9000 
investorrelations@anikatherapeutics.com

AUDITORS

CORPORATE COUNSEL

TRANSFER AGENT

Deloitte & Touche LLP 
200 Berkeley Street 
Boston, MA 02116 
Phone: 617.437.2000 
www.deloitte.com

K&L Gates LLP 
1 Lincoln Street 
Boston, MA 02111 
Phone: 617.261.3100 
www.klgates.com

American Stock Transfer & Trust Company LLC
6201 15th Avenue  
Brooklyn, NY 11219  
Phone: 800.937.5449 
www.astfinancial.com 
help@astfinancial.com

FORWARD LOOKING STATEMENT
This document contains “forward-looking statements,” which are not statements of historical fact, and are forward-looking statements within the meaning of Section 
27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. These statements include, but are not limited to, 
those relating to the Company’s long-term strategies and growth plans, the Company’s 5-year strategic plan, the Company’s expectations with respect to its 2019 finan-
cial performance, the Company’s U.S. and international commercial efforts, the Company’s launch of its bone repair product via its hybrid commercial model, and the 
Company’s pursuit of strategic acquisitions and partnerships. These statements are based upon the current beliefs and expectations of the Company’s management and 
are subject to significant risks, uncertainties, and other factors. The Company’s actual results could differ materially from any anticipated future results, performance, 
or achievements described in the forward-looking statements as a result of a number of factors including, but not limited to, (i) the Company’s ability to successfully 
commence and/or complete clinical trials of its products on a timely basis or at all; (ii) the Company’s ability to obtain pre-clinical or clinical data to support domestic and 
international pre-market approval applications, 510(k) applications, ornew drug applications, or to timely file and receive FDA or other regulatory approvals or clearances 
of its products; (iii) that such approvals will not be obtained in a timely manneror without the need for additional clinical trials, other testing or regulatory submissions, 
as applicable; (iv) the Company’s research and product development efforts and their relative success, including whether we have any meaningful sales of any new 
products resulting from such efforts; (v) the cost effectiveness and efficiency of the Company’s clinical studies, man¬ufacturing operations, and production planning; (vi) 
the strength of the economies in which the Company operates or will be operating, as well as the political stability of any of those geographic areas; (vii) future deter-
minations by the Company to allocate resources to products and in directions not presently contemplated; (viii) the Company’s ability to successfully commercialize its 
products, in the U.S. and abroad; (ix) quarterly sales volume variation experienced by the Company, which can make future results difficult to predict and period-to period 
comparisons potentially less meaningful; (x) the Company’s ability to provide an adequate and timely supply of its products to its customers; and (xi) the Company’s ability 
to achieve its growth targets. Additional factors and risks are described in the Company’s periodic reports filed with the Securities and Exchange Commission, and they 
are available on the SEC’s website at www.sec.gov.

8  

ANNUAL REPORT 2 018

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, 2018 

  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 000-21326  
Anika Therapeutics, Inc. 
(Exact Name of Registrant as Specified in Its Charter)  

Delaware 
(State or Other Jurisdiction of Incorporation or Organization) 

04-3145961 
(IRS Employer Identification No.) 

32 Wiggins Avenue, Bedford, Massachusetts 01730 
(Address of Principal Executive Offices) (Zip Code) 

(781) 457-9000 
(Registrant’s Telephone Number, Including Area Code) 

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

Title of Each Class 
Common Stock, par value $0.01 per share 

Name of Each Exchange on Which Registered 
NASDAQ Global Select 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 if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be 
contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this 
Form 10-K or any amendment to this Form 10-K.  

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,” “smaller reporting company,” 
and “emerging growth company” in Rule 12b-2 of the Exchange Act.  

Large accelerated filer   Accelerated filer  

 Non-accelerated filer  

 Smaller reporting company   Emerging growth company  

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

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No  

The  aggregate  market  value  of  voting  common  stock  held  by  non-affiliates  of  the  registrant  as  of  June 30,  2018,  the  last  day  of  the 
registrant’s most recently completed second fiscal quarter, was $460,209,312 computed by reference to the closing price of common stock 
on such date. The registrant does not have any non-voting stock outstanding. 

At February 10, 2019, there were 14,211,672 shares of the registrant’s common stock outstanding. 

Documents Incorporated By Reference 

Portions of the registrant’s proxy statement for its 2019 annual meeting of stockholders are incorporated by reference in Part III of this 
Annual Report on Form 10-K. 

 
 
 
 
 
ANIKA THERAPEUTICS, INC. 
TABLE OF CONTENTS 

Page 

Cautionary Note Regarding Forward-Looking Statements ..........................................................................   3 

Part I 
   Item 1. 
Business .......................................................................................................................................................   4 
   Item 1A.  Risk Factors .................................................................................................................................................   13 
Properties .....................................................................................................................................................   26 
   Item 2. 
   Item 3. 
Legal Proceedings ........................................................................................................................................   27 
Part II 

Item 5.  Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 

Securities ......................................................................................................................................................   27 
   Item 6. 
Selected Financial Data ................................................................................................................................   28 
   Item 7.  Management’s Discussion and Analysis of Financial Condition and Results of Operations .......................   29 
   Item 7A.  Quantitative and Qualitative Disclosures About Market Risk .....................................................................   45 
   Item 8. 
Financial Statements and Supplementary Data ............................................................................................   46 
   Item 9A.  Controls and Procedures ..............................................................................................................................   76 
Part III 
   Item 10.  Directors, Executive Officers and Corporate Governance ...........................................................................   78 
   Item 11.  Executive Compensation .............................................................................................................................   78 
   Item 12.  Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters ....   78 
   Item 13.  Certain Relationships and Related Transactions, and Director Independence .............................................   78 
   Item 14.  Principal Accounting Fees and Services ......................................................................................................   78 
Part IV 
   Item 15.  Exhibits and Financial Statement Schedules ................................................................................................   78 
Signatures ..........................................................................................................................................................................   81 

References in this Annual Report on Form 10-K to “we,” “us,” “our,” “our company,” and other similar references refer to 
Anika Therapeutics, Inc. and its subsidiaries unless the context otherwise indicates. 

ANIKA,  ANIKA  THERAPEUTICS,  ANIKAVISC,  CINGAL,  HYAFF,  HYDRELLE,  HYVISC,  MONOVISC,  and 
ORTHOVISC are our registered trademarks, and HYALOSS and ELEVESS, are our trademarks. For convenience, these 
trademarks appear in this Annual Report on Form 10-K without ® and ™ symbols, but that practice does not mean that we 
will not assert, to the fullest extent under applicable law, our rights to the trademarks. This Annual Report on Form 10-K also 
contains trademarks and trade names that are the property of other companies. 

2 

  
     
  
     
  
  
     
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
FORM 10-K 
ANIKA THERAPEUTICS, INC. 
For Fiscal Year Ended December 31, 2018 

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS 

This Annual Report on Form 10-K contains "forward-looking statements" within the meaning of Section 27A of the 
Securities  Act  of  1933  and  Section 21E  of  the  Securities  Exchange  Act  of  1934  concerning  our  business,  consolidated 
financial condition, and results of operations. The Securities and Exchange Commission ("SEC") encourages companies to 
disclose forward-looking statements so that investors can better understand a company’s future prospects and make informed 
investment  decisions.  Forward-looking  statements  are  subject  to  risks  and  uncertainties,  many  of  which  are  outside  our 
control, which could cause actual results to differ materially from these statements. Therefore, you should not rely on any of 
these forward-looking statements. Forward-looking statements can be identified by such words as "will," "likely," "may," 
"believe,"  "expect,"  "anticipate,"  "intend,"  "seek,"  "designed,"  "develop,"  "would,"  "future,"  "can,"  "could,"  and  other 
expressions  that  are  predictions  of  or  indicate  future  events  and  trends  and  that  do  not  relate  to  historical  matters.  All 
statements  other  than  statements  of  historical  facts  included  in  this  Annual  Report  regarding  our  strategies,  prospects, 
financial condition, operations, costs, plans, and objectives are forward-looking statements. Examples of forward-looking 
statements include, among others, statements regarding expected future operating results, expectations regarding the timing 
and receipt of regulatory results, anticipated levels of capital expenditures, and expectations of the effect on our financial 
condition of claims, litigation, and governmental and regulatory proceedings. 

Please refer to "Risk Factors" for important factors that we believe could cause actual results to differ materially 
from those in our forward-looking statements. Any forward-looking statement made by us in this Annual Report on Form 
10-K is based only on information currently available to us and speaks only as of the date on which it is made. We undertake 
no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, 
whether as a result of new information, future developments, or otherwise. 

3 

  
  
  
  
  
  
  
  
  
  
  
  
 
 
ITEM 1. BUSINESS 

Overview 

PART I 

We are a global, integrated orthopedic and regenerative medicines company committed to improving the lives of 
patients  with  degenerative  orthopedic  diseases  and  traumatic  conditions  with  clinically  meaningful  therapies  along  the 
continuum  of  care,  from  palliative  pain  management  to  regenerative  tissue  repair.  We  have  over  two  decades  of  global 
expertise developing, manufacturing, and commercializing more than twenty products based on its proprietary Hyaluronic 
Acid (“HA”)  technology. Our  orthopedic  medicine portfolio  includes ORTHOVISC, MONOVISC, and  CINGAL,  which 
alleviate pain and restore joint function by replenishing depleted HA, and HYALOFAST, a solid HA-based scaffold to aid 
cartilage repair and regeneration. 

Our therapeutic offerings consist of products in the following areas: Orthobiologics, Dermal, Surgical, and Other, 
which  includes  our  ophthalmic  and  veterinary  products.  All  of  our  products  are  based  on  HA,  a  naturally  occurring, 
biocompatible polymer found throughout the body. Due to its unique biophysical and biochemical properties, HA plays an 
important role in a number of physiological functions such as the protection and lubrication of soft tissues and joints, the 
maintenance of the structural integrity of tissues, and the transport of molecules to and within cells. 

Our proprietary technologies for modifying the HA molecule allow product properties to be tailored specifically to 
therapeutic use. Our patented technology chemically modifies HA to allow for longer residence time in the body. We also 
offer products made from HA based on two other technologies: HYAFF, which is a solid form of HA, and ACP gel, an 
autocross-linked polymer of HA. Our technologies are protected by an extensive portfolio of owned and licensed patents. 

Since our inception in 1992, we have utilized a commercial partnership model for the distribution of our products to 
end-users.  Our  strong,  worldwide  network  of  distributors  has  historically  provided,  and  continues  to  provide,  a  solid 
foundation for our revenue growth and territorial expansion. For near-term and long-term opportunities in the U.S. market, 
we have evaluated a potential hybrid commercial approach that would see us balance a small direct model with an optimal 
form of strategic partnership, an approach we intend to utilize for the commercialization of our injectable, HA-based surgical 
bone repair product. For longer-term future products in the U.S. market, we intend to evaluate our commercial model and 
possible alternatives or augmentations in each instance on a case-by-case basis, based on market dynamics and other factors. 
These models could include direct sales, distribution partnerships, or a hybrid of those forms. We believe that the combination 
of the direct and distribution commercial models will maximize the revenue potential from our current and future product 
portfolio. 

On May 2, 2018, we publicly disclosed a voluntary recall of certain production lots of our HYAFF-based products, 
HYALOFAST, HYALOGRAFT C, and HYALOMATRIX. We communicated with all affected distributors in advance of 
that announcement, and we took all required or otherwise appropriate actions with respect to applicable regulatory bodies. 
We  initiated  the  voluntary  recall  following  internal  quality  testing,  which  indicated  that  the  products  were  at  risk  of  not 
maintaining certain measures throughout their entire shelf life. While there was no indication of any safety or efficacy issue 
related to the products, we are committed to the highest standards of quality and removed the products from the field as a 
precautionary measure. During the first quarter of 2018, we recorded a revenue reserve of $1.1 million, $0.9 million of which 
related to revenue recorded in prior periods, and adjustments during the balance of the year were immaterial. We also recorded 
an inventory charge for fiscal year 2018 of $0.8 million for the related non-saleable inventory, and we incurred $0.3 million 
of expenses associated with the administration and remediation of the voluntary recall. During the fourth quarter of 2018, we 
resolved this matter and resumed shipment of these products, and as of December 31, 2018, all of the affected products had 
been returned to us without the need for any  material change to the related reserves. As a result of this voluntary recall, 
revenue generated from the affected products during fiscal year 2018 declined between $1 million and $2 million as compared 
to fiscal year 2017. 

The following sections provide more specific information about our products and related activities: 

4 

  
  
  
  
  
  
  
  
  
  
 
 
Orthobiologics 

Our  Orthobiologics  products  primarily  consist  of  viscosupplement  and  regenerative  orthopedic  products.  These 
products are used in a wide range of treatments, from providing pain relief from osteoarthritis to regenerating damaged tissue 
such as cartilage. Osteoarthritis is a debilitating disease that causes pain, swelling, and restricted movement in joints. It occurs 
when the cartilage in a joint gradually deteriorates due to the effects of mechanical stress, which can be caused by a variety 
of factors, including the normal aging process. In an osteoarthritic joint, particular regions of the joint’s articulating surfaces 
are  exposed  to  irregular  forces,  which  results  in  the  remodeling  of  tissue  surfaces  that  disrupt  the  normal  equilibrium  or 
mechanical function. As osteoarthritis advances, the joint gradually loses its ability to regenerate cartilage tissue, and the 
cartilage  layer  attached  to  the  bone  eventually  deteriorates  to  the  point  that  the  bone  becomes  exposed.  Advanced 
osteoarthritis  often  requires  surgery  and  the  possible  implantation  of  artificial  joints.  The  current  treatment  options  for 
osteoarthritis,  prior  to  joint  replacement  surgery,  include  viscosupplements,  analgesics,  non-steroidal  anti-inflammatory 
drugs, and steroid injections. 

Our viscosupplement franchise includes ORTHOVISC, MONOVISC, ORTHOVISC mini, and CINGAL. Our first 
viscosupplement product, ORTHOVISC, is a three-injection osteoarthritis treatment regimen available in the United States, 
Canada, and other international markets throughout the world. ORTHOVISC has been marketed by us internationally since 
1996,  and  it  was  approved  for  sale  in  the  United  States  in  2004.  MONOVISC  is  our  second  generation,  single-injection 
osteoarthritis treatment, and it is also available in the United States, Canada, and other international markets throughout the 
world. MONOVISC has been marketed by us internationally since 2008 and was approved by the FDA for sale in the United 
States in February 2014, with the related U.S. commercial introduction of the product in April 2014. In the United States, our 
viscosupplement franchise, consisting of our ORTHOVISC and MONOVISC products, continues to maintain the overall 
market leadership position. ORTHOVISC mini has been available in Europe since 2008, and it is designed for the treatment 
of  osteoarthritis  in  small  joints.  CINGAL,  our  third  generation  single-injection  osteoarthritis  product,  combining  the  HA 
formulation utilized in MONOVISC with an active steroid component, is available in Canada, the European Union, and other 
international markets throughout the world. Commercial launch of this next generation viscosupplement was achieved in 
Canada during May 2016 and in the European Union during June 2016. For additional information about CINGAL in the 
United States, see the section captioned “Business—Research and Development of Potential Products.” 

In the United States, ORTHOVISC is indicated for the treatment of pain caused by osteoarthritis of the knee in 
patients who have failed to respond adequately to conservative, non-pharmacologic therapy and to simple analgesics, such as 
acetaminophen.  ORTHOVISC  is  a  sterile,  clear,  viscous  solution  of  hyaluronan  dissolved  in  physiological  saline  and 
dispensed in a single-use syringe. A complex sugar of the glycosaminoglycan family, hyaluronan is a high-molecular-weight 
polysaccharide composed of repeating disaccharide units of sodium glucuronate and N-acetyl glucosamine. ORTHOVISC is 
injected into joints in a series of three intra-articular injections one week apart. ORTHOVISC became available for sale in 
the  United  States  on  March 1,  2004,  and  it  is  marketed  by  DePuy  Synthes  Mitek  Sports  Medicine,  a  division  of  DePuy 
Orthopaedics, Inc. (“Mitek”) under the terms of an initial ten-year licensing, distribution, supply, and marketing agreement 
which was entered into in December 2003 (the “Mitek ORTHOVISC Agreement”). The Mitek ORTHOVISC Agreement has 
been extended for two additional five-year terms, and it will now expire on December 20, 2023, unless it is further extended 
by  Mitek.  Outside  of  the  U.S.,  we  have  a  number  of  distribution  relationships  servicing  international  markets  including 
Canada, Europe, the Middle East, Latin America, and Asia. We continue to seek to establish distribution relationships in 
other key markets. See the sections captioned “Management’s Discussion and Analysis of Financial Condition and Results 
of Operations—Management Overview” and “Risk Factors.” 

In the United States, MONOVISC is also indicated for the treatment of pain caused by osteoarthritis of the knee in 
patients who have failed to respond adequately to conservative, non-pharmacologic therapy and to simple analgesics, such as 
acetaminophen. MONOVISC is a sterile, clear, viscous solution of partially cross-linked sodium hyaluronate in a phosphate 
buffered saline solution. A treatment of MONOVISC is comprised of one injection of the product delivered directly into the 
affected joint. MONOVISC became available for sale in the United States in April 2014, and it is marketed by Mitek under 
the terms of a fifteen-year licensing, distribution, supply, and marketing agreement, which was entered into on December 21, 
2011 (the “Mitek MONOVISC Agreement”). Outside of the United States, we have a number of distribution relationships 
servicing international markets including Canada, Europe, the Middle East, Latin America, Asia, Australia, and certain other 
international  countries.  We  continue  to  seek  to  establish  distribution  relationships  in  other  key  markets.  See  the  sections 
captioned  “Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations—Management 
Overview” and “Risk Factors.” 

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In addition to the four viscosupplement products discussed above, we also offer several additional products used in 
connection with orthopedic regenerative medicine. These products are based on the HYAFF technology and are currently 
available  in  Europe,  South  America,  Asia,  and  certain  other  international  markets.  They  include  HYALOFAST,  a 
biodegradable support for human bone marrow mesenchymal stem cells used for cartilage regeneration and as an adjunct for 
microfracture  surgery;  HYALONECT,  a  resorbable  knitted  fabric  mesh  for  use  in  orthopedic  and  trauma  reconstructive 
procedures  to  maintain  the  relative  position  of  engrafted  bone  tissue  or  bone  fragments  from  comminuted  fractures;  and 
HYALOSS MATRIX, HYAFF fibers used to mix blood/bone grafts to form a paste for bone regeneration. We also offer 
HYALOGLIDE, an ACP gel used in tenolysis treatment, with the potential for use in flexor tendon adhesion prevention and 
for use in the shoulder for prevention of adhesive capsulitis with additional clinical data. This product is commercialized 
through a network of distributors, primarily in Europe and the Middle East. We also received CE Mark approval in December 
2016 for a product which utilizes our proprietary HA technology to treat pain associated with lateral epicondylitis, better 
known  as  tennis  elbow.  Outside  of  the  United  States,  this  product  is  marketed  under  the  trade  name  ORTHOVISC-T. 
Additionally,  in  the  second  quarter  of  2016,  we  submitted  an  Investigational  Device  Exemption  (“IDE”)  to  the  FDA  to 
conduct a Phase III clinical trial for this treatment, and the IDE was approved by the FDA in June 2016. In addition to these 
products, we also received 510(k) clearance for an injectable, HA-based surgical bone repair product in December 2017, 
which we intend to launch in the U.S. during 2019 utilizing the previously-described hybrid commercial approach. In total, 
Orthobiologics products accounted for 89%, 87%, and 87% of our product revenue in 2018, 2017, and 2016, respectively.  

Dermal 

Our dermal products consist of advanced wound care products, based on the HYAFF technology, and an aesthetic 
dermal  filler,  based  on our proprietary  chemically  modified,  cross-linked HA  technology.  Products utilizing  our  HYAFF 
technology are used for the treatment of skin wounds, ranging from burns to diabetic ulcers. The products cover a variety of 
wound  treatment  solutions  including  debridement  agents,  advanced  therapies  to  aid  healing,  and  scaffolds  used  as  skin 
substitutes. Leading products include HYALOMATRIX and HYALOFILL, for the treatment of complex wounds such as 
burns and ulcers. The dermal products are commercialized through a network of distributors, primarily in the United States, 
Europe,  Latin  America,  and  the  Middle  East. Products  cleared  for  sale  in  the  United  States  include  HYALOMATRIX, 
HYALOFILL,  HYALOGRAN,  HYALOSAFE,  and  HYALOMATRIX  3D.  In  2014,  we  entered  into  an  agreement  with 
Medline Industries, Inc. with a current expiration date of December 31, 2022 to commercialize HYALOMATRIX in the 
United States. 

Our aesthetic dermatology product is a dermal filler based on our proprietary, chemically modified, cross-linked 
HA, and it is commercially available in select countries in the Middle East. Internationally, this product is marketed under 
the ELEVESS name. In the United States, the trade name is HYDRELLE, although the product is not currently marketed in 
the United States. 

Surgical 

Our surgical business consists of products used to prevent post-surgical adhesions after abdominal-pelvic, spinal, 
and ear, nose, and throat (“ENT”) surgeries. HYALOBARRIER is a clinically proven, post-operative adhesion barrier for 
use in the abdominopelvic area. The product is currently commercialized in Europe, the Middle East, and certain African and 
Asian countries through a distribution network, but it is not approved for sale in the United States. 

Surgical  adhesions  occur  when  fibrous  bands  of  tissues  form  between  adjacent  tissue  layers  during  the  wound 
healing process. Although surgeons attempt to minimize the formation of adhesions, they nevertheless occur quite frequently 
after  surgery.  Adhesions  in  the  abdominal  and  pelvic  cavity  can  cause  particularly  serious  problems  such  as  intestinal 
blockage  following  abdominal  surgery  and  infertility  following  pelvic  surgery.  Fibrosis  following  spinal  surgery  can 
complicate re-operation and may cause pain. 

6 

   
  
  
  
  
  
   
  
 
 
We  also  offer  several  products  used  in  connection  with  the  treatment  of  ENT  disorders. The  lead  products  are 
MEROGEL, a woven fleece nasal packing, and MEROGEL INJECTABLE, a thick, viscous hydrogel composed of cross-
linked  hyaluronic  acid—a  biocompatible  agent  that  creates  a  moist  wound-healing  environment. We  have  partnered with 
Medtronic XoMed, Inc. (“Medtronic”) for worldwide distribution of these ENT products. 

Other 

Our other products include our ophthalmic and veterinary products, which are legacy products and not a part of our 
core business. Our ophthalmic business includes injectable, high molecular weight HA products used as viscoelastic agents 
in ophthalmic surgical procedures such as cataract extraction and intraocular lens implantation. These products coat, lubricate, 
and protect sensitive tissue such as the endothelium, and they function to maintain the shape of the eye, thereby facilitating 
ophthalmic surgical procedures. Our veterinary product, HYVISC, is a high molecular weight injectable HA product for the 
treatment of joint dysfunction in horses due to non-infectious synovitis associated with equine osteoarthritis. HYVISC has 
viscoelastic properties that lubricate and protect the tissues in horse joints. HYVISC is distributed by Boehringer Ingelheim 
Vetmedica, Inc. (“Boehringer”) in the United States and in selected countries in the Middle East. 

See  Note 3  “Revenue  by  Product  Group,  by  Significant  Customer  and  by  Geographic  Location;  Geographic 
Information”  to  our  consolidated  financial  statements  included  elsewhere  in  this  Annual  Report  on  Form  10-K  for  a 
discussion regarding our segments and geographic sales. 

See also the section captioned “Risk Factors—Risks Related to Our Commercialization Activities—We experience 
quarterly sales volume variation, which makes our future results difficult to predict and makes period-to-period comparisons 
potentially  not  meaningful”  for  a discussion  regarding  the  effect  that  quarterly  sales volume  variation  could have  on our 
business and financial performance. 

See  also  the  section  captioned  “Risk  Factors  —Risks  Related  to  Our  Business  and  Competitive  Position—A 
significant portion of our revenues are derived from a small number of customers, the loss of which could materially adversely 
affect our business, financial condition and results of operations” for a discussion regarding our dependence on large-volume 
customers and the effects that the loss of any such customer could have on our business and financial performance. 

See  also  the  section  captioned  “Risk  Factors—Risks  Related  to  Our  Business  and  Industry—Our  manufacturing 
processes involve inherent risks, and disruption could materially adversely affect our business, financial condition and results 
of operations” for a discussion of the sources and availability of raw materials related to the manufacture of our products. 

Research and Development of Potential Products 

Our research and development efforts primarily consist of the development of new medical applications for our HA-
based  technology,  the  management  of  clinical  trials  for  certain  product  candidates,  the  preparation  and  processing  of 
applications for regulatory approvals or clearances at all relevant stages of product development, and process development 
and  scale-up  manufacturing  activities  for  our  existing  and  new  products.  Our  development  focus  is  orthopedic  and 
regenerative  medicines  and  includes  products  for  tissue  protection,  repair,  and  regeneration.  For  the  years  ended 
December 31, 2018, 2017 and 2016, these expenses were $18.2 million, $18.8 million, and $10.7 million, respectively. We 
anticipate that we will continue to commit significant resources to, and increase our aggregate spending on, research and 
development activities, including in relation to preclinical activities and clinical trials, in the future. 

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Our  third  generation,  single-injection  osteoarthritis  product  under  development  in  the  United  States,  CINGAL, 
which is composed of our proprietary cross-linked HA material combined with an approved steroid and is designed to provide 
both short- and long-term pain relief to patients, is our lead pipeline product and a critical component of our growth strategy. 
We completed an initial CINGAL Phase III clinical trial, including the associated statistical analysis for 368 enrolled patients, 
during the fourth quarter of 2014 with data indicating that the product met all primary and secondary endpoints relative to 
placebo set forth for the trial. During the first half of 2015, we completed a CINGAL retreatment study with 242 patients who 
had participated in the Phase III clinical trial and reported safety data related to the retreatment study. This initial Phase III 
clinical trial and the associated retreatment study supported the Health Canada and CE Mark approval of the product, and the 
commercial launch of the product in both Canada and the European Union occurred in the second quarter of 2016. In the 
United States, after discussions with the U.S. Food and Drug Administration (“FDA”) related to the regulatory pathway for 
CINGAL, we conducted a formal meeting with the FDA’s Office of Combination Products (“OCP”) to present and discuss 
our data in September 2015, and we submitted a formal request for designation with OCP a month later. In its response to 
our  formal  request  for  designation,  OCP  assigned  the  product  to  the  FDA’s  Center  for  Drug  Evaluation  and  Research 
(“CDER”) as the lead agency center for premarket review and regulation. We then held discussions with CDER to understand 
the requirements for submitting a New Drug Application (“NDA”) for CINGAL. We held a meeting with CDER in September 
2016 to align on an approval framework and on submission requirements for this NDA for CINGAL, including the execution 
of  an  additional  Phase  III  clinical  trial  to  supplement  our  existing  CINGAL  pivotal  study  data.  We  submitted  an 
Investigational New Drug Application (“IND”) in late 2016, and discussions with CDER indicated that they did not have 
objections to our clinical protocol design. As a result, we commenced work on this second Phase III clinical trial (“CINGAL 
16-02 Study”) in the first quarter of 2017, and the first patient was treated in the second quarter of 2017. Enrollment of the 
576 patients  in  this  second  Phase III  clinical  trial  was  completed  during October  2017,  and we  completed  the  six-month 
patient follow-up in April 2018. We received and analyzed the data from the CINGAL 16-02 Study during the second quarter 
of  2018,  and,  while  substantial  pain  reduction  associated  with  CINGAL  was  evident  at  each  measurement  point,  we 
determined  based  on  statistical  analysis  that  it  did  not  meet  the  primary  study  endpoint  of  demonstrating  a  statistically 
significant difference in pain reduction between CINGAL and the approved steroid component of CINGAL at the six-month 
time point. In the third quarter of 2017, we initiated an additional three-month extended follow-up study in conjunction with 
the CINGAL 16-02 Study to investigate the efficacy of CINGAL over this longer period. The first patients were enrolled in 
this follow-up study in the fourth quarter of 2017 and we completed the nine-month patient follow-up in the third quarter of 
2018. Given the totality of the results from our studies related to CINGAL, we have evaluated multiple strategies to optimize 
the potential U.S. regulatory pathway for the product. We recently met with FDA to discuss this potential approval pathway 
for CINGAL in the United States moving forward. In the meeting, FDA indicated that an additional Phase III clinical trial 
would  be  necessary  to  support  U.S.  marketing  approval  for  CINGAL,  and  we  are  continuing  to  align  with  FDA  on  the 
parameters and requirements for this additional clinical trial, which we expect to commence once alignment is achieved. 

We have several research and development programs underway for new products, including for HYALOFAST (in 
the United States), an innovative product for cartilage tissue repair, and other early stage regenerative medicine development 
programs. HYALOFAST, which received CE Mark approval in September 2009, is commercially available in Europe and 
certain international countries. During the first quarter of 2015, we submitted an Investigational Device Exemption (“IDE”) 
for HYALOFAST to the FDA, which was approved in July 2015. We commenced patient enrollment in a clinical trial in 
December  2015,  and  we  are  advancing  site  initiations  and  patient  enrollment  activities.  In  the  second  quarter  of  2016,  a 
supplement to the HYALOFAST IDE was approved to expand the inclusion criteria for the clinical study, which was aimed 
at decreasing the time needed to complete the clinical trial. The previously-described voluntary recall of certain production 
lots of our HYAFF-based products did not impact the HYALOFAST clinical trial, as the product used in the clinical trial is 
not sourced from the affected production lots. Given the changing medical landscape with respect to the randomization arm 
for this trial, the microfracture procedure, we are actively pursuing alternative strategies to accelerate patient enrollment. 

In the third quarter of 2017, we submitted an application to the FDA for 510(k) clearance of an injectable, HA-based 
surgical bone repair product that is reabsorbed by the body and replaced by the growth of new bone during the healing process. 
The  510(k)  clearance  was  received  from  the  FDA  in  December  2017,  and  we  expect  to  make  this  bone  repair  product 
commercially available in the United States during 2019 utilizing the previously-described hybrid commercial approach. In 
addition to other early stage research and development initiatives we are currently undertaking, we are working to expand 
our regenerative medicine pipeline with a new product candidate in the form of an implant for rotator cuff repair utilizing our 
proprietary solid HA, which could be used to repair partial and full-thickness rotator cuff tears. We finalized development of 
an initial product prototype during the fourth quarter of 2018, and we are performing important preclinical testing of and 
developing the surgical instrumentation for the potential product. 

We  are  also  currently  proceeding  with  other  research  and  development  programs,  one  of  which  utilizes  our 
proprietary HA technology to treat pain associated with common repetitive overuse injuries, such as lateral epicondylitis, also 
known as tennis elbow. We submitted a CE Mark application for this treatment during the first quarter of 2016 and received 
a CE Mark for the treatment of pain associated with tennis elbow in December 2016. We began work towards a post-market 

8 

  
  
  
clinical study in relation to the CE Mark for this product in the fourth quarter of 2018. Outside of the United States, this 
product is marketed under the trade name ORTHOVISC-T. Additionally, in the second quarter of 2016, we submitted an IDE 
to the FDA to conduct a Phase III clinical trial for this treatment, which was approved by the FDA in June 2016. We also 
have  several  other  research  and  development  programs  underway  focused  on  expanding  the  indications  of  our  current 
products, including MONOVISC. Notwithstanding those internal programs, the previously-disclosed program conducted and 
funded by Mitek seeking to expand MONOVISC’s indication to include treatment of pain associated with osteoarthritis of 
the hip was cancelled in the fourth quarter of 2018 after the performance of an independent interim analysis required by the 
related clinical protocol. During 2019, we will also be performing post-market clinical work in relation to the CE Mark for 
MONOVISC. 

In  June  2015,  we  entered  into  an  agreement  with  the  Institute  for  Applied  Life  Sciences  at  the  University  of 
Massachusetts Amherst to collaborate on research to develop a therapy for rheumatoid arthritis. The purpose of this research 
was to develop a novel modality for the treatment of rheumatoid arthritis. The agreement with the University of Massachusetts 
Amherst  was  extended  in  January  2018,  and  it  was  terminated  in  October  2018  after  discussions  between  the  parties.  In 
January 2018, we entered into an agreement with the University of Liverpool to develop an injectable mesenchymal stem cell 
therapy for the treatment of age-related osteoarthritis with the goal of bringing a therapeutics candidate through clinical trials 
to market to meet an unmet therapeutic need. We are currently in the preclinical phase of this program and aim to finalize 
proof of concept during the second quarter of 2020. 

Our  research  and  development  efforts  may  not  be  successful  in  (1) developing  our  existing  product  candidates, 
(2) expanding  the  therapeutic  applications  of  our  existing  products,  or  (3) resulting  in  new  applications  for  our  HA 
technology. There is also a risk that we may choose not to pursue development of potential product candidates. We may not 
be able to obtain regulatory approval for any new applications we develop. Furthermore, even if all regulatory approvals are 
obtained, there can be no assurances that we will achieve meaningful sales of such products or applications. 

See  also  the  section  captioned  “Risk  Factors—Risks  Related  to  Our  Product  Development  and  Regulatory 
Compliance —Failure to obtain, or any delay in obtaining, FDA or other U.S. and foreign governmental approvals for our 
products may have a material adverse effect on our business, financial condition and results of operations.” for a discussion 
regarding the impact of government regulations on our product development activities. 

Patent and Proprietary Rights 

Our products and trademarks, including our corporate name, product names, and logos, are proprietary. We rely on 
a  combination  of  patent  protection,  trade  secrets  and  trademark  laws,  license  agreements,  and  confidentiality  and  other 
contractual provisions to protect our proprietary information. 

We have a policy of seeking patent protection for patentable aspects of our proprietary technology. In the United 
States, we own 19 patents, 1 of which is co-owned with other parties, license 10 patents, and have 4 patent applications 
currently pending. These U.S. patents have expiration dates through 2030. Internationally, we own 181 patents, 7 of which 
are co-owned with other parties, license 71 patents, and have 29 patent applications currently pending. Outside of the United 
States, we own, co-own, license, or have filed for patents in 39 jurisdictions. Our international patents have expiration dates 
through  2032. In  2018,  we  were  granted  29  new  patents  in  Austria,  Czech  Republic,  Denmark,  France,  Germany,  Great 
Britain, Ireland, Italy, the Netherlands, Poland, Spain, Sweden, and Switzerland. Many of these patents, including all licensed 
patents, belong to the Anika S.r.l. patent estate, which is extensive and partly intertwined with its former parent company 
Fidia Farmaceutici S.p.A. (“Fidia”) through a patent licensing agreement that provides Anika S.r.l. with access to certain of 
Fidia’s patents to the extent required to support Anika S.r.l.’s products. In 2018, 3 of the patents belonging to the Anika S.r.l. 
patent estate expired in the United States, and 13 expired internationally. We intend to seek patent protection for products 
and processes developed in the course of our activities when we believe such protection is in our best interests and when the 
cost of seeking such protection is not inordinate relative to the potential benefits. 

Other entities have filed patent applications for, or have been issued patents concerning, various aspects of HA-
related products or processes. In addition, the products or processes we develop may infringe the patent rights of others in 
the future. Any such infringement may have a material adverse effect on our business, financial condition, and results of 
operations. 

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We rely upon trade secrets and proprietary know-how for certain non-patented aspects of our technology. To protect 
such  information,  we  require  certain  customers  and  vendors,  and  all  employees,  consultants,  and  licensees  to  enter  into 
confidentiality agreements limiting the disclosure and use of such information. These agreements, however, may not provide 
adequate protection. 

See also the section captioned “Risk Factors—Risks Related to Our Intellectual Property—We may be unable to 
adequately protect our intellectual property rights, which could have a material impact on our business and future financial 
results” for a discussion of the risks we face with respect to protecting intellectual property we develop. 

We have granted Mitek an exclusive and non-transferable, royalty-bearing license to develop, commercialize, and 
sell  ORTHOVISC  and  MONOVISC  in  the United  States pursuant  to  the  Mitek  ORTHOVISC Agreement  and  the  Mitek 
MONOVISC Agreement. These agreements include a license to manufacture and have manufactured such products in the 
event that we are unable to supply Mitek with ORTHOVISC or MONOVISC in accordance with the terms of the relevant 
agreement. We have also granted Mitek the exclusive, royalty free right to use the trademarks ORTHOVISC and MONOVISC 
in connection with the marketing, distribution, and sale of the licensed products within the United States. 

Government Regulation 

The clinical development, manufacturing, and marketing of our products are subject to governmental regulation in 
the  United  States,  the  European  Union,  and  other  territories  worldwide.  Various  statutes,  regulations  and  interpretations 
thereof, directives, and guidelines, including the Food, Drug, and Cosmetic Act in the United States, govern the development, 
design, non-clinical and clinical research, testing, manufacture, safety, efficacy, labeling, packaging, storage, record keeping, 
premarket clearance or approval, adverse event reporting, advertising, and promotion of our products. Product development 
and approval within these various regulatory frameworks takes a number of years and involves the expenditure of substantial 
resources. Pharmaceutical and medical device manufacturers are also inspected regularly by the FDA and other applicable 
regulatory bodies. 

Medical products regulated by the FDA are generally classified as drugs, biologics, or medical devices, and the 
current  classification  standards  for  our  current  or  future  may  be  altered  over  time.  Drugs  and  biologic  products  undergo 
rigorous preclinical testing prior to beginning clinical trials. Clinical trials for new drugs or biologic products include Phase 
I trials in healthy volunteers to understand safety, dosage tolerance, and pharmacokinetics, Phase II trials in a limited patient 
population  to  identify  initial  efficacy  and  side  effects,  and  Phase  III  pivotal  trials  to  statistically  evaluate  the  safety  and 
efficacy of the product. Medical devices intended for human use are classified into three categories (Class I, II or III) on the 
basis of the controls deemed reasonably necessary by the FDA to assure their safety and effectiveness. Class II devices are 
cleared  for  marketing  under  the  premarket  notification  510(k)  regulatory  pathway,  which  may  include  clinical  testing. 
Class III  devices  require  pre-market  approval  based  on  valid  scientific  evidence  of  safety  and  effectiveness,  including 
evidence elicited through appropriate clinical testing. The failure to adequately demonstrate the quality, safety, and efficacy 
of a product under development can delay or prevent regulatory approval of the product. In order to gain marketing approval, 
we must submit to the relevant regulatory authority for review information on the quality aspects of the product as well as 
the non-clinical and clinical data. The FDA undertakes this review in the United States. 

In the European Union, medical devices must be CE Marked in order to be marketed. CE marking a device involves 
working with a Notified Body, and in some cases a Competent Authority, to demonstrate that the device meets all applicable 
requirements of the Medical Devices Directive and that our Quality Management System is compliant. Drug approval in the 
European Union follows one of several possible processes: (i) a centralized procedure involving members of the European 
Medicines Agency’s Committee for Medicinal Products for Human Use; (ii) a “mutual recognition procedure” in which an 
individual country's regulatory agency approves the product followed by “mutual recognition” of this approval by regulatory 
agencies of other countries; or (iii) a decentralized procedure in which the approval is sought through the regulatory agencies 
of multiple countries at the same time. 

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Approval timelines can range from several months to several years, or applications can be denied entirely. Product 
or product component classifications as drugs, biologics, or medical devices may change over time due to new regulations or 
augmented interpretation of data or current regulations. The approval process can be affected by a number of factors. For 
example, additional studies or clinical trials may be requested during the review, which may delay marketing approval and 
involve  unbudgeted  costs.  As  a  condition  of  approval,  the  regulatory  agency  may  require  post-marketing  surveillance  to 
monitor for adverse effects, and may require other additional studies, as it deems appropriate. After approval for an initial 
indication, further clinical studies are generally necessary to gain approval for any additional indications. The terms of any 
approval, including labeling content, may be more restrictive than expected and could affect the marketability of a product. 

As a condition of approval, the relevant regulatory agency requires that the product continues to meet applicable 
regulatory requirements related to quality, safety, and efficacy, and it requires strict procedures to monitor and report any 
adverse effects. Where adverse effects occur or may occur, the regulatory agency may require additional studies or changes 
to the labeling. Compelling new “adverse” data may result in a product approval being withdrawn at any stage following 
review by an agency and discussion with the product manufacturer. 

The branch of the FDA responsible for product marketing oversight routinely reviews company marketing practices 
and also may impose pre-clearance requirements on materials intended for use in marketing of approved drug products. We 
are also subject to various U.S. federal and state laws pertaining to healthcare fraud and abuse, including anti-kickback and 
false claims laws. Similar review and regulation of advertising and marketing practices exists in the other geographic areas 
where we operate. 

The FDA has broad regulatory compliance and enforcement powers. If the FDA determines that we failed to comply 
with  applicable  regulatory  requirements,  it  can  take  a  variety  of  compliance  or  enforcement  actions,  including,  without 
limitation, issuing an FDA Form 483 notice of inspectional observations or a warning letter, imposing civil money penalties, 
suspending or delaying issuance of approvals, requiring product recall, imposing a total or partial shutdown of production, 
withdrawal of approvals or clearances already granted, pursuing product seizures, consent decrees or other injunctive relief, 
or criminal prosecution through the Department of Justice. The FDA can also require us to repair, replace, or refund the cost 
of products that we manufactured or distributed. Outside the United States, regulatory agencies may exert a range of similar 
powers. 

We are also subject to various laws and regulations concerning data privacy. Changing privacy laws in the United 
States,  Europe,  Brazil  and  elsewhere,  including  the  adoption  by  the  European  Union  of  the  General  Data  Protection 
Regulation  (“GDPR”)  effective  in  May  2018,  create  new  individual  privacy  rights  and  impose  increased  obligations  on 
companies handling personal data. The GDPR, which is wide-ranging in scope, imposes several requirements relating to the 
consent of the individuals to whom the personal data relates, the information provided to the individuals, the security and 
confidentiality of the personal data, data breach notification, and the use of third party processors in connection with the 
processing of the personal data. The GDPR also imposes strict rules on the transfer of personal data out of the E.U. to the 
U.S. and empowers enforcement agencies to impose large penalties for noncompliance, including the potential for fines of 
up to €20 million or 4% of the annual global revenues of the infringer, whichever is greater. 

See  also  the  sections  captioned  “Risk  Factors—Risks  Related  to  Our  Product  Development  and  Regulatory 
Compliance—Failure to obtain, or any delay in obtaining, FDA or other U.S. and foreign governmental approvals for our 
products may have a material adverse effect on our business, financial condition and results of operations,” “Risk Factors—
Risks Related to Our Product Development and Regulatory Compliance—Once obtained, we cannot guarantee that FDA or 
international product approvals will not be withdrawn or that relevant agencies will not require other corrective action, and 
any withdrawal or corrective action could materially affect our business and financial results,” “Risk Factors—Risks Related 
to Our Product Development and Regulatory Compliance—Our operations and products are subject to extensive regulation, 
compliance with which is costly and time consuming, and our failure to comply may result in substantial penalties, including 
recalls  of  our  products,”  “Risk  Factors—Risks  Related  to  Our  Product  Development  and  Regulatory  Compliance—Any 
changes in FDA or international regulations related to product approval, including those that apply retroactively, could 
adversely affect our competitive position and materially affect our business and financial results,” and “Risk Factors—Risks 
Related  to  Our  Product  Development  and  Regulatory  Compliance—We  are  subject  to  various  healthcare  laws  and 
regulations, and any failure to comply with applicable laws could subject us to significant liability and harm our business” 
for a discussion regarding the potential impact of government regulations on our business and financial results. 

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Competition 

We  compete  with  many  companies  including  large  pharmaceutical  firms  and  specialized  medical  products 
companies across all of our product lines. Many of these companies have substantially greater financial resources, larger 
research and development staffs, more extensive marketing and manufacturing organizations, and more experience in the 
regulatory processes than we have. We also compete with academic institutions, government agencies, and other research 
organizations, which  may  be  involved  in the  research  and development and commercialization of products.  Many of our 
competitors  also  compete  against  us  in  securing  relationships  with  collaborators  for  their  research  and  development  and 
commercialization programs. 

We compete with other market participants primarily on the efficacy of our products, our products’ reputation for 
safety,  our  focus  on  HA-based  products,  and  the  breadth  of  our  HA-based  product  portfolio.  Other  factors  that  impact 
competition in our industry are the timing and scope of regulatory approvals, the availability of raw material and finished 
product supply, marketing and sales capability, reimbursement coverage, product pricing, and patent protection. Some of the 
principal factors that may affect our ability to compete in the HA development and commercialization markets include: 

  The quality and breadth of our continued development of our technology portfolio; 

  Our ability to complete successful clinical studies and obtain FDA marketing and foreign regulatory approvals 

prior to our competitors; 

  The execution by our key partners of their commercial strategies for our products and our ability to manage our 

relationships with those key partners; 

  The successful execution of our commercial strategies, including our hybrid commercial approach; 

  Our ability to recruit and retain skilled employees; and 

  The  availability  of  capital  resources  to  fund  strategic  activities  related  to  the  significant  expansion  of  our 

business or product portfolio, including through acquisitions of third parties or certain assets. 

We are aware of several companies that are developing and/or marketing products utilizing HA for a variety of 
human applications. In some cases, competitors have already obtained product approvals, submitted applications for approval, 
or commenced human clinical studies, either in the United States or in certain foreign countries. All of our products face 
substantial competition. There exist major worldwide competing products, made from HA and other materials, for use in 
orthopedics, surgical adhesion prevention, advanced wound care, ENT, cosmetic dermatology, ophthalmic surgery, and the 
treatment of equine osteoarthritis. There is a risk that we will be unable to compete effectively against our current or future 
competitors. Additionally, legislation and regulation aimed at curbing rising healthcare costs has resulted in a consolidation 
trend in the healthcare industry to create larger companies, including hospitals, with greater market power. In turn, this has 
led to greater and more intense competition in the provision of products and services to market participants. Important market 
makers, like group purchasing organizations and integrated delivery networks, have increased their negotiating leverage, and 
if these market makers demand significant price concessions or if we are excluded as a supplier by these market makers, our 
product revenue could be adversely impacted. 

See  also  the  sections  captioned  “Risk  Factors—Risks  Related  to  Our  Business  and  Competitive  Position—
Substantial competition could materially affect our financial performance,” “Risk Factors—Risks Related to Our Business 
and Competitive Position—We are dependent upon marketing and distribution partners and the failure to maintain strategic 
alliances  on  acceptable  terms  will  have  a  material  adverse  effect  on  our  business,  financial  condition,  and  results  of 
operations,” “Risk Factors—Risks Related to Our Commercialization Activities—Our business may be adversely affected if 
consolidation in the healthcare industry leads to demand for price concessions or if we are excluded from being a supplier 
by  a  group  purchasing  organization  or  similar  entity,”  “Risk  Factors—Risks  Related  to  Our  Business  and  Industry—We 
actively explore acquisitions as a part of our future growth strategy, which exposes us to a variety of risks that could adversely 
affect  our  business  operations,”  and  “Risk  Factors—Risks  Related  to  Our  Business  and  Industry—Attractive  acquisition 
opportunities may not be available to us” for additional discussion of the impact competition could have on our business and 
financial results. 

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Employees 

As of December 31, 2018, we had 133 employees, 24 of whom were located outside the United States. We consider 
our  relations  with  our  employees  to  be  good. None  of  our  U.S.  employees  are  represented  by  labor  unions,  but  certain 
employees based in Italy are represented by unions, adding complexity and additional risks to the wage and employment 
decision processes. 

Environmental Laws 

We believe that we are in compliance with all foreign, federal, state, and local environmental regulations with respect 
to our manufacturing facilities and that the cost of ongoing compliance with such regulations does not have a material effect 
on our operations. 

Product Liability 

The testing, marketing, and sale of human health care products entails an inherent risk of allegations of product 
liability, and we cannot assure that substantial product liability claims will not be asserted against us. Although we have not 
received  any  material  product  liability  claims  to  date  and  have  coverage  under  our  insurance  policy  of  $5.0  million  per 
occurrence and $5.0 million in the aggregate, we cannot assure that if material claims arise in the future, our insurance will 
be adequate to cover all situations. Moreover, we cannot assure that such insurance, or additional insurance, if required, will 
be available in the future or, if available, will be available on commercially reasonable terms. Any product liability claim, if 
successful, could have a material adverse effect on our business, financial condition, and results of operation. 

Available Information 

Our Annual Reports on Form 10-K, including our consolidated financial statements, Quarterly Reports on Form 10-
Q, Current Reports on Form 8-K, and other information, including amendments and exhibits to such reports, filed or furnished 
pursuant to the Securities Exchange Act of 1934, as amended, are available free of charge in the “SEC Filings” section of our 
website located at http://www.anikatherapeutics.com, as soon as reasonably practicable after the reports are filed with or 
furnished to the SEC. The information on our website is not part of this Annual Report on Form 10-K. Reports filed with the 
SEC may be viewed at www.sec.gov.  

ITEM 1A. RISK FACTORS 

Our  operating  results  and  financial  condition  have  varied  in  the  past  and  could  vary  significantly  in  the  future 
depending on a number of factors. You should consider carefully the risks and uncertainties described below, in addition to 
the other information contained in this Annual Report on Form 10-K, before deciding whether to purchase our common stock. 
If any of the following risks actually occurs, our business, financial condition, results of operations, and future prospects 
could be materially and adversely affected. In that event, the trading price of our common stock could decline, and you could 
lose part or all of your investment. 

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Risks Related to Our Business and Competitive Position 

Our financial performance depends on the continued sales growth and increasing demand for our products and we may 
not be able to successfully manage the expansion of our operations. 

 Our future success depends on substantial growth in product sales. There can be no assurance that such growth can 
be achieved or, if achieved, sustained. There can be no assurance that, even if substantial growth in product sales and the 
demand for our products is achieved, we will be able to: 

  Maintain and develop the necessary manufacturing capabilities; 

  Develop and successfully implement appropriate new commercial models to generate increased sales or obtain 

the assistance of additional marketing partners; 

  Attract, retain, and integrate required key personnel; and 

 

Implement  the  financial,  accounting,  and  management  systems  needed  to  manage  our  overall  business  and 
growing demand for our products. 

Our failure to successfully manage future growth could have a material adverse effect on our business, financial 

condition, and results of operations. 

Substantial competition could materially affect our financial performance. 

We  compete  with  many  companies,  including  large  pharmaceutical  companies,  specialized  medical  products 
companies, and healthcare companies. Many of these companies have substantially greater financial resources, larger research 
and  development  staffs,  more  extensive  intellectual  technology  portfolios,  more  extensive  marketing  and  manufacturing 
organizations,  and  more  experience  in  the  regulatory  process  than  us.  We  also  compete  with  academic  institutions, 
government agencies, and other research organizations that may be involved in research, development, and commercialization 
of products similar to our own. Because a number of companies are developing or have developed HA products for similar 
applications and have received FDA approval, the successful commercialization of a particular product will depend in part 
upon  our  ability  to  complete  clinical  studies  and  obtain  FDA  marketing  and  foreign  regulatory  approvals  prior  to  our 
competitors, or, if regulatory approval is not obtained prior to our competitors, to identify markets for our products that may 
be sufficient to permit meaningful sales of our products. For example, we are aware of several companies that are developing 
and/or marketing products utilizing HA for a variety of human applications. In some cases, competitors have already obtained 
product approvals, submitted applications for approval, or have commenced human clinical studies, either in the United States 
or in certain foreign countries. For example, certain HA products made by our competitors for the treatment of osteoarthritis 
in the knee received FDA approval before ours and have been marketed in the United States since 1997, as well as select 
markets in Canada, Europe, and other countries. In addition, the market for our current or future products could be adversely 
impacted if disruptive technologies or modalities are developed by third parties. There can be no assurance that we will be 
able  to  compete  against  current  or  future  competitors  or  that  competition  will  not  have  a  material  adverse  effect  on  our 
business, financial condition, and results of operations.  

A significant portion of our revenues are derived from a small number of customers, the loss of which could materially 
adversely affect our business, financial condition and results of operations. 

We have historically derived the majority of our revenues from a small number of customers who resell our products 
to end-users, and most of these customers are significantly larger companies than us. For the year ended December 31, 2018, 
five customers accounted for 86% of product revenue, with Mitek alone accounting for 73% of product revenue. We expect 
to continue to be dependent on a small number of large customers, especially Mitek, for the majority of our revenues in the 
near-term future. The failure of these customers to purchase our products in the amounts they historically have or in amounts 
that we expect would seriously harm our business. 

In addition, if present and future customers terminate their purchasing arrangements with us, significantly reduce or 
delay their orders, or seek to renegotiate their agreements on terms less favorable to us, our business, financial condition, and 
results of operations will be adversely affected. If we accept terms less favorable than the terms of the current agreements, 
such renegotiations  may  have  a  material  adverse  effect on our  business,  financial  condition,  and/or results of operations. 
Furthermore, in any future negotiations we may be subject to the perceived or actual leverage that these customers may have 
given their relative size and importance to us. Any termination, change, reduction, or delay in orders could seriously harm 

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our  business,  financial  condition,  and  results  of  operations.  Accordingly,  unless  and  until  we  diversify  and  expand  our 
customer base, or develop alternative commercial strategies, our future success will significantly depend upon the timing and 
size of future purchases by our largest customers, and the financial and operational success of these customers. The loss of 
any one of our major customers or the delay of significant orders from such customers, even if only temporary, could reduce 
or delay our recognition of revenues, harm our reputation in the industry, and reduce our ability to accurately predict cash 
flow, and, as a consequence, it could seriously harm our business, financial condition, and results of operations. 

Our license agreements with Mitek provide substantial control of the U.S. marketing and development of MONOVISC 
and ORTHOVISC to Mitek, and Mitek’s actions could have a material impact on our business, financial condition and 
results of operations. 

The Mitek MONOVISC Agreement and Mitek ORTHOVISC Agreement provide Mitek with, among other things, 
the  exclusive  right  to  market  and  sell  MONOVISC  and  ORTHOVISC  in  the  United  States,  unilateral  decision-making 
authority  over  the  sale,  price,  and  promotion  of  MONOVISC  and  ORTHOVISC,  substantial  control  over  the  future 
development of MONOVISC and ORTHOVISC related to the treatment of pain associated with osteoarthritis, a license to 
manufacture and have manufactured such products in the event that we are unable to supply Mitek with ORTHOVISC or 
MONOVISC in accordance with the terms of the relevant agreement, and certain rights of first refusal with respect to future 
products we develop  for  the treatment  of pain  associated with  osteoarthritis.  In  exchange,  Mitek pays  us  a  transfer price 
calculated with reference to historical end-user prices in the market and a fixed royalty on their net product sales. As Mitek 
accounts for a large percentage of our yearly revenue and has unilateral decision-making authority over in-market activities, 
including end-user pricing and discounts, reimbursement strategy, and overall promotion strategy, actions taken by Mitek 
could impact our ability to predict and generate revenue and have a material impact on our business, financial condition, and 
results of operations. 

We are dependent upon marketing and distribution partners and the failure to maintain strategic alliances on acceptable 
terms will have a material adverse effect on our business, financial condition, and results of operations. 

Though we intend to implement a hybrid commercial approach in the United States in the near-term and evaluate 
future opportunities for the optimal commercial approach, our success will remain dependent, in part, upon the efforts of our 
marketing and distribution partners and the terms and conditions of our relationships with such partners. One partner, Mitek 
accounted for 73% of our product revenue in fiscal year 2018. We cannot assure you that our partners, including Mitek, will 
not seek to renegotiate their current agreements on terms less favorable to us or terminate such agreements. A failure to renew 
these partnerships on terms satisfactory to us, or at all, could result in a material adverse effect on our operating results. 

We continue to seek to establish long-term distribution relationships in regions and countries not covered by existing 
agreements, and we may need to obtain the assistance of additional marketing partners to bring new and existing products to 
market  and  to  replace  certain  marketing  partners.  There  can  be  no  assurance  that  we  will  be  able  to  identify  or  engage 
appropriate distribution or collaboration partners or effectively transition to any such new partnerships. The failure to establish 
strategic  partnerships  for  the  marketing  and  distribution  of  our  products  on  acceptable  terms  and  within  our  planned 
timeframes could have a material adverse effect on our business, financial condition, and results of operations. 

As our international sales and operations grow, we could become increasingly subject to additional economic, political, 
and other risks that could harm our business. 

Since we manufacture our products for sale worldwide, our business is subject to risks associated with doing business 
internationally. During the years ended December 31, 2018, 2017, and 2016, 19%, 20%, and 19%, respectively, of our product 
sales were to international distributors. We continue to be subject to a variety of risks, which could cause fluctuations in the 
results of our international and domestic operations. These risks include: 

  The impact of recessions and other economic conditions in economies, including Europe in particular, outside 

the United States; 

 

Instability of foreign economic, political, and labor conditions; 

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  Unfavorable labor regulations applicable to our European operations, such as severance and the unenforceability 

of non-competition agreements in the European Union; 

  The  impact  of  strikes,  work  stoppages,  work  slowdowns,  grievances,  complaints,  claims  of  unfair  labor 

practices, or other collective bargaining disputes; 

  Difficulties in complying with restrictions imposed by regulatory or market requirements, tariffs, or other trade 

barriers or by U.S. export laws; 

 

Imposition of government controls limiting the volume of international sales; 

  Longer accounts receivable payment cycles; 

  Potentially  adverse  tax  consequences,  including,  if  required  or  applicable,  difficulties  transferring  funds 

generated in non-U.S. jurisdictions to the United States in a tax efficient manner; 

  Difficulties in protecting intellectual property, especially in international jurisdictions; 

  Difficulties in managing international operations; and 

  Burdens of complying with a wide variety of foreign laws. 

Our success depends, in part, on our ability to anticipate and address these and any new risks. We cannot guarantee 

that these or other factors will not adversely affect our business or operating results. 

Risks Related to Our Commercialization Activities 

We cannot be certain that we will be successful or timely in implementing changes to our current commercial model in 
the  United  States,  including  the  hybrid  commercial  approach  we  intend  to  utilize  for  the  commercialization  of  our 
injectable, HA-based surgical bone repair product and certain potential future products, and our failure to do so could 
negatively impact our business and financial results. 

For near-term opportunities in the U.S. market, including for our injectable, HA-based surgical bone repair product, 
we intend to utilize hybrid commercial approach that would see us balance a small direct model with an optimal form of 
strategic partnership. For longer-term future products in the U.S. market, we intend to evaluate the appropriate commercial 
model for each on a case-by-case basis, based on market dynamics and other factors. These models could include direct sales, 
distribution partnerships, or a hybrid of those forms. We cannot be certain that we will be successful in implementing these 
models, including the hybrid commercial approach, as we may not be able to attract or retain the sophisticated personnel 
required for such approach, to identify or negotiate favorable or acceptable terms with a desirable strategic partner, to timely 
execute on our strategies, or to generate meaningful sales of our products as a result of other market dynamics. Our failure to 
successfully or timely augment our current commercial model could have an adverse material effect on our business, financial 
condition, and results of operations. 

We are facing a delay in the pathway to commercialize our CINGAL product in the United States, and we may face other 
unforeseen difficulties and delays in achieving regulatory approval for CINGAL, which could affect our business and 
financial results. 

In the second quarter of 2018, we received and analyzed the results of our second Phase III clinical trial for CINGAL 
and found that, while substantial pain reduction associated with CINGAL was evident at each measurement point, the data 
did  not  meet  the  primary  study  endpoint  of  demonstrating  a  statistically  significant  difference  in  pain  reduction  between 
CINGAL and the approved steroid component of CINGAL at the six-month time point. After completing the analysis of the 
data related to the totality of our studies for CINGAL, we recently met with FDA to discuss a potential approval pathway for 
CINGAL in the United States moving forward. In the meeting, FDA indicated that an additional Phase III clinical trial would 
be necessary to support U.S. marketing approval for CINGAL, and we are continuing to align with FDA on the parameters 
and requirements for this additional clinical trial, which we expect to commence once alignment is achieved. Because these 
results or other unforeseen future developments could have a substantial negative impact on the timeline for and the cost 
associated  with  a  potential  CINGAL  regulatory  approval,  if  any,  our  overall  business  condition,  financial  results,  and 
competitive position could be affected. 

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We must achieve market acceptance of our products in order to be successful in the future. 

Our success will depend in part upon the acceptance of our existing and future products by the medical community, 
hospitals, physicians, other health care providers, third-party payers, and end-users. Such acceptance may depend upon the 
extent to which the medical community and end-users perceive our products as safer, more effective, or more cost-competitive 
than other similar products. Ultimately, for our new products to gain general market acceptance, it may also be necessary for 
us  to  develop  marketing  partners  or  viable  commercial  strategies  for  the  distribution  of  our  products.  There  can  be  no 
assurance that our new products will achieve significant market acceptance on a timely basis, or at all. Failure of some or all 
of our future products to achieve significant market acceptance could have a material adverse effect on our business, financial 
condition, and results of operations. 

Sales of our products are largely dependent upon third party reimbursement and our performance may be harmed by 
health care cost containment initiatives or decisions of individual third party payers. 

In the United States and other foreign markets, health care providers, such as hospitals and physicians, that purchase 
health care products, such as our products, generally rely on third party payers, including Medicare, Medicaid, and other 
health insurance and managed care plans, to reimburse all or part of the cost of the health care product. We have generally 
depended upon the distributors of our products to secure reimbursement and reimbursement approvals. Reimbursement by 
third party payers, both in the United States and internationally, may depend on a number of factors, including the individual 
payer’s  determination  that  the  use  of  our  products  is  clinically  useful  and  cost-effective,  medically  necessary,  and  not 
experimental  or  investigational.  Since  reimbursement  approval  is  required  from  each  payer  individually,  seeking  such 
approvals can be a time consuming and costly process which, in the future, could require us or our marketing partners to 
provide  supporting  scientific,  clinical,  and  cost-effectiveness  data  for  the  use  of  our  products  to  each  payer  separately. 
Significant uncertainty exists as to the reimbursement status of newly approved health care products, and any failure or delay 
in obtaining reimbursement approvals can negatively impact sales of our new products. In addition, we cannot be certain that 
payers who currently provide reimbursement for our products will continue to provide such reimbursement in the future, and 
such payer decisions could negatively impact the sales of our current or future products. 

In addition, third party payers are increasingly attempting to contain the costs of health care products and services 
by limiting both coverage and the level of reimbursement for new therapeutic products and by refusing, in some cases, to 
provide coverage for uses of approved products for disease indications for which the FDA, or the applicable foreign regulatory 
agency, has granted marketing approval. Also, the U.S. Congress, certain state legislatures, and certain foreign governments 
and regulatory agencies have considered reforms, including, among other items, the potential repeal of the Affordable Care 
Act in the United States, which may affect current reimbursement practices and create additional uncertainty about the pricing 
of our products, including the potential implementation of controls on health care spending through limitations on the growth 
of Medicare and Medicaid spending. There can be no assurance that third party reimbursement coverage will be available or 
adequate for any products or services developed by us. Outside the United States, the success of our products is also dependent 
in part upon the availability of reimbursement and health care payment systems. Domestic and international reimbursement 
laws and regulations may change from time to time. Lack of adequate coverage and reimbursement provided by governments 
and other third party payers for our products and services, including continuing coverage for MONOVISC and ORTHOVISC 
in the United States, and any change of classification by the Centers for Medicare and Medicaid Services for ORTHOVISC 
and MONOVISC, could have a material adverse effect on our business, financial condition, and results of operations. 

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Our business may be adversely affected if consolidation in the healthcare industry leads to demand for price concessions 
or if we are excluded from being a supplier by a group purchasing organization or similar entity. 

Because healthcare costs have risen significantly over the past decade, numerous initiatives and reforms have been 
launched by legislators, regulators, and third-party payers to curb these costs. As a result, there has been a consolidation trend 
in  the  healthcare  industry  to  create  larger  companies,  including  hospitals,  with  greater  market  power.  As  the  healthcare 
industry consolidates, competition to provide products and services to industry participants has become and may continue to 
become  more  intense.  This  may  result  in  greater  pricing  pressures  and  the  exclusion  of  certain  suppliers  from  important 
markets as group purchasing organizations, independent delivery networks, and large single accounts continue to use their 
market power to consolidate purchasing decisions. If a group purchasing organization excludes us from being one of their 
suppliers,  our  net  sales  could  be  adversely  impacted.  We  expect  that  market  demand,  government  regulation,  third-party 
reimbursement policies, and societal pressures will continue to change the worldwide healthcare industry, which may exert 
further downward pressure on the prices of our products. 

We experience quarterly sales volume variation, which makes our future results difficult to predict and makes period-to-
period comparisons potentially not meaningful. 

We experience quarterly fluctuations in our products sales as a result of multiple factors, many of which are outside 
of our control. These quarterly fluctuations create uncertainty as to the volume of sales that we may achieve in a given period. 
As a result, comparing our operating results on a period-to-period basis might not be meaningful. You should not rely on our 
past  results  as  an  indication  of  our  future  performance.  Our  operating  results  could  be  disproportionately  affected  by  a 
reduction in revenue because a proportionately smaller amount of our expenses varies with our revenue. As a result, our 
quarterly operating results are difficult to predict, even in the near term. 

Risks Related to Our Product Development and Regulatory Compliance 

Failure to obtain, or any delay in obtaining, FDA or other U.S. and foreign governmental approvals for our products may 
have a material adverse effect on our business, financial condition and results of operations. 

Several of our current products, and any future products we may develop, will require clinical trials to determine 
their safety and efficacy for United States and international marketing approval by regulatory bodies, including the FDA. 
Product  development  and  approval  within  the  FDA  framework  takes  a  number  of  years  and  involves  the  expenditure  of 
substantial resources. There can be no assurance that the FDA will accept submissions related to our new products or the 
expansion of the indications of our current products, and, even if submissions are accepted, there can be no guarantee that the 
FDA will grant approval for our new products, including CINGAL, HYALOFAST, or other line extensions of our current 
products, or for the expansion of indications of our current products on a timely basis, if at all. In addition to regulations 
enforced by the FDA, we are subject to other existing and future federal, state, local, and foreign regulations applicable to 
product approval, which may vary significantly across jurisdictions. Additional approval of existing products may be required 
when  changes  to  such  products  may  affect  the  safety  and  effectiveness,  including  for  new  indications  for  use,  labeling 
changes, process or manufacturing changes, the use of a different facility to manufacture, process or package the device, and 
changes in performance or design specifications. Failure to obtain regulatory approvals of our products, including any changes 
to existing products, could have an adverse material impact on our business, financial condition, and results of operations. 

Even if ultimately granted, FDA and international regulatory approvals may be subject to significant, unanticipated 
delays throughout the regulatory approval process. Internally, we make assumptions regarding product approval timelines, 
both in the United States and internationally, in our business planning, and any delay in approval could materially affect our 
competitive position in the relevant product market and our projections related to future business results. 

We cannot be certain that product approvals, both in the United States and internationally, will not include significant 
limitations  on the  product  indications,  and other  claims  sought  for  use, under  which  the  products  may  be  marketed.  The 
relevant approval or clearance may also include other significant conditions of approval such as post-market testing, tracking, 
or surveillance requirements. Any of these factors could significantly impact our competitive position in relation to such 
products and could have a negative impact on the sales of such products. 

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Once obtained, we cannot guarantee that FDA or international product approvals will not be withdrawn or that relevant 
agencies  will  not  require  other  corrective  action,  and  any  withdrawal  or  corrective  action  could  materially  affect  our 
business and financial results. 

Once obtained, marketing approval can be withdrawn by the FDA or comparable foreign regulatory agencies for a 
number of reasons, including the failure to comply with ongoing regulatory requirements or the occurrence of unforeseen 
problems following initial approval. Regulatory authorities could also limit or prevent the manufacture or distribution of our 
products. Any regulatory limitations on the use of our products or any withdrawal or suspension of approval or rescission of 
approval  by  the  FDA  or  a  comparable  foreign  regulatory  agency  could  have  a  material  adverse  effect  on  our  business, 
financial condition, and results of operations. 

Our operations and products are subject to extensive regulation, compliance with which is costly and time consuming, 
and our failure to comply may result in substantial penalties, including recalls of our products. 

The FDA and foreign regulatory bodies impose extensive regulations applicable to our operations and products, 
including  regulations  governing  product  standards,  packing  requirements,  labeling  requirements,  quality  system  and 
manufacturing requirements, import restrictions, tariff regulations, duties, and tax requirements. We cannot assure you that 
we will be able to achieve and maintain compliance required for FDA, CE marking, or other foreign regulatory approvals for 
any or all of our operations and products or that we will be able to produce our products in a timely and profitable manner 
while complying with applicable requirements. 

Failure to comply with applicable regulatory requirements could result in substantial penalties, including warning 
letters, fines, injunctions, civil penalties, seizure of products, total or partial suspension of production, refusal to grant pre-
market  clearance  or  pre-market  approval  for  devices  or  drugs,  withdrawal  of  approvals,  and  criminal  prosecution. 
Additionally, regulatory authorities have the power to require the recall of our products. It also might be necessary for us, in 
applicable circumstances, to initiate a voluntary recall per regulatory requirements of one or several of our products. The 
imposition of any of the foregoing penalties, whether voluntarily or involuntary, could have a material negative impact on 
our business, financial condition, and results of operations. 

Any  changes  in  FDA  or  international  regulations  related  to  product  approval  or  approval  renewal,  including  those 
currently under consideration by FDA or those that apply retroactively, could adversely affect our competitive position 
and materially affect our business and financial results. 

FDA and foreign regulations depend heavily on administrative interpretation, and we cannot assure you that future 
interpretations made by the FDA or other regulatory bodies, with possible retroactive effect, will not adversely affect us. 
Additionally, any changes, whether in interpretation or substance, in existing regulations or policies, or any future adoption 
of new regulations or policies by relevant regulatory bodies, could prevent or delay approval of our products. In the event our 
future, or current, products, including HA generally, are classified, or re-classified, as human drugs, combination products, 
or biologics by the FDA or an applicable international regulatory body, the applicable review process related to such products 
is typically substantially longer and substantially more expensive than the review process to which they are currently subject 
as medical devices. In 2018, FDA publicly indicated its intent to consider HA products for certain indications for regulation 
as a drug and has indicated that industry should submit new products or indication expansions to the OCP to designate the 
appropriate  FDA  office  for  review.  There  exists  uncertainty  with  respect  to  the  final  interpretation,  implementation,  and 
consequences of this development, and this or any other potential regulatory changes in approach or interpretation similar in 
substance to those mentioned in this paragraph and affecting our products could materially impact our competitive position, 
business, and financial results. 

Additionally, the implementation of the new European Medical Device Regulation (“EU MDR”), set to take full 
effect in 2020, is expected to change several aspects of the existing regulatory framework in Europe. Specifically, the EU 
MDR will require changes in the clinical evidence required for medical devices, post-market clinical follow-up evidence, 
annual reporting of safety information for Class III products, and bi-annual reporting for Class II products, Unique Device 
Identification (“UDI”) for all products, submission of core data elements to a European UDI database prior to placement of 
a device on the market, reclassification of medical devices, and multiple other labeling changes. Approvals for certain of our 
currently-marketed products could be curtailed or withdrawn as a result of the implementation of the EU MDR, and acquiring 
approvals for new products could be more challenging and costly. For example, the CE Mark indication for MONOVISC of 
the treatment of pain associated with osteoarthritis in all synovial joints was limited to the knee joint by our notified body as 
a result of the EU MDR, pending our generation of adequate data to support the broader indication previously granted. We 
do not expect this limitation to have a material impact on MONOVISC’s revenue generation, but compliance with this and 
any other requirements could be time consuming and costly, and our failure to comply may subject us to significant liabilities, 
which could have a material adverse effect on our business, financial condition, and results of operation.  

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We may rely on third parties to support certain aspects of our clinical trials. If these third parties do not successfully carry 
out their contractual duties or meet expected deadlines, we may not be able to obtain regulatory approval or commercialize 
our products, and our business could be substantially harmed. 

We have hired  experienced  clinical  development  and  regulatory  staff,  and we have  also retained  the services  of 
knowledgeable external service providers, including consultants and clinical research organizations, to develop and supervise 
our clinical trials and regulatory processes. Despite our internal investment in staffing, we will remain dependent upon these 
third-party  contract  research  organizations  to  carry  out  portions  of  our  clinical  and  preclinical  research  studies  for  the 
foreseeable future. As a result, we have had and will have less control over the conduct of the clinical trials, the timing and 
completion of the trials, the required reporting of adverse events, and the management of data developed through the trials 
than  would  be  the  case  if  we  were  relying  entirely  on  our  own  staff.  Outside  parties  may  have  staffing  difficulties,  may 
undergo changes in priorities or may become financially distressed, adversely affecting their willingness or ability to conduct 
our trials. Failure by these third parties to comply with regulatory requirements or to meet timing expectations may require 
us to repeat clinical or preclinical trials, which would delay the regulatory approval process, or require substantial unexpected 
expenditures. 

We are subject to various healthcare laws and regulations, and any failure to comply with applicable laws could subject 
us to significant liability and harm our business. 

Our business involves substantial interaction and collaboration with healthcare professionals, including physician 
consultants, clinical investigators, and actual and potential customers. These relationships are subject to federal and state 
healthcare laws, as well as equivalent foreign regulations. These statutes and regulations include, without limitation, false 
claims laws, anti-kickback regulations, the Foreign Corrupt Practices Act, and the Physician Payments Sunshine Act. Any 
failure to comply with these laws could subject us to significant liabilities, which could have a material adverse effect on our 
business, financial condition, and results of operation. 

We are subject to environmental regulations and any failure to comply with applicable laws could subject us to significant 
liabilities and harm our business. 

We  are  subject  to  a  variety  of  local,  state,  federal,  and  foreign  government  regulations  relating  to  the  storage, 
discharge,  handling,  emission,  generation,  manufacture,  and  disposal  of  toxic  or  other  hazardous  substances  used  in  the 
manufacture of our products. Any failure by us to control the use, disposal, removal, or storage of hazardous chemicals or 
toxic substances could subject us to significant liabilities, which could have a material adverse effect on our business, financial 
condition, and results of operations. 

Risks Related to Our Business and Industry 

We actively explore acquisitions as a part of our future growth strategy, which exposes us to a variety of risks that could 
adversely affect our business operations. 

Our  business  and  future  growth  strategy  includes  as  an  important  component  the  acquisition  of  businesses, 
technologies, services, or products that we believe are a strategic fit with or otherwise provide value to our business. We may 
fund  these  acquisitions  by  utilizing  our  cash,  incurring  debt,  issuing  additional  shares  of  our  common  stock,  or  by  other 
means.  Completed  acquisitions  may  expose  us  to  a  number  of  risks  and  expenses,  including  unanticipated  liabilities, 
amortization  expenses  related  to  intangible  assets  with  definite  lives,  or  risks  associated  with  entering  new  markets  with 
which we have limited experience or where commercial alliances with experienced partners or existing sales channels are not 
available. Whether or not completed, acquisitions may result in diversion of management resources otherwise available for 
ongoing development of our business and significant expenditures. 

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We may not be able to realize the expected benefits of any completed acquisitions, including growth synergies and 
cost savings from the integration of acquired businesses or assets with our existing operations and technologies, as rapidly as 
expected, or at all. In addition, the integration and reorganization processes for our acquisitions may be complex, costly, and 
time  consuming  and  include  unanticipated  issues,  expenses,  and  liabilities.  We  may  have  difficulty  in  developing, 
manufacturing, and marketing the products of a newly acquired company in a manner that enhances the performance of our 
combined businesses or product lines and allows us to realize value from expected synergies. Moreover, we may lose key 
clients or employees of acquired businesses as a result of the change in ownership to us. Following an acquisition, we may 
not achieve the revenue or net income levels that justify the acquisition. Acquisitions may also result in one-time charges, 
such as write-offs or restructuring charges, impairment of goodwill or acquired In-Process Research and Development, which 
could adversely affect our operating results. The failure to achieve the expected benefits of any acquisition may harm our 
business, financial condition, and results of operations. 

Attractive acquisition opportunities may not be available to us. 

We routinely consider the acquisition of other businesses. However, we may not locate suitable acquisition targets 
or have the opportunity to make acquisitions of such targets on favorable terms, which could negatively impact the growth 
of our business. In order to pursue such opportunities, we may require significant additional financing, which may not be 
available to us on favorable terms, if at all. Our current or potential competitors, many of which have significantly greater 
resources than we do, may compete with us to acquire compatible businesses, which would increase the acquisition prices 
and could cause us to expend significant time and funds on acquisitions we are unable to complete. 

The acquisitions we have made or may make in the future may make us the subject of lawsuits from either an acquired 
company’s stockholders, an acquired company’s previous stockholders, or our current stockholders. 

We may be the subject of lawsuits from either an acquired company’s stockholders, an acquired company’s previous 
stockholders, or our current stockholders. These lawsuits could result from the actions of the acquisition target prior to the 
date  of  the  acquisition,  from  the  acquisition  transaction  itself,  or  from  actions  after  the  acquisition.  Defending  potential 
lawsuits  could  cost  us  significant  expense  and  distract  management’s  attention  from  the  operation  of  the  business. 
Additionally, these lawsuits could result in the cancellation of, or the inability to renew, certain insurance coverage that would 
be necessary to protect our assets. 

Customer and employee uncertainty about the effects of any acquisitions could harm us. 

Customers of any companies we acquire may, in response to the consummation of the acquisitions, delay or defer 
purchasing decisions, which could adversely affect the success of our acquired businesses. Similarly, employees of acquired 
companies may experience uncertainty about their future roles, which may adversely affect our ability to attract and retain 
key management, sales, marketing, and technical personnel following an acquisition. 

We may seek additional financing in the future, which could be difficult to obtain and which could dilute your ownership 
interest or the value of your shares. 

Our future capital requirements and the adequacy of available funds will depend, however, on numerous factors, 

including: 

  Market acceptance of our existing and future products; 

  The success and sales of our products under various distributor agreements and other appropriate commercial 

strategies, including the ability of our partners to achieve third party reimbursement for our products; 

  The  successful  commercialization  of  products  in  development  through  appropriate  commercial  models  and 

marketing channels; 

  Progress in our product development efforts; 

  The magnitude and scope of such product development efforts; 

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  Any potential acquisitions of products, technologies, or businesses; 

  Progress with preclinical studies, clinical trials, and product approvals and clearances by the FDA and other 

agencies; 

  The cost and timing of our efforts to manage our manufacturing capabilities and related costs; 

  The cost of filing, prosecuting, defending, and enforcing patent claims and other intellectual property rights and 

the cost of defending any other legal proceeding; 

  Competing technological and market developments; 

  The development of strategic alliances for the marketing of certain of our products; 

  The  terms  of  such  strategic  alliances,  including  provisions  (and  our  ability  to  satisfy  such  provisions)  that 

provide upfront and/or milestone payments to us; and 

  The cost of maintaining adequate inventory levels to meet current and future product demand. 

To the extent funds generated from our operations, together with our existing capital resources, are insufficient to 
meet future requirements, we will be required to obtain additional funds through equity or debt financings, through strategic 
alliances with corporate partners and others, or through other sources. The terms of any future equity financings may be 
dilutive to our investors and the terms of any debt financings may contain restrictive covenants, which limit our ability to 
pursue certain courses of action. Our ability to obtain financing is dependent on the status of our future business prospects as 
well as conditions prevailing in the relevant capital markets at the time we seek financing. No assurance can be given that 
any additional financing will be made available to us or will be available on acceptable terms should such a need arise. 

Our  manufacturing  processes  involve  inherent  risks,  and  disruption  could  materially  adversely  affect  our  business, 
financial condition, and results of operations. 

The operation of biomedical manufacturing plants involves many risks, including the risks of breakdown, failure, or 
substandard  performance  of  equipment,  the  occurrence  of  natural  and  other  disasters,  and  the  need  to  comply  with  the 
requirements of directives of government agencies, including the FDA. In addition, we rely on a small number of suppliers 
for certain key raw materials and a small number of suppliers for a number of other materials required for the manufacturing 
and delivery of our HA products. Although we believe that alternative sources for many of these and other components and 
raw  materials  that  we use  in  our  manufacturing processes  are  available, we  cannot  be  certain  that  the  supply  of  key  raw 
materials, specifically HA, will continue be available at current levels or will be sufficient to meet our future needs. Any 
supply interruption could harm our ability to manufacture our products until a new source of supply is identified and qualified. 
We may not be able to find sufficient alternative suppliers in a reasonable time period, or on commercially reasonable terms, 
if at all, and our ability to produce and supply our products could be impaired. 

We use raw materials derived from animal sources to produce certain of our products, and there is no guarantee that we 
will be able to continue to utilize this source of material in the future. 

Our  manufacturing  processes  and  research  and  development  efforts  for  some  of  our  ophthalmic  and  veterinary 
products involve products derived from animals. We procure our animal-derived raw materials from a qualified vendor, who 
controls for contamination and has processes that effectively inactivate infectious agents; however, we cannot assure you that 
we can completely eliminate the risk of transmission of infectious agents. Furthermore, regulatory authorities could in the 
future impose restrictions on the use of animal-derived raw materials that could impact our business. 

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The utilization of animals in research and development and product commercialization is subject to increasing focus 
by animal rights activists. The activities of animal rights groups and other organizations that have protested animal based 
research and development programs or boycotted the products resulting from such programs could cause an interruption in 
our  manufacturing  processes  and  research  and  development  efforts.  The  occurrence  of  material  operational  problems, 
including  but  not  limited  to  the  events  described  above,  could  have  a  material  adverse  effect  on  our  business,  financial 
condition, and results of operations during the period of such operational difficulties and beyond. 

We lease properties in the United States and Italy, and there is no guarantee that these leaseholds will be without issue or 
sufficient to support future growth. 

We lease approximately 134,000 square feet of administrative, research and development, and manufacturing space 
in Bedford, MA and approximately 33,000 square feet of office, research and development, training, and warehousing space 
in Padova, Italy. The current term of the Bedford lease extends to 2022, and the current term of the Padova lease extends to 
2032, each with several options for renewal. Please see Item 2 – Properties for additional information on our current leases. 
The nature of these leaseholds presents certain risks. We must maintain a positive working relationship with the respective 
owners as a dispute with either owner over payment, maintenance, or any other matter could be disruptive to our business. 
Additionally, there is a possibility that changes to our business or the geographic location of the facilities could make either 
location less suitable to our operations. Any renegotiation or termination of either lease could result in substantial cost or 
business interruption to our operations. Additionally, there is no guarantee that our current space will be sufficient to support 
our future growth or that any future relocation or expansion of our operations would be completed smoothly or in a timely 
manner due to, among other things, unexpected construction delays or unexpected difficulties related to the achievement of 
necessary permitting. Any business disruption as a result of any of these factors could have a material impact on our business, 
financial condition, and results of operations. 

We may face circumstances in the future that will result in impairment charges, including, but not limited to, goodwill 
impairment and In-Process Research and Development (“IPR&D”) charges. 

As of December 31, 2018, we had long-lived assets, including goodwill and IPR&D, of $76.1 million. If the fair 
value of any of our long-lived assets decreases as a result of an economic slowdown, a downturn in the markets where we 
sell products and services, or a downturn in our financial performance or future outlook, we may be required to record an 
impairment charge on such assets. 

We are required to test intangible assets with indefinite life periods for potential impairment annually and on an 
interim basis if there are indicators of a potential impairment. We also are required to evaluate amortizable intangible assets 
and fixed assets for impairment if there are indicators of a possible impairment. Impairment charges could have a negative 
impact on our results of operations and financial position, as well as on the market price of our common stock. 

We could become subject to product liability claims, which, if successful, could materially adversely affect our business, 
financial condition, and results of operations. 

The  testing,  marketing,  and  sale  of  human  health  care  products  entail  an  inherent  risk  of  allegations  of  product 
liability, and there can be no assurance that substantial product liability claims will not be asserted against us. Although we 
have not received any material product liability claims to date and have an insurance policy of $5.0 million per occurrence 
and $5.0 million in the aggregate to cover such product liability claims should they arise, there can be no assurance that 
material claims will not arise in the future or that our insurance will be adequate to cover all situations. Moreover, there can 
be no assurance that such insurance, or additional insurance, if required, will be available in the future or, if available, will 
be available on commercially reasonable terms. Any product liability claim, if successful, could have a material adverse effect 
on our business, financial condition, and results of operations.  

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Our business is dependent upon hiring and retaining qualified management and technical personnel. 

We are highly dependent on the members of our management and technical staff, the loss of one or more of whom 
could have a material adverse effect on us. We have experienced a number of management changes in recent years, and there 
can be no assurances that any future management changes will not adversely affect our business. We believe that our future 
success will depend in large part upon our ability to attract and retain technical and highly skilled executive, managerial, 
professional,  and  technical  personnel.  We  face  significant  competition  for  such  personnel  from  competitive  companies, 
research and academic institutions, government entities, and other organizations. There can be no assurance that we will be 
successful in hiring or retaining the personnel we require. The failure to hire and retain such personnel could have a material 
adverse effect on our business, financial condition, and results of operations. 

Currency exchange rate fluctuations may have a negative impact on our reported earnings. 

Approximately 5% of our business during 2018 was conducted in functional currencies other than the U.S. dollar, 
which is our reporting currency. Thus, currency fluctuations among the U.S. dollar and the other currencies in which we do 
business  have  caused  and  will  continue  to  cause  foreign  currency  transaction  gains  and  losses.  Currently,  we  attempt  to 
manage foreign currency risk through the matching of assets and liabilities. In the future, we may undertake to manage foreign 
currency risk through additional hedging methods. We recognize foreign currency gains or losses arising from our operations 
in the period incurred. We cannot guarantee that we will be successful in managing foreign currency risk or in predicting the 
effects of exchange rate fluctuations upon our future operating results because of the variability of currency exposure and the 
potential volatility of currency exchange rates. 

Information security breaches or business system disruptions may adversely affect our business.  

We rely on our information technology infrastructure and management information systems to effectively run our 
business.  While  we  have  not  previously  experienced  a  material  information  security  breach  caused  by  illegal  hacking, 
computer viruses, or acts of vandalism or terrorism, we may in the future be subject to such a breach. Our security measures 
or  those  of  our  third-party  service  providers  may  not  detect  or  prevent  such  breaches.  Any  such  compromise  to  our 
information security could result in an interruption in our operations, the unauthorized publication of our confidential business 
or proprietary information, the unauthorized release of customer, vendor, or employee data, the violation of privacy, including 
under the GDPR recently promulgated in the European Union, or other laws and exposure to litigation, any of which could 
harm our business and operating results. 

Risks Related to Our Intellectual Property 

We  may  be  unable  to  adequately  protect  our  intellectual  property  rights,  which  could  have  a  material  impact  on  our 
business and future financial results. 

Our efforts to enforce our intellectual property rights may not be successful. We rely on a combination of copyright, 
trademark,  patent,  and  trade  secret  laws,  confidentiality  procedures,  and  contractual  provisions  to  protect  our  proprietary 
rights. Our success will depend, in part, on our ability to obtain and enforce patents and trademarks, to protect trade secrets, 
to obtain licenses to technology owned by third parties when necessary, and to conduct our business without infringing on 
the proprietary rights of others. The patent positions of pharmaceutical, medical product, and biotechnology firms, including 
ours, can be uncertain and involve complex legal and factual questions. There can be no assurance that any patent applications 
will result in the issuance of patents or, if any patents are issued, that they will provide significant proprietary protection or 
commercial  advantage  or  will  not  be  circumvented  by  others.  Filing  and  prosecution  of  patent  applications,  litigation  to 
establish the validity and scope of patents, assertion of patent infringement claims against others, and the defense of patent 
infringement claims by others can be expensive and time consuming. There can be no assurance that, in the event that any 
claims with respect to any of our patents, if issued, are challenged by one or more third parties, any court or patent authority 
ruling  on  such  challenge  will  determine  that  such  patent  claims  are  valid  and  enforceable.  An  adverse  outcome  in  such 
litigation or patent review process could cause us to lose exclusivity covered by the disputed rights. If a third party is found 
to have rights covering products or processes used by us, we could be forced to cease using the technologies or marketing the 
products covered by such rights, we could be subject to significant liabilities to such third party, and we could be required to 
license technologies from such third party in order to continue production of the products. Furthermore, even if our patents 
are determined to be valid, enforceable, and broad in scope, there can be no assurance that competitors will not be able to 
design around such patents and compete with us using the resulting alternative technology. We have a policy of seeking 
patent protection for patentable aspects of our proprietary technology. We intend to seek patent protection with respect to 
products and processes developed in the course of our activities when we believe such protection is in our best interest and 
when the cost of seeking such protection is not inordinate. However, no assurance can be given that any patent application 
will  be  filed,  that  any  filed  applications  will  result  in  issued  patents,  or  that  any  issued  patents  will  provide  us  with  a 

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competitive advantage or will not be successfully challenged by third parties. The protections afforded by patents will depend 
upon their scope and validity, and others may be able to design around our patents. 

We also rely upon trade secrets and proprietary know-how for certain non-patented aspects of our technology. To 
protect such information, we require all employees, consultants, and licensees to enter into confidentiality agreements limiting 
the disclosure and use of such information. There can be no assurance that these agreements provide meaningful protection 
or  that  they  will  not  be  breached,  that  we  would  have  adequate  remedies  for  any  such  breach,  or  that  our  trade  secrets, 
proprietary know-how, and our technological advances will not otherwise become known to others. In addition, there can be 
no assurance that, despite precautions taken by us, others have not and will not obtain access to our proprietary technology. 
Further,  there  can  be  no  assurance  that  third  parties  will  not  independently  develop  substantially  equivalent  or  better 
technology.  

There can be no assurance that we will not infringe upon the intellectual property rights of others, which could have a 
significant impact on our business and financial results. 

Other entities have filed patent applications for, or have been issued patents concerning, various aspects of HA-
related products or processes, including in the segments in which we do business. There can be no assurance that the products 
or processes developed by us will not infringe on the patent rights of others in the future. The cost of defending infringement 
suits is typically large, and there is no guarantee that any future defense would be successful. In addition, infringement could 
lead to substantial damages payouts or our inability to produce or market certain of our current or future products. As a result, 
any such infringement may have a material adverse effect on our business, financial condition, and results of operations. 

Risks Related to Ownership of Our Common Stock 

Our stock price may be highly volatile, and we cannot assure you that market making in our common stock will continue. 

The market price of shares of our common stock may be highly volatile. Factors such as announcements of new 
commercial  products  or  technological  innovations  by  us  or  our  competitors,  disclosure  of  results  of  clinical  testing  or 
regulatory  proceedings,  government  regulation  and  approvals,  developments  in  patent  or  other  proprietary  rights,  public 
concern as to the safety of products developed by us, and general market conditions may have a significant effect on the 
market price of our common stock. The trading price of our common stock could be subject to wide fluctuations in response 
to  quarter-to-quarter  variations  in  our  operating  results,  material  announcements  by  us  or  our  competitors,  governmental 
regulatory action, conditions in the health care industry generally or in the medical products industry specifically, or other 
events or factors, many of which are beyond our control. In addition, the stock market has experienced extreme price and 
volume fluctuations, which have particularly affected the market prices of many medical products companies and which often 
have been unrelated to the operating performance of such companies. Our operating results in future quarters may be below 
the expectations of equity research analysts and investors. In such an event, the price of our common stock would likely 
decline, perhaps substantially. 

If securities or industry analysts do not publish or cease publishing research or reports about us, our business, or our 
market, or if they adversely change their recommendations regarding our stock, our stock price and trading volume could 
decline. 

The trading market for our common stock is influenced by the research and reports that securities or industry analysts 
may publish about us, our business, our market, or our competitors. No person is under any obligation to publish research or 
reports on us, and any person publishing research or reports on us may discontinue doing so at any time without notice. If 
adequate research coverage is not maintained on our company or if any of the analysts who cover us downgrade our stock or 
publish inaccurate or unfavorable research about our business or provide relatively more favorable recommendations about 
our competitors, our stock price would likely decline. If any analysts who cover us were to cease coverage of our company 
or fail to regularly publish reports on us, we could lose visibility in the financial markets, which in turn could cause our stock 
price or trading volume to decline. 

25 

   
  
  
  
  
  
  
  
  
  
 
 
We currently do not intend to pay dividends on our common stock in the foreseeable future. 

We have never declared or paid any cash dividends on our common stock. We currently intend to retain earnings, if 
any, for use in our business and do not anticipate paying cash dividends on our common stock in the foreseeable future. 
Accordingly, investors are not likely to receive any dividends on their common stock in the foreseeable future, and their 
ability to achieve a return on their investment will therefore depend on appreciation in the price of our common stock. 

Our charter documents contain anti-takeover provisions that may prevent or delay an acquisition of our company. 

Our charter documents continue to contain anti-takeover provisions that could prevent or delay an acquisition of our 
company. The provisions include, among others, a classified board of directors, advance notice to the board of stockholder 
proposals, limitations on the ability of stockholders to remove directors and to call stockholder meetings, and a provision that 
allows vacancies on the Board of Directors to be filled by vote of a majority of the remaining directors. We are also subject 
to Section 203 of the Delaware General Corporate Law which, subject to certain exceptions, prohibits a Delaware corporation 
from engaging in any of a broad range of business combinations with any “interested stockholder” for a period of three years 
following  the  date  that  such  stockholder  becomes  an  interested  stockholder.  Those  provisions  could  have  the  effect  of 
discouraging a third party from pursuing a non-negotiated takeover of our company at a price considered attractive by many 
stockholders and could have the effect of preventing or delaying a potential acquirer from acquiring control of our company. 

ITEM 2. PROPERTIES 

Our corporate headquarters is located in Bedford, Massachusetts, where we lease approximately 134,000 square feet 
of administrative, research and development, and manufacturing space. We entered into this lease in January 2007, and the 
lease commenced in May 2007 for an initial term of ten and a half years. In October 2016, we exercised the first option under 
the lease to extend its term for five years. There are two additional renewal periods, each of which is subject to the condition 
that we notify the landlord of our exercise of such option at least one year prior to the expiration of the then current term. 
Two additional renewal options each extend the term an additional five years, and the final renewal option extends the term 
an additional six years. 

In October 2015, Anika S.r.l. entered into a build-to-suit lease agreement for a new European headquarters facility 
consisting of approximately 33,000 square feet of general office, research and development, training, and warehousing space 
located in Padova, Italy. This lease, which has an initial term of fifteen years, commenced in February 2017 in accordance 
with the lease agreement, as amended in February 2017. The lease will automatically renew for up to three additional six-
year terms, subject to certain terms and conditions. Anika S.r.l. may elect to early withdraw from this lease subject to certain 
financial penalties after six years and with no penalties after the ninth year. The lease provides for an initial yearly rent of 
approximately $0.3 million. 

Prior to April 2017, Anika S.r.l. leased approximately 28,000 square feet of laboratory, warehouse, and office space 
in  Abano  Terme,  Italy  from  Fidia.  The  lease  commenced  in  December  2009.  In  December  2016,  following  discussions 
between Anika S.r.l. and Fidia, Anika S.r.l. notified Fidia of its intention to terminate this lease agreement as of March 2017, 
in accordance with the terms of the lease. 

In 2018, we had aggregate facility lease expenses of approximately $1.8 million. We believe that the capacity of our 
Bedford, Massachusetts corporate headquarters is sufficient to satisfy our needs for the immediately foreseeable future. We 
also believe that Anika S.r.l.’s leased facility in Padova, Italy will be sufficient to satisfy its needs for the foreseeable future. 

26 

  
  
  
  
  
   
  
  
  
  
 
 
ITEM 3. LEGAL PROCEEDINGS 

We are involved from time-to-time in various legal proceedings arising in the normal course of business. Although 
the outcomes of these legal proceedings are inherently difficult to predict, we do not expect the resolution of these proceedings 
to have a material adverse effect on our financial position, results of operations, or cash flow. 

PART II 

ITEM 5. MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND 
ISSUER PURCHASES OF EQUITY SECURITIES 

Common Stock Information 

Our common stock has traded on the NASDAQ Global Select Market since November 25, 1997, under the symbol 

“ANIK.” 

 At December 31, 2018, the closing price per share of our common stock was $33.61 as reported on the NASDAQ 
Global Select Market, and there were 121 holders of record. We believe that the number of beneficial owners of our common 
stock at that date was substantially greater, due to shares being held by intermediaries. 

We have never declared or paid any cash dividends on our common stock. We currently intend to retain earnings, if 
any, for use in our business and do not anticipate paying cash dividends on our common stock in the foreseeable future. 
Payment of future dividends, if any, on our common stock will be at the discretion of our Board of Directors after taking into 
account various factors, including our financial condition, operating results, anticipated cash needs, and plans for expansion. 

27 

   
  
  
  
  
  
  
  
  
 
 
Performance Graph 

Set forth below is a graph comparing the total returns of our company, the NASDAQ Composite Index, and the 
NASDAQ Biotechnology Index. The graph assumes $100 is invested on December 31, 2013 in our common stock and each 
of the indices. Past performance is not indicative of future results. 

   Dec-13 

   Dec-14 

   Dec-15 

   Dec-16 

   Dec-17 

   Dec-18 

Anika Therapeutics, Inc. ...............   $ 
NASDAQ Composite Index ..........   $ 
NASDAQ Biotechnology Index ....   $ 

100.00    $ 
100.00    $ 
100.00    $ 

106.76    $
113.40    $
134.10    $

100.00    $
119.89    $
149.42    $

128.30    $ 
128.89    $ 
117.02    $ 

141.27    $
165.29    $
141.66    $

88.08  
158.87  
128.45  

Securities Authorized for Issuance Under Equity Compensation Plans 

For information regarding securities authorized for issuance under our employee stock-based compensation plans, 
see Part III, Item 12, Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters, 
included elsewhere in this Annual Report on Form 10-K. 

ITEM 6. SELECTED FINANCIAL DATA 

The following selected consolidated financial data should be read in conjunction with the Consolidated Financial 
Statements and the Notes thereto and the section captioned “Management’s Discussion and Analysis of Financial Condition 
and  Results  of  Operations”  included  elsewhere  in  this  Annual  Report  on  Form 10-K.  The  Balance  Sheet  Data  at 
December 31, 2018 and 2017 and the Statement of Operations Data for each of the three years ended December 31, 2018, 
2017, and 2016 have been derived from the audited Consolidated Financial Statements for such years, included elsewhere 
in this Annual Report on Form 10-K. The Balance Sheet Data at December 31, 2016, 2015, and 2014, and the Statement of 
Operations Data for each of the two years in the period ended December 31, 2015 and 2014 have been derived from audited 
consolidated financial statements for such years not included in this Annual Report on Form 10-K. 

28 

  
  
 
 
  
  
  
  
  
  
  
  
 
 
2018 

Years ended December 31, 
2016 
(in thousands, except per share data) 

2015 

2017 

2014 

Statements of Operations Data: 
Product revenue ..............................................................   $ 105,531     $ 107,783     $ 102,932      $
Licensing, milestone and contract revenue .....................     
447        
Total revenue ..................................................................      105,555        113,420        103,379        
24,027        
Cost of product revenue .................................................     
Product gross profit ........................................................     
78,905        
Product gross margin ......................................................     
77 %     
Total operating expenses ................................................     
52,772        
32,547        
Net income .....................................................................     
2.15      $
Diluted net income per common share ...........................   $
Diluted common shares outstanding ..............................     
15,116        

31,280       
74,251       
70%     
83,806       
18,722       
1.27     $
14,689       

27,364       
80,419       
75%     
67,691       
31,816       
2.11     $
15,068       

5,637       

24       

87,696     $  75,474  
5,303       
30,121  
92,999        105,595  
20,930  
21,053       
54,544  
66,643       
72%
76%    
44,148  
44,865       
38,319  
30,758       
2.51  
2.01     $ 
15,269  
15,321       

2018 

2017 

Years ended December 31, 
2016 
(in thousands) 

2015 

2014 

Balance Sheet Data: 
Cash, cash equivalents and investments .........................    $ 159,014    $ 157,256    $ 124,761    $ 138,458    $  106,906  
Working capital ..............................................................       191,654       193,254       161,641       159,155       131,863  
Total assets .....................................................................       278,993       282,617       240,246       235,748       192,808  
Long-term liabilities .......................................................      
8,737  
Retained earnings ...........................................................       218,233       199,511       168,209       135,662       104,904  
Stockholders' equity .......................................................       263,612       263,491       222,773       210,848       178,098  

6,054      

8,674      

4,092      

7,622      

*  

In  2015,  the  Company  adopted  new  accounting  guidance  related  to  the  presentation  of  deferred  income  taxes,  which  has  been  applied  above 
retrospectively. Current deferred tax assets and liabilities have been reclassified as non-current deferred tax assets and liabilities. 

**  The Company adopted the guidance in the FASB’s Accounting Standards Codification (“ASC”) Revenue from Contracts with Customers (ASC 606) 
using the modified retrospective method effective January 1, 2018. Revenues for all periods prior to January 1, 2018 were recognized under ASC 605, 
Revenue Recognition.  

The following section contains statements that are not statements of historical fact and are forward-looking statements within 
the  meaning  of  the  federal  securities  laws.  These  statements  involve  known  and  unknown  risks,  uncertainties,  and  other 
factors  that  may  cause  our  actual  results,  performance,  or  achievement  to  differ  materially  from  anticipated  results, 
performance, or achievement, expressed or implied in such forward-looking statements. These statements reflect our current 
views with respect to future events, are based on assumptions, and are subject to risks and uncertainties. We discuss many of 
these  risks  and  uncertainties  at  the  beginning  of  this  Annual  Report  on  Form 10-K  and  under  the  sections  captioned 
“Business” and “Risk Factors.” The following discussion should also be read in conjunction with the consolidated financial 
statements and the Notes thereto appearing elsewhere in this Annual Report on Form 10-K. 

ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF 
OPERATIONS 

Management Overview 

We are a global, integrated orthopedic and regenerative medicines company committed to improving the lives of 
patients  with  degenerative  orthopedic  diseases  and  traumatic  conditions  with  clinically  meaningful  therapies  along  the 
continuum  of  care,  from  palliative  pain  management  to  regenerative  tissue  repair.  We  have  over  two  decades  of  global 
expertise developing, manufacturing, and commercializing our products based on our proprietary hyaluronic acid (“HA”) 
technology. Our orthopedic medicine portfolio includes ORTHOVISC, MONOVISC, and CINGAL, which alleviate pain 
and restore joint function by replenishing depleted HA, and HYALOFAST, a solid HA-based scaffold to aid cartilage repair 
and regeneration. 

Our therapeutic offerings consist of products in the following areas: Orthobiologics, Dermal, Surgical, and Other, 
which  includes  our  ophthalmic  and  veterinary  products.  All  of  our  products  are  based  on  HA,  a  naturally  occurring, 
biocompatible polymer found throughout the body. Due to its unique biophysical and biochemical properties, HA plays an 
important role in a number of physiological functions such as the protection and lubrication of soft tissues and joints, the 
maintenance of the structural integrity of tissues, and the transport of molecules to and within cells. 

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Our proprietary technologies for modifying the HA molecule allow product properties to be tailored specifically to 
therapeutic use. Our patented technology chemically modifies HA to allow for longer residence time in the body. We also 
offer products made from HA based on two other technologies: HYAFF, which is a solid form of HA, and ACP gel, an 
autocross-linked polymer of HA. Our technologies are protected by an extensive portfolio of owned and licensed patents. 

Since our inception in 1992, we have utilized a commercial partnership model for the distribution of our products to 
end-users.  Our  strong,  worldwide  network  of  distributors  has  historically  provided,  and  continues  to  provide,  a  solid 
foundation for our revenue growth and territorial expansion. For near-term and long-term opportunities in the U.S. market, 
we have evaluated a potential hybrid commercial approach that would see us balance a small direct model with an optimal 
form of strategic partnership, an approach we intend to utilize for the commercialization of our injectable, HA-based surgical 
bone repair product. For longer-term future products in the U.S. market, we intend to evaluate the appropriate commercial 
model for each instance on a case-by-case basis, based on market dynamics and other factors. These models could include 
direct sales, distribution partnerships, or a hybrid of those forms. We believe that the combination of the direct and distribution 
commercial models will maximize the revenue potential from our current and future product portfolio. 

On May 2, 2018, we publicly disclosed a voluntary recall of certain production lots of our HYAFF-based products, 
HYALOFAST, HYALOGRAFT C, and HYALOMATRIX. We communicated with all affected distributors in advance of 
that announcement, and we have taken all required or otherwise appropriate actions with respect to applicable regulatory 
bodies. We initiated the voluntary recall following internal quality testing, which indicated that the products were at risk of 
not maintaining certain measures throughout their entire shelf life. While there was no indication of any safety or efficacy 
issue related to the products, we are committed to the highest standards of quality and removed the products from the field as 
a precautionary measure. During the first quarter of 2018, we recorded a revenue reserve of $1.1 million, $0.9 million of 
which related to revenue recorded in prior periods, and adjustments during the balance of the year were immaterial. We also 
recorded an inventory charge for fiscal year 2018 of $0.8 million for the related non-saleable inventory, and we incurred $0.3 
million of expenses associated with the administration and remediation of the voluntary recall. During the fourth quarter of 
2018, we resolved this matter and resumed shipment of these products, and all of the affected products had been returned 
with no material change to the related reserves as of December 31, 2018. As a result of this voluntary recall, revenue generated 
from the affected products during fiscal year 2018 declined between $1 million and $2 million as compared to fiscal year 
2017. 

The following sections provide more information about our products: 

Orthobiologics 

Our orthobiologics business contributed 89% of our product revenue for the year ended December 31, 2018. Our 
orthobiologics products primarily consist of viscosupplement and regenerative orthopedic products. Our viscosupplement 
products include ORTHOVISC, ORTHOVISC mini, and MONOVISC, each of which is commercialized in various territories 
worldwide, and CINGAL, our next generation viscosupplement launched internationally in Canada and the European Union 
in  the  second  quarter  of  2016  after  receiving  Health  Canada  and  CE  Mark  approval.  ORTHOVISC,  our  original 
viscosupplement product, is a three-injection osteoarthritis treatment marketed by us in the United States since 2004 and 
internationally since 1996 through various distribution agreements. MONOVISC, our second generation viscosupplement, is 
a  single-injection  osteoarthritis  treatment  marketed  in  the  United  States  since  2014  and  internationally  since  2008. 
ORTHOVISC mini is available in Europe and is designed for the treatment of osteoarthritis in small joints. We are currently 
seeking regulatory approval for CINGAL, our third generation, single-injection osteoarthritis product, in the United States. 

We  currently  offer  several  orthopedic  products  used  in  connection  with  regenerative  medicine. The  products 
currently available in Europe and certain international markets include HYALOFAST, a biodegradable support for human 
bone  marrow  mesenchymal  stem  cells  used  for  cartilage  regeneration  and  as  an  adjunct  for  microfracture  surgery; 
HYALONECT, a resorbable knitted fabric mesh for use in orthopedic and trauma reconstructive procedures to maintain the 
relative position of engrafted bone tissue or bone fragments from comminuted fractures; and HYALOSS, HYAFF fibers used 
to mix blood/bone grafts to form a paste for bone regeneration. We also offer HYALOGLIDE, an ACP gel used in tenolysis 
treatment that, with additional clinical data, may demonstrate potential for flexor tendon adhesion prevention and for the 
treatment of adhesive capsulitis prevention in the shoulder. This product is commercialized through a network of distributors, 
primarily in Europe and the Middle East. We believe that the U.S. market offers excellent expansion potential to increase 
revenue for these products, and this will continue to be a focus area for us moving forward. 

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In addition to the products discussed above, we received CE Mark approval in December 2016 for a product which 
utilizes  our  proprietary  HA  technology  to  treat  pain  associated  with  lateral  epicondylitis,  better  known  as  tennis  elbow. 
Outside of the United States, this product is marketed under the trade name ORTHOVISC-T. Additionally, in the second 
quarter of 2016, we submitted an IDE to the FDA to conduct a Phase III clinical trial for this treatment, and the IDE was 
approved by  the FDA  in June 2016. We  also received 510(k)  clearance  for  an  injectable, HA-based  surgical bone  repair 
product  in  December 2017, which we  intend  to  launch  in  the U.S. during 2019 utilizing  the previously-described  hybrid 
commercialization approach. 

Our strategy is to continue to add new products, to expand the indications for use of both our current and any new 
products, and to expand our commercial reach. The orthobiologics area has been our fastest growing area, generating 67% 
growth from 2013 to 2018. We continue to seek new distribution partnerships around the world, in concert with entering new 
markets with other appropriate sales strategies, and we expect total orthobiologics product sales to decrease modestly in 2019 
compared to 2018 based mainly on pricing declines in the U.S. market partially offset by increased sales of MONOVISC and 
CINGAL internationally. 

Dermal  

Our dermal products contributed less than 1% to our product revenue for the year ended December 31, 2018 mainly 
due  to  the  previously-described  voluntary  recall  of  certain  production  lots  of  our  HYAFF-based  products.  Our  dermal 
franchise consists of advanced wound care products, which are based on the HYAFF technology, and an aesthetic dermal 
filler. We offer products for the treatment of skin wounds ranging from burns to diabetic ulcers. The products cover a variety 
of  wound  treatment  solutions  including  debridement  agents,  advanced  therapies,  and  scaffolds  used  as  skin  substitutes. 
Leading  products  include  HYALOMATRIX  and  HYALOFILL  for  the  treatment  of  complex  wounds,  such  as  burns  and 
ulcers, and for use in connection with the regeneration of skin. Our dermal products are commercialized through a network 
of distributors, primarily in the United States, Europe, Latin America, and the Middle East. Products cleared for sale in the 
United States  include  HYALOMATRIX,  HYALOFILL, HYALOGRAN, HYALOSAFE,  and HYALOMATRIX 3D. We 
have a commercial partnership agreement with Medline Industries, Inc. to commercialize HYALOMATRIX in the United 
States on an exclusive basis through 2022. 

Our aesthetic dermatology product is a dermal filler based on our proprietary, chemically modified, cross-linked 
HA, and it is primarily commercialized in certain countries in the Middle East. Internationally, this product is marketed under 
the ELEVESS trade name. In the United States, the trade name is HYDRELLE, although the product is not currently marketed 
in the United States. 

Surgical  

Our surgical group consists of products used to prevent surgical adhesions and to treat ENT disorders. For the year 
ended  December 31,  2018,  sales  of  surgical  products  contributed  5%  of  our  product  revenue.  Included  in  our  surgical 
franchise is HYALOBARRIER, a clinically proven post-operative adhesion barrier for use in the abdomino-pelvic area. The 
product  is  currently  commercialized  in  Europe,  the  Middle  East,  and  certain  African  and  Asian  countries  through  a 
distribution network, but it is not approved in the United States. 

We  also  offer  several  products  used  in  connection  with  the  treatment  of  ENT  disorders. The  lead  products  are 
MEROGEL, a woven fleece nasal packing, and MEROGEL INJECTABLE, a thick, viscous hydrogel composed of cross-
linked  HA,  a  biocompatible  agent  that  creates  a  moist  wound-healing  environment. We  partner  with  Medtronic  for  the 
worldwide distribution of these products. 

31 

   
  
  
  
  
  
  
  
  
 
 
Other 

Our other products include our ophthalmic and veterinary products, which constituted 6% of our product revenue 
for the year ended December 31, 2018. These legacy products are not a part of our core business. Our ophthalmic business 
includes HA viscoelastic products used in ophthalmic surgery. Sales of ophthalmic products contributed 2% of our product 
revenue and sales of HYVISC, our veterinary product used for the treatment of equine osteoarthritis, contributed 4% of our 
product revenue for the year ended December 31, 2018. 

Research and Development 

  Our research and development efforts primarily consist of the development of new medical applications for our 
HA-based technology, the management of clinical trials for certain product candidates, the preparation and processing of 
applications for regulatory approvals or clearances at all relevant stages of product development, and process development 
and  scale-up  manufacturing  activities  for  our  existing  and  new  products.  Our  development  focus  is  orthopedic  and 
regenerative  medicine  and  includes  products  for  tissue  protection,  repair,  and  regeneration.  We  anticipate  that  we  will 
continue to commit significant resources in the near future to research and development activities, including in relation to 
preclinical  activities  and  clinical  trials.  These  activities  are  aimed  at  the  delivery  of  a  steady  cascade  of  new  product 
development and launches over the next several years. 

Our research and development efforts primarily consist of the development of new medical applications for our HA-
based  technology,  the  management  of  clinical  trials  for  certain  product  candidates,  the  preparation  and  processing  of 
applications for regulatory approvals or clearances at all relevant stages of product development, and process development 
and  scale-up  manufacturing  activities  for  our  existing  and  new  products.  Our  development  focus  is  orthopedic  and 
regenerative  medicines  and  includes  products  for  tissue  protection,  repair,  and  regeneration.  For  the  years  ended 
December 31, 2018, 2017 and 2016, these expenses were $18.2 million, $18.8 million, and $10.7 million, respectively. We 
anticipate that we will continue to commit significant resources to, and increase our aggregate spending on, research and 
development activities, including in relation to preclinical activities and clinical trials, in the future. 

Our  third  generation,  single-injection  osteoarthritis  product  under  development  in  the  United  States,  CINGAL, 
which is composed of our proprietary cross-linked HA material combined with an approved steroid and is designed to provide 
both short- and long-term pain relief to patients, is our lead pipeline product and a critical component of our growth strategy. 
We completed an initial CINGAL Phase III clinical trial, including the associated statistical analysis for 368 enrolled patients, 
during the fourth quarter of 2014 with data indicating that the product met all primary and secondary endpoints relative to 
placebo set forth for the trial. During the first half of 2015, we completed a CINGAL retreatment study with 242 patients who 
had participated in the Phase III clinical trial and reported safety data related to the retreatment study. This initial Phase III 
clinical trial and the associated retreatment study supported the Health Canada and CE Mark approval of the product, and the 
commercial launch of the product in both Canada and the European Union occurred in the second quarter of 2016. In the 
United States, after discussions with the FDA related to the regulatory pathway for CINGAL, we conducted a formal meeting 
with the FDA’s OCP to present and discuss our data in September 2015, and we submitted a formal request for designation 
with OCP a month later. In its response to our formal request for designation, OCP assigned the product to the FDA’s CDER 
as  the  lead  agency  center  for  premarket  review  and  regulation.  We  then  held  discussions  with  CDER  to  understand  the 
requirements for submitting an NDA for CINGAL. We held a meeting with CDER in September 2016 to align on an approval 
framework and on submission requirements for this NDA for CINGAL, including the execution of an additional Phase III 
clinical trial to supplement our existing CINGAL pivotal study data. We submitted an IND in late 2016, and discussions with 
CDER indicated that they did not have objections to our clinical protocol design. As a result, we commenced work on this 
second Phase III clinical trial (“CINGAL 16-02 Study”) in the first quarter of 2017, and the first patient was treated in the 
second quarter of 2017. Enrollment of the 576 patients in this second Phase III clinical trial was completed during October 
2017, and we completed the six-month patient follow-up in April 2018. We received and analyzed the data from the CINGAL 
16-02 Study during the second quarter of 2018, and, while substantial pain reduction associated with CINGAL was evident 
at each measurement point, we determined based on statistical analysis that it did not meet the primary study endpoint of 
demonstrating a statistically significant difference in pain reduction between CINGAL and the approved steroid component 
of CINGAL at the six-month time point. In the third quarter of 2017, we initiated an additional three-month extended follow-
up study in conjunction with the CINGAL 16-02 Study to investigate the efficacy of CINGAL over this longer period. The 
first patients were enrolled in this follow-up study in the fourth quarter of 2017 and we completed the nine-month patient 
follow-up in the third quarter of 2018. Given the totality of the results from our studies related to CINGAL, we have evaluated 
multiple strategies to optimize the potential U.S. regulatory pathway for the product. We recently met with FDA to discuss 
this potential approval pathway for CINGAL in the United States moving forward. In the meeting, FDA indicated that an 
additional Phase III clinical trial would be necessary to support U.S. marketing approval for CINGAL, and we are continuing 
to align with FDA on the parameters and requirements for this additional clinical trial, which we expect to commence once 
alignment is achieved. 

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We have several research and development programs underway for new products, including for HYALOFAST (in 
the United States), an innovative product for cartilage tissue repair, and other early stage regenerative medicine development 
programs. HYALOFAST, which received CE Mark approval in September 2009, is commercially available in Europe and 
certain international countries. During the first quarter of 2015, we submitted an Investigational Device Exemption (“IDE”) 
for HYALOFAST to the FDA, which was approved in July 2015. We commenced patient enrollment in a clinical trial in 
December  2015,  and  we  are  advancing  site  initiations  and  patient  enrollment  activities.  In  the  second  quarter  of  2016,  a 
supplement to the HYALOFAST IDE was approved to expand the inclusion criteria for the clinical study, which was aimed 
at decreasing the time needed to complete the clinical trial. The previously-described voluntary recall of certain production 
lots of our HYAFF-based products did not impact the HYALOFAST clinical trial, as the product used in the clinical trial is 
not sourced from the affected production lots. Given the changing medical landscape with respect to the randomization arm 
for this trial, the microfracture procedure, we are actively pursuing alternative strategies to accelerate patient enrollment. 

In the third quarter of 2017, we submitted an application to the FDA for 510(k) clearance of an injectable, HA-based 
surgical bone repair product that is reabsorbed by the body and replaced by the growth of new bone during the healing process. 
The  510(k)  clearance  was  received  from  the  FDA  in  December  2017,  and  we  expect  to  make  this  bone  repair  product 
commercially available in the United States during 2019 utilizing the previously-described hybrid commercial approach. In 
addition to other early stage research and development initiatives we are currently undertaking, we are working to expand 
our regenerative medicine pipeline with a new product candidate in the form of an implant for rotator cuff repair utilizing our 
proprietary solid HA, which could be used to repair partial and full-thickness rotator cuff tears. We finalized development of 
an initial product prototype during the fourth quarter of 2018, and we are performing important preclinical testing of and 
developing the surgical instrumentation for the potential product. 

We  are  also  currently  proceeding  with  other  research  and  development  programs,  one  of  which  utilizes  our 
proprietary HA technology to treat pain associated with common repetitive overuse injuries, such as lateral epicondylitis, also 
known as tennis elbow. We submitted a CE Mark application for this treatment during the first quarter of 2016 and received 
a CE Mark for the treatment of pain associated with tennis elbow in December 2016. We began work towards a post-market 
clinical study in relation to the CE Mark for this product in the fourth quarter of 2018. Outside of the United States, this 
product is marketed under the trade name ORTHOVISC-T. Additionally, in the second quarter of 2016, we submitted an IDE 
to the FDA to conduct a Phase III clinical trial for this treatment, which was approved by the FDA in June 2016. We also 
have  several  other  research  and  development  programs  underway  focused  on  expanding  the  indications  of  our  current 
products, including MONOVISC. Notwithstanding those internal programs, the previously-disclosed program conducted and 
funded by Mitek seeking to expand MONOVISC’s indication to include treatment of pain associated with osteoarthritis of 
the hip was cancelled in the fourth quarter of 2018 after the performance of an independent interim analysis required by the 
related clinical protocol. During 2019, we will also be performing post-market clinical work in relation to the CE Mark for 
MONOVISC. 

In  June  2015,  we  entered  into  an  agreement  with  the  Institute  for  Applied  Life  Sciences  at  the  University  of 
Massachusetts Amherst to collaborate on research to develop a therapy for rheumatoid arthritis. The purpose of this research 
was to develop a novel modality for the treatment of rheumatoid arthritis. The agreement with the University of Massachusetts 
Amherst  was  extended  in  January  2018,  and  it  was  terminated  in  October  2018  after  discussions  between  the  parties.  In 
January 2018, we entered into an agreement with the University of Liverpool to develop an injectable mesenchymal stem cell 
therapy for the treatment of age-related osteoarthritis with the goal of bringing a therapeutics candidate through clinical trials 
to market to meet an unmet therapeutic need. We are currently in the preclinical phase of this program and aim to finalize 
proof of concept during the second quarter of 2020. 

33 

  
  
  
  
 
 
Summary of Critical Accounting Policies; Significant Judgments and Estimates 

Our discussion and analysis of our financial condition and results of operations are based upon our consolidated 
financial statements included elsewhere in this Annual Report on Form 10-K, which consolidated financial statements have 
been prepared in accordance with accounting principles generally accepted in the United States. The preparation of these 
consolidated financial statements requires us to make estimates and judgments that affect the reported amounts of assets, 
liabilities, revenues and expenses, and the related disclosure of contingent assets and liabilities. We monitor our estimates on 
an ongoing basis for changes in facts and circumstances, and material changes in these estimates could occur in the future. 
Changes in estimates are recorded in the period in which they become known. We base our estimates on historical experience 
and other assumptions that we believe to be reasonable under the circumstances. Actual results may differ from our estimates 
if past experience or other assumptions do not turn out to be substantially accurate. 

We have identified the policies below as critical to our business operations and the understanding of our results of 
operations. The impact and any associated risks related to these policies on our business operations are discussed throughout 
this section captioned “Management’s Discussion and Analysis of Financial Condition and Results of Operations” where 
such policies affect our reported and expected financial results. For a detailed discussion on the application of these and other 
accounting policies, see Note 2 to the consolidated financial statements included elsewhere in this Annual Report on Form 
10-K. 

Revenue Recognition - General 

We adopted the guidance in the ASC 606 using the modified retrospective method effective January 1, 2018. The 
adoption of ASC 606 was applied to all contracts not completed as of the date of adoption. The adoption did not have a 
material  impact  on  the  amount  and  timing  of  revenue  recognized  in  the  consolidated  financial  statements.  We  made  no 
adjustments to our previously reported product and total revenue, as those periods continue to be presented in accordance 
with our historical accounting practices under Topic 605, Revenue Recognition. 

Pursuant to ASC 606, we recognize revenue when a customer obtains control of promised goods or services. The 
amount of revenue that is recorded reflects the consideration that we expect to receive in exchange for those goods or services. 
We apply the following five-step model in order to determine this amount: (i) identification of the promised goods or services 
in the contract; (ii) determination of whether the promised goods or services are performance obligations, including whether 
they are capable of being distinct or distinct in the context of the contract; (iii) measurement of the transaction price, including 
the  constraint  on  variable  consideration;  (iv)  allocation  of  the  transaction  price  to  the  performance  obligations;  and  (v) 
recognition of revenue when (or as) we satisfy each performance obligation. 

We have agreements with Mitek that include the grant of certain licenses, performance of development services, and 
the supply of product at Mitek’s option. Revenues from the agreements with Mitek represent 73% of total revenues for the 
year-ended  December  31,  2018.  We  completed  the  performance  obligations  related  to  granted  licenses  and  development 
services  under  these  agreements prior  to  2016. We have no  remaining material  performance  obligations under  the Mitek 
agreements. 

We have agreements with other customers that may include the delivery of a license and supply of product. The 

upfront payments under such agreements upon the delivery of the license have not been material. 

Our typical supply agreements represent a promise to deliver product at the customer’s discretion that are considered 
options.  We  assess  if  these  options  provide  a  material  right  to  the  licensee  and  if  so,  they  are  accounted  for  as  separate 
performance obligations.  The majority of our supply agreements do not provide options that are considered material rights. 

Certain  of  our  agreements  include  sales-based  royalties  and  milestones.  As  we  consider  the  license  to  be  the 
predominant item to which the royalties relate for these agreements, sales-based royalties and milestones are only recognized 
when the later of the underlying sale occurs or the performance obligation to which some or all of the sales-based royalty has 
been satisfied (or partially satisfied). This is generally in the same period that our licensees complete their product sales in 
their territory, for which we are contractually entitled to a percentage-based royalty. Revenue from sales-based royalties is 
included in product revenues. 

Product Revenue 

We sell our products principally to a number of distributors (i.e., our customers) under legally-enforceable, executed 
contracts. Our distributors subsequently resell the products to sub-distributors and health care providers, among others. We 
recognize  revenue  from  product  sales  when  the  distributor  obtains  control  of  our  product,  which  typically  occurs  upon 

34 

  
  
  
  
  
  
  
  
  
  
  
shipment to the distributor, in return for agreed-upon, fixed-price consideration. Performance obligations are generally settled 
quickly after purchase order acceptance; therefore, the value of unsatisfied performance obligations at the end of any reporting 
period is generally immaterial. 

Our payment terms are consistent with prevailing practice in the respective markets in which we do business. Most 
of our distributors make payments based on fixed-price contract terms, which are not affected by contingent events that could 
impact the transaction price. Payment terms fall within the one-year guidance for the practical expedient, which allows us to 
forgo adjustment of the contractual payment amount of consideration for the effects of a significant financing component. 
Our contracts with customers do not customarily provide a right of return, unless certain product quality standards are not 
met. 

Some of our distributor agreements have volume based discounts with tiered pricing which are generally prospective 
in  nature.  These  prospective  discounts  together  with  any  free-of-charge  sample  units  offered  are  evaluated  as  potential 
material rights. If the prospective discounts or free-of-charge sample units are considered material rights, these would be 
separate  performance  obligations  and  a  portion  of  the  sales  transaction  price  is  allocated  to  the  material  right.  Revenue 
allocated to the material right is recognized when the additional goods are transferred to the customer or when the option 
expires. During 2018, the consideration allocated to material rights was not significant. 

We receive payments from our customers based on billing schedules established in each contract. Up-front payments 
and fees are recorded as deferred revenue upon receipt or when due, and may require deferral of revenue recognition to a 
future period until we perform our obligations under these arrangements. Amounts are recorded as accounts receivable when 
our right to consideration is unconditional. 

Generally, distributor contracts contain Free on Board (FOB) or Ex-Works (EXW) shipping point terms where the 
customer pays the shipping company directly for all shipping and handling costs. In those contracts in which we pay for the 
shipping and handling, the associated costs are generally recorded along with the product sale at the time of shipment in cost 
of product revenue when control over the products has transferred to the customer. We do not collect sales tax on product 
sales as it is not applicable. Value-add and other taxes collected by us concurrently with revenue-producing activities are 
excluded  from  revenue.  Our  general  product  warranty  does  not  extend  beyond  an  assurance  that  the  product  or  services 
delivered will be consistent with stated contractual specifications, which does not create a separate performance obligation. 
We recognize the incremental costs of obtaining contracts as an expense when incurred as the amortization period of the 
assets that we otherwise would have recognized is one year or less in accordance with the practical expedient in paragraph 
ASC 340-40-25-4. These costs are included in selling, general & administrative expenses. 

Included as a component of product revenue is sales-based royalty revenue, which represents the utilization of our 
intellectual property licensed by our commercial partners. We record royalty revenues based on estimated net sales of licensed 
products as reported to us by our commercial partners. Differences between actual and estimated royalty revenues have not 
been material and are typically adjusted in the following quarter when the actual amounts are known. 

Licensing, Milestone and Contract Revenue 

The  agreements  with  Mitek  include  variable  consideration  such  as  contingent  development  and  regulatory 
milestones.  As  of  the  date  of  adoption  of  ASC  606,  there  is  one  remaining  regulatory  milestone  related  to  the  Mitek 
agreements and we have no performance obligation related to this milestone. In general, variable consideration is included in 
the transaction price only to the extent a significant reversal in the amount of cumulative revenue recognized is not probable 
to  occur.  Future  payments  for  regulatory  milestones  will  be  recognized  as  revenue  when  the  regulatory  milestone  is 
considered probable of being achieved. 

Inventories 

Inventories are stated at the lower of standard cost and net realizable value, with approximate cost determined using 
the first-in, first-out method. Work-in-process and finished goods inventories include materials, labor, and manufacturing 
overhead. Inventory costs associated with product candidates that have not yet received regulatory approval are capitalized 
if we believe there is probable future commercial use and future economic benefit. 

Our policy is to write-down inventory when conditions exist that suggest inventory may be in excess of anticipated 
demand or is obsolete based upon assumptions about future demand for our products and market conditions. We regularly 
evaluate our ability to realize the value of inventory based on a combination of factors including, but not limited to, historical 
usage rates, forecasted sales or usage, product end of life dates, and estimated current or future market values. Purchasing 
requirements and alternative usage avenues are explored within these processes to mitigate inventory exposure.  

35 

  
  
   
  
  
  
  
  
  
  
Goodwill and Acquired In-Process Research and Development 

Goodwill is the amount by which the purchase price of acquired net assets in a business combination exceeded the 
fair values of net identifiable assets on the date of acquisition. Acquired In-Process Research and Development (“IPR&D”) 
represents the fair value assigned to research and development assets that we acquire that have not been completed at the date 
of  acquisition  or  are  pending  regulatory  approval  in  certain  jurisdictions.  The  value  assigned  to  the  acquired  IPR&D  is 
determined by estimating the costs to develop the acquired technology into commercially viable products, estimating the 
resulting revenue from the projects, and discounting the net cash flows to present value.  

Goodwill  and  IPR&D  are  evaluated  for  impairment  annually,  or  more  frequently  if  events  or  changes  in 
circumstances indicate that the asset might be impaired. Factors we consider important, on an overall company basis, that 
could trigger an impairment review include significant underperformance relative to historical or projected future operating 
results,  significant  changes  in  our  use  of  the  acquired  assets or  the  strategy  for our overall  business,  significant negative 
industry  or  economic  trends,  a  significant  decline  in our stock price for  a  sustained  period, or  a reduction of  our market 
capitalization relative to net book value. 

To conduct impairment tests of goodwill, the fair value of the reporting unit is compared to its carrying value. If the 
reporting unit’s carrying value exceeds its fair value, we record an impairment loss to the extent that the carrying value of 
goodwill exceeds its implied fair value. Our annual assessment for impairment of goodwill as of November 30, 2018 indicated 
that the fair value of our reporting unit exceeded the carrying value of the reporting unit. 

To conduct impairment tests of IPR&D, the fair value of the IPR&D project is compared to its carrying value. If the 
carrying value exceeds its fair value, we record an impairment loss to the extent that the carrying value of the IPR&D project 
exceeds its fair value. We estimate the fair value for IPR&D projects using discounted cash flow valuation models, which 
require the use of significant estimates and assumptions, including, but not limited to, estimating the timing of and expected 
costs to complete the in-process projects, projecting regulatory approvals, estimating future cash flows from product sales 
resulting from completed projects and in-process projects, and developing appropriate discount rates. Our annual assessment 
for impairment of IPR&D indicated that the fair value of our other IPR&D assets as of November 30, 2018 exceeded their 
respective  carrying values. See also  the  section  captioned  “Risk  Factors—Risks  Related  to  Risks  Related  to  Our  Product 
Development and Regulatory Compliance — Failure to obtain, or any delay in obtaining, FDA or other U.S. and foreign 
governmental approvals for our products may have a material adverse effect on our business, financial condition and results 
of operations” for a discussion regarding the effect that failure to obtain, or any delay in obtaining, FDA or other U.S. and 
foreign governmental approvals could have on our business and financial performance. 

Through  December  31,  2018,  there  have  not  been  any  events  or  changes  in  circumstances  that  indicate  that  the 
carrying value of goodwill or acquired intangible assets may not be recoverable. We continue to monitor and evaluate the 
financial performance of our business, including the impact of general economic conditions, to assess the potential for the 
fair value of the reporting unit to decline below its book value. There can be no assurance that, at the time future impairment 
tests are completed, a material impairment charge will not be recorded. 

Long-Lived Assets 

Long-lived assets primarily include property and equipment and intangible assets with finite lives. Our intangible 
assets are comprised of purchased developed technologies, distributor relationships, patents, and a fully amortized trade name. 
The  distributor  relationships  and  trade  name  were  fully  amortized  as  of  December  31,  2018.  These  intangible  assets  are 
carried at cost, net of accumulated amortization. Amortization is recorded on a straight-line basis over the intangible assets' 
useful lives, which range from 5 to 16 years. We review long-lived assets for impairment when events or changes in business 
circumstances indicate that the carrying amount of the assets may not be fully recoverable or that the useful lives of those 
assets are no longer appropriate. Each impairment test is based on a comparison of the undiscounted cash flows to the recorded 
value of the asset. If impairment is indicated, the asset is written down to its estimated fair value based on a discounted cash 
flow analysis. 

36 

  
  
  
  
  
  
  
  
  
 
 
Stock-Based Compensation 

We  measure  the  compensation  cost  of  award  recipients’  services  received  in  exchange  for  an  award  of  equity 
instruments based on the grant-date fair value of the underlying award. That cost is recognized over the period during which 
an  employee  is  required  to  provide  service  in  exchange  for  the  award.  For  performance-based  awards  with  financial 
achievement targets, we recognize expense using the graded vesting methodology based on the number of shares expected to 
vest.  Compensation  cost  associated  with  performance  grants  is  estimated  using  the  Black-Scholes  valuation  method 
multiplied by the expected number of shares to be issued, which is adjusted based on the estimated probabilities of achieving 
the  performance  goals.  Changes  to  the  probability  assessment  and  the  estimated  shares  expected  to  vest  will  result  in 
adjustments  to  the  related  share-based  compensation  expense  that  will  be  recorded  in  the  period  of  the  change.  If  the 
performance targets are not achieved, no compensation cost is recognized and any previously recognized compensation cost 
is reversed. See Note 13, Equity Incentive Plan, to the consolidated financial statements included elsewhere in this Annual 
Report on Form 10-K for a description of the types of stock-based awards granted, the compensation expense related to such 
awards, and detail of equity-based awards outstanding. See Note 16, Income Taxes, to the consolidated financial statements 
included elsewhere in this Annual Report on Form 10-K for details related to the tax benefit recognized in the consolidated 
statement of operations for stock-based compensation. 

Income Taxes 

Our income tax expense includes U.S. and international income taxes. Certain items of income and expense are not 
reported in tax returns and financial statements in the same year. The tax effects of these differences are reported as deferred 
tax  assets  and  liabilities.  Deferred  tax  assets  are  recognized  for  the  estimated  future  tax  effects  of  deductible  temporary 
differences and tax operating loss and credit carry-forwards. Changes in deferred tax assets and liabilities are recorded in the 
provision for income taxes. We assess the likelihood that our deferred tax assets will be recovered from future taxable income, 
and to the extent we believe that it is more likely than not that all or a portion of deferred tax assets will not be realized, we 
establish a valuation allowance. To the extent we establish a valuation allowance or increase this allowance in a period, we 
include an expense within the tax provision in the consolidated statement of operations. 

37 

  
  
  
   
  
  
  
 
 
Results of Operations 

Year ended December 31, 2018 compared to year ended December 31, 2017 

Statement of Operations Detail 

Years Ended December 31, 

2017 
2018 
(in thousands, except percentages) 

   $ Inc/(Dec)     % Inc/(Dec) 

Product revenue ..................................................................   $  105,531     $  107,783     $ 
Licensing, milestone and contract revenue .........................     
5,637       
113,420       
Total revenue ..................................................................     

24       
105,555       

(2,252)     
(5,613)     
(7,865)     

(2%) 
(100%) 
(7%) 

Operating expenses: 

Cost of product revenue .................................................     
Research & development ................................................     
Selling, general & administrative ...................................     
Total operating expenses ....................................................     
Income from operations ......................................................     
Interest income, net ........................................................     
Income before income taxes ...............................................     
Provision for income taxes .............................................     
Net income .........................................................................   $ 
Product gross profit ................................................................   $ 
Product gross margin ..............................................................     

31,280       
18,190       
34,336       
83,806       
21,749       
1,458       
23,207       
4,485       
18,722     $ 
74,251     $ 
70%     

27,364       
18,787       
21,540       
67,691       
45,729       
473       
46,202       
14,386       
31,816     $ 
80,419     $ 
75%     

3,916      
(597)     
12,796      
16,115      
(23,980)     
985      
(22,995)     
(9,901)     
(13,094)     
(6,168)     

14% 
(3%) 
59% 
24% 
(52%) 
208% 
(50%) 
(69%) 
(41%) 
(8%) 

Total revenue  

Total revenue for the year ended December 31, 2018 decreased by $7.9 million, as compared to the prior year, to 
$105.6 million. This decrease was primarily due to the achievement of a one-time $5.0 million milestone in 2017 for reaching 
a target MONOVISC U.S. end-user sales threshold set forth in the Mitek MONOVISC Agreement and the absence of an 
equivalent milestone payment in 2018, as well as the impact of pricing declines in the U.S. viscosupplement market and the 
previously-described voluntary recall of certain production lots of certain of our HYAFF-based products. 

Product revenue  

Product revenue for the year ended December 31, 2018 was $105.6 million, a decrease of $2.3 million, or 2.0%, 
compared to prior year. A moderate decrease in our dermal and orthobiologics product revenue was partially offset by a 
product revenue  increase  in our surgical  and other  franchises. The following  table presents  comparative  product  revenue 
analysis by product franchise: 

2018 

Years Ended December 31, 
2017 

   $ Inc/(Dec) 

   % Inc/(Dec) 

Orthobiologics .................................     $ 
Dermal ............................................       
Surgical ...........................................       
Other ...............................................       
   $ 

93,556     $ 
396       
5,514       
6,065       
105,531     $ 

93,816     $ 
2,755       
5,262       
5,950       
107,783     $ 

(260)      
(2,359)      
252       
115       
(2,252)      

(0%) 
(86%) 
5% 
2% 
(2%) 

Orthobiologics 

Our  orthobiologics  franchise  consists  of  our  joint  health  and  orthopedic  products.  Overall,  revenue  from  our 
orthobiologics franchises decreased by $0.3 million in 2018 as compared to 2017 primarily as a result of the voluntary recall 
of certain production lots of our HYAFF-based products and a decline in worldwide ORTHOVISC revenue offset in part by 
strong growth in domestic MONOVISC and international CINGAL revenue. In addition, sales volume gains for our U.S. 
viscosupplements were offset by pricing declines in the U.S. viscosupplement market, a trend we expect to continue in 2019. 
Overall,  we  expect  orthobiologics  product  revenue  in  2019  to  decrease  as  compared  to  2018,  primarily  due  to  the 
ORTHOVISC  and  MONOVISC  pricing  declines  in  the  U.S.  viscosupplement  market,  offset  in  part  by  growth  in  global 

38 

  
  
  
  
  
  
    
    
  
  
  
  
  
  
  
  
  
  
    
        
        
       
   
    
        
        
       
   
       
   
  
  
  
  
  
  
  
  
  
  
  
     
     
     
     
  
  
  
CINGAL revenue and the commercial launch of our injectable, HA-based surgical bone repair product via the previously-
described hybrid commercial approach. 

Dermal 

Our dermal franchise consists of advanced wound care products, which are based on our HYAFF technology, and 
aesthetic dermal fillers. Our advanced wound care products treat complex skin wounds ranging from burns to diabetic ulcers, 
with HYALOMATRIX and HYALOFILL as the lead products. Dermal revenue had a significant decline in 2018 as compared 
to  2017  due  to  the  previously-described  voluntary  recall  of  certain  production  lots  of  our  HYAFF-based  products.  We 
resolved the matter and resumed shipment of these products in November 2018, and we expect dermal revenue to increase in 
2019 to pre-recall levels as compared to 2018. 

Surgical 

Our surgical franchise consists primarily of our anti-adhesion products, HYALOBARRIER and our ENT offerings, 
of which MEROGEL is the leading product. We are partnered with Medtronic for the worldwide distribution of our ENT 
products. Revenue from our surgical products increased $0.3 million, or 5%, in 2018 as compared to 2017. The increase of 
surgical product revenue was primarily due to an increase in sales of our ENT products. We expect surgical product revenue 
to increase in 2019 as compared to 2018 primarily due to increased worldwide revenue of surgical anti-adhesion product and 
ENT sales in the U.S. 

Other 

Other product revenue was derived from sales of our ophthalmic and veterinary products. Other product revenue 
increased modestly in 2018 as compared to 2017 primarily as a result of increased sales of ophthalmic products. We expect 
other revenue to increase in 2019 as compared to 2018, driven by increases in demand for our ophthalmic and veterinary 
products. 

Licensing, milestone and contract revenue 

Licensing, milestone and contract revenue for the year ended December 31, 2018 was insignificant, compared to 
$5.6 million for 2017. This decrease was primarily due to the achievement of a one-time $5.0 million milestone in 2017 for 
reaching a target MONOVISC U.S. end-user sales threshold set forth in the Mitek MONOVISC Agreement and the absence 
of an equivalent milestone payment in 2018. We expect licensing, milestone and contract revenue to be at an equivalent level 
in 2019 as compared to 2018. 

Product gross profit and margin 

Product  gross  profit  for  the  year  ended  December 31,  2018  was  $74.3  million,  or  70%  of  product  revenue,  as 
compared with $80.4 million, or 75% of product revenue, for the year ended December 31, 2017. The decrease in product 
gross margin for the twelve-month period ended December 31, 2018 was primarily caused by an increase in inventory reserves 
related to certain raw materials, inventory write-offs and charges associated with the previously described voluntary recall of 
certain production lots of our HYAFF-based products, higher production costs, and revenue mix and pricing dynamics. 

Research and development  

Research and development expenses for the year ended December 31, 2018 decreased by $0.6 million, or 3%, as 
compared to the prior year, mainly due to a decrease in expenses for our HYALOFAST and CINGAL phase III clinical trials, 
partially offset by increases in our product development activities, including those related to the development of a product 
for rotator cuff therapy and pre-commercial development of our injectable, HA-based surgical bone repair product. Research 
and development expense as a percentage of total revenue was 17% in 2018 and 2017. Research and development expenses 
are expected to increase in 2019 and beyond compared to 2018 as we further develop new products and initiate clinical trials 
based  on  our  development  activities,  perform  required  post-market  clinical  follow-ups  for  our  MONOVISC  and 
ORTHOVISC-T products in the European Union, and as a result of current or future changes to the regulatory environments 
in the jurisdictions in which we do business. 

39 

   
  
  
  
  
  
  
  
  
  
  
  
   
 
 
Selling, general and administrative 

Selling, general and administrative expenses for the year ended December 31, 2018 increased by $12.8 million, or 
59%, as compared to 2017. The increase was primarily due to non-cash stock-based compensation expense related to the 
retirement of our former Chief Executive Officer, non-recurring CINGAL U.S. pre-launch market research activities, and 
increased  personnel  and  external  professional  fees.  We  expect  selling,  general  and  administrative  expenses  for  2019  to 
approximate  those  for 2018  and  include  investments  in  our  commercial  capabilities  and  the  implementation  of  improved 
operational and financial technology platforms required to grow our business both domestically and internationally. 

Income taxes 

Provisions for income taxes were $4.5 million and $14.4 million for the years ended December 31, 2018 and 2017, 
respectively. The decrease in the effective tax rate in 2018 of 11.8%, as compared to 2017, is primarily due to the reduction 
of Federal Corporate Income Tax rate as a result of the Tax Cuts and Jobs Act of 2017 (“Tax Act”) tax reform legislation. 
This legislation makes significant changes to the U.S. tax law, including a reduction in the corporate tax rate from 35% to 
21% starting in 2018. In addition, the Company realized a windfall tax benefit in 2018 related to exercises of employee equity 
awards resulting in a discrete period income tax benefit of $1.5 million compared to $0.4 million in 2017. 

A reconciliation of the U.S. federal statutory tax rate to the effective tax rate for the periods ending December 31 is 

as follows: 

Years ended December 31, 

Statutory federal income tax rate ..................................................   
State tax expense, net of federal benefit .......................................   
Impact of rate change on deferred taxes .......................................   
State investment tax credit ............................................................   
Federal, state and foreign research and development credits .......   
Foreign rate differential ................................................................   
Domestic production deduction ....................................................   
Stock compensation ......................................................................   
Non-deductible Section 162(m) compensation limitation ............   
Foreign derived intangible income deduction ..............................   
Other, including nondeductible expenses .....................................   
Effective income tax rate ..............................................................   

2018 
21.0% 
5.5% 
0.0% 
(0.2)% 
(3.4)% 
(0.4)% 
0.0% 
(4.8)% 
4.3% 
(1.3)% 
(1.4)% 
19.3% 

2017 
35.0% 
4.8% 
(4.9)% 
(0.7)% 
(1.4)% 
0.5% 
(2.8)% 
(0.2)% 
0.7% 
0.0% 
0.1% 
31.1% 

As  of December  31, 2018, we  had gross net  operating  losses  (“NOL”)  for  income  tax  purposes  in  Italy  of  $5.8 
million with no expiration date. In connection with the preparation of the financial statements, we performed an analysis to 
ascertain if it was more likely than not that we would be able to utilize, in future periods, the net deferred tax assets associated 
with our NOL carry-forward. We have concluded that the positive evidence outweighs the negative evidence and, thus, that 
the deferred tax assets are realizable on a “more likely than not” basis. As such, we have not recorded a valuation allowance 
at December 31, 2018 or 2017. 

In  the  normal  course  of  business,  Anika  and  its  subsidiaries  may  be  periodically  examined  by  various  taxing 
authorities. We file income tax returns in the U.S. federal jurisdiction, in certain U.S. states, and in Italy. The associated tax 
filings remain subject to examination by applicable tax authorities for a certain length of time following the tax year to which 
those filings relate. The 2015 through 2017 tax years remain subject to examination by the IRS and other taxing authorities 
for U.S. federal and state tax purposes. The 2012 through 2017 tax years remain subject to examination by the appropriate 
governmental authorities for Italy. 

Net income  

For the year ended December 31, 2018, net income was $18.7 million, or $1.27 per diluted share, compared to $31.8 
million, or $2.11 per diluted share, for the same period in the prior year. The decrease in net income and diluted earnings per 
share  was  primarily  a  result  of  decreased  total  revenue,  decreased  product  gross  margin,  the  impact  of  the  previously-
described  voluntary  recall  of  certain  production  lots  of  certain  of  our  HYAFF-based  products,  and  one-time  expenses 
associated with the retirement of our former CEO and CINGAL U.S. pre-launch market research activities. The decreased 
revenue and increased expenses are offset by a decreased effective federal income tax rate as a result of the 2017 Income Tax 
Reform Legislation. 

40 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
  
Year ended December 31, 2017 compared to year ended December 31, 2016 

Statement of Operations Detail 

Product revenue ................................................................   $
Licensing, milestone and contract revenue .......................     
Total revenue ................................................................      

107,783     $
5,637       
113,420       

102,932     $ 
447       
103,379       

4,851      
5,190      
10,041      

5% 
1,161% 
10% 

Years Ended December 31, 

2017 

2016 

   $ Inc/(Dec)     %Inc/(Dec) 

(in thousands, except percentages) 

Operating expenses: 

Cost of product revenue ...............................................      
Research & development ..............................................      
Selling, general & administrative .................................      
Total operating expenses ..................................................     
Income from operations ....................................................     
Interest income, net ......................................................      
Income before income taxes .............................................     
Provision for income taxes ...........................................      
Net income .......................................................................   $
Product gross profit ..............................................................   $
Product gross margin ............................................................     

Total revenue  

27,364       
18,787       
21,540       
67,691       
45,729       
473       
46,202       
14,386       
31,816     $
80,419     $
75%    

24,027       
10,732       
18,013       
52,772       
50,607       
263       
50,870       
18,323       
32,547     $ 
78,905     $ 
77%     

3,337      
8,055      
3,527      
14,919      
(4,878)     
210      
(4,668)     
(3,937)     
(731)     
1,514      

14% 
75% 
20% 
28% 
(10%) 
80% 
(9%) 
(21%) 
(2%) 
2% 

Total revenue for the year ended December 31, 2017 increased by $10.0 million, as compared to the prior year, to 
$113.4 million. This increase was primarily due to the growth of our orthobiologics franchise, specifically an increase in 
global  MONOVISC  revenue  and  our  achievement  of  $5.0  million  of  milestone  revenue  in  2017  for  reaching  a  target 
MONOVISC U.S. end-user sales threshold set forth in the Mitek MONOVISC Agreement. 

Product revenue  

Product revenue for the year ended December 31, 2017 was $107.8 million, an increase of $4.9 million, or 5.0%, 
compared to the prior year. Product revenue increases in our Orthobiologics, Dermal, and Other franchises were partially 
offset by moderate decreases in product revenue in our Surgical franchise. The following table presents comparative product 
revenue analysis by product franchise: 

Years Ended December 31, 

2017 

2016 

   $ Inc/(Dec)     % Inc/(Dec) 

Orthobiologics ................    $ 
Dermal ............................      
Surgical ..........................      
Other ..............................      
   $ 

Orthobiologics 

93,816     $ 
2,755       
5,262       
5,950       
107,783     $ 

(in thousands, except percentages) 
4,121       
(4)      
(165)      
899       
4,851       

89,695     $ 
2,759       
5,427       
5,051       
102,932     $ 

5% 
(0%) 
(3%) 
18% 
5% 

Our  orthobiologics  franchise  consists  of  our  joint  health  and  orthopedic  products.  Overall,  revenue  from  our 
orthobiologics franchises increased $4.1 million, or 5%, in 2017 as compared to 2016. The growth in 2017 reflected a growing 
end-user  demand,  continued  market  penetration,  increased  revenue  from  worldwide  MONOVISC  sales,  and  CINGAL 
revenue associated with the product’s commercial launch in Canada and Europe in 2016. ORTHOVISC and MONOVISC 
global revenue also increased 1% in 2017 as compared to 2016. The increase in international viscosupplement revenue in 
2017 was driven primarily by increased sales of MONOVISC resulting from a robust and growing end-user demand. 

41 

  
  
  
  
  
  
  
  
  
  
  
    
        
        
       
   
    
        
        
       
   
       
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
 
 
Dermal 

Our dermal franchise consists of advanced wound care products, which are based on our HYAFF technology, and 
aesthetic dermal fillers. Our advanced wound care products treat complex skin wounds ranging from burns to diabetic ulcers, 
with  HYALOMATRIX  and  HYALOFILL  as  the  lead  products.  Dermal  revenue  had  no  significant  change  in  2017  as 
compared to 2016. The revenue, in part, is from the agreement we entered into in July 2014 with Medline Industries, Inc. to 
commercialize HYALOMATRIX in the United States on an exclusive basis through 2022. 

Surgical 

Our  surgical  franchise  consists  of  products  used  to  prevent  surgical  adhesions  and  to  treat  ear,  nose,  and  throat 
(“ENT”) disorders. Sales of our surgical products decreased $0.2 million, or 3%, in 2017 as compared to 2016. The decrease 
of surgical product revenue was primarily due to a decrease in sales generated by our ENT products and unfavorable impact 
from foreign currency exchange rate fluctuations compared with the same periods in the prior year. Our surgical franchise 
consists primarily of our anti-adhesion products, including HYALOBARRIER and our ENT offerings, of which MEROGEL 
is the leading product. We are partnered with Medtronic for the worldwide distribution of our ENT products.  

Other 

Other  product  revenue  includes  revenues  from  ophthalmic  and  veterinary  products.  The  other  product  revenue 

increased in 2017 from 2016 due to a recovery from weak 2016 sales volume for these franchises. 

Licensing, milestone and contract revenue 

Licensing, milestone and contract revenue for the year ended December 31, 2017 was $5.6 million, compared to 
$0.4 million for 2016. The year over year increase was primarily the result of the recognition of licensing and milestone 
revenue for the year ended December 31, 2017 of $5.0 million for the achievement of a milestone payment under the Mitek 
MONOVISC  Agreement.  During  the  second  quarter  of  2017,  we  collected  and  fully  recognized  revenue  for  a  milestone 
payment of $5.0 million as a result of U.S. MONOVISC 12-month end-user sales exceeding $100 million. 

Product gross profit and margin 

Product  gross  profit  for  the  year  ended  December 31,  2017  was  $80.4  million,  or  75%  of  product  revenue,  as 
compared with $78.9 million, or 77% of product revenue, for the year ended December 31, 2016. The increase in product 
gross profit was primarily due to the increased volume compared to the prior year, while the decrease in product gross margin 
was due to inventory write-offs in 2017, as well as certain lower than anticipated product yields during the insource of the 
manufacturing of certain products to our Bedford facility. 

Research and development  

Research and development expenses for the year ended December 31, 2017 increased by $8.1 million, or 75%, as 
compared to the prior year, mainly due to an increase in expenses for our HYALOFAST and CINGAL phase III clinical 
trials.  We  also  increased  our  pre-clinical  product  development  activities,  including  with  respect  to  achieving  a  510(k) 
clearance of an injectable, HA-based surgical bone repair product. Research and development expense as a percentage of 
total revenue was 17% in 2017 and 10% in 2016. 

Selling, general and administrative 

Selling, general and administrative expenses for the year ended December 31, 2017 increased by $3.5 million, or 
20%, as compared to 2016. The increase was primarily as a result of increased personnel related costs, external professional 
fees, and additions to our allowance for doubtful accounts. 

42 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
Income taxes 

Provisions for income taxes were $14.4 million and $18.3 million for the years ended December 31, 2017 and 2016, 
respectively. The decrease in the effective tax rate in 2017 of 4.9%, as compared to 2016, is primarily due to the revaluation 
of the deferred tax liability as a result of the Tax Cuts and Jobs Act tax reform legislation and an increased benefit from 
research and development activities. In accordance with Staff Accounting Bulletin No. 118, which provides guidance on 
accounting for the tax effects of the 2017 Tax Act, we have recorded a reasonable estimate of the impact on the consolidated 
financial  statements.  The  provisional  amounts  incorporate  assumptions  made  based  upon  our  current  interpretation  and 
implementation guidance of the 2017 Tax Act. 

A reconciliation of the U.S. federal statutory tax rate to the effective tax rate for the periods ending December 31 is 

as follows: 

Statutory federal income tax rate .................................................    
State tax expense, net of federal benefit .......................................    
Impact of rate change on deferred taxes .......................................    
Permanent items, including nondeductible expenses ...................    
State investment tax credit ...........................................................    
Federal, state and foreign research and development credits .......    
Foreign rate differential ................................................................    
Domestic production deduction ...................................................    
Effective income tax rate .............................................................    

Years ended December 31, 

2017 

2016 

35.0%       
4.8%       
(4.9%)      
0.6%       
(0.7%)      
(1.4%)      
0.5%       
(2.8%)      
31.1%       

35.0% 
4.5% 
0.0% 
0.5% 
(0.1%) 
(0.9%) 
(0.1%) 
(2.9%) 
36.0% 

As of December 31, 2017, we had gross NOL for income tax purposes in Italy of $4.0 million with no expiration 
date. In connection with the preparation of the financial statements, we performed an analysis to ascertain if it was more 
likely than not that we would be able to utilize, in future periods, the net deferred tax assets associated with our NOL carry-
forward. We have concluded that the positive evidence outweighs the negative evidence and, thus, that the deferred tax assets 
not otherwise subject to a valuation allowance are realizable on a “more likely than not” basis. As such, we have not recorded 
a valuation allowance at December 31, 2017 or 2016. 

 In  the  normal  course  of  business,  Anika  and  its  subsidiaries  may  be  periodically  examined  by  various  taxing 
authorities. We file income tax returns in the U.S. federal jurisdiction, in certain U.S. states, and in Italy. The associated tax 
filings remain subject to examination by applicable tax authorities for a certain length of time following the tax year to which 
those filings relate. 

Net income  

For the year ended December 31, 2017, net income was $31.8 million, or $2.11 per diluted share, compared to $32.5, 
or $2.15 per diluted share, for the same period in the prior year. The decrease in net income and diluted earnings per share 
was primarily a result of increased expenses for our HYALOFAST and CINGAL phase III clinical trials and increases in 
personnel related costs, external professional fees, and additions to our allowance for doubtful accounts. These increased 
expenses are offset by increased total revenue and a decreased effective federal income tax rate as a result of the 2017 Income 
Tax Reform Legislation. 

Concentration of Risk 

We have historically derived the majority of our revenues from a small number of customers, most of whom resell 
our products to end-users and most of whom are significantly larger companies than us. For the year ended December 31, 
2018, five customers accounted for 86% of product revenue, with Mitek alone accounting for 73% of product revenue. We 
expect to continue to be dependent on a small number of large customers, especially Mitek, for the majority of our revenues 
for the foreseeable future. The failure of these customers to purchase our products in the amounts they historically have or in 
amounts that we expect would seriously harm our business. 

43 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
 
 
In addition, if present and future customers terminate their purchasing arrangements with us, significantly reduce or 
delay their orders, or seek to renegotiate their agreements on terms less favorable to us, our business, financial condition, and 
results of operations will be adversely affected. If we accept terms less favorable than the terms of the current agreements, 
such renegotiations  may  have  a  material  adverse  effect on our  business,  financial  condition,  and/or results of operations. 
Furthermore, in any future negotiations we may be subject to the perceived or actual leverage that these customers may have 
given their relative size and importance to us. Any termination, change, reduction, or delay in orders could seriously harm 
our  business,  financial  condition,  and  results  of  operations.  Accordingly,  unless  and  until  we  diversify  and  expand  our 
customer  base,  our  future  success  will  significantly  depend  upon  the  timing  and  size  of  future  purchases  by  our  largest 
customers and the financial and operational success of these customers. The loss of any one of our major customers or the 
delay of significant orders from such customers, even if only temporary, could reduce or delay our recognition of revenues, 
harm our reputation in the industry, and reduce our ability to accurately predict cash flow, and, as a consequence, it could 
seriously harm our business, financial condition, and results of operations. 

See  Note  3,  Revenue  by  Product  Group,  by  Significant  Customer  and  by  Geographic  Location;  Geographic 
Information, to the consolidated financial statements included elsewhere in this Annual Report on Form 10-K for information 
regarding significant customers. 

Liquidity and Capital Resources  

We require cash to fund our operating expenses and to make capital expenditures. Historically we have generated 
positive  cash  flow  from  operations,  which,  together  with  our  available  cash,  investments,  and  debt,  have  met  our  cash 
requirements. Cash, cash equivalents, and investments totaled $159.0 million and $157.3 million, and working capital totaled 
$191.7 million and $193.3 million, at December 31, 2018 and December 31, 2017, respectively. As of December 31, 2018, 
we have $50.0 million of available credit under our senior revolving credit facility with Bank of America, N.A., and we were 
in compliance with the terms of said credit agreement. We believe that we have adequate financial resources to support our 
business for at least the next twelve months. 

Cash provided by operating activities was $34.9 million, $40.8 million, and $24.4 million for 2018, 2017, and 2016, 
respectively.  The  decrease  in  cash  provided  by  operations  in  2018  was  due  primarily  to  higher  operating  expenses  in 
manufacturing  operations,  sales  and  marketing,  and  an  increase  in  inventory  on  hand  offset  by  a  decrease  in  accounts 
receivable. 

Cash  used  in  investing  activities  was  $50.3  million,  $12.5  million,  and  $6.8  million  for  2018,  2017,  and  2016, 
respectively. The increase was due to increased purchases of investments, partially offset by lower capital expenditures as 
compared to 2017 and 2016. 

Cash provided (used) by financing activities was ($28.9) million, $0.3 million, and ($24.0) million for 2018, 2017, 
and 2016, respectively. The increase in cash used in financing activities for the year ended December 31, 2018 was primarily 
attributable  to  the  utilization  of  $30.0  million  cash  to  repurchase  outstanding  common  stock  under  the Fixed  Dollar 
Accelerated Share Repurchase program and $1.8 million of tax payments related to employee tax withholdings on vested 
RSAs which were retired, offset in part by $2.9 million in proceeds from equity awards. Similarly, the Company initiated a 
$25.0 million accelerated share repurchase program in February 2016 and concluded the program in August 2016. 

44 

  
  
  
  
  
  
  
  
 
 
Contractual Obligations and Other Commercial Commitments 

The  table  below  summarizes  our  non-cancelable  operating  leases,  purchase  commitments,  and  contractual 
obligations related to future periods which are not reflected in our consolidated balance sheet at December 31, 2018. Purchase 
commitments  relate  primarily  to  non-cancellable  inventory  commitments  and  capital  expenditures  entered  in  the  normal 
course of business: 

Payments due by period (in thousands) 

   Less than 

   More than 

Total 

1 year 

   1 - 3 years 

   3 - 5 years 

5 years 

Operating Leases (1) ....................................   $ 
Purchase Commitments (2) ..........................     
Year Ended December 31, 2018 .................   $ 

8,703    $ 
17,591      
26,294    $ 

1,879     $ 
13,132       
15,011     $ 

3,841    $ 
2,087      
5,928    $ 

2,086     $ 
1,589       
3,675     $ 

897  
783  
1,680  

(1) 

(2) 

Includes a lease we entered into in January 2007, pursuant to which we lease our corporate headquarters facility, which consists of approximately 
134,000 square feet of general office, research and development, and manufacturing space located in Bedford, Massachusetts. The lease has an initial 
term of ten and one-half years, and commenced in May 2007. In February 2017, we finalized the exercise of its first option under the lease to extend 
the terms from November 1, 2017 through October 31, 2022, including the determination of a new annual base rent of $1.5 million which is included 
in the disclosure above. No other terms of this lease were altered. We have an option under this lease to extend its lease-term for up to three additional 
periods subject to the condition that the Company notify the landlord that we are exercising each option at least one year prior to the expiration of the 
original or then-current term. The next two renewal options each extend the term an additional five years, while the final renewal option extends the 
term by six years. This schedule does not include the amounts that would be due if the company exercised the renewal options. 

Also includes a lease entered into pursuant to which Anika S.r.l. leases its Italian facility. In October 2015, Anika S.r.l, entered into a build-to-
suit  lease  agreement  for  a  new  European  headquarters  facility  consisting  of  approximately  33,000  square  feet  of  general  office,  research  and 
development, training, and warehousing space located in Padova, Italy. This lease has an initial term of fifteen years which commenced in February 
2017. The lease will automatically renew for up to three additional six-year terms, subject to certain terms and conditions. We have the ability to 
withdraw from this lease subject to certain financial penalties after six years and with no penalties after the ninth year. As such, lease commitments 
through the ninth year are included in the table above. The lease provides for an initial yearly rent of approximately $0.3 million. See the section 
captioned “Item 2—Properties” in this Annual Report on Form 10-K for additional discussion regarding these leases. 
Includes purchase commitments for materials, clinical trials, and other day to day business requirements. 

Accounting for Off-Balance Sheet Arrangements 

We do not use special purpose entities or other off-balance sheet financing techniques, except for operating leases 
as disclosed in the contractual obligations table above, that we believe have or are reasonably likely to have a current or future 
material effect on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, 
or capital resources. 

 Recent Accounting Pronouncements 

A discussion of recent accounting pronouncements is included in Note 2 to the consolidated financial statements in 

this Annual Report on Form 10-K. 

ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK 

Primary Market Risk Exposures 

We  manage  our  investment  portfolio  in  accordance  with  our  investment  policy.  The  primary  objectives  of  our 
investment policy are to preserve principal, maintain a high degree of liquidity to meet operating and other needs, and obtain 
competitive returns subject to prevailing market conditions without significantly increasing risk. To achieve this objective, 
we maintain our portfolio of cash equivalents and investments in a variety of high quality securities, including money market 
funds and bank certificates of deposits. The investments are classified as available-for-sale and consequently are recorded at 
fair  value with  unrealized  gains  or  losses reported  as  a  separate  component of  accumulated other  comprehensive  income 
(loss). Our portfolio of cash equivalents and investments is subject to interest rate fluctuations, changes in credit quality of 
the issuer, and other factors. 

Foreign Exchange Risk 

Our primary market risk exposures are in the area of currency exchange rate risk. A significant portion of Anika 
S.r.l.’s revenue and operating expenses are denominated in Euros. We are utilizing clinical vendors which are located in 
various countries outside of the United States and invoice us in their local currency. We do not engage in foreign currency 
hedging arrangements for our accounts payable, and, consequently, foreign currency fluctuations may adversely affect our 

45 

  
  
  
  
  
  
  
    
  
  
  
  
  
  
  
   
  
  
  
  
  
  
  
  
earnings. In addition, we have one major supplier contract denominated in a foreign currency. Gains and losses arising from 
transactions denominated in foreign currencies are primarily related to intercompany accounts that have been determined to 
be  temporary  in  nature  and  cash,  accounts  payable,  and  accounts  receivable  denominated  in  non-functional  currencies. 
Unfavorable fluctuations in exchange rates would have a negative impact on our financial statements. The impact of currency 
exchange rate fluctuations for the contract on our financial statements was immaterial in 2018. In the future, we may undertake 
to manage foreign currency risk through additional hedging methods. We recognize foreign currency gains or losses arising 
from our operations in the period incurred.  

ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA 

ANIKA THERAPEUTICS, INC. AND SUBSIDIARIES 

INDEX TO CONSOLIDATED FINANCIAL STATEMENTS 

Reports of Independent Registered Public Accounting Firms ........................................................................................... 
Consolidated Balance Sheets as of December 31, 2018 and 2017 .................................................................................... 
Consolidated Statements of Operations and Comprehensive Income for the Years Ended December 31, 2018, 2017 

and 2016 ........................................................................................................................................................................ 
Consolidated Statements of Stockholders’ Equity for the Years Ended December 31, 2018, 2017 and 2016 .................. 
Consolidated Statements of Cash Flows for the Years Ended December 31, 2018, 2017 and 2016 ................................. 
Notes to Consolidated Financial Statements ..................................................................................................................... 

47
49

50
51
52
53

46 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

To the Board of Directors and Stockholders of Anika Therapeutics, Inc. 

Opinion on the Financial Statements 

We have audited the accompanying consolidated balance sheets of Anika Therapeutics, Inc. and subsidiaries (the "Company") 
as  of  December  31,  2018  and  2017,  the  related  consolidated  statements  of  operations  and  comprehensive  income, 
stockholders’ equity and cash flows for the years ended December 31, 2018 and 2017, and the related notes (collectively 
referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all material respects, the 
financial position of the Company as of December 31, 2018 and 2017, and the results of its operations and its cash flows for 
the years ended December 31, 2018 and 2017, in conformity with the accounting principles generally accepted in the United 
States of America. 

We have also 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, 2018, based on criteria established in 
Internal Control — Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway 
Commission and our report dated February 26, 2019, expressed an unqualified opinion on the Company's internal control 
over financial reporting. 

Basis for Opinion 

These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion 
on the Company's financial statements based on our audit. We are a public accounting firm registered with the 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. 

/s/ Deloitte & Touche LLP 

Boston, Massachusetts 
February 26, 2019 

We have served as the Company’s auditor since 2017. 

47 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
Report of Independent Registered Public Accounting Firm 

To the Board of Directors and Stockholders of Anika Therapeutics, Inc. 

In our opinion, the consolidated statements of operations and comprehensive income, of stockholders’ equity and of cash 
flows for the year ended December 31, 2016 present fairly, in all material respects, the results of operations and cash flows 
of  Anika  Therapeutics,  Inc.  and  its  subsidiaries  for  the  year  ended  December  31,  2016,  in  conformity  with  accounting 
principles  generally  accepted  in  the  United  States  of  America.  These  financial  statements  are  the  responsibility  of  the 
Company's management. Our responsibility is to express an opinion on these financial statements based on our audit. We 
conducted  our  audit  of  these  financial  statements  in  accordance  with  the  standards  of  the  Public  Company  Accounting 
Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance 
about  whether  the  financial  statements  are  free  of  material  misstatement.  An  audit  includes  examining,  on  a  test  basis, 
evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and 
significant estimates made by management, and evaluating the overall financial statement presentation. We believe that our 
audit provides a reasonable basis for our opinion. 

/s/ PricewaterhouseCoopers LLP 

Boston, Massachusetts 
February 24, 2017 

48 

  
  
  
  
  
  
 
 
Anika Therapeutics, Inc. and Subsidiaries 
Consolidated Balance Sheets 
(in thousands, except per share data) 

Current assets: 

ASSETS 

Cash and cash equivalents .......................................................................................    $
Investments ..............................................................................................................      
Accounts receivable, net of reserves of $1,525 and $1,914 at December 31, 2018 

and December 31, 2017, respectively ..................................................................      
Inventories, net ........................................................................................................      
Prepaid expenses and other current assets ...............................................................      
Total current assets ..............................................................................................      
Property and equipment, net ........................................................................................       
Other long-term assets .................................................................................................       
Intangible assets, net ...................................................................................................       
Goodwill ......................................................................................................................       
Total assets ..................................................................................................................     $

LIABILITIES AND STOCKHOLDERS’ EQUITY 

Current liabilities: 

Accounts payable ....................................................................................................    $
Accrued expenses and other current liabilities ........................................................      
Total current liabilities ........................................................................................      
Other long-term liabilities ...........................................................................................       
Deferred tax liability ...................................................................................................       
Commitments and contingencies (Note 12) 
Stockholders’ equity: 

Preferred stock, $0.01 par value; 1,250 shares authorized, no shares issued and 

December 31, 

2018 

2017 

89,042      $
69,972        

20,775        
21,300        
1,854        
202,943        
54,111        
4,897        
9,191        
7,851        
278,993      $

3,143      $
8,146        
11,289        
550        
3,542        

133,256   
24,000   

23,825   
22,035   
3,211   
206,327   
56,183   
1,254   
10,635   
8,218   
282,617   

6,747   
6,326   
13,073   
660   
5,393   

outstanding at December 31, 2018 and December 31, 2017, respectively ..........      

-        

-   

Common stock, $.01 par value; 90,000 and 60,000 shares authorized, 14,210 and 
14,688 shares issued and outstanding at December 31, 2018 and December 31, 
2017, respectively ................................................................................................      
Additional paid-in-capital ........................................................................................      
Accumulated other comprehensive loss ..................................................................      
Retained earnings ....................................................................................................      
Total stockholders’ equity ...................................................................................      
Total liabilities and stockholders’ equity.....................................................................     $

142        
50,763        
(5,526 )      
218,233        
263,612        
278,993      $

147   
68,617   
(4,784 ) 
199,511   
263,491   
282,617   

The accompanying notes are an integral part of these consolidated financial statements.  

49 

  
  
  
  
  
     
         
    
  
     
         
    
     
         
    
     
         
    
     
         
    
     
         
    
  
 
  
  
 
 
Anika Therapeutics, Inc. and Subsidiaries 
Consolidated Statements of Operations and Comprehensive Income 
(in thousands, except per share data) 

For the Years Ended December 31, 
2017 
107,783     $ 
5,637       
113,420       

2018 
105,531     $ 
24       
105,555       

2016 
102,932  
447  
103,379  

24,027  
10,732  
18,013  
52,772  
50,607  
263  
50,870  
18,323  
32,547  

2.22  
14,682  

2.15  
15,116  

32,547  
(668) 
31,879  

Product Revenue ............................................................................    $ 
Licensing, milestone and contract revenue .....................................      
Total revenue ..............................................................................      

Operating expenses: 

Cost of product revenue .............................................................      
Research & development ............................................................      
Selling, general & administrative ...............................................      
Total operating expenses ................................................................      
Income from operations ..................................................................      
Interest and other income, net ....................................................      
Income before income taxes ...........................................................      
Provision for income taxes .........................................................      
Net income .....................................................................................    $ 

31,280       
18,190       
34,336       
83,806       
21,749       
1,458       
23,207       
4,485       
18,722     $ 

27,364       
18,787       
21,540       
67,691       
45,729       
473       
46,202       
14,386       
31,816     $ 

Basic net income per share: 

Net income .................................................................................    $ 
Basic weighted average common shares outstanding .................      

1.30     $ 
14,442       

2.18     $ 
14,575       

Diluted net income per share: 

Net income .................................................................................    $ 
Diluted weighted average common shares outstanding ..............      

1.27     $ 
14,689       

2.11     $ 
15,068       

Net income .........................................................................................    $ 
Foreign currency translation adjustment ....................................      
Comprehensive income ......................................................................    $ 

18,722     $ 
(742)      
17,980     $ 

31,816     $ 
2,533       
34,349     $ 

The accompanying notes are an integral part of these consolidated financial statements. 

50 

              
  
  
  
  
  
  
  
     
        
        
   
     
        
        
   
  
     
        
        
   
     
        
        
   
     
        
        
   
  
     
        
        
   
   
 
  
  
 
 
Anika Therapeutics, Inc. and Subsidiaries 
Consolidated Statements of Stockholders' Equity 
(in thousands) 

Common Stock 

  Accumulated     
Other 

Total 

 Number of $.01 Par  Additional Paid   Retained  Comprehensive  Stockholders'
  Shares 

 Earnings  

in Capital 

  Value   

Loss 

Equity 
210,848  

Balance, December 31, 2015 ...................     15,037   $  150   $ 

81,685    $135,662   $ 

(6,649)   $ 

Issuance of common stock for equity 

awards .............................................    
Tax benefit related to equity awards....    
Stock-based compensation expense.....    
Repurchase of common stock ..............    
Net income ..........................................    
Other comprehensive loss ...................    

1     
-     
-     
(5)    
-     
-     
Balance, December 31, 2016 ...................     14,627   $  146   $ 

121     
-     
-     
(531)    
-     
-     

1,006      
647      
3,392      
(24,995)     

-     
-     
-     
-     
-       32,547     
-     
-      
61,735    $168,209   $ 

-      
-      
-      
-      
-      
(668)     
(7,317)   $ 

1,007  
647  
3,392  
(25,000) 
32,547  
(668) 
222,773  

Issuance of common stock for equity 

61     
-     

1     
-     

313      
5,807      

-     
-     

-      
-      

314  
5,807  

awards .............................................    
Stock-based compensation expense.....    
Cumulative effect of change in 
accounting for stock-based 
compensation ...................................    
Net income ..........................................    
Other comprehensive income ..............    

-     
-     
-     
Balance, December 31, 2017 ...................     14,688   $  147   $ 

-     
-     
-     

762      

(514)    
-       31,816     
-     
-      
68,617    $199,511   $ 

-      
-      
2,533      
(4,784)   $ 

248  
31,816  
2,533  
263,491  

Issuance of common stock for equity 

awards .............................................    

362     

4     

2,882      

-     

-      

2,886  

Retirement of common stock for 

minimum tax withholdings ..............    
Stock-based compensation expense.....    
Repurchase of common stock ..............    
Net income ..........................................    
Other comprehensive loss ...................    

(1)    
-     
(8)    
-     
-     
Balance, December 31, 2018 ...................     14,210   $  142   $ 

(34)    
-     
(806)    
-     
-     

(1,790)     
11,046      
(29,992)     

-     
-     
-     
-       18,722     
-     
-      
50,763    $218,233   $ 

-      
-      
-      
-      
(742)     
(5,526)   $ 

(1,791) 
11,046  
(30,000) 
18,722  
(742) 
263,612  

The accompanying notes are an integral part of these consolidated financial statements. 

51 

  
  
 
  
 
  
 
  
   
  
 
 
  
 
 
  
  
 
  
  
  
  
 
 
Anika Therapeutics, Inc. and Subsidiaries 
Consolidated Statements of Cash Flows 
(in thousands) 

For the years ended December 31, 
2017 

2016 

2018 

18,722     $ 

31,816     $ 

32,547  

Cash flows from operating activities: 

Net income .....................................................................................    $ 
Adjustments to reconcile net income to net cash provided by 

operating activities: 
Depreciation and amortization ...................................................      
Loss on disposal of fixed assets ..................................................      
Stock-based compensation expense ............................................      
Deferred income taxes ................................................................      
Provision for doubtful accounts ..................................................      
Provision for inventory ...............................................................      
Accretion to amortized cost of investments................................      
Changes in operating assets and liabilities: 

Accounts receivable ...............................................................      
Inventories ..............................................................................      
Prepaid expenses, other current and long-term assets ............      
Accounts payable ...................................................................      
Accrued expenses, other current and long-term liabilities......      
Income taxes payable .............................................................      
Net cash provided by operating activities ...........................................      

5,910       
152       
11,046       
(1,817)      
57      
4,419       
(371)      

2,914       
(7,577)      
899       
(1,671)      
1,313       
922       
34,918       

4,290       
150       
5,807       
(1,198)      
1,609       
695       
-       

2,674       
(6,521)      
(1,454)      
3,890       
(1,313)      
367       
40,812       

Cash flows from investing activities: 

Proceeds from maturity of investments ..........................................      
Purchase of investments .................................................................      
Purchase of property and equipment ..............................................      
Net cash (used in) investing activities ................................................      

46,000       
(91,601)      
(4,656)      
(50,257)      

41,500       
(45,000)      
(8,980)      
(12,480)      

Cash flows from financing activities: 

Repurchase of common stock .........................................................      
Tax payments related to witholdings on vested restricted stock.....      
Proceeds from exercise of equity awards .......................................      
Net cash (used in) provided by financing activities ............................      

(30,000)      
(1,790)      
2,886       
(28,904)      

-       
-       
314       
314       

3,734  
-  
3,392  
(65) 
52  
654  
-  

(6,201) 
(1,738) 
(898) 
(5,059) 
1,582  
(3,552) 
24,448  

46,500  
(39,249) 
(14,014) 
(6,763) 

(25,000) 
-  
1,007  
(23,993) 

Exchange rate impact on cash ............................................................      

29       

349       

(138) 

Increase (Decrease) in cash and cash equivalents ..............................      
Cash and cash equivalents at beginning of period ..............................      
Cash and cash equivalents at end of period ........................................    $ 
Supplemental disclosure of cash flow information: 

(44,214)      
133,256       
89,042     $ 

28,995       
104,261       
133,256     $ 

(6,446) 
110,707  
104,261  

Cash paid for income taxes.............................................................    $ 

5,560     $ 

15,088     $ 

22,826  

Non-cash Investing Activities: 

Purchases of property and equipment included in accounts 

payable and accrued expenses ....................................................    $ 
Build-to-suit lease agreement .........................................................    $ 

351     $ 
-     $ 

1,891     $ 
-     $ 

1,257  
1,723  

The accompanying notes are an integral part of these consolidated financial statements. 

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Anika Therapeutics, Inc. and Subsidiaries 
Notes to Consolidated Financial Statements 
(amounts in thousands, except share and per share amounts or as otherwise noted) 

1. Nature of Business 

Anika Therapeutics, Inc. (the “Company”) is a global, integrated orthopedic and regenerative medicines company 
committed to improving the lives of patients with degenerative orthopedic diseases and traumatic conditions with clinically 
meaningful  therapies  along  the  continuum  of  care,  from  palliative  pain  management  to  regenerative  tissue  repair.  The 
Company has over two decades of global expertise developing, manufacturing, and commercializing products based on its 
proprietary  Hyaluronic  Acid  (“HA”)  technology.  The  Company’s  orthopedic  medicine  portfolio  includes  ORTHOVISC, 
MONOVISC, and CINGAL, which alleviate pain and restore joint function by replenishing depleted HA, and HYALOFAST, 
a solid HA-based scaffold to aid cartilage repair and regeneration. 

The Company is subject to risks common to companies in the biotechnology and medical device industries including, 
but not limited to, development by the Company or its competitors of new technological innovations, dependence on key 
personnel, protection of proprietary technology, commercialization of existing and new products, and compliance with U.S. 
Food and Drug Administration (“FDA”) and foreign regulations and approval requirements, as well as the ability to grow the 
Company’s business through appropriate commercial strategies. 

At the Company’s annual stockholders’ meeting on May 31, 2018, the Company’s stockholders approved an increase 
in the number of shares of common stock that the Company is authorized to issue from 60 million to 90 million and ratified 
a  change  in  the  Company’s  state  of  incorporation  from  the  Commonwealth  of  Massachusetts  to  the  State  of  Delaware, 
pursuant to a plan of domestication. The Company became a Delaware corporation with the authorization to issue up to 90 
million shares of its common stock on June 6, 2018. Upon its domestication in Delaware, the affairs of the Company became 
subject to the Delaware General Corporation Law, the Company implemented a new certificate of incorporation and new 
bylaws,  and  each  previously  outstanding  share  of  the  Company’s  common  stock  as  a  Massachusetts  corporation  (Anika 
Massachusetts) converted into an outstanding share of common stock of the Company as a Delaware corporation (Anika 
Delaware). The domestication was a tax-free reorganization under the U.S. Internal Revenue Code, and it did not affect the 
Company’s business operations. 

2. Summary of Significant Accounting Policies 

Use of Estimates 

The preparation of financial statements in conformity with generally accepted accounting principles in the United 
States of America requires management to make estimates and assumptions that affect the reported amounts of assets and 
liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts 
of revenues and expenses during the reporting period. Actual results could differ from those estimates. 

Principles of Consolidation 

The accompanying consolidated financial statements include the accounts of Anika Therapeutics, Inc. and its wholly 
owned subsidiaries, Anika Securities, Inc. (a Massachusetts Securities Corporation), and Anika Therapeutics S.r.l. (“Anika 
S.r.l.”). All intercompany balances and transactions have been eliminated in consolidation. 

53 

  
  
  
  
  
  
  
  
  
  
  
  
 
 
Foreign Currency Translation 

The  functional  currency  of  the  Company’s  foreign  subsidiary  is  the  Euro.  Assets  and  liabilities  of  the  foreign 
subsidiary are translated using the exchange rate existing on each respective balance sheet date. Revenues and expenses are 
translated using the average exchange rates for the period. The translation adjustments resulting from this process are included 
in stockholders’ equity as a component of accumulated other comprehensive income (loss) which resulted in a gain (loss) 
from foreign currency translation of ($0.7) million, $2.5 million, and ($0.7) million for the years ended December 31, 2018, 
2017, and 2016, respectively.  

Gains  and  losses  resulting  from  foreign  currency  transactions  are  recognized  in  the  consolidated  statements  of 
operations. Recorded balances that are denominated in a currency other than the functional currency are remeasured to the 
functional currency using the exchange rate at the balance sheet date and gains or losses are recorded in the statements of 
operations. The Company recognized a gain (loss) from foreign currency transactions of ($0.4) million, $0.7 million, and 
($0.3) million during the years ended December 31, 2018, 2017, and 2016, respectively.  

Fair Value Measurements 

Fair value is defined as the price that would be received from selling an asset, or paid to transfer a liability, in an 
orderly transaction between market participants at the measurement date. When determining the fair value measurements for 
assets and liabilities required to be recorded at fair value, the Company considers the principal or most advantageous market 
in which it would transact and considers assumptions that market participants would use when pricing the asset or liability, 
such  as  inherent  risk,  transfer  restrictions, and risk of non-performance.  The  accounting  standard  establishes  a  fair  value 
hierarchy that requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when 
measuring fair value. 

 A financial instrument’s categorization within the fair value hierarchy is based upon the lowest level of input that 

is significant to the fair value measurement. Three levels of inputs that may be used to measure fair value are: 

•  Level  1  –  Valuation  is  based  upon  quoted  prices  for  identical  instruments  traded  in  active  markets.  Level  1 

instruments include securities traded on active exchange markets, such as the New York Stock Exchange. 

•  Level 2 – Valuation is based upon quoted prices for similar instruments in active markets, quoted prices for identical 
or similar instruments in markets that are not active and model-based valuation techniques for which all significant 
assumptions are directly observable in the market. 

•  Level 3 – Valuation is generated from model-based techniques that use significant assumptions not observable in 
the  market.  These  unobservable  assumptions  reflect  the  Company’s  own  estimates  of  assumptions  market 
participants would use in pricing the instrument. 

The Company’s financial assets have been classified as Levels 1. The Company’s financial assets (which include 
cash equivalents and investments) have been initially valued at the transaction price and subsequently valued, at the end of 
each reporting period, utilizing third party pricing services or other market observable data. 

54 

  
  
  
  
   
   
  
  
  
  
  
  
  
  
 
 
Allowance for Doubtful Accounts 

The Company maintains an allowance for doubtful accounts for estimated losses resulting from the inability of its 
customers to make required payments, which is included in selling, general and administrative expenses in the accompanying 
consolidated  statements  of  operations.  In  determining  the  adequacy  of  the  allowance  for  doubtful  accounts,  management 
specifically  analyzes  individual  accounts  receivable,  historical  bad  debts,  customer  concentrations,  customer  credit-
worthiness, current economic conditions, accounts receivable aging trends, and changes in the Company’s customer payment 
terms. A summary of activity in the allowance for doubtful accounts is as follows: 

2018 

December 31, 
2017 

2016 

Balance, beginning of the year .....................    $ 
Amounts provided ....................................      
Amounts recovered ..................................      
Amounts written off .................................      
Translation adjustments ............................      
Balance, end of the year ...............................    $ 

1,914     $ 
57       
(360)      
-       
(86)      
1,525     $ 

194     $ 
1,609       
-       
(6)      
117       
1,914     $ 

167  
52  
-  
(16) 
(9) 
194  

Revenue Recognition - General 

The  Company  adopted  the  guidance  the  FASB’s  Accounting  Standards  Codification  (“ASC”) Revenue  from 
Contracts with Customers (ASC 606) using the modified retrospective method effective January 1, 2018. The adoption of 
ASC 606 was applied to all contracts not completed as of the date of adoption. The adoption did not have a material impact 
on the amount and timing of revenue recognized in the consolidated financial statements. The Company made no adjustments 
to  previously  reported product  and  total  revenue,  as  those periods  continue  to be presented  in  accordance with  historical 
accounting practices under Topic 605, Revenue Recognition. 

Pursuant  to  ASC  606,  the  Company  recognizes  revenue  when  a  customer  obtains  control  of  promised  goods  or 
services. The amount of revenue that is recorded reflects the consideration that the Company expects to receive in exchange 
for  those  goods  or  services.  The  Company  applies  the  following  five-step  model  in  order  to  determine  this  amount:  (i) 
identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services 
are performance obligations, including whether they are capable of being distinct or distinct in the context of the contract; 
(iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction 
price to the performance obligations; and (v) recognition of revenue when (or as) the Company satisfies each performance 
obligation. 

The Company has agreements with DePuy Synthes Mitek Sports Medicine, a division of DePuy Orthopaedics, Inc. 
(“Mitek”) that include the grant of certain licenses, performance of development services, and the supply of product at Mitek’s 
option. Revenues from the agreements with Mitek represent 73% of total revenues for the year-ended December 31, 2018. 
The  Company  completed  the  performance  obligations  related  to  granted  licenses  and  development  services  under  these 
agreements prior to 2016. The Company has no remaining material performance obligations under the Mitek agreements. 

The Company has agreements with other customers that may include the delivery of a license and supply of product. 

The upfront payments under such agreements upon the delivery of the license have not been material. 

The Company’s typical supply agreements represent a promise to deliver product at the customer’s discretion that 
are considered options. The Company assessed if these options provide a material right to the licensee and if so, they are 
accounted for as separate performance obligations.  The majority of the Company’s supply agreements do not provide options 
that are considered material rights. 

Certain of the Company’s agreements include sales-based royalties and milestones. As the Company considered the 
license to be the predominant item to which the royalties relate for these agreements, sales-based royalties and milestones are 
only recognized when the later of the underlying sale occurs or the performance obligation to which some or all of the sales-
based royalty has been satisfied (or partially satisfied). This is generally in the same period that the Company’s licensees 
complete their product sales in their territory, for which the Company is contractually entitled to a percentage-based royalty. 
Revenue from sales-based royalties is included in product revenues. 

55 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
Product Revenue 

The Company sells its products principally to a number of distributors (i.e., its customers) under legally-enforceable, 
executed contracts. The Company’s distributors subsequently resell the products to sub-distributors and health care providers, 
among others. The Company recognizes revenue from product sales when the distributor obtains control of the Company’s 
product,  which  typically  occurs  upon  shipment  to  the  distributor,  in  return  for  agreed-upon,  fixed-price  consideration. 
Performance  obligations  are  generally  settled  quickly  after  purchase  order  acceptance;  therefore,  the  value  of  unsatisfied 
performance obligations at the end of any reporting period is generally immaterial. 

The  Company’s  payment  terms  are  consistent  with  prevailing  practice  in  the  respective  markets  in  which  the 
Company does business. Most of the Company’s distributors make payments based on fixed-price contract terms, which are 
not affected by contingent events that could impact the transaction price. Payment terms fall within the one-year guidance 
for the practical expedient, which allows us to forgo adjustment of the contractual payment amount of consideration for the 
effects of a significant financing component. The Company’s contracts with customers do not customarily provide a right of 
return, unless certain product quality standards are not met. 

Some of the Company’s distributor agreements have volume based discounts with tiered pricing which are generally 
prospective in nature. These prospective discounts together with any free-of-charge sample units offered are evaluated as 
potential  material  rights.  If  the  prospective  discounts  or  free-of-charge  sample  units  are  considered  material  rights,  these 
would  be  separate  performance  obligations  and  a  portion  of  the  sales  transaction  price  is  allocated  to  the  material  right. 
Revenue allocated to the material right is recognized when the additional goods are transferred to the customer or when the 
option expires. During 2018, the consideration allocated to material rights was not significant. 

The Company receives payments from its customers based on billing schedules established in each contract. Up-
front payments and fees are recorded as deferred revenue upon receipt or when due, and may require deferral of revenue 
recognition to a future period until the Company performs its obligations under these arrangements. Amounts are recorded 
as accounts receivable when its right to consideration is unconditional. As of January 1, 2018 and December 31, 2018 deferred 
revenue was $0. 

Generally, distributor contracts contain Free on Board (FOB) or Ex-Works (EXW) shipping point terms where the 
customer pays the shipping company directly for all shipping and handling costs. In those contracts in which the Company 
pays for the shipping and handling, the associated costs are generally recorded along with the product sale at the time of 
shipment in cost of product revenue when control over the products has transferred to the customer. The Company does not 
collect sales tax on product sales as it is not applicable. Value-add and other taxes collected by us concurrently with revenue-
producing  activities  are  excluded  from  revenue.  The  Company’s  general  product  warranty  does  not  extend  beyond  an 
assurance that the product or services delivered will be consistent with stated contractual specifications, which does not create 
a separate performance obligation. The Company recognizes the incremental costs of obtaining contracts as an expense when 
incurred as the amortization period of the assets that the Company otherwise would have recognized is one year or less in 
accordance  with  the  practical  expedient  in  paragraph  ASC  340-40-25-4.  These  costs  are  included  in  selling,  general  & 
administrative expenses. 

Included as a component of product revenue is sales-based royalty revenue, which represents the utilization of the 
Company’s  intellectual  property  licensed  by  its  commercial  partners.  The  Company  records  royalty  revenues  based  on 
estimated net sales of licensed products as reported to us by the Company’s commercial partners. Differences between actual 
and estimated royalty revenues have not been material and are typically adjusted in the following quarter when the actual 
amounts are known. 

Licensing, Milestone and Contract Revenue 

The  agreements  with  Mitek  include  variable  consideration  such  as  contingent  development  and  regulatory 
milestones.  As  of  the  date  of  adoption  of  ASC  606,  there  is  one  remaining  regulatory  milestone  related  to  the  Mitek 
agreements and the Company has no performance obligation related to this milestone. In general, variable consideration is 
included in the transaction price only to the extent a significant reversal in the amount of cumulative revenue recognized is 
not probable to occur. Future payments for regulatory milestones will be recognized as revenue when the regulatory milestone 
is considered probable of being achieved. 

56 

  
  
  
  
  
  
  
  
   
 
 
Cash and Cash Equivalents  

The Company considers only those investments which are highly liquid, readily convertible to cash, and that mature 
within three months from date of purchase to be cash equivalents. The Company’s cash equivalents consist of money market 
funds, mutual funds, and bank certificates of deposit with an original maturity of less than 90 days. 

Investments 

The Company’s investments consist of U.S. treasury bills. The Company has designated all investments as available-
for-sale, and therefore such investments are reported at fair value, with unrealized gains and losses recorded in accumulated 
other comprehensive income (loss). For securities sold prior to maturity, the cost of securities sold is based on the specific 
identification method. Realized gains and losses on the sale of investments are recorded in interest and other income, net. 
Interest is recorded when earned. Investments with original maturities greater than approximately three months and remaining 
maturities less than one year are classified as short-term investments. Investments with remaining maturities greater than one 
year are classified as long-term investments. The Company considers securities with original maturities of three months or 
less from the purchase date to be cash equivalents. 

All  of  the  Company’s  investments  are  subject  to  a  periodic  impairment  review.  The  Company  recognizes  an 
impairment  charge  when  a  decline  in  the  fair  value  of  its  investments  below  the  cost  basis  is  judged  to  be  other-than-
temporary.  Factors  considered  in  determining  whether  a  loss  is  temporary  include  the  extent  and  length  of  time  the 
investment's fair value has been lower than its cost basis, the financial condition and near-term prospects of the investee, 
extent of the loss related to credit of the issuer, the expected cash flows from the security, the Company’s intent to sell the 
security, and whether or not the Company will be required to sell the security prior the expected recovery of the investment's 
amortized  cost  basis. During the  years  ended December 31, 2018  and 2017,  the  Company did not record  any other-than-
temporary impairment charges on its available-for-sale securities because the Company does not intend to sell the securities 
and it is not more likely than not that the Company will be required to sell these securities before the recovery of their cost 
basis. 

Concentration of Credit Risk and Significant Customers 

The Company has no significant off-balance sheet risks related to foreign exchange contracts, option contracts, or 
other foreign hedging arrangements. The Company’s cash equivalents and investments are held with two major international 
financial institutions. 

The Company, by policy, routinely assesses the financial strength of its customers. As a result, the Company believes 

that its accounts receivable credit risk exposure is limited. 

As of December 31, 2018 and 2017, Mitek represented 75% and 68%, respectively, of the Company’s accounts 

receivable balance, no other single customer accounted for more than 10% of accounts receivable in either period. 

Inventories 

Inventories are stated at the lower of standard cost and net realizable value, with approximate cost determined using 
the first-in, first-out method. Work-in-process and finished goods inventories include materials, labor, and manufacturing 
overhead. Inventory costs associated with product candidates that have not yet received regulatory approval are capitalized 
if the Company believes there is probable future commercial use and future economic benefit. 

The Company’s policy is to write-down inventory when conditions exist that suggest inventory may be in excess 
of anticipated demand or is obsolete based upon assumptions about future demand for the Company’s products and market 
conditions. The Company regularly evaluates the ability to realize the value of inventory based on a combination of factors 
including, but not limited to, historical usage rates, forecasted sales or usage, product end of life dates, and estimated current 
or  future  market  values.  Purchasing  requirements  and  alternative  usage  avenues  are  explored  within  these  processes  to 
mitigate inventory exposure.  

57 

  
  
  
  
  
  
  
  
  
  
  
  
 
 
When recorded, inventory write-downs are intended to reduce the carrying value of inventory to its net realizable 
value. Inventory of $25.1 million, including $3.8 million within Other long-term assets, and $22.0 million as of December 
31,  2018  and  2017,  respectively,  is  stated  net  of  inventory  reserves  of  approximately  $3.5  million  and  $1.7  million, 
respectively. If actual demand for the Company’s products deteriorates, or if market conditions are less favorable than those 
projected, additional inventory write-downs may be required. 

Property and Equipment 

Property and equipment are recorded at cost and depreciated using the straight-line method over their estimated 

useful lives, which are typically: 

Asset 
Computer equipment and software .......................  
Furniture and fixtures ...........................................  
Equipment ............................................................  
Leasehold improvements ......................................   Shorter of useful life or term of lease   

Estimated useful life  
(in years) 
3-10 
5-7  
5-20 

Maintenance and repairs are charged to expense when incurred; additions and improvements are capitalized. Fully 
depreciated assets are retained in the accounts until they are no longer used and no further charge for depreciation is made in 
respect of these assets. When an item is sold, retired or removed from service, the cost and related accumulated depreciation 
is relieved, and the resulting gain or loss, if any, is recognized in income. 

Construction-in-process is stated at cost, which includes the cost of construction and other direct costs attributable 
to the construction. Construction-in-process is not depreciated until such time as the relevant assets are completed and put 
into use. 

Goodwill and Acquired Intangible Assets 

Goodwill is the amount by which the purchase price of acquired net assets in a business combination exceeded the 
fair values of net identifiable assets on the date of acquisition. Acquired In-Process Research and Development (“IPR&D”) 
represents the fair value assigned to research and development assets that the Company acquires that have not been completed 
at the date of acquisition or are pending regulatory approval in certain jurisdictions. The value assigned to the acquired IPR&D 
is determined by estimating the costs to develop the acquired technology into commercially viable products, estimating the 
resulting revenue from the projects, and discounting the net cash flows to present value.   

Goodwill  and  IPR&D  are  evaluated  for  impairment  annually  or  more  frequently  if  events  or  changes  in 
circumstances indicate that the asset might be impaired. Factors the Company considers important, on an overall company 
basis, that could trigger an impairment review include significant underperformance relative to historical or projected future 
operating results, significant changes in the Company’s use of the acquired assets or the strategy for its overall business, 
significant negative industry or economic trends, a significant decline in the Company’s stock price for a sustained period, or 
a reduction of its market capitalization relative to net book value. 

To conduct impairment tests of goodwill, the fair value of the reporting unit is compared to its carrying value. If the 
reporting unit’s carrying value exceeds its fair value, the Company records an impairment loss to the extent that the carrying 
value  of  goodwill  exceeds  its  implied  fair  value.  The  Company’s  annual  assessment  for  impairment  of  goodwill  as  of 
November 30, 2018 indicated that the fair value of its reporting unit exceeded the carrying value of the reporting unit. 

To conduct impairment tests of IPR&D, the fair value of the IPR&D project is compared to its carrying value. If the 
carrying value exceeds its fair value, the Company records an impairment loss to the extent that the carrying value of the 
IPR&D project exceeds its fair value. The Company estimates the fair value for IPR&D using discounted cash flow valuation 
models, which require the use of significant estimates and assumptions, including but not limited to, estimating the timing of 
and expected costs to complete the in-process projects, projecting regulatory approvals, estimating future cash flows from 
product  sales  resulting  from  completed  projects  and  in-process  projects,  and  developing  appropriate  discount  rates.  The 
Company’s  annual  assessment  for  impairment  of  IPR&D  indicated  that  the  fair  value  of  its  other  IPR&D  assets  as  of 
November 30, 2018 and 2017 exceeded the respective carrying values. 

58 

   
  
  
 
 
 
 
 
  
  
  
  
  
  
  
   
 
 
Long-Lived Assets 

Long-lived assets primarily include property and equipment and intangible assets with finite lives. The Company’s 
intangible assets are comprised of purchased developed technologies, patents, and trade names. These intangible assets are 
carried at cost, net of accumulated amortization. Amortization is recorded on a straight-line basis over the intangible assets' 
useful lives, which range from approximately five to sixteen years. The Company reviews long-lived assets for impairment 
when events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable 
or  that  the  useful  lives  of  those  assets  are  no  longer  appropriate.  Each  impairment  test  is  based  on  a  comparison  of  the 
undiscounted cash flows to the recorded value of the asset. If impairment is indicated, the asset is written down to its estimated 
fair value based on a discounted cash flow analysis. 

Research and Development 

Research and development costs consist primarily of clinical trials, salaries and related expenses for personnel, and 
fees  paid  to  outside  consultants  and  outside  service  providers,  including  costs  associated  with  licensing,  milestone  and 
contract revenue. Research and development costs are expensed as incurred. 

Stock-Based Compensation 

The  Company  has  stock-based  compensation  plans  under  which  it  grants  various  types  of  equity-based  awards, 
including restricted stock units (“RSUs”), restricted stock awards (“RSAs”), performance options, and stock options. The 
Company  measures  the  compensation  cost  of  award  recipients’  services  received  in  exchange  for  an  award  of  equity 
instruments based on the grant date fair value of the underlying award. That cost is recognized over the period during which 
an employee is required to provide service in exchange for the award. 

For performance-based options with financial and business milestone achievement targets, the Company recognizes 
expense using the graded  vesting  methodology  over  the  service  period. Compensation cost  associated  with performance-
based options is based on the probable outcome of the performance conditions. Changes to the probability assessment and 
the estimated shares expected to vest will result in adjustments to the related stock-based compensation expense that will be 
recorded in the period of the change. If the performance targets are not achieved, no compensation cost is recognized, and 
any previously recognized compensation cost is reversed. The Company recorded $0.7 million, $0.8 million, and $0.3 million 
related to performance-based options in 2018, 2017, and 2016, respectively. 

See  Note  13,  Equity  Incentive  Plan,  to  the  consolidated  financial  statements  included  elsewhere  in  this  Annual 
Report on Form 10-K for a description of the types of stock-based awards granted, the compensation expense related to such 
awards, and detail of equity-based awards outstanding. 

Income Taxes 

The  Company’s  income  tax  expense  includes  U.S. and  international  income  taxes.  Certain  items  of  income  and 
expense are not reported in tax returns and financial statements in the same year. The tax effects of these timing differences 
are reported as deferred tax assets and liabilities. Deferred tax assets are recognized for the estimated future tax effects of 
deductible  temporary  differences,  tax  operating  losses,  and  tax  credit  carry-forwards  (including  investment  tax  credits). 
Changes  in  deferred  tax  assets  and  liabilities  are  recorded  in  the  provision  for  income  taxes.  The  Company  assesses  the 
likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes that it is more 
likely than not that all or a portion of deferred tax assets will not be realized, the Company establishes a valuation allowance 
to reduce the deferred tax assets to the appropriate valuation. To the extent the Company establishes a valuation allowance 
or increases or decreases this allowance in a given period, it includes the related tax expense or tax benefit within the tax 
provision in the consolidated statement of operations in that period. 

59 

  
  
  
  
  
  
  
  
  
  
  
 
 
Comprehensive Income 

Comprehensive  income  consists  of  net  income  and  other  comprehensive  income  (loss),  which  includes  foreign 
currency translation adjustments. For the purposes of comprehensive income disclosures, the Company does not record tax 
provisions or benefits for the net changes in the foreign currency translation adjustment, as it intends to indefinitely reinvest 
undistributed earnings of its foreign subsidiary. Accumulated other comprehensive income (loss) is reported as a component 
of stockholders' equity. 

Segment Information 

Operating segments are components of an enterprise about which separate financial information is available that is 
evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources 
and in assessing performance. The Company’s chief operating decision maker is its President and Chief Executive Officer. 
Based on the criteria established by ASC 280, Segment Reporting, the Company has one operating and reportable segment. 

Contingencies 

In the normal course of business, the Company is involved from time-to-time in various legal proceedings and other 
matters  such  as  contractual  disputes,  which  are  complex  in  nature  and  have  outcomes  that  are  difficult  to  predict.  The 
Company records accruals for loss contingencies to the extent that it concludes that it is probable that a liability has been 
incurred and the amount of the related loss can be reasonably estimated. The Company considers all relevant factors when 
making assessments regarding these contingencies. Although the outcomes of any potential legal proceedings are inherently 
difficult to predict, the Company does not expect the resolution of any potential legal proceedings to have a material adverse 
effect on its financial position, results of operations, or cash flow. 

Subsequent Events 

Events occurring subsequent to December 31, 2018 have been evaluated for potential recognition or disclosure in 
the consolidated financial statements. As a result of the evaluation, no subsequent events were required to be recognized or 
disclosed. 

Recent Accounting Pronouncements 

In  February  2016,  the  Financial  Accounting  Standards  Board  (“FASB”)  issued  Accounting  Standards  Update 
(“ASU”) No. 2016-02, Leases (Topic 842), which amends existing leasing accounting requirements. The most significant 
change will result in the recognition of lease assets and lease liabilities by lessees for virtually all leases. The new guidance 
will also require significant additional disclosures about the amount, timing, and uncertainty of cash flows from leases. ASU 
2016-02 is effective for fiscal years and interim periods beginning after December 15, 2018. This updated guidance provided 
an optional transition method, which allows for the initial application of the new accounting standard at the adoption date and 
the recognition of a cumulative-effect adjustment to the opening balance of retained earnings as of the beginning of the period 
of adoption. The Company adopted the new standard beginning on January 1, 2019 and elected the optional transition method 
with no restatement of prior period amounts. A number of optional practical expedients may be elected to simplify the impact 
of adoption. The Company has assessed ASU 2016-02 and the impact that adopting this new accounting standard will have 
on its consolidated financial statements and footnote disclosures. The Company expects to record, upon adoption right-of-
use assets of approximately $20.0 to $23.0 million and corresponding liabilities related to its real estate leases with terms of 
more than 12 months that are not treated as financing leases under Topic 842. The adoption of this standard is not expected 
to  have  a  significant  impact  on  the  Company’s  consolidated  statements  of  operations  and  comprehensive  income  and 
consolidated statements of cash flows. 

In  August  2018,  the  FASB  issued  ASU  No.  2018-15, Intangibles  –  Goodwill  and  Other  –  Internal-Use 
Software (Subtopic  350-40),  which  amends  ASU  No.  2015-05, Customers  Accounting  for  Fees  in  a  Cloud  Computing 
Agreement, to help entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement (hosting 
arrangement) by providing guidance for determining when the arrangement includes a software license. The most significant 
change will align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service 
contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software and 
hosting arrangements that include an internal-use software license. Accordingly, the amendments in ASU 2018-15 require an 
entity  in  a  hosting  arrangement  that  is  a  service  contract  to  follow  the  guidance  in  Subtopic  350-40  to  determine  which 
implementation costs to capitalize as an asset related to the service contract and which costs to expense. ASU 2018-15 is 
effective  for  fiscal  years  and  interim  periods  beginning  after  December  15,  2019.  Early  adoption  is  permitted,  including 

60 

  
   
  
  
  
  
  
  
  
  
adoption in any interim period for all entities. The Company is assessing ASU 2018-15 and the impact that adopting this new 
accounting standard will have on its consolidated financial statements and footnote disclosures. 

3. Revenue by Product Group, by Significant Customer and by Geographic Location; Geographic Information 

Product revenue by product group is as follows: 

2018 

Years Ended December 31, 
2017 

2016 

Orthobiologics ..........................................    $
Dermal ......................................................      
Surgical ....................................................      
Other .........................................................      

Percentage 
of Product  
Revenue 

Percentage 
of Product  
Revenue 

   Revenue    
93,556       
396       
5,514       
6,065       
  $ 105,531       

   Revenue    
93,816      
2,755      
5,262      
5,950      
100%  $ 107,783      

89%  $
0%    
5%    
6%    

   Revenue    
87%  $  89,695      
2,759      
5,427      
5,051      
100%  $  102,932      

3%    
5%    
5%    

Percentage  
of Product  
Revenue 

87%
3%
5%
5%
100%

Product  revenue  from  the  Company’s  sole  significant  customer,  Mitek,  as  a  percentage  of  the  Company’s  total 

product revenue was 73%, 73%, and 75% for the years ended December 31, 2018, 2017, and 2016, respectively. 

ORTHOVISC became available for sale in the United States on March 1, 2004, and it is marketed exclusively by 
Mitek under the terms of an initial ten-year licensing, distribution, supply, and marketing agreement entered into in December 
2003. The agreement was extended by Mitek for additional five-year terms in 2012 and in 2017, with the current agreement 
to expire on December 20, 2023. 

In December 2011, the Company entered into a fifteen-year licensing agreement with Mitek to exclusively market 
MONOVISC in the United States. The agreement provides certain milestone payments to the Company when rolling end-
user sales of U.S. MONOVISC exceed certain target sales goals. For the years ended December 31, 2018, 2017, and 2016, 
the  Company  recognized  milestone  revenue  of  $0.0  million,  $5.0  million,  and  $0.0  million,  respectively.  The  milestone 
revenue of $5.0 million in 2017 was as a result of MONOVISC achieving end-user sales in 2017 of $100 million within a 
consecutive 12-month period in the United States. 

Total revenue by geographic location based on the location of the customer in total and as a percentage of total 

revenue are as follows: 

Total 
Revenue    

2018 
Percentage of 
Revenue 

Years Ended December 31, 
2017 
Percentage of 
Revenue 

Total 
Revenue    

Total 
Revenue    

2016 
Percentage of 
Revenue 

Geographic Location: 

United States .......................................    $ 85,351       
Europe .................................................       11,730       
Other ....................................................      
8,474       
Total ................................................    $ 105,555       

81%  $ 92,905      
11%     12,435      
8,080      
8%    
100%  $ 113,420      

82%  $  83,972      
11%     10,953      
8,454      
7%    
100%  $  103,379      

81%
11%
8%
100%

61 

   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
        
        
       
        
       
   
  
  
 
 
On May 2, 2018, the Company publicly disclosed a voluntary recall of certain production lots of its HYAFF-based 
products,  HYALOFAST,  HYALOGRAFT  C,  and  HYALOMATRIX.  The  Company  initiated  the  voluntary  recall  after 
internal quality testing, which indicated that the products were at risk of not maintaining certain measures throughout their 
entire shelf life. While there was no indication of any safety or efficacy issue related to the products at the time, the Company 
removed the products from the field as a precautionary measure. During the three-month period ended March 31, 2018 the 
Company recorded a revenue reserve for this voluntary recall of $1.1 million of which $0.9 million was related to revenue 
recorded  in  prior  periods.  The  adjustments  related  to  the  initial  revenue  reserve  subsequent  to  March  31,  2018  were 
immaterial. The revenue reserves impacted Dermal and Orthobiologics product groups and all geographic locations. 

Net long-lived assets, consisting of net property and equipment, are subject to geographic risks because they are 
generally difficult to move and to effectively utilize in another geographic area in a reasonable time period and because they 
are relatively illiquid. Net tangible long-lived assets by principal geographic areas are as follows: 

United States .............................................................   $ 
Italy ...........................................................................     
Total ......................................................................   $ 

51,385     $ 
2,726       
54,111     $ 

52,828  
3,355  
56,183  

   Years Ended December 31, 

2018 

2017 

4. Investments 

All of the Company’s investments are classified as available-for-sale and are carried at fair value with unrealized 
gains and losses recorded as a component of accumulated other comprehensive income (loss), net of related income taxes. 
The Company held U.S. treasury bills of $70.0 million at December 31, 2018. The Company held certificates of deposit of 
$24.0 million at December 31, 2017. Unrealized losses and the associated tax impact on the Company’s available-for-sale 
securities were insignificant as of December 31, 2018 and December 31, 2017, respectively. 

5. Fair Value Measurements 

The Company’s investments are all classified within Level 1 of the fair value hierarchy. The Company’s investments 
classified within Level 1 of the fair value hierarchy are valued based quoted prices in active markets. Level 2 are based on 
matrix pricing compiled by third party pricing vendors, using observable market inputs such as interest rates, yield curves, 
and  credit  risk.  For  cash  and  cash  equivalents,  current  receivables,  accounts  payable,  and  interest  accrual,  the  carrying 
amounts approximate fair value, because of the short maturity of these instruments, and therefore fair value information is 
not included in the table below.  

62 

  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
The classification of the Company’s cash equivalents and investments within the fair value hierarchy is as follows: 

Fair Value Measurements at Reporting Date Using 

Quoted Prices  
in Active  
Markets 
 for Identical  
Assets (Level 1)    

Significant  
Other 
 Observable  
Inputs (Level 2)    

Significant  
 Unobservable  
Inputs (Level 3) 

December 31,  
2018 

   Amortized Cost 

Cash equivalents: 
Money Market Funds ....................   $ 

Investments: 
U.S. treasury bills ..........................   $ 

4,984     $ 

4,984     $ 

69,972     $ 

69,972     $ 

-     $ 

-     $ 

-     $ 

4,984  

-     $ 

69,972  

Fair Value Measurements at Reporting Date Using 

Quoted Prices  
in Active  
Markets 
 for Identical  
Assets (Level 1)    

Significant  
Other 
 Observable  
Inputs (Level 2)    

Significant  
 Unobservable  
Inputs (Level 3) 

December 31,  
2017 

   Amortized Cost 

Cash equivalents: 
Money market funds ......................   $ 
Bank certificates of deposit ............     
Total cash equivalents ....................   $ 

Investments: 
Bank certificates of deposit ............   $ 

5,893     $ 
500       
6,393     $ 

5,893     $ 
-       
5,893     $ 

-     $ 
500       
500     $ 

-     $ 
-       
-     $ 

5,893  
500  
6,393  

24,000     $ 

-     $ 

24,000     $ 

-     $ 

24,000  

The Company did not have transfers in or out of Level 3 of the fair value hierarchy during the years ended December 

31, 2018 and 2017. 

6. Earnings per Share (“EPS”)  

Basic EPS is calculated by dividing net income by the weighted average number of shares outstanding during the 
period. Unvested RSAs, although legally issued and outstanding, are not considered outstanding for purposes of calculating 
basic  earnings  per  share.  Diluted  EPS  is  calculated  by  dividing  net  income  by  the  weighted  average  number  of  shares 
outstanding plus the dilutive effect, if any, of outstanding stock options, stock appreciation rights (“SARs”), RSAs, and RSUs 
using the treasury stock method. 

The following table provides share information used in the calculation of the Company's basic and diluted earnings 

per share: 

Shares used in the calculation of basic earnings per share ...................      
Effect of dilutive securities: 

Stock options, SARs, RSAs and RSUs .........................................     
Diluted shares used in the calculation of earnings per share ................      

Years Ended December 31, 
2017 

2016 

2018 

14,442       

14,575       

14,682  

247       
14,689       

493       
15,068       

434  
15,116  

Stock options to purchase 0.7 million shares, 0.5 million shares, and 0.4 million shares for the years ended December 
31, 2018, 2017, and 2016, respectively, were excluded from the computation of diluted EPS as their effect would have been 
anti-dilutive. The anti-dilutive restricted shares for the years 2018, 2017 and 2016 were insignificant. 

At December 31, 2018, 2017, and 2016 a total of 42 thousand, 0.1 million, and 0.1 million shares of issued and 

outstanding unvested RSAs were excluded from the basic earnings per share. 

On May 24, 2018, the Company entered into an accelerated stock repurchase agreement with Morgan Stanley & Co. 
LLC  (“Morgan  Stanley”)  pursuant  to  a  Fixed  Dollar  Accelerated  Share  Repurchase  Transaction  (“ASR  Agreement")  to 
purchase $30.0 million of shares of its common stock. Pursuant to the terms of the ASR Agreement, the Company delivered 
$30.0 million cash to Morgan Stanley and received an initial delivery of 0.4 million shares of the Company’s common stock 

63 

  
  
    
  
    
  
  
  
    
        
        
        
        
   
  
    
        
        
        
        
   
    
        
        
        
        
   
  
  
    
  
    
  
  
  
    
        
        
        
        
   
  
    
        
        
        
        
   
    
        
        
        
        
   
  
  
  
  
  
  
  
  
  
  
  
    
        
        
   
  
  
  
on May 24, 2018 based on a closing market price of $41.41 and the applicable contractual discount. This was approximately 
60% of the then estimated total number of shares expected to be repurchased under the ASR Agreement. 

On July 16, 2018, the Company settled the approximately $12.0 million remaining under the ASR Agreement, which 
was recorded as an equity forward sale contract and was included in additional paid-in-capital in stockholders' equity in the 
consolidated balance sheet as it met the criteria for equity accounting. Pursuant to the terms of the ASR Agreement, the final 
number of shares and the average purchase price was determined at the end of the applicable purchase period, which was 
July 16, 2018. Based on the volume-weighted average price since the effective date of the ASR Agreement less the applicable 
contractual discount, Morgan Stanley delivered 0.4 million additional shares to the Company on July 19, 2018. In total, 0.8 
million shares were repurchased under the ASR Agreement at an average repurchase price of $37.18 per share. These shares 
are held by the Company as authorized but unissued shares. All shares were repurchased in accordance with the publicly 
announced program, and the Company will not make any further purchases under the program. The initial and final delivery 
of shares resulted in an immediate reduction of the number of outstanding shares used to calculate the weighted-average 
common shares outstanding for basic and diluted net income per share on the effective date of the ASR Agreement. 

On February 26, 2016, the Company entered into an accelerated stock repurchase agreement with Morgan Stanley 
pursuant  to  a  Fixed  Dollar  Accelerated  Share  Repurchase  Transaction  (“ASR  Agreement")  to  purchase  $25.0  million  of 
shares of its common stock. Pursuant to the terms of the ASR Agreement, the Company paid Morgan Stanley $25.0 million in 
cash and received an initial delivery of 0.4 million shares of the Company’s common stock on February 29, 2016 based on a 
closing market price of $46.40 per share and the applicable contractual discount. 

On August 26, 2016, the Company settled the approximately $7.5 million remaining under the ASR Agreement, 
which was recorded as an equity forward sale contract and was included in additional paid-in capital in stockholders' equity 
in the consolidated balance sheet as it met the criteria for equity accounting. Pursuant to the terms of the ASR Agreement, 
the final number of shares and the average purchase price was determined at the end of the applicable purchase period, which 
was August 26, 2016. Based on the volume-weighted average price since the effective date of the ASR Agreement less the 
applicable contractual discount, Morgan Stanley delivered 0.1 million additional shares to the Company on August 31, 2016. 
In total, 0.5 million shares were repurchased under the ASR Agreement at an average repurchase price of $47.08 per share. 
These shares are held by the Company as authorized but unissued shares. The initial and final delivery of shares resulted in 
immediate reductions of the outstanding shares used to calculate the weighted-average common shares outstanding for basic 
and diluted net income per share. 

7. Inventories 

Inventories consist of the following: 

December 31, 

2018 

2017 

Raw materials .............................................................................    $ 
Work-in-process .........................................................................      
Finished goods............................................................................      
Total .......................................................................................    $ 

13,688     $ 
4,626       
6,819       
25,133     $ 

Inventories ..................................................................................    $ 
Other long-term assets ................................................................      

21,300     $ 
3,833       

11,296  
6,062  
4,677  
22,035  

22,035  
-  

Other long-term assets include inventory expected to remain on hand beyond one year as of December 31, 2018. 

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As a result of the voluntary recall of certain production lots of the Company’s HYAFF-based products, more fully 
described in Note 3, the Company recorded an inventory reserve of $0.8 million for non-saleable inventory. In addition, the 
Company recorded a net inventory reserve of $1.3 million for certain HA raw materials, and it recorded a lower of cost or 
net realizable value adjustment of $1.2 million for certain HYAFF-based products during the year ended December 31, 2018. 

8. Property and Equipment 

Property and equipment is stated at cost and consists of the following: 

December 31, 

2018 

2017 

Equipment and software .............................................................    $
Furniture and fixtures .................................................................      
Leasehold improvements ............................................................      
Construction in progress .............................................................      
Subtotal ..................................................................................      
Less accumulated depreciation ...................................................      
Total .......................................................................................    $

39,646     $
2,014       
33,801       
2,720       
78,181       
(24,070)      
54,111     $

37,137  
1,947  
31,459  
5,830  
76,373  
(20,190) 
56,183  

Construction-in-progress at December 31, 2018 and 2017 primarily represents the costs incurred for the development 
of an injectable, HA-based surgical bone repair product expected to launch in 2019. In addition, construction-in-progress at 
December 31, 2017 also included the costs incurred for the implementation of a new ERP that was placed in service in January 
2018. 

Depreciation expense was $4.9 million, $3.3 million, and $2.7 million for the years ended December 31, 2018, 2017, 

and 2016, respectively. 

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9. Acquired Intangible Assets, Net 

Intangible assets consist of the following: 

December 31, 2018 

December 31, 2017 

Accumulated
Currency  
Translation  
Adjustment  

Accumulated 
Amortization  

Net Book 
Value   

Accumulated 
Currency  
Translation  
Adjustment  

Accumulated 
Amortization  

Net Book 
Value   

Useful  
Life 
(in years) 

 Gross Value 

Developed 
technology ........  $ 
In-process 
research & 
development .....    
Distributor 
relationships ......    
Patents ................    
Elevess trade 
name .................    
Total ...............  $ 

17,100   $ 

(2,824)  $ 

(8,672)  $  5,604   $ 

(2,550)  $ 

(7,723)  $  6,827    

15 

4,406     

(1,168)    

-       3,238     

(1,015)    

        3,391    Indefinite 

4,700     
1,000     

(415)    
(169)    

(4,285)    
(482)    

-     
349     

(415)    
(152)    

(4,285)    
(431)    

-    
417    

1,000     
28,206   $ 

-      
(4,576)  $ 

(1,000)    
-     
(14,439)  $  9,191   $ 

-      
(4,132)  $ 

(1,000)    

-    
(13,439)  $ 10,635    

5 
16 

9 

The Company performed an annual assessment of IPR&D intangible assets as of November 30, 2018.  Based upon 
that assessment, for the fiscal year 2018 there were no events or changes in circumstances that would result in a change in 
the carrying value of IPR&D.  

Total amortization expense was $1.0 million, $1.0 million, and $1.1 million for the years ended December 31, 2018, 
2017, and 2016, respectively. Amortization expense on intangible assets is expected to be approximately $1.0 million in 2019, 
$1.0 million annually through 2022, and approximately $2.1 million in aggregate thereafter. 

10. Goodwill 

The Company completed its annual impairment review as of November 30, 2018 and concluded that no impairment 
in the carrying value exists as of that date with respect to goodwill. Through December 31, 2018, there have not been any 
events or changes in circumstances that indicate that the carrying value of goodwill may not be recoverable. Changes in the 
carrying value of goodwill were as follows: 

Balance, beginning .....................................................................   $ 
Effect of foreign currency adjustments ......................................     
Balance, ending ..........................................................................   $ 

8,218  
(367) 
7,851  

December 31, 
2018 

66 

  
  
  
 
  
 
 
 
 
  
  
  
  
   
  
  
  
  
  
  
  
  
  
  
 
 
11. Accrued Expenses 

Accrued expenses consist of the following: 

December 31, 

2018 

2017 

Compensation and related expenses ..................................     $
Professional fees................................................................       
Voluntary recall .................................................................       
Research grants .................................................................       
Clinical trial costs ..............................................................       
Income taxes payable ........................................................       
Other .................................................................................       
Total ..............................................................................     $

4,446     $
1,989       
116       
400       
577       
385       
233       
8,146     $

2,893  
448  
-  
419  
2,318  
-  
248  
6,326  

Included in Compensation and related expenses as of December 31, 2018 are the accrued and unpaid costs related 
to the retirement of the Company’s former Chief Executive Officer as of March 9, 2018. On March 8, 2018 the Company 
entered into a $0.3 million one-year, post-retirement consulting agreement with the former Chief Executive Officer to provide 
certain services as may be requested by the Company through February 28, 2019. On the same date, the Company and the 
former Chief Executive Officer entered into a release agreement related to terms in his employment agreement. Under the 
terms of these agreements, the former Chief Executive Officer is entitled to receive from the Company, as a result of his 
retirement, aggregate benefits of $1.7 million over the 18-month period subsequent to March 9, 2018, among other benefits. 
As more fully described in Note 13, all of the former Chief Executive Officer’s outstanding equity awards vested in full and 
became exercisable upon his retirement. 

Accrued liabilities related to the previously-described product recall of certain production lots of the Company’s 
HYAFF-based products, more fully described in Note 3, includes an accrual as of December 31, 2018 of $0.1 million of 
expenses associated with the administration and remediation of the voluntary recall. 

12. Commitments and Contingencies 

Leasing Arrangements 

On October 9, 2015, the Company’s Italian subsidiary, Anika S.r.l. entered into a build-to-suit lease agreement with 
Consorzio  Zona  Industriale  E  Porto  Fluviale  di  Padova  (“ZIP”)  as  landlord,  pursuant  to  which  Anika  S.r.l.  leases  a  new 
European headquarters facility, consisting of approximately 33,000 square feet of general office, research and development, 
training, and warehousing space located in Padova, Italy. The lease has an initial term of fifteen years, which commenced on 
March 1, 2017. The lease will automatically renew for up to three additional six-year terms, subject to certain terms and 
conditions. The Company has the ability to withdraw from this lease subject to certain financial penalties after six years and 
with no penalties after the ninth year. Beginning on the commencement date, the lease provides for an initial yearly rent of 
approximately $0.3 million. 

Construction of the new facility commenced during the first quarter of 2016. During the period of construction, the 
Company was the deemed owner of the facility. Accordingly, the landlord's costs of constructing the facility were capitalized, 
as a non-cash transaction, offset by a corresponding facility lease obligation in the Company’s consolidated balance sheet. 
When the construction concluded on March 1, 2017, the Company removed the construction-in-process asset of $3.1 million 
and related liability from its consolidated balance sheet. The Company commissioned ZIP for additional tenant improvements 
of $0.8 million, which are recorded within Other long-term assets and amortized over the life of the lease on a straight line 
basis. The  lease  is  accounted  for  as  an operating  lease based on  the  Company’s  assessment  of  the  applicable  accounting 
principles.  

67 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
Rental expense in connection with the various facility leases totaled $1.8 million, $1.8 million, and $1.3 million for 
the years ended December 31, 2018, 2017, and 2016, respectively. The increased expense in 2017 is primarily a result of 
finalizing the exercise of the Company’s first option under the lease to extend the terms from November 1, 2017 through 
October 31, 2022, including the determination of a new annual base rent for the Company’s headquarters facility in Bedford, 
Massachusetts. 

The Company’s future lease commitments as of December 31, 2018 are as follows: 

2019 ..................................................................................    $
2020 ..................................................................................      
2021 ..................................................................................      
2022 ..................................................................................      
2023 ..................................................................................      
2024 and thereafter ...........................................................      
Total ..............................................................................    $

1,879 
1,917 
1,924 
1,672 
414 
897 
8,703 

Warranty and Guarantor Arrangements   

In certain of its contracts, the Company warrants to its customers that the products it manufactures conform to the 
product specifications as in effect at the time of delivery of the specific product. The Company may also warrant that the 
products it manufactures do not infringe, violate or breach any U.S. patent or intellectual property rights, trade secret, or other 
proprietary information of any third party. On occasion, the Company contractually indemnifies its customers against any 
and all losses arising out of, or in any way connected with, any claim or claims of breach of its warranties or any actual or 
alleged defect in any product caused by the negligence or acts or omissions of the Company. The Company  maintains a 
products  liability  insurance  policy  that  limits  its  exposure  to  these  risks.  Based  on  the  Company’s  historical  activity,  in 
combination with its liability insurance coverage, the Company believes the estimated fair value of these indemnification 
agreements is immaterial. The Company has no accrued warranties at December 31, 2018 or 2017, respectively, and has no 
history of claims paid. 

Legal Proceedings 

The Company is involved from time-to-time in various legal proceedings arising in the normal course of business. 
Although the outcomes of potential legal proceedings are inherently difficult to predict, the Company does not expect the 
resolution of potential legal proceedings to have a material adverse effect on its financial position, results of operations, or 
cash flow. 

13. Equity Incentive Plan  

Equity Incentive Plan 

The  Anika  Therapeutics,  Inc.  2017 Omnibus  Incentive  Plan  (the  “2017  Plan”) was  approved by  the Company’s 
stockholders on June 13, 2017 and provides for the grant of incentive stock options, nonqualified stock options, SARs, RSAs, 
RSUs,  and  performance  options  that  may  be  settled  in  cash,  stock,  or  other  property.  In  accordance  with  the  2017  Plan 
approved by the Company’s stockholders, each share award other than stock options or SAR’s will reduce the number of 
total  shares  available  for  grant  by  2.0 shares.  Subject  to  adjustment  for  specified  types  of  changes  in  the  Company’s 
capitalization, no more than 1.2 million shares of common stock may be issued under the 2017 Plan. There are 0.9 million 
shares available for future grant at December 31, 2018. 

68 

   
  
  
  
  
  
  
  
  
  
  
 
 
The  2017  Plan  replaced  the  Anika  Therapeutics, Inc.  Stock  Option  and  Incentive  Plan,  as  amended,  (the  “2003 
Plan”), as the plan under which future grants to employees, directors, officers, and consultants will be made. The terms of the 
2003  Plan  provide  for  grants  of  nonqualified  and  incentive  stock  options,  common  stock,  RSAs,  RSUs,  and  SARs  to 
employees, directors, officers, and consultants. The 2003 Plan was approved by the Company’s stockholders on June 4, 2003 
and subsequently amended by the Board of Directors on May 29, 2009 and by the Company’s stockholders on June 7, 2011 
and June 18, 2013 to increase the number of shares reserved for issuance. Pursuant to the 2011 amendment, each share award 
issued after June 7, 2011, other than stock options or SARs, reduced the number of total shares available for grant by 1.9 
shares. Pursuant to the 2013 amendment, each share award issued after June 18, 2013, other than stock options or SARs, 
reduced the number of total shares available for grant by 1.5 shares. 

 The  Company  may  satisfy  the  awards  upon  exercise,  or  upon  fulfillment  of  the  vesting  requirements  for  other 
equity-based awards, with either newly-issued shares or shares reacquired by the Company. Stock-based awards are granted 
with  an  exercise  price  equal  to  the  market  price  of  the  Company’s  stock  on  the  date  of  grant.  Awards  contain  service 
conditions or service and performance conditions, and they generally become exercisable ratably over one to four years with 
a maximum contractual term of ten years. 

The Company estimates the fair value of stock options and SARs using the Black-Scholes valuation model. Fair 
value of restricted stock is measured by the grant-date price of the Company’s shares. Key input assumptions used to estimate 
the fair value of stock options and SARs include the exercise price of the award, the expected award term, the expected 
volatility of the Company’s stock over the option’s expected term, the risk-free interest rate over the award’s expected term, 
and the Company’s expected annual dividend yield. 

The expected volatility assumption is evaluated against the historical volatility of the Company’s common stock 
over  a 4.5  year  average,  and  it  is  adjusted if  there  are  material  changes in  historical  volatility.  The  risk-free  interest  rate 
assumption is based on U.S. Treasury interest rates at the time of grant. 

The weighted-average grant-date fair value per share of stock options granted in 2018, 2017 and 2016 was $20.01, 
$16.87 and $16.65, respectively. The fair value of each stock option during 2018, 2017, and 2016 was estimated on the grant 
date using the Black-Scholes option-pricing model with the following assumptions: 

Risk free interest rate ............................  
Expected volatility ................................   37.12% -  45.61%    38.74% -  44.31%    47.33% -  51.61% 
Expected life (years) .............................  
Expected dividend yield ........................  

4.0 -  4.5 
0.00% 

 4.5   
0.00% 

 4.0   
0.00% 

2018 
2.15% -  2.82% 

2017 
1.60% -  1.86% 

2016 
0.94% -  1.55% 

 Stock Options and Restricted Stock 

The following table sets forth share information for stock-based compensation awards granted and exercised during 

the period ended December 31, 2018 and 2017: 

Twelve Months Ended  
December 31, 

2018 

2017 

Grants: 

Stock options ............................................      
RSAs ........................................................      
RSUs ........................................................      

199,970       
64,578       
15,457       

Exercises: 

Stock options ............................................      
SARs ........................................................      

284,548       
-       

440,688  
26,306  
9,970  

12,941  
5,000  

69 

  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
     
        
   
  
  
  
 
 
The Company recorded $11.0 million, $5.8 million, and $3.4 million of stock-based compensation expense for the 
years ended December 31, 2018, 2017, and 2016, respectively, for stock options, SARs, RSAs and RSUs with corresponding 
tax benefits of $1.5 million, $0.4 million and $0.6 million, respectively. Upon the retirement of the Company’s former Chief 
Executive  Officer  on  March  9,  2018,  all  of  his  outstanding  stock-based  compensation  awards  vested  in  full  and  became 
exercisable in accordance with their terms, resulting in a one-time expense of $6.2 million that was fully recognized during 
the three-month period ended March 31, 2018. 

The Company presents the expenses related to stock-based compensation awards in the same expense line items as 

cash compensation paid to each of its employees as follows: 

Cost of product revenue ...............................................................    $ 
Research & development ..............................................................      
Selling, general & administrative .................................................      
Total stock-based compensation expense .....................................    $ 

(160)    $ 
851       
10,355       
11,046     $ 

439     $ 
564       
4,804       
5,807     $ 

148  
467  
2,777  
3,392  

2018 

2017 

2016 

The decrease in stock-based compensation expense within the cost of product revenue line item for the year ended 
December  31,  2018  is  due  to  forfeitures  associated  with  unvested  stock  option  awards  from  the  resignation  of  a  former 
executive. 

The combined stock options and SARs activity for the year ended December 31, 2018 is as follows: 

2018 

Options and SARs outstanding at beginning of year ...........................................      
Granted ............................................................................................................      
Cancelled .........................................................................................................      
Expired ............................................................................................................      
Exercised .........................................................................................................      
Options and SARs outstanding at end of year .....................................................      

Number of 
Shares 

Weighted 
Average Exercise 
Price Per Share 
33.70  
58.11  
50.19  
46.49  
10.14  
42.06  

1,327,200     $ 
199,970     $ 
(104,629)    $ 
(1,079)    $ 
(284,548)    $ 
1,136,914     $ 

All the 1,136,914 stock options and SARs outstanding at December 31, 2018 are vested or are expected to vest, with 
a weighted-average exercise price of $42.06 as well as an aggregate intrinsic value of $3.7 million. The weighted average 
remaining contractual term of the vested and expected to vest stock options and SARs was 5.0 years as of December 31, 
2018. 

As of December 31, 2018, total unrecognized compensation costs related to non-vested stock options and SARs was 

approximately $4.4 million and is expected to be recognized over a weighted average period of 2.4 years. 

70 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
The exercisable options and SARs at December 31, 2018 are as follows: 

Number 
 Outstanding    

Weighted Avg  
Exercise Price    

Weighted  
Average  
Remaining  
Term 
(in years) 

Incentive stock options ............................       
Non-qualified stock options ....................       
Performance awards ................................       
Stock appreciation rights .........................       

139,674     $ 
453,790     $ 
100,963     $ 
35,250     $ 

24.53       
40.74       
40.72       
6.36       

4.1  
3.2  
3.1  
1.1  

The total intrinsic value of stock options and SARs exercised was $8.5 million, $0.5 million and $2.1 million for the 

years ended December 31, 2018, 2017 and 2016, respectively. 

The total fair value of stock options and SARs vested during the years ended December 31, 2018, 2017 and 2016 

was approximately $6.7 million, $2.1 million and $1.3 million, respectively. 

The RSA and RSU activity for the year ended December 31, 2018 is as follows: 

2018 

Weighted 
Average 
Grant Date 
Fair Value 

Number of 
Shares 

Unvested at Beginning of year ..................................................      
Granted..................................................................................      
Cancelled ..............................................................................      
Vested/Released ....................................................................      
Unvested at end of year .............................................................      

229,226     $ 
80,035     $ 
(126,946)    $ 
(123,232)    $ 
59,083     $ 

42.47  
58.84  
42.47  
50.80  
47.26  

The total fair value of RSAs and RSUs vested during the years ended December 31, 2018, 2017 and 2016 was $6.8 
million, $2.3 million and $1.0 million. The weighted-average grant-date fair value of RSAs and RSUs granted during the 
years ended December 31, 2018, 2017 and 2016 was $58.84, $52.03 and $38.11, respectively. 

14. Employee Benefit Plan 

The Company’s U.S. employees are eligible to participate in the Company’s 401(k) savings plan. Employees may 
elect to contribute a percentage of their compensation to the plan, and the Company will make 140% matching contributions 
up  to  a  limit  of  5%  of  an  employee’s  eligible  compensation.  In  addition,  the  Company  may  make  annual  discretionary 
contributions. The Company made matching contributions of $0.8 million, $0.6 million, and $0.6 million for the years ended 
December 31, 2018, 2017, and 2016, respectively. 

15. Shareholder Rights Plan 

On April 4, 2008, the Board of Directors of the Company adopted a Shareholder Rights Plan (the “2008 Plan”). The 
2008 Plan expired on April 8, 2018, and the Company did not extend the 2008 Plan or adopt a new Shareholder Rights Plan. 

16. Income Taxes  

On  December  22,  2017,  the  Tax  Cuts  and  Jobs  Act  (the  “2017  Tax  Act”)  was  enacted.  This  legislation  made 

significant changes to the U.S. tax law, including a reduction in the corporate tax rate from 35% to 21% starting in 2018. 

In accordance with Staff Accounting Bulletin No. 118, which provides guidance on accounting for the tax effects of 
the 2017 Tax Act, the Company has recorded the impact on the consolidated financial statements. There were no significant 
changes in the provisional amount recorded in 2017 related to the finalization of the Company’s analysis. The other provisions 
of the Tax Act did not have a material impact on the 2017 consolidated financial statements. 

71 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
 
 
Income Tax Expense 

The components of the Company’s income before income taxes and its provision for (benefit from) income taxes 

consist of the following: 

Income before income taxes 

Years ended December 31, 
2017 

2018 

2016 

Domestic ..................................................................................    $ 
Foreign .....................................................................................      
   $ 

26,227     $ 
(3,020)      
23,207     $ 

48,446     $ 
(2,244)      
46,202     $ 

50,181  
689  
50,870  

Provision for (benefit from) income taxes: 
Current provision: 

Federal ......................................................................................    $ 
State ..........................................................................................      
Foreign .....................................................................................      

Deferred provision: 

Federal ......................................................................................      
State ..........................................................................................      
Foreign .....................................................................................      

Total provision .........................................................................    $ 

Years ended December 31, 
2017 

2018 

2016 

4,783     $ 
1,644       
405       
6,832       

(992)      
(152)      
(1,203)      
(2,347)      
4,485     $ 

12,608     $ 
2,737       
31       
15,376       

(426)      
(68)      
(496)      
(990)      
14,386     $ 

14,982  
3,265  
302  
18,549  

(70) 
(84) 
(72) 
(226) 
18,323  

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Deferred Tax Assets and Liabilities 

Significant components of the Company’s deferred tax assets and liabilities consist of the following: 

December 31, 

2018 

2017 

Deferred tax assets: 

Net operating loss carry forward, foreign ................     $ 
Stock-based compensation expense ........................       
Foreign currency exchange .....................................       
Accrued expenses and other ....................................       
Inventory reserve .....................................................       
Deferred tax assets ..................................................     $ 

1,382     $ 
3,148       
363       
818       
1,500       
7,211     $ 

959  
2,309  
265  
496  
740  
4,769  

December 31, 

2018 

2017 

Deferred tax liabilities: 

Acquisition-related Intangibles ...............................    $ 
Depreciation ............................................................      
Deferred tax liabilities .............................................    $ 

(2,405)    $ 
(8,348)      
(10,753)    $ 

(2,743) 
(7,419) 
(10,162) 

Net deferred tax liabilities ...........................................     $ 

(3,542)    $ 

(5,393) 

Tax Rate 

The  reconciliation  between  the  U.S.  federal  statutory  rate  and  the  Company’s  effective  rate  is  summarized  as 

follows: 

Years ended December 31, 
2017 

2016 

2018 

Statutory federal income tax rate ...................................................................     
State tax expense, net of federal benefit ........................................................     
Impact of rate change on deferred taxes ........................................................     
Permanent items, including nondeductible expenses ....................................     
State investment tax credit ............................................................................     
Federal, state and foreign research and development credits ........................     
Foreign rate differential .................................................................................     
Domestic production deduction .....................................................................     
Stock compensation .......................................................................................     
Non-deductible Section 162(m) compensation limitation .............................     
Foreign derived intangible income deduction ...............................................     
Effective income tax rate ...............................................................................     

21.0%     
5.5%     
0.0%     
(1.4%)     
(0.2%)     
(3.4%)     
(0.4%)     
0.0%     
(4.8%)     
4.3%     
(1.3%)     
19.3%     

35.0%     
4.8%     
(4.9%)     
0.1%     
(0.7%)     
(1.4%)     
0.5%     
(2.8%)     
(0.2%)     
0.7%     
0.0%     
31.1%     

35.0% 
4.5% 
0.0% 
0.1% 
(0.1%) 
(0.9%) 
(0.1%) 
(2.9%) 
0.1% 
0.3% 
0.0% 
36.0% 

As of December 31, 2018, the Company had NOL’s for income tax purposes in Italy of $5.8 million that do not 

expire. 

Accounting for Uncertainty in Income Taxes 

The Company had no unrecognized tax benefits for the years ended December 31, 2018 and 2017, respectively. The 
Company does not anticipate experiencing any significant increases or decreases in its unrecognized tax benefits within the 
twelve months following December 31, 2018. 

In  the  normal  course  of  business,  Anika  and  its  subsidiaries  may  be  periodically  examined  by  various  taxing 
authorities. We file income tax returns in the U.S. federal jurisdiction, in certain U.S. states, and in Italy. The associated tax 
filings remain subject to examination by applicable tax authorities for a certain length of time following the tax year to which 
those filings relate. The 2015 through 2017 tax years remain subject to examination by the IRS and other taxing authorities 
for U.S. federal and state tax purposes. The 2012 through 2017 tax years remain subject to examination by the appropriate 
governmental authorities for Italy. 

73 

  
  
  
  
  
  
  
     
        
   
  
  
  
  
  
  
     
        
   
  
     
        
   
  
  
  
  
  
  
  
  
  
  
  
  
Upon the settlement of certain stock-based awards (i.e., exercise, vesting, forfeiture, or cancellation), the actual tax 
deduction is compared with cumulative financial reporting compensation cost, and any excess tax deduction related to these 
awards is considered a windfall tax benefit. With the adoption of ASU 2016-09 in 2017, the Company records windfall tax 
benefits  to  income  tax  expense.  The  Company  follows  the  with-and-without  approach  for  the  direct  effects  of 
windfall/shortfall  items  and  to  determine  the  timing  of  the  recognition  of  any  related  benefits.  The  Company  recorded  a 
windfall tax benefit in income tax expense of $1.5 million in 2018 compared to $0.4 million in 2017. 

17. Revolving Credit Agreement 

On October 24, 2017, the Company, as borrower, entered into a new five-year agreement with Bank of America, 
N.A., as administrative agent, swingline lender and issuer of letters of credit, for a $50.0 million senior revolving line of 
credit (the “Credit Agreement”). Subject to certain conditions, the Company may request up to an additional $50.0 million in 
commitments for a maximum aggregate commitment of $100.0 million, which requests must be approved by the Revolving 
Lenders (as defined  in  the  Credit  Agreement).  Loans under  the  Credit  Agreement  generally  bear  interest  equal  to,  at  the 
Company’s option, either: (i) LIBOR plus the Applicable Margin, as defined below, or the (ii) Base Rate, defined as the 
highest of: (a) the Federal Funds Rate plus 0.50%, (b) Bank of America, N.A.’s prime rate and (c) the one month LIBOR 
adjusted daily plus 1.0%, plus the Applicable Margin. The Applicable Margin ranges from 0.25% to 1.75% based on the 
Company’s consolidated leverage ratios at the time of the borrowings under the Credit Agreement. The Company has agreed 
to pay a commitment fee in an amount that is equal to 0.25% per annum on the actual daily unused amount of the credit 
facility and that is due and payable quarterly in arrears. Loan origination costs are included in Other long-term assets and are 
being amortized over the five-year term of the Credit Agreement. As of December 31, 2018 and 2017, there are no outstanding 
borrowings under the Credit Agreement and the Company is in compliance with the terms of the Credit Agreement. 

 The  Credit  Agreement  contains  customary  representations,  warranties,  affirmative  and  negative  covenants, 
including financial covenants, events of default and indemnification provisions in favor of the Lenders (as defined in the 
Credit Agreement). The covenants include restrictions governing the Company’s leverage ratio and interest coverage ratio, 
its incurrence of liens and indebtedness, and its entry into certain merger and acquisition transactions or dispositions and 
other matters, all subject to certain exceptions. The financial covenants require the Company not to exceed certain maximum 
leverage and interest coverage ratios. The Lenders have been granted a first priority lien and security interest in substantially 
all of the Company’s assets, except for certain intangible assets. 

74 

  
  
  
  
  
 
 
18. Quarterly Financial Data (Unaudited) 

Year 2018 
Product revenue ..................................................................   $ 
Total revenue ......................................................................     
Cost of product revenue .....................................................     
Gross profit on product revenue .........................................     
Net income .........................................................................   $ 
Per common share information: 

Basic net income per share .............................................   $ 
Basic common shares outstanding ..................................     
Diluted net income per share ..........................................   $ 
Diluted common shares outstanding ..............................     

Quarter ended
December 31   

Quarter ended
September 30  

Quarter ended
June 30 

Quarter ended
March 31 

26,950   $ 
26,956     
7,001     
19,949     
7,717   $ 

0.54   $ 
14,168     
0.54   $ 
14,299     

26,781    $ 
26,787      
8,282      
18,499      
7,599    $ 

0.53    $ 
14,237      
0.53    $ 
14,377      

30,542   $ 
30,548     
8,152     
22,390     
10,092   $ 

0.69   $ 
14,652     
0.68   $ 
14,915     

21,258   
21,264   
7,845   
13,413   
(6,686 ) 

(0.46 ) 
14,679   
(0.46 ) 
14,679   

Quarter ended
December 31   

Quarter ended
September 30  

Quarter ended
June 30 

Quarter ended
March 31 

28,884   $ 
29,388     
8,716     
20,168     
8,067   $ 

0.55   $ 
14,596     
0.53   $ 
15,141     

27,178    $ 
27,184      
6,250      
20,928      
6,887    $ 

0.47    $ 
14,579      
0.46    $ 
15,115      

28,340   $ 
33,462     
6,315     
22,025     
11,369   $ 

0.78   $ 
14,588     
0.76   $ 
15,044     

23,381   
23,386   
6,083   
17,298   
5,493   

0.38   
14,576   
0.37   
15,043   

Year 2017 
Product revenue ..................................................................   $ 
Total revenue ......................................................................     
Cost of product revenue .....................................................     
Gross profit on product revenue .........................................     
Net income .........................................................................   $ 
Per common share information: 

Basic net income per share .............................................   $ 
Basic common shares outstanding ..................................     
Diluted net income per share ..........................................   $ 
Diluted common shares outstanding ..............................     

75 

  
 
 
   
      
       
      
    
  
 
 
   
      
       
      
    
  
  
  
  
  
  
  
 
 
ITEM 9A. CONTROLS AND PROCEDURES 

(a) 

Evaluation of disclosure controls and procedures. 

As  required  by  Rule 13a-15  under  the  Securities  Exchange  Act  of  1934  (“Exchange  Act”),  we  carried  out  an 
evaluation under the supervision and with the participation of our management, including our chief executive officer and 
chief financial officer, of the effectiveness of the design and operation of our disclosure controls and procedures as of the end 
of the period covered by this report. Based upon that evaluation, the chief executive officer and chief financial officer have 
concluded  that  our  disclosure  controls  and  procedures  are  effective  as  of  December  31,  2018  to  ensure  that  information 
required to be disclosed by us in reports we file or submit under the Exchange Act is recorded, processed, summarized, and 
reported  within  the  time  periods  specified  in  SEC  rules  and  forms.  Disclosure  controls  and  procedures  include,  without 
limitation, controls and procedures designed to ensure that information required to be disclosed by our company in the reports 
we  file  or  submit  under  the  Exchange  Act  is  accumulated  and  communicated  to  our  management,  including  our  chief 
executive officer and chief financial officer, or persons performing similar functions, as appropriate to allow timely decisions 
regarding required disclosure. On an on-going basis, we review and document our disclosure controls and procedures, and 
our  internal  control  over  financial  reporting,  and  we  may  from  time  to  time  make  changes  aimed  at  enhancing  their 
effectiveness and ensuring that our systems evolve with our business. 

(b) 

Changes in internal controls over financial reporting. 

In January 2018, we placed in service our new enterprise resource planning software. In this regard, we reviewed 
and modified our internal controls, as necessary. There were no changes in our internal control over financial reporting during 
the quarter ended December 31, 2018 that have materially affected, or that are reasonably likely to materially affect, our 
internal controls over financial reporting. 

Management’s Report on Internal Control over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting 
as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act. Our internal control over financial reporting is a process 
designed  to  provide  reasonable  assurance  regarding  the  reliability  of  financial  reporting  and  the  preparation  of  financial 
statements for external purposes in accordance with generally accepted accounting principles in the United States. 

Because of its inherent limitations, internal control over financial reporting can provide only reasonable assurance, 
and it 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. 

Our management assessed the effectiveness of our internal control over financial reporting as of December 31, 2018. 
In  making  this  assessment, management  used  the  criteria  set forth by  the  Committee  of  Sponsoring Organizations of  the 
Treadway Commission in its 2013 Internal Control—Integrated Framework. 

Based on its assessment and those criteria, our management believes that our company maintained effective internal 

control over financial reporting as of December 31, 2018. 

The  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December 31,  2018  has  been  audited  by 
Deloitte & Touche LLP an independent registered public accounting firm, as stated in their report which is included below 
in this Item 9A of this annual report on Form 10-K. 

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM  

To the Board of Directors and Stockholders of Anika Therapeutics, Inc. 

Opinion on Internal Control over Financial Reporting  

We have audited the internal control over financial reporting of Anika Therapeutics, Inc. and subsidiaries (the “Company”) 
as of December 31, 2018, based on criteria established in Internal Control — Integrated Framework (2013) issued by the 
Committee of Sponsoring Organizations of the Treadway Commission (COSO). In our opinion, the Company maintained, in 
all material respects, effective internal control over financial reporting as of December 31, 2018, based on criteria established 
in Internal Control — Integrated Framework (2013) issued by COSO. 

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) 
(PCAOB), the consolidated financial statements as of and for the year ended December 31, 2018, of the Company and our 
report dated February 26, 2019, expressed an unqualified opinion on those financial statements. 

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 
Annual Report on 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/ Deloitte & Touche LLP 

Boston, Massachusetts  
February 26, 2019 

77 

  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
 
 
PART III 

ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  our  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of our 
fiscal year ended December 31, 2018. 

ITEM 11. EXECUTIVE COMPENSATION 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  our  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of our 
fiscal year ended December 31, 2018. 

ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND 
RELATED STOCKHOLDER MATTERS 

The information required under this item and Item 5 of this Annual Report on Form 10-K under the heading “Equity 
Compensation  Plan  Information”  is  incorporated  herein  by  reference  to  our  definitive  proxy  statement  pursuant  to 
Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of our fiscal year 
ended December 31, 2018. 

ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR 
INDEPENDENCE 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  our  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of our 
fiscal year ended December 31, 2018. 

ITEM 14. PRINCIPAL ACCOUNTING FEES AND SERVICES 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  our  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of our 
fiscal year ended December 31, 2018. 

ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES 

PART IV 

(a) 

Documents filed as part of Form 10-K. 

(1)            Financial Statements 

Reports of Independent Registered Public Accounting Firms ........................................................................... 
47
49
Consolidated Balance Sheets ............................................................................................................................. 
50
Consolidated Statements of Operations and Comprehensive Income ............................................................... 
Consolidated Statements of Stockholders’ Equity ............................................................................................ 
51
Consolidated Statements of Cash Flows ........................................................................................................... 
52
Notes to Consolidated Financial Statements .....................................................................................................  53-75

(2)            Schedules 

Schedules have been omitted as all required information has been disclosed in the financial statements and related 

footnotes.  

78 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
(3)            Exhibits 

Exhibit  
Number 

Description 

3.1 
3.2 
10.1a 

10.1b 

10.2a 

10.2b 

10.2c 

10.2d 

10.2e 

10.3a 

10.3b 

10.4a 

10.4b 

10.5 

10.6a 

10.6b 

10.7 

*10.8 

*10.9 

  Certificate of Incorporation of Anika Therapeutics, Inc. 
   Bylaws of Anika Therapeutics, Inc., effective as of June 6, 2018 

Lease, dated January 3, 2007, between Anika Therapeutics, Inc. and Farley White Wiggins, LLC, relating to 32 
Wiggins Avenue, Bedford, Massachusetts 
Amendment  No.  1  to  Lease,  dated  February  1,  2007,  between  Anika  Therapeutics,  Inc.  and  Farley  White 
Wiggins, LLC, relating to 32 Wiggins Avenue, Bedford, Massachusetts 
Lease  Agreement,  dated  December  30,  2009,  between  Fidia  Farmaceutici  S.p.A.  and  Fidia  Advanced 
Biopolymers S.r.l., relating to Via Ponte della Fabbrica 3/A and 3/B Abano Terme, Padua, Italy 
Amendment  No. 1  to  Lease Agreement,  dated  June 18, 2010,  between Fidia  Farmaceutici  S.p.A.  and Anika 
Therapeutics S.r.l. (formerly Fidia Advanced Biopolymers S.r.l.) relating to Via Ponte Della Fabbrica 3/A and 
3/B Abano Terme, Padua, Italy 
Amendment No. 2 to Lease Agreement, dated September 20, 2010, between Fidia Farmaceutici S.p.A. and Anika 
Therapeutics S.r.l. (formerly Fidia Advanced Biopolymers S.r.l.) relating to Via Ponte Della Fabbrica 3/A and 
3/B Abano Terme, Padua, Italy 
Translation of Amendment No. 3 to Lease Agreement, dated April 16, 2012, between Fidia Farmaceutici S.p.A. 
and Anika Therapeutics S.r.l. (formerly Fidia Advanced Biopolymers S.r.l.) relating to Via Ponte Della Fabbrica 
3/A and 3/B Abano Terme, Padua, Italy 
Translation of Amendment No. 4 to Lease Agreement, dated February 22, 2016, between Fidia Farmaceutici 
S.p.A. and Anika Therapeutics S.r.l. (formerly Fidia Advanced Biopolymers S.r.l.) relating to Via Ponte Della 
Fabbrica 3/A and 3/B Abano Terme, Padua, Italy 
Translation of Lease Agreement, dated October 9, 2015, between Anika Therapeutics S.r.l. and Consorzio Zona 
Industriale  E  Porto  Fluviale  di  Padova  relating  to  Land  Registry  of  the  Municipality  of  Padova,  Page  148, 
cadastral map 516 and 517 
Translation of Amendment No. 1 to Lease Agreement, dated February 2, 2017, between Anika Therapeutics 
S.r.l. and Consorzio Zona Industriale E Porto Fluviale di Padova relating to Land Registry of the Municipality 
of Padova, Page 148, cadastral map 516 and 517 
Credit Agreement, dated as of October 24, 2017, among Anika Therapeutics, Inc., certain subsidiaries of Anika 
Therapeutics, Inc. as are or may from time to time become parties to the Credit Agreement, Bank of America, 
N.A., as administrative agent, swingline lender and issuer of letters of credit, and the lenders party thereto. 
Security  and  Pledge  Agreement,  dated  as  of  October  24,  2017,  among  Anika  Therapeutics,  Inc.,  certain 
subsidiaries of Anika Therapeutics, Inc. listed on the signature pages thereto, and Bank of America, N.A., as 
administrative agent. 
Sale and Purchase Agreement, dated December 30, 2009, by and between Fidia Farmaceutici S.p.A. and Anika 
Therapeutics, Inc. 
Tolling  Agreement,  dated  December  30,  2009,  between  Fidia  Farmaceutici  S.p.A.  and  Fidia  Advanced 
Biopolymers S.r.l. 
Amendment No. 1 to Tolling Agreement, dated January 1, 2012, between Fidia Farmaceutici S.p.A. and Anika 
Therapeutics S.r.l. (formerly Fidia Advanced Biopolymers S.r.l.)  
Registration  Rights  Agreement,  dated  December  30,  2009,  between  Anika  Therapeutics,  Inc.  and  Fidia 
Farmaceutici S.p.A. 
License Agreement, dated as of December 20, 2003, by and between Anika Therapeutics, Inc. and Ortho Biotech 
Products, L.P. 
License Agreement, dated as of December 21, 2011, by and between Anika Therapeutics, Inc. and DePuy Mitek, 
Inc. 

   Anika Therapeutics, Inc. Senior Executive Incentive Compensation Plan 
   Anika Therapeutics, Inc. Non-Employee Director Compensation Policy 

†10.10 
†10.11 
†10.12a     Second Amended and Restated 2003 Stock Option and Incentive Plan (adopted April 5, 2011) 
†10.12b     Amendment to Second Amended and Restated 2003 Stock Option and Incentive Plan (adopted April 11, 2013) 

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Exhibit  
Number 

Description 

†10.12c     Form  of  Incentive  Stock  Option  Agreement  under  Second  Amended  and  Restated  2003  Stock  Option  and 

Incentive Plan   

†10.12d     Form  of  Non-Qualified  Stock  Option  Agreement  for  Non-Employee  Directors  under  Second  Amended  and 

Restated 2003 Stock Option and Incentive Plan  

Amendment No. 1 dated March 8, 2018 to Employment Agreement dated July 27, 2017 by and between Anika 
Therapeutics, Inc. and Joseph G. Darling 

Form of Notice of Grant of Incentive Stock Option, including Terms and Conditions of Stock Option, granted 
under Anika Therapeutics, Inc. 2017 Omnibus Incentive Plan. 
Form of Notice of Grant of Nonqualified Stock Option, including Terms and Conditions of Stock Option, granted 
under Anika Therapeutics, Inc. 2017 Omnibus Incentive Plan 
Form of Notice of Grant of Restricted Stock Award, including Terms and Conditions of Restricted Stock Award, 
granted under Anika Therapeutics, Inc. 2017 Omnibus Incentive Plan. 
Form of Notice of Grant of Restricted Stock Units, including Terms and Conditions of Restricted Stock Units, 
granted under Anika Therapeutics, Inc. 2017 Omnibus Incentive Plan 

†10.13a     Anika Therapeutics, Inc. 2017 Omnibus Incentive Plan  
†10.13b    
†10.13c    
†10.13d    
†10.13e    
†10.14a     Employment Agreement, dated July 27, 2017, by and between Anika Therapeutics, Inc. and Joseph Darling 
†10.14b    
†10.15a     Employment Agreement, dated March 22, 2010, between Anika Therapeutics, Inc. and Sylvia Cheung 
†10.15b    
†10.16a     Employment Agreement, dated September 10, 2009, between Anika Therapeutics, Inc. and Frank J. Luppino 
†10.16b    
†10.17a    
†10.17b    
10.18 
10.19 

Amendment No. 1 to Employment Agreement, dated December 1, 2010, by and between Anika Therapeutics, 
Inc. and Frank J. Luppino 
Employment Agreement, dated October 17, 2008, between Anika Therapeutics, Inc. and Charles H. Sherwood, 
Ph.D. 
Amendment No. 1 to Employment Agreement, dated December 8, 2010, by and between Anika Therapeutics, 
Inc. and Charles H. Sherwood, Ph.D. 

Amendment No. 1 to the Employment Agreement, dated December 8, 2010, by and between Anika Therapeutics, 
Inc. and Sylvia Cheung 

   Consulting Agreement between Anika Therapeutics, Inc. and Charles H. Sherwood, Ph.D., dated March 8, 2018 
Fixed Dollar Accelerated Share Repurchase Transaction Confirmation entered into as of May 24, 2018 by and 
between Morgan Stanley & Co. LLC and Anika Therapeutics, Inc. 

21.1 
23.1 
23.2 
31.1 
31.2 
**32.1 

***101 

   List of Subsidiaries of Anika Therapeutics, Inc. 
   Consent of Deloitte & Touche LLP  
   Consent of PricewaterhouseCoopers LLP 
   Certification of Principal Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 
   Certification of Principal Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 

Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act 
of 2002 
The following materials from the Annual Report on Form 10-K of Anika Therapeutics, Inc. for the fiscal year 
ended December 31, 2018, formatted in XBRL:  (i) Consolidated Balance Sheets as of December 31, 2018 and 
December 31, 2017; (ii) Consolidated Statements of Operations and Comprehensive Income for the Years Ended 
December 31, 2018, December 31, 2017, and December 31, 2016; (iii) Consolidated Statements of Stockholders’ 
Equity for the Years Ended December 31, 2018, December 31, 2017, and December 31, 2016; (iv) Consolidated 
Statements of Cash Flows for the Years Ended December 31, 2018, December 31, 2017, and December 31, 
2016; and (v) Notes to Consolidated Financial Statements 

†  Management contract or compensatory plan or arrangement. 
* 

** 

Certain  portions  of  this  document  have  been  omitted  pursuant  to  a  confidential  treatment  request  filed  with  the 
Securities and Exchange Commission. The omitted portions have been filed separately with the Commission. 
The certification attached as Exhibit 32.1 that accompanies this Form 10-K is not deemed filed with the SEC and is 
not to be incorporated by reference into any filing of Anika Therapeutics, Inc. under the Securities Act of 1933 or the 
Securities Exchange Act of 1934, whether made before or after the date of this Form 10-K, irrespective of any general 
incorporation language contained in such filing. 

***  Pursuant to Rule 406T of Regulation S-T, XBRL (Extensible Business Reporting Language) information is deemed 
not filed or a part of a registration statement or prospectus for purposes of sections 11 or 12 of the Securities Act of 
1933,  is  deemed  not  filed  for  purposes  of  section 18  of  the  Securities  Exchange  Act  of  1934  and  otherwise  is  not 
subject to liability under these sections. 

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Pursuant  to  the  requirements  of  Section 13  or  15(d)  of  the  Securities  Exchange  Act  of  1934,  as  amended,  the 

registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized. 

SIGNATURES 

Date: February 26, 2019 

ANIKA THERAPEUTICS, INC. 

By:  

/s/ JOSEPH G. DARLING 
Joseph G. Darling 

   President and Chief Executive Officer  

SIGNATURES 

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/ JOSEPH G. DARLING. 
Joseph G. Darling 

  Chief Executive Officer, President, Director 
  (Principal Executive Officer) 

   February 26, 2019 

/s/ SYLVIA CHEUNG 
Sylvia Cheung 

  Chief Financial Officer 
  (Principal Accounting Officer and Principal Financial Officer) 

   February 26, 2019 

/s/ JOSEPH L. BOWER 
Joseph L. Bower 

  Director, Chairman of the Board 

/s/ CHERYL BLANCHARD 
Cheryl Blanchard 

  Director 

/s/ RAYMOND J. LAND 
Raymond J. Land 

  Director 

/s/ GLENN R. LARSEN, PH.D. 
Glenn R. Larsen, Ph.D. 

  Director 

/s/ JEFFERY S. THOMPSON 
Jeffery S. Thompson 

  Director 

/s/ SUSAN VOGT 
Susan Vogt 

  Director 

   February 26, 2019 

   February 26, 2019 

   February 26, 2019 

   February 26, 2019 

   February 26, 2019 

   February 26, 2019 

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32 Wiggins Avenue 
Bedford, MA 01730 USA

www.anikatherapeutics.com

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