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CASI Pharmaceuticals Inc

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FY2018 Annual Report · CASI Pharmaceuticals Inc
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FORM 10-K 

SECURITIES AND EXCHANGE COMMISSION 

WASHINGTON, D. C. 20549 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15 (d) OF 
THE SECURITIES EXCHANGE ACT OF 1934  
For the fiscal year ended December 31, 2018 

Commission file number 0-20713 

CASI PHARMACEUTICALS, INC. 
_______________ 
(Exact name of registrant as specified in its charter) 

Delaware 

58-1959440 

(State of Incorporation) 

(I.R.S. Employer Identification No.) 

9620 Medical Center Drive, Suite 300, Rockville, MD 

(Address of principal executive offices) 

20850 

(Zip Code) 

Registrant's telephone number, including area code:   (240) 864-2600 

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

Common Stock, $0.01 par value 
(Title of each class) 

The NASDAQ Stock Market LLC 
(Name of each exchange on which registered) 

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 X 

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

Yes___ No X 

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

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be 
submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such 
shorter period that the registrant was required to submit and post such files). Yes X No___  

Indicate by check mark 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, 
or  a  smaller  reporting  company.   See  the definitions of “large accelerated filer,”  “accelerated filer”  and  “smaller  reporting 
company” in Rule 12b-2 of the Exchange Act.  (Check one): 

Large accelerated filer (cid:134)  

Accelerated filer (cid:59)  

Non-accelerated filer (cid:134)  

Smaller reporting company (cid:59)(cid:3)
Emerging growth  
company (cid:134) 

                                                     
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
  
  
 
 
 
 
 
 
 
 
  
  
  
 
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. (cid:134) 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).  Yes__ No X  

As  of  June  30,  2018,  the  aggregate  market  value  of  the  shares  of  common  stock  held  by  non-affiliates  was 
approximately $424,418,326.  

As of March 25, 2019, 95,717,052 shares of the Company’s common stock were outstanding. 

Documents Incorporated By Reference 

The registrant intends to file a definitive proxy statement pursuant to Regulation 14A within 120 days 

of the end of the fiscal year ended December 31, 2018. The proxy statement is incorporated herein by 
reference into the following parts of the Form 10-K:  

Part III, Item 10, Directors, Executive Officers and Corporate Governance;  
Part III, Item 11, Executive Compensation;  
Part III, Item 12, Security Ownership of Certain Beneficial Owners and Management and Related  
Stockholder Matters;  
Part III, Item 13, Certain Relationships and Related Transactions, and Director Independence; and 
Part III, Item 14, Principal Accounting Fees and Services. 

================================================================================== 

 
 
 
 
 
 
 
 
  
  
  
  
  
  
CASI PHARMACEUTICALS, INC. 
FORM 10-K - FISCAL YEAR ENDED DECEMBER 31, 2018 

TABLE OF CONTENTS 

Form 10-K 
Part No. 

                  I 

Form 10-K 
Item No. 
1 

1A 

1B 

2 

3 

4 

5 

6 

7 

7A 

8 

9 

9A 

9B 

10 

11 

12 

13 

14 

15 

                  II 

                   III 

                   IV 

  Page No.   
Business                                                                                                                     3 

Description 

Risk Factors                                                                                                             15   

Unresolved Staff Comments                                                                                    31 

Properties                                                                                                                 31 

Legal Proceedings                                                                                                    31 

Mine Safety Disclosure                                                                                            31   

Market for Registrant's Common Equity, 
Related Stockholder Matters                                                                                   
And Issuer Purchases of Equity Securities 

                31 

Selected Financial Data                                                                                            31 

Management's Discussion and Analysis of 
Financial Condition and Results of Operations                                                       31 

Quantitative and Qualitative Disclosures 
About Market Risk                                                                                                   39 

Financial Statements and Supplementary Data                                                        39 

Changes in and Disagreements with Accountants 
On Accounting and Financial Disclosure                                                                39 

Controls and Procedures                

Other Information                

                39 

                41 

Directors, Executive Officers and Corporate Governance                                      41 

Executive Compensation 

Security Ownership of Certain Beneficial Owners and  
Management and Related Stockholder Matters 

Certain Relationships and Related Transactions, and Director 
Independence 

Principal Accounting Fees and Services 

Exhibits and Financial Statement Schedules 

Signatures 

Audited Consolidated Financial Statements 

                41 

                41 

                42 

                42 

                42 

                47 

              F-1 

1 

 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
              
 
 
SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS 

This report contains certain 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.  Forward-looking statements also 
may be included in other statements that we make.  All statements that are not descriptions of historical facts are forward-
looking  statements.    These  statements  can  generally  be  identified  by  the  use  of  forward-looking  terminology  such  as 
“believes,” “expects,” “intends,” “may,” “will,” “should,” or “anticipates” or similar terminology.  These forward-looking 
statements include, among others, statements regarding the timing of our clinical trials, our cash position and future expenses, 
and our future revenues.  

             Actual results could differ materially from those currently anticipated due to a number of factors, including:  risks 
relating to interests of our largest stockholders that differ from our other stockholders; the difficulty of executing our business 
strategy in China; the risk that we will not be able to effectively select, register and commercialize products from our recently 
acquired portfolio of abbreviated new drug applications (ANDAs); our lack of experience in manufacturing products and 
uncertainty  about  our  resources  and  capabilities  to  do  so  on  a  clinical  or  commercial  scale;  risks  relating  to  the 
commercialization,  if  any,  of  our  products and proposed products (such  as  marketing,  safety,  regulatory,  patent,  product 
liability, supply, competition and other risks); our inability to predict when or if our product candidates will be approved for 
marketing  by  the  China  National  Medical  Products  Administration  authorities;  our  inability  to  enter  into  strategic 
partnerships for the development, commercialization, manufacturing and distribution of our proposed product candidates or 
future candidates; the volatility in the market price of our common stock; risks relating to the need for additional capital and 
the  uncertainty  of  securing  additional  funding  on  favorable  terms;  risks  associated  with  our  product  candidates;  risks 
associated with any early-stage products under development;  risk that results in preclinical and early clinical models are not 
necessarily indicative of later clinical results; uncertainties relating to preclinical and clinical trials, including delays to the 
commencement of such trials; the lack of success in the clinical development of any of our products; and our dependence on 
third parties.  Such factors, among others, could have a material adverse effect upon our business, results of operations and 
financial condition.  

We  caution  investors  that  actual  results  or  business  conditions  may  differ  materially  from  those  projected  or 
suggested in forward-looking statements as a result of various factors including, but not limited to, those described above 
and in Section IA, “Risk Factors” of this Annual Report on Form 10-K for the fiscal year ended December 31, 2018 (this 
“Annual Report”) and our other filings with the Securities and Exchange Commission (“SEC”). We cannot assure you that 
we  have  identified  all  the  factors  that  create  uncertainties.    Moreover,  new  risks  emerge  from  time  to  time  and  it  is  not 
possible for our management to predict all risks, nor can we assess the impact of all risks on our business or the extent to 
which  any  risk,  or  combination  of  risks,  may  cause  actual  results  to  differ  from  those  contained  in  any  forward-looking 
statements. Readers should not place undue reliance on forward-looking statements, which only speak as of the date made. 
We undertake no obligation to publicly release the result of any revision of these forward-looking statements to reflect events 
or circumstances after the date they are made or to reflect the occurrence of unanticipated events. Additional information 
about the factors and risks that could affect our business, financial condition and results of operations, are contained in our 
filings with the U.S. Securities and Exchange Commission (“SEC”), which are available at www.sec.gov. 

2 

 
 
 
 
 
 
 
 
 
ITEM 1.     BUSINESS. 

OVERVIEW 

PART I 

CASI Pharmaceuticals, Inc. (“CASI”, the “Company”) (Nasdaq: CASI) is a U.S. pharmaceutical company 
with a platform to develop and accelerate the launch of pharmaceutical products and innovative therapeutics in China, 
U.S., and throughout the world. We are focused on acquiring, licensing, developing and commercializing products 
that address areas of unmet medical need.  We intend to execute our plan to become a leading platform to launch 
medicines in the greater China market leveraging our China-based regulatory and commercial competencies and our 
global  drug  development  expertise.  We  conduct  substantially  all  of  our  operations  through  our  wholly-owned 
subsidiary,  CASI  Pharmaceuticals  (Beijing)  Co.,  Ltd.  (“CASI  China”),  which  is  headquartered  in  Beijing,  China.  
CASI China has established China operations that are growing as we continue to further in-license or acquire products 
for our pipeline. 

Our  product  pipeline  features  the  following:  (1)  U.S.  Food  and  Drug  Administration  (FDA)  approved 
hematology oncology drugs in-licensed from Spectrum Pharmaceuticals, Inc. and certain of its affiliates (“Spectrum”) 
for  the  greater  China  market,  consisting  of  Melphalan  Hydrochloride  For  Injection  (EVOMELA®),  Ibritumomab 
Tiuxetan  (ZEVALIN®)  and  Vincristine  Sulfate  Liposome  Injection  (MARQIBO®),  (2)  a  portfolio  of  26  FDA-
approved abbreviated new drug applications (“ANDAs”), including entecavir and tenofovir disoproxil fumarate (TDF) 
indicated for hepatitis B virus; and (3) four pipeline ANDAs that are pending FDA approval.  We intend to prioritize 
a select subset of the ANDAs for product registration and commercialization in China. In addition to these advanced 
products,  our  pipeline  includes  a  proprietary  Phase  2  drug  candidate,  ENMD-2076,  that  we  have  previously 
determined not to pursue as a single agent, and instead we are exploring the feasibility of combination as a clinical 
strategy.  We also have proprietary early-stage immune-oncological potential candidates in preclinical development.  

We  believe  our  product  mix  reflects  a  risk-balanced  approach  between  products  in  various  stages  of 
development,  between  products  that  are  branded  and  non-branded,  and  between  products  that  are  proprietary  and 
generic.  We intend to continue building a significant product pipeline of high quality pharmaceuticals, as well as 
innovative drug candidates for commercialization in China and for the rest of the world.  For in-licensed products, we 
use a market-oriented approach to identify pharmaceutical candidates that we believe have the potential for gaining 
widespread market acceptance, either globally or in China, and for which development can be accelerated under our 
drug development strategy.  For our FDA-approved ANDAs, we intend to select and commercialize certain niche 
products from the portfolio that complement our therapeutic focus areas and which offer unique market and cost-
effective manufacturing opportunities in China and/or in the U.S. 

We believe the China operations offer a significant market and growth potential due to extraordinary increase 
in  demand  for  high  quality  medicine  coupled  with  regulatory  reforms  in  China  that  make  it  easier  for  global 
pharmaceutical companies to introduce new pharmaceutical products into the country.  We will continue to in-license 
clinical-stage and late-stage drug candidates, and leverage our platform and expertise, and hope to be the partner of 
choice to provide access to the China market.  We expect the implementation of our plans will include leveraging our 
resources  and  expertise  in  both  the  U.S.  and  China  so  that  we  can  maximize  development  and  clinical  strategies 
concurrently under U.S. FDA and China National Medical Products Administration (NMPA) regulatory regimes. 

In order to capitalize on the drug development and capital resources available in China, we are doing business 
in  China  through  our  wholly-owned  China-based  subsidiary  that  will  execute  the  China  portion  of  our  drug 
development strategy, including conducting clinical trials in China, pursuing local funding opportunities and strategic 
collaborations,  and  implementing  our  commercial  launches.  In  December  2018,  we  received  NMPA  approval  of 
Melphalan Hydrochloride For Injection (EVOMELA), for: 

(cid:120) 

(cid:120) 

use  as a high-dose  conditioning  treatment  prior  to hematopoietic progenitor (stem) cell transplantation in 
patients with multiple myeloma, and 
the palliative treatment of patients with multiple myeloma for whom oral therapy is not appropriate.  

3 

 
 
 
 
 
 
 
 
 
 
We intend to begin commercializing this drug through CASI China beginning in 2019 using EVOMELA 
supplied  through  Spectrum  and  its  suppliers.  All  future  needs  will  be  sourced  from  Acrotech  Biopharma  L.L.C. 
(“Acrotech”) and its suppliers.  

The  Company  is  building  an  internal  commercial  team  to  prepare  for  the  launch  of  our  first  commercial 
product, Melphalan Hydrochloride for Injection (EVOMELA) in 2019.  As part of the strategy to support our future 
clinical and commercial manufacturing needs and to manage our supply chain for certain products, on December 26, 
2018, the Company established CASI Pharmaceuticals (Wuxi) Co., Ltd. (“CASI Wuxi”) in China to construct a cGMP 
manufacturing facility in Wuxi, China.  The site is currently in the design and engineering phase with construction 
expected  to  begin  in  2019.  Through  CASI  China,  we  will  focus  on  China  market  devoting  more  resources  and 
investment going forward. 

HEMATOLOGY ONCOLOGY PRODUCTS FOR THE GREATER CHINA MARKET 

In September 2014, we acquired from Spectrum exclusive rights in greater China (including Taiwan, Hong 
Kong  and  Macau)  to  three oncology  products,  including  (1)  Melphalan  Hydrochloride  for  Injection  (EVOMELA) 
approved in the U.S. primarily for use as a high-dose conditioning treatment prior to hematopoietic progenitor (stem) 
cell transplantation in patients with multiple myeloma, (2) Ibritumomab Tiuxetan (ZEVALIN) approved in the U.S. 
for advanced non-Hodgkin’s lymphoma; and (3) Vincristine Sulfate Liposome Injection (MARQIBO) approved in 
the  U.S.  for  advanced  adult  Ph-  acute  lymphoblastic  leukemia  (ALL).    On  March  1,  2019,  Spectrum  sold  these 
products,  along  with  the  licenses  and  contracts  relating  thereto,  to  Acrotech.  The  Company  does  not  expect  any 
material adverse effect on its operations to result from the sale.  A description of the products and their current status 
is below. 

Melphalan Hydrochloride for Injection (EVOMELA) 

Melphalan Hydrochloride For Injection (EVOMELA) is a new intravenous formulation of melphalan being 
investigated by Acrotech in the multiple myeloma transplant setting. The formulation avoids the use of propylene 
glycol, which is used as a co-solvent in the current formulation of melphalan and has been reported to cause renal and 
cardiac side-effects that limit the ability to deliver higher quantities of intended therapeutic compounds. The use of 
Captisol technology to reformulate melphalan is anticipated to allow for longer administration durations and slower 
infusion rates, potentially enabling clinicians to avoid reductions and safely achieve a higher dose intensity of pre-
transplant chemotherapy.  In March 2016, Spectrum received notification from the FDA of the grant of approval of 
its NDA for EVOMELA (melphalan) for injection primarily for use as a high-dose conditioning treatment prior to 
hematopoietic  progenitor  (stem)  cell  transplantation  in  patients  with  multiple  myeloma.  In  December  2016,  the 
NMPA,  formerly  the  China  Food  and  Drug  Administration,  accepted  for  review  our  import  drug  registration 
application for Melphalan Hydrochloride For Injection (EVOMELA) and in 2017 has granted priority review of the 
import drug registration clinical trial application (CTA). On December 3, 2018, we received NMPA’s approval for 
importation, marketing and sales in China.   The Company has assembled an internal commercial team and a local 
distribution partner working together and currently preparing for the commercial launch of Melphalan Hydrochloride 
for Injection (EVOMELA) in 2019.  The Company is also preparing for a post-marketing study. 

Ibritumomab Tiuxetan (ZEVALIN)  

Ibritumomab  Tiuxetan  (ZEVALIN)  injection  for  intravenous  use  is  a  CD20-directed  radiotherapeutic 
antibody. It is indicated for the treatment of patients with relapsed or refractory, low-grade or follicular B-cell non-
Hodgkin’s  lymphoma  (NHL).  ZEVALIN is  also  indicated  for  the  treatment  of  patients  with  previously  untreated 
follicular  non-Hodgkin’s  Lymphoma  who  achieve  a  partial  or  complete  response  to  first-line  chemotherapy. 
ZEVALIN  therapeutic  regimen  consists  of  two  components:  rituximab,  and  Yttrium-90  (Y-90)  radiolabeled 
ZEVALIN  for  therapy.  ZEVALIN  builds  on  the  combined  effect  of  a  targeted  biologic  monoclonal  antibody 
augmented  with  the  therapeutic  effects  of  a  beta-emitting  radioisotope.  Since  ZEVALIN is  already  approved  and 
marketed  in  the  U.S.,  we  expect  that  gaining  approval  from  local  regulatory  authorities  for  commercialization  in 
greater China will require a shorter timeframe compared to clinical-stage drugs.  In 2017, the NMPA accepted for 
review our import drug registration for Ibritumomab Tiuxetan (ZEVALIN) including both the antibody kit and the 
radioactive Yttrium-90 component. On February 12, 2019 the Company received NMPA’s approval of the Company’s 

4 

 
 
 
 
 
 
 
 
Clinical  Trial  Application  (CTA)  to  allow  for  a  confirmatory  registration  trial  to  evaluate  the  drug’s  efficacy  and 
safety. We intend to advance Ibritumomab Tiuxetan (ZEVALIN). 

Vincristine Sulfate Liposome Injection (MARQIBO) 

Vincristine  Sulfate  Liposome  Injection  (MARQIBO)  is  a  novel,  sphingomyelin/cholesterol  liposome-
encapsulated, formulation of vincristine sulfate, a microtubule inhibitor. MARQIBO is approved by the FDA for the 
treatment  of  adult  patients  with  Philadelphia  chromosome-negative  (Ph-)  acute  lymphoblastic  leukemia  (ALL)  in 
second or greater relapse or whose disease has progressed following two or more anti-leukemia therapies. In January 
2016, the NMPA accepted for review our import drug registration application for and on March 4, 2019 the Company 
received  NMPA’s  approval  of  the  Company’s  Clinical  Trial  Application  (CTA)  to  allow  for  a  confirmatory 
registration  trial  to  evaluate  its  efficacy  and  safety.  We  intend  to  advance  Vincristine  Sulfate  Liposome  Injection 
(MARQIBO). 

U.S. FDA ANDAs 

On  January  26,  2018  the  Company  acquired  a portfolio of  25 U.S.  FDA-approved  abbreviated new drug 
applications (ANDAs), one ANDA that FDA tentatively approved, and three ANDAs that are pending FDA approval.  
We  will  select  and  commercialize  certain  products  from  the  portfolio  that  offer  unique  market  and  cost-effective 
manufacturing  opportunities  in  China  and/or  in  the  U.S.  In  October  2018,  we  acquired  an  additional  U.S.  FDA-
approved abbreviated new drug application for tenofovir disoproxil fumarate (TDF ANDA), which is indicated for 
the treatment of hepatitis B virus. 

Our portfolio consists of the following: 

Approved Products 

Benazepril tablets 

Heparin sodium for injection 

Bisoprolol fumarate tablets 

Lisinopril tablets and Lisinopril BPP tablets  

Burprenorphine HCL Sublingual tablets 

Methimazole tablets  

Cefprozil tablets 

Cilostazol tablets – 50mg 

Cilostazol tablets – 100mg 

Desvenlafaxine ER tablets 

Midodrine tablets  

Nabumetone tablets  

Naratriptan tablets  

Ondansetron HCL tablets  

Diclofenac potassium 50mg tablets 

Repaglinide tablets  

Diclofenac sodium DR 25mg, 50mg tablets 

Ribavirin capsules  

Diclofenac sodium DR 75mg tablets 

Spironolactone tablets  

Econazole nitrate cream 

Tenofovir disoproxil fumarate (TDF) 

Entecavir tablets 

Tizanidine tablets  

Epinastine HCl Ophthalmic Solution 

Triamterene and hydrochlorothiazide combination 
tablets  

5 

 
 
 
 
 
 
 
 
 
Products Pending FDA Approval 

Aripiprazole tablets 

    Bromfenac Ophthalmic Solution 

Bepotastine Ophthalmic Solution 

    Telmisartan and hydrochlorothiazide tablets 

OTHER ASSETS 

ENMD-2076, internally developed, is an orally-active, Aurora A/angiogenic kinase inhibitor with a unique 
kinase selectivity profile and multiple mechanisms of action. We have completed multiple Phase 2 studies in the U.S 
and  one  study  in  China  and  have  determined  not  to  pursue  ENMD-2076  as  a  single  agent  and  are  exploring  the 
feasibility  of  combination  as  a  clinical  strategy.    We  also  have  two  proprietary  early-stage  immune-oncological 
potential candidates in preclinical development.  

CASI WUXI 

The  Company  is  building  an  internal  commercial  team  to  prepare  for  the  launch  of  our  first  commercial 
product, Melphalan Hydrochloride for Injection (EVOMELA) in 2019.  As part of our strategy to support our future 
clinical and commercial manufacturing needs and to manage our supply chain, the Company has established CASI 
Wuxi to construct a cGMP manufacturing facility in Wuxi, China to support our future manufacturing needs.   On 
November  16,  2018,  the  Company  announced  that  it  had  entered  into  framework  agreements  to  establish  a  joint 
venture to build and operate a manufacturing facility in the Wuxi Huishan Economic Development Zone in Jiangsu 
Province, China. We intend to invest, over time, $80 million in CASI Wuxi. Our investment will consist of (i) $21 
million in cash within three months of the date of the establishment of CASI Wuxi, (ii) a transfer of selected ANDAs 
valued  at  $30  million,  and  (iii)  an  additional  $29  million  cash  payment  within  three  years  from  the  date  of 
establishment of CASI Wuxi. CASI Wuxi was established on December 26, 2018 and in February 2019, we funded 
our initial $21 million investment in CASI Wuxi. Additionally, Wuxi Jintou Huicun Investment Enterprise (Limited 
Partnership), a limited partnership organized under Chinese law, shall contribute the equivalent in RMB of USD $20 
million in cash in CASI Wuxi.  The site is currently in the design and engineering phase with construction expected 
to begin in 2019.   

BUSINESS DEVELOPMENT  

We intend to continue our path to become fully integrated with drug development and commercial operations.  
Our current external business development effort is concentrated on acquiring additional drug candidates through in-
license and acquisitions to expand our pipeline.  We intend for our pipeline to reflect a diversified and risk-balanced 
set  of  assets  that  include  (1)  late-stage  clinical  drug  candidates  in-licensed  for  China  regional  rights,  such  as 
EVOMELA,  ZEVALIN  and  MARQIBO;  (2)  high  quality  generic  pharmaceuticals,  such  as  the  portfolio  acquired 
from Sandoz in 2018 and tenofovir disoproxil fumarate (TDF) recently acquired from Laurus Labs, and (3) proprietary 
or licensed innovative drug candidates.  We use a market-oriented approach to identify pharmaceutical candidates that 
we believe have the potential for gaining widespread market acceptance, either globally or in China, and for which 
development can be accelerated under our global drug development strategy.  Although oncology is our principal 
clinical and commercial focus, we are opportunistic about other therapeutic areas can address unmet medical needs.   

RELATIONSHIPS RELATING TO PROGRAMS  

Contract Manufacturing. Clinical trial materials for Melphalan Hydrochloride For Injection (EVOMELA), 
Ibritumomab  Tiuxetan  (ZEVALIN)  and  Vincristine  Sulfate  Liposome  Injection  (MARQIBO) are  supplied  by  our 
partner Acrotech and its contract manufacturers.   

On  March  7,  2019,  the  Company  entered  into  a  three-year  exclusive  distribution  agreement    with  China 
Resources Guokang Pharmaceuticals Co., Ltd (“CRGK”) to appoint CRGK on an exclusive basis as its distributor to 
distribute  Melphalan  Hydrochloride  for  Injection  (EVOMELA)  in  the  territory  of  the  People’s  Republic  of  China 
(excluding  Hong  Kong,  Taiwan  and  Macau),  subject  to  certain  terms  and  conditions.  The  Company’s  internal 

6 

 
 
 
 
 
 
 
 
 
 
 
marketing  and  sales  team  will  continue  to be  responsible  for  commercial  activities,  including, for  example,  direct 
interaction with KOLs, physicians, hospital centers and the generating of sales.  

We  anticipate  that  the  manufacturing  for  our  newly  acquired  ANDA  portfolio  will  be  through  multiple 
sources that may include our own facility in Wuxi, China (when constructed) and contract manufacturers located in 
China and outside of the U.S. after technology transfer. Established relationships, coupled with supply agreements, 
have secured the necessary resources to supply clinical materials for our clinical development program and to supply 
commercial  inventory  for  Melphalan  Hydrochloride  For  Injection  (EVOMELA)  and  future  product  launches.  We 
believe that our current strategy of in-house manufacturing for certain products and outsourcing manufacturing for 
other products is cost-effective and allows for the flexibility we require.  

INTELLECTUAL PROPERTY  

We generally seek patent protection for our technology and product candidates in the United States, Canada, 
China and other key markets.  The patent position of biopharmaceutical companies generally is highly uncertain and 
involves complex legal and factual questions.  Our success will depend, in part, on whether we can: (i) obtain patents 
to protect our own products; (ii) obtain licenses to use the technologies of third parties, which may be protected by 
patents; (iii) protect our trade secrets and know-how; and (iv) operate without infringing the intellectual property and 
proprietary rights of others. 

With  regard  to  our  in-licensed  drug  candidates  Melphalan  Hydrochloride  For  Injection  (EVOMELA), 
Ibritumomab  Tiuxetan  (ZEVALIN)  and  Vincristine  Sulfate  Liposome  Injection  (MARQIBO),  we  have  acquired 
exclusive  licenses  to  intellectual  property  to  enable  us  to  develop  and  commercialize  the  drug  candidates  in  our 
commercial markets. 

With respect to ENMD-2076, we directly own 22 granted patents or allowed patent applications (including 
2 granted United States patents, 1 granted Chinese patent, and 18 granted patents and 1 additional pending patent 
application  in  Brazil).   The  patent  term  for  U.S.  Patent  No.  7,563,787  will  expire  March  5,  2027,  assuming  all 
maintenance fees are paid.  If the FDA approves ENMD-2076, this patent term may be extended.  The patent terms 
of our granted patents (including any patents issuing from our pending patent applications) in other countries will 
expire September 29, 2026, assuming all annuities are paid and not considering any term extensions for regulatory 
approval that might be available.  We also directly own two pending U.S. provisional applications directed to treatment 
methods using ENMD-2076. 

We have pending trademark applications for CASI and CASI PHARMACEUTICALS. 

We review and assess our portfolio on a regular basis to secure protection and to align our patent strategy 

with our overall business strategy.   

GOVERNMENT REGULATION  

U.S. Food and Drug Administration (FDA) 

Our  development,  manufacture,  and  potential  sale  of  therapeutics  in  the  United  States,  China  and  other 

countries are subject to extensive regulations by federal, state, local and foreign governmental authorities.  

In the United States, the FDA regulates product candidates being developed as drugs or biologics.  New drugs 
are  subject  to  regulation  under  the  Federal  Food,  Drug,  and  Cosmetic  Act  (FFDCA),  and  biological  products,  in 
addition  to  being  subject  to  certain  provisions  of  the  FFDCA,  are  regulated  under  the  Public  Health  Service  Act 
(PHSA).  We believe that the FDA will regulate the products currently being developed by us or our collaborators as 
new  drugs.    Both  the  FFDCA  and  PHSA  and  corresponding  regulations  govern,  among  other  things,  the  testing, 
manufacturing, safety, efficacy, labeling, storage, recordkeeping, advertising and other promotion of biologics or new 
drugs, as the case may be.  FDA clearances must be obtained before clinical testing, and approvals must be obtained 
before marketing of biologics or drugs.  

From time to time, legislation is drafted, introduced and passed in Congress that could significantly change 

7 

 
 
 
 
 
 
 
 
 
 
 
 
 
the statutory provisions governing the approval, manufacturing and marketing of products regulated by the FDA. In 
addition to new legislation, FDA regulations and policies are often revised or reinterpreted by the agency in ways that 
may significantly affect our business and our product candidates or any future product candidates we may develop. It 
is  impossible  to  predict  whether  further  legislative  or  FDA  regulation  or  policy  changes  will  be  enacted  or 
implemented and what the impact of such changes, if any, may be. 

Preparing drug candidates for regulatory approval has historically been a costly and time-consuming process.  
Generally, in order to gain FDA permission to test a new agent, a developer first must conduct preclinical studies in 
the laboratory and in animal model systems to gain preliminary information on an agent's effectiveness and to identify 
any safety problems.  The results of these studies are submitted as a part of an Investigational New Drug Application 
(IND) for a drug or biologic, which the FDA must review before human clinical trials of an investigational drug can 
begin.  In addition to the known safety and effectiveness data on the drug or biologic, the IND must include a detailed 
description of the clinical investigations proposed.  Based on the current FDA organizational structure, ENMD-2076 
is regulated as a new chemical entity by the FDA’s Center for Drug Evaluation and Research.  Generally, as new 
chemical entities like our small molecules are discovered, formal IND-directed toxicology studies are required prior 
to initiating human testing.  Clinical testing may begin 30 days after submission of an IND to the FDA unless FDA 
objects to the initiation of the study or has outstanding questions to discuss with the IND sponsor.  

In order to commercialize any drug or biological products, we or our collaborators must sponsor and file an 
IND and conduct clinical studies to demonstrate the safety and effectiveness necessary to obtain FDA approval of 
such products.  For studies conducted under INDs sponsored by us or our collaborators, we or our collaborators will 
be  required  to  select  qualified  investigators  (usually  physicians  within  medical  institutions)  to  supervise  the 
administration of the products, test or otherwise assess patient results, and collect and maintain patient data; monitor 
the  investigations  to  ensure  that  they  are  conducted  in  accordance  with  applicable  requirements,  including  the 
requirements  set  forth  in  the  general  investigational  plan  and  protocols  contained  in  the  IND;  and  comply  with 
applicable reporting and recordkeeping requirements.  

Clinical trials  of drugs or biologics are normally done in three phases, although  the phases may overlap. 
Phase  1  trials  for  drug  candidates  to  be  used  to  treat  cancer  patients  are  concerned  primarily  with  the  safety  and 
preliminary effectiveness of the drug, involve a small group ranging from 15 - 40 subjects, and may take from six 
months to over one year to complete.  Phase 2 trials normally involve 30 - 200 patients and are designed primarily to 
demonstrate effectiveness in treating or diagnosing the disease or condition for which the drug is intended, although 
short-term side effects and risks in study subjects whose health is impaired may also be examined.  Phase 3 trials are 
expanded  clinical  trials  with  larger  numbers  of  patients  which  are  intended  to  evaluate  the  overall  benefit-risk 
relationship of the drug and to gather additional information for proper dosage and labeling of the drug.  Phase 3 
clinical trials generally take two to five years to complete, but may take longer.  The FDA receives reports on the 
progress of each phase of clinical testing, as well as reports of unexpected adverse experiences occurring during the 
trial.    The  FDA  may  require  the  modification,  suspension,  or  termination  of  clinical  trials,  if  it  concludes  that  an 
unwarranted risk is presented to patients, or, in Phase 2 and 3, if it concludes that the study protocols are deficient in 
design to meet their stated objectives.  

If clinical trials of a new drug candidate are completed successfully, the sponsor of the product may seek 
FDA marketing approval.  If the product is classified as a new drug, an applicant must file a New Drug Application 
(NDA) with the FDA and receive approval before marketing the drug commercially.  The NDA must include detailed 
information about the product and its manufacturer and the results of product development, preclinical studies and 
clinical trials. Generic drugs, which are therapeutic equivalents of existing brand name drugs, require the filing of an 
ANDA. An ANDA does not, for the most part, require clinical studies since safety and efficacy have already been 
demonstrated by the product originator. However, the ANDA must provide data to support the bioequivalence of the 
generic drug product.  User fees must be paid with submission of applications for non-orphan products in order to 
support the cost of agency review.  While such fees are not significant for ANDAs, an NDA for a non-orphan product 
requires a user fee of over $2.4 million. 

The testing and approval processes require substantial time and effort, and there can be no assurance that any 
approval will be obtained on a timely basis, if at all.  The time required by the FDA to review and approve NDAs and 
ANDAs is variable and, to a large extent, beyond our control.  Notwithstanding the submission of relevant data, the 
FDA may ultimately decide that an NDA does not satisfy its regulatory criteria and deny the approval.  Further, the 
FDA may require additional clinical studies before making a decision on approval. In addition, the FDA may condition 

8 

 
 
 
 
 
  
marketing  approval  on  the  conduct  of  specific  post-marketing studies  to  further  evaluate  safety  and effectiveness.  
Even if FDA regulatory clearances are obtained, a marketed product is subject to continuing regulatory requirements 
and  review  relating  to  current  Good  Manufacturing  Practices,  or  cGMP,  adverse  event  reporting,  promotion  and 
advertising,  and  other  matters.  The  FDA  strictly  regulates  labeling,  advertising,  promotion  and  other  types  of 
information on products that are placed on the market. Products may be promoted only for the approved indications 
and in accordance with the provisions of the approved label.  Discovery of previously unknown problems or failure 
to  comply  with  the  applicable  regulatory  requirements  may  result  in  restrictions  on  the  marketing of a  product  or 
withdrawal of the product from the market, as well as possible civil or criminal sanctions.  

The Generic Drug Enforcement Act of 1992 establishes  penalties  for  wrongdoing  in  connection with  the 
development  or  submission of  an  application.  In  general,  the  FDA  is  authorized  to  temporarily bar  companies,  or 
temporarily or permanently bar individuals, from submitting or assisting in the submission of applications to FDA, 
and to temporarily deny approval and suspend applications to market drugs under certain circumstances. In addition 
to debarment, the FDA has numerous discretionary disciplinary powers, including the authority to withdraw approval 
of an application or to approve an application under certain circumstances and to suspend the distribution of all drugs 
approved or developed in connection with certain wrongful conduct. The FDA may also withdraw product approval 
or take other corrective measures if ongoing regulatory requirements are not met or if safety or efficacy questions are 
raised after the product reaches the market. 

Manufacturers  and  other  entities  involved  in  the  manufacturing  and  distribution  of  approved  products  are 
required  to  register  their  establishments  with  the  FDA  and  certain  state  agencies,  and  are  subject  to  periodic 
unannounced  inspections  by the  FDA  and certain  state  agencies for  compliance  with  cGMP    and  other  laws.  The 
cGMP  requirements  apply  to  all  stages  of  the  manufacturing  process,  including  the  production,  processing, 
sterilization, packaging, labeling, storage and shipment of the product. Manufacturers must establish validated systems 
to ensure that products meet specifications and regulatory requirements, and test each product batch or lot prior to its 
release. We rely, and expect to continue to rely, on third parties for the production of clinical quantities of our product 
candidates  and  any  future  product  candidates  we  may  develop.  Future  FDA  and  state  inspections  may  identify 
compliance issues at the facilities of our contract manufacturers that may disrupt production or distribution or may 
require substantial resources to correct. 

Healthcare Regulation 

Federal  and  state  healthcare  laws, including  fraud  and  abuse  and health  information privacy  and  security 
laws, also apply to our business. If we fail to comply with those laws, we could face substantial penalties and our 
business, results of operations, financial condition and prospects could be adversely affected. The laws that may affect 
our ability to operate include, but are not limited to: the federal Anti-Kickback Statute, which prohibits, among other 
things, soliciting, receiving, offering or paying remuneration, directly or indirectly, to induce, or in return for, the 
purchase  or  recommendation  of  an  item  or  service  reimbursable  under  a  federal  healthcare  program,  such  as  the 
Medicare and Medicaid programs; and federal civil and criminal false claims laws and civil monetary penalty laws, 
which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, 
claims for payment from Medicare, Medicaid, or other third-party payers that are false or fraudulent. Additionally, we 
are  subject  to  state  law  equivalents  of  each  of  the  above  federal  laws,  which  may  be  broader  in  scope  and  apply 
regardless of whether the payer is a federal healthcare program, and many of which differ from each other in significant 
ways and may not have the same effect, further complicate compliance efforts. 

Numerous federal and state laws, including state security breach notification laws, state health information 
privacy laws and federal and state consumer protection laws, govern the collection, use and disclosure of personal 
information.  Other  countries  also  have,  or  are  developing,  laws  governing  the  collection,  use  and  transmission  of 
personal information. In addition, most healthcare providers who are expected to prescribe our products and from 
whom  we  obtain  patient  health  information,  are  subject  to  privacy  and  security  requirements  under  the  Health 
Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology and Clinical 
Health Act, or HIPAA. Although we are not directly subject to HIPAA, we could be subject to criminal penalties if 
we  obtain  and/or  disclose  individually  identifiable  health  information  from  a  HIPAA-covered  entity,  including 
healthcare  providers,  in  a  manner  that  is  not  authorized  or  permitted  by  HIPAA.  The  legislative  and  regulatory 
landscape for privacy and data protection continues to evolve, and there has been an increasing amount of focus on 
privacy  and  data  protection  issues  with  the  potential  to  affect  our  business,  including  recently  enacted  laws  in  a 

9 

 
 
 
majority of states requiring security breach notification. These laws could create liability for us or increase our cost 
of doing business.  

In  addition,  the  Patient  Protection  and  Affordable  Care  Act,  as  amended  by  the  Health  Care  Education 
Reconciliation  Act,  or  the  PPACA,  created  a  federal  requirement  under  the  federal  Open  Payments  program,  that 
requires  certain  manufacturers  to  track  and  report  to  the  Centers  for  Medicare  and  Medicaid  Services,  or  CMS, 
annually  certain  payments  and  other  transfers  of  value  provided  to  physicians  and  teaching  hospitals  made  in  the 
previous calendar year. In addition, there are also an increasing number of state laws that require manufacturers to 
make reports to states on pricing and marketing information. These laws may affect our sales, marketing, and other 
promotional activities by imposing administrative and compliance burdens on us. In addition, given the lack of clarity 
with respect to these laws and their implementation, our reporting actions could be subject to the penalty provisions 
of the pertinent state and federal authorities. 

For those marketed products which are covered in the United States by the Medicaid programs, we have 
various obligations, including government price reporting and rebate requirements, which generally require products 
be offered at substantial rebates/discounts to Medicaid and certain purchasers (including “covered entities” purchasing 
under the 340B Drug Discount Program). We are also required to discount such products to authorized users of the 
Federal Supply Schedule of the General Services Administration, under which additional laws and requirements apply. 
These  programs  require  submission  of  pricing  data  and  calculation  of  discounts  and  rebates  pursuant  to  complex 
statutory formulas, as well as the entry into government procurement contracts governed by the Federal Acquisition 
Regulations, and the guidance governing such calculations is not always clear. Compliance with such requirements 
can require significant investment in personnel, systems and resources, but failure to properly calculate prices, or offer 
required discounts or rebates could subject us to substantial penalties. 

National Medical Products Administration (NMPA, formerly the China Food and Drug Administration) 

In the PRC, the newly-formed NMPA is the authority under the State Administration for Market Regulation 
(SAMR)  that  monitors  and  supervises  the  administration  of  pharmaceuticals  products,  medical  appliances  and 
equipment, and cosmetics.  We are also subject to regulation and oversight by different levels of the food and drug 
administration in China.  For clinical-stage product candidates, our development activities in China can follow two 
purposes: (1) to obtain clinical data to support our global FDA-regulated trials as is the case for our proprietary ENMD-
2076, and (2) to obtain clinical data to support local registration with the NMPA.  For late-stage product candidates 
that we in-license for greater China rights, such as Melphalan Hydrochloride For Injection (EVOMELA), Ibritumomab 
Tiuxetan (ZEVALIN) and Vincristine Sulfate Liposome Injection (MARQIBO), our development activities in China 
are to secure marketing approval from NMPA by conducting import drug registration.  The “Law of the PRC on the 
Administration  of  Pharmaceuticals,”  as  amended  on  May  24,  2015,  provides  the  basic  legal  framework  for  the 
administration of  the production and sale  of  pharmaceuticals  in  China  and  covers  the manufacturing,  distributing, 
packaging, pricing and advertising of pharmaceutical products in China. Its implementation regulations set out detailed 
implementation rules with respect to the administration of pharmaceuticals in China.  We are also subject to other 
PRC laws and regulations that are applicable to manufacturers and distributors in general. 

Product Manufacturing.  For the registration of locally manufactured drugs, both drug substance and drug 
product  need  to  be  manufactured  in  China  through  either  a  self-owned  facility  or  a  contract  manufacturing 
organization. The study drug to be used for clinical trials must be manufactured in compliance with NMPA Good 
Manufacturing  Practice  (GMP)  guidelines.  A  domestic  manufacturer  of  pharmaceutical  products  and  active 
pharmaceutical ingredient (API) must obtain the drug manufacturing license, the GMP certification and the drug/API 
registration approval to produce pharmaceutical products and API for marketing in China. GMP certification criteria 
include  institution  and  staff  qualifications,  production  premises  and  facilities,  equipment,  raw  materials,  hygiene 
conditions, production management, quality controls, product distributions, maintenance of records and manner of 
handling  customer  complaints  and  adverse  reaction  reports.    Both  the  drug  manufacturing  license  and  the  GMP 
certificate is valid for five years, and must be renewed at least six months before its expiration date.  A manufacturer 
is required to obtain GMP certificates to cover all of its production operations. 

 In addition, before commencing business, a pharmaceutical manufacturer must also obtain a business license 

from the Administration of Market Regulation at the local level. 

10 

 
 
 
 
  
Preclinical Research and Clinical Trials.  For an investigational new drug application, a clinical trial approval 
issued from the NMPA was historically required to conduct clinical trials. However, since July 24, 2018, the NMPA 
announced to adopt a negative notification system for clinical trial approvals. In particular, if the applicant does not 
receive  negative  comments  within  60  days  after  the  CDE  accepts  the  clinical  trial  application,  the  applicant  can 
proceed with the clinical trial immediately based on the protocol submitted without the need for obtaining a clinical 
trial approval. Chemical generics, on the other hand, only need to undergo bioequivalent studies upon a filing for 
record with the NMPA.  In order to apply for a clinical trial application approval to support local registration in China, 
a pharmaceutical  company  is  required  to  conduct  a  series  of preclinical research including research on chemistry, 
pharmacology, toxicology and pharmacokinetics of pharmaceuticals.  This preclinical research should be conducted 
in compliance with the relevant regulatory guidelines issued by the NMPA.  In particular, safety evaluation research 
must be conducted in compliance with China’s Good Laboratory Practice. 

After completion of preclinical studies and obtaining permission to conduct the clinical trial from the NMPA, 
clinical trials are generally conducted in three sequential phases that may overlap or be combined, known as Phase 1, 
Phase 2, and Phase 3 clinical trials, in compliance with China’s Good Clinical Practice: 

Phase  1  –  preliminary  trial  of  clinical  pharmacology  and  human  safety  evaluation  studies.    The 
primary objective is to observe the pharmacokinetics and the tolerance level of the human body to the new 
medicine as a basis for ascertaining the appropriate methods of dosage. 

Phase 2 – preliminary exploration on the therapeutic efficacy.  The purpose is to assess preliminarily 
the efficacy and safety of pharmaceutical products on patients with the target indication of the pharmaceutical 
products and to provide the basis for the design and dosage tests for Phase 3.  The dosing and methodology 
of research in this phase generally adopts double-blind, random methods with limited sample sizes. 

Phase 3 – confirm the therapeutic efficacy.  The objective is to further verify the efficacy and safety 
of pharmaceutical products on patients within the target indication, to evaluate the benefits and risks and 
finally  to  provide  sufficient  experimentally  proven  evidence  to  support  the  registration  application of  the 
pharmaceutical  products.   In general,  the  trial  should  adopt  double-blind  random  methods  with  sufficient 
sample sizes. 

Import  Drug  Registration  or  Multi  Regional  Clinical  Trials.    NMPA  regulations  allow  foreign  drug 
developers to conduct import drug registration or multi regional clinical trials in China for a new drug as part of a 
global drug development program. An International Multicenter Clinical Trial (IMCCT) Application needs to be filed 
with the NMPA and approval is required prior to conducting the trials.   

In October, 2017, the NMPA released the Decision on Adjusting Items concerning the Administration of 

Imported Drug Registration, which includes the following key points:  

(cid:120) 

(cid:120) 

If the International Multicenter Clinical Trial, or IMCCT, of a drug is conducted in China, the IMCCT drug 
does not need to be approved or entered into either a Phase II or III clinical trial in a foreign country, except 
for preventive biological products. Phase I IMCCT is permissible in China.  

If the IMCCT is conducted in China, the application for drug marketing authorization can be submitted 
directly after the completion of the IMCCT. 

(cid:120)  With respect to clinical trial and market authorization applications for imported innovative chemical drugs 
and therapeutic biological products, the marketing authorization in the country or region where the foreign 
drug manufacturer is located will not be required. 

(cid:120)  With respect to drug applications that have been accepted before the release of this Decision, if relevant 
requirements are met, importation permission can be granted if such applications request exemption of 
clinical trials for the imported drugs based on the data generated from IMCCT. 

The NMPA Decision on IMCCT and the application for imported new drugs is expected to streamline and 

accelerate the applications for imported new drugs. 

11 

 
 
 
 
 
 
 
 
 
 
 
 
In order to apply for an IMCCT Application in China, a biopharmaceutical company is required to submit a 
comprehensive investigation new drug application package filed with foreign regulatory agency, i.e. the FDA, in a 
format compliant with NMPA guidance. 

After obtaining the IMCCT approval from the NMPA, clinical trials are conducted in compliance with the 

both FDA/ICH and NMPA Good Clinical Practice guidelines. 

Data derived from IMCCT can be used for the New Drug Registration Applications with the NMPA. When 
using IMCCT data to support New Drug Registration Applications in China, applicants shall submit completed global 
clinical trial report, statistical analysis report and database, along with relevant supporting data in accordance with the 
ICH-CTD  (International  Conference  on  Harmonization-Common  Technical  Document)  content  and  format 
requirements; subgroup research results summary and comparative analysis shall also be conducted concurrently. 

New Drug Registration and Application.  After completion of the 3 phases of clinical trials demonstrating the 
safety and effectiveness of a pharmaceutical in its targeted indication, a New Drug Registration Application needs to 
be filled with the NMPA, which includes research data of chemistry, manufacturing and controls, pre-clinical studies 
and clinical trial report. For imported drugs, the New Drug Registration Application is also known as the Import Drug 
License Application. 

Once a new drug registration approval or import drug license is received, the product can be sold nationwide 

in China. 

Generic Quality Consistency Evaluation.  The NMPA has launched the generic quality consistency evaluation 
(GQCE) since 2013, which requires domestically-manufactured generic drugs to conform to the quality standards of 
originator products.  In 2016, the Chinese regulatory authorities announced that imported generic drugs must also pass 
the GQCE in China. By way of background, the GQCE generally required the manufacturers of generics to conduct 
bioequivalent studies (or dissolution tests) of a generic drug against a qualified reference drug (typically the originator 
drug) in order to establish equivalence to the originator products. If there is no qualified reference drug, the generic 
manufacturer has to conduct a clinical efficacy trial.   

The first wave of GQCE focuses on 289 oral formulations of chemical drugs listed in China’s Essential Drug 
List.  The NMPA will reject to renew the marketing authorizations of these generic drugs if their manufacturers fail 
to  complete  the  GQCE  by  the  end  of  2018  (or  the  end  of  2021  if  clinical  efficacy  trials  are  required).    If  the 
manufacturers  can  prove  that  the  generics  are  products  in  shortage  and  clinically  essential,  they  can  apply  for  an 
extension up to 5 years in order to pass the GQCE.  Once one generic manufacturer successfully passes the GQCE, 
all  of  the  other  manufacturers  producing  the  same  generic  drug  must  complete  their  GQCE  within  three  years 
following the first successful GQCE.  Otherwise, the NMPA will not renew their respective marketing authorizations.   

The launch of GQCE will significantly enhance of the bar of entry of generic manufacturers.  Generics that 
pass  the  GQCE  will  be  on  a  preferred  list  at  public  hospital  tenders  and  will  be  entitled  to  a  more  favorable 
reimbursement status.  Public hospitals will only be allowed to purchase from the first three generic manufacturers 
who pass the GQCE.  At the end of 2018, a pilot project concerning centralized procurement of 31 types of drugs 
covering 11 major Chinese cities directed hospitals to purchase generics that have passed the GQCE, which resulted 
in dramatic prices cuts for generics that won the tenders.  

Pricing. Instead of direct government-set pricing which were historically used in China but abolished in June 
2015, the government regulates prices for pharmaceuticals (except for narcotic and Type 1 psychotropic drugs) mainly 
by  establishing  a  price  negotiation,  consolidated  procurement  mechanism,  and  revising  medical  insurance 
reimbursement  standards.  The  Chinese  government  has  initiated  several  rounds  of  price  negotiations  with 
manufacturers  of  patented  drugs,  drugs  with  an  exclusive  source  of  supply,  and  oncology  drugs  since  2016.    The 
average percentage of price reduction has been over 50%.  Once the government agreed with the drug manufacturers 
on the supply prices, the drugs would be automatically listed in the National Reimbursement Drug List (NRDL) and 
qualified for public hospital purchase. 

12 

 
 
 
 
 
 
 
 
 
 
 
 
Reimbursement. China is a single-payor market with near universal healthcare provided by the government. 
Up to 99% of the population receives healthcare coverage at various levels of reimbursement. Commercial insurance 
is available but is minimally adopted, and is seen as a supplement above and beyond government reimbursement.  To 
obtain government reimbursement for a drug, the government must agree to add it to the NRDL or the provincial 
reimbursement drug lists at a negotiated price (at times at a significant discount). Prior to this time, the market is self-
pay, where patients will be responsible for 100% of the launch price determined by the company. We believe the self-
pay  market  in  China  is  expanding,  given  the  rise  in  personal  income  levels  in  the  country.  The  government  has 
committed to updating the NRDL in 2019. Previous updates to the NRDL occurred in 2017 and 2009. In addition, 
there were also NRDL price negotiations in 2018 for oncology drugs. Admission to the NRDL depends on a number 
of factors, including on-market experience, scale of patient adoption, physician endorsement, cost effectiveness and 
budget  impact.  Provincial  governments  have  some  discretion  to  add  additional  drugs  not  listed  in  the  NDRL  to 
provincial reimbursement drug lists.  

Hospital Listing. Government hospitals currently represent over 90% of the pharmaceutical market in China. 
In order for a new drug to be prescribed at a government hospital, it has to be listed in the hospital formulary. The 
process of entry into the formulary is commonly referred to as “hospital listing”, and typically requires a long lead 
time. These decisions are made on a hospital-by-hospital basis with timing that can range from every six months to 
every five years. Some hospitals also have temporary listing procedures that can accelerate timing.  Private hospital 
and non-hospital pharmacies, which represent less than 10% of the drug market in China, do not require a formulary 
process to sell a drug. 

Centralized  Procurement  and  Tenders.  Provincial  and  municipal  government  agencies  will  establish  a 
provincial drug procurement agency to operate a mandatory collective tender process for purchases by government 
hospitals  of  a  medicine  included  in  provincial  or  local  medicine  procurement  catalogs.  The  provincial  or  local 
medicine  procurement  catalogs  are  determined  by  the  provincial  drug  procurement  agency  based  on  the  National 
Essential Drugs List, the NDRL, local hospital formularies, etc. If a new drug has been included in a government 
hospital formulary, the NDRL or the provincial reimbursement drug list, the relevant hospitals must participate in 
collective tender processes for the purchase of such new drug. During the collective tender process, the provincial 
drug procurement agency will establish a committee consisting of recognized pharmaceutical experts. The committee 
will assess the bids submitted by the various participating pharmaceutical manufacturers, taking into consideration, 
among other things, the quality and price of the drug product and the service and reputation of the manufacturer. Only 
drug products that have been selected in the collective tender processes may be purchased by participating hospitals.  

COMPETITION   

Competition  in  the  pharmaceutical,  biotechnology  and  biopharmaceutical  industries  is  intense  and  based 
significantly on scientific and technological factors, the availability of patent and other protection for technology and 
products,  the  ability  and  length  of  time  required  to  obtain  governmental  approval  for  testing,  manufacturing  and 
marketing and the ability to commercialize products in a timely fashion.  Moreover, the biopharmaceutical industry is 
characterized by rapidly evolving technology that could result in the technological obsolescence of any products that 
we develop. 

We  compete  with  many  specialized  biopharmaceutical  firms,  as  well  as  a  growing  number  of  large 
pharmaceutical  companies  that  are  applying  biotechnology  to  their  operations.  It  is  probable  that  the  number  of 
companies  seeking  to  develop  products  and  therapies  for  the  treatment  of  unmet  needs  in  oncology will  increase.  
Many biopharmaceutical companies have focused their development efforts in the human therapeutics area, including 
oncology  and  inflammation,  and  many  major  pharmaceutical  companies  have  developed  or  acquired  internal 
biotechnology  capabilities  or  made  commercial  arrangements  with  other  biopharmaceutical  companies.  These 
companies, as well as academic institutions, governmental agencies and private research organizations, also compete 
with us in recruiting and retaining highly qualified scientific personnel and consultants.  

The biopharmaceutical industry has undergone, and is expected to continue to undergo, rapid and significant 
technological change.  Consolidation and competition are expected to intensify as technical advances in each field are 
achieved and become more widely known.  In order to compete effectively, we will be required to continually expand 
our scientific expertise and technology, identify and retain capable personnel and pursue scientifically feasible and 
commercially viable opportunities. 

13 

 
 
 
 
 
  
 
Our competition will be determined in part by the potential indications for which our product candidates may 
be  developed  and  ultimately  approved  by  regulatory  authorities.    The  relative  speed  with  which  we  develop  new 
products,  complete  clinical  trials,  obtain  regulatory  approvals,  and  complete  the  other  requirements  to  get  a 
pharmaceutical product on the market are critical factors in gaining a competitive advantage.  We may rely on third 
parties to commercialize our products, and accordingly, the success of these products will depend in significant part 
on these third parties' efforts and ability to compete in these markets.  The success of any collaboration will depend in 
part upon our collaborative partners' own competitive, marketing and strategic considerations, including the relative 
advantages of alternative products being developed and marketed by our collaborative partners and our competitors.  

Many  of  our  existing  or  potential  competitors  have  substantially  greater  financial,  technical  and  human 
resources than we do and may be better equipped to develop, manufacture and market products.  In addition, many of 
these competitors have extensive experience in preclinical testing and human clinical trials and in obtaining regulatory 
approvals. The existence of competitive products, including products or treatments of which we are not aware, or 
products or treatments that may be developed in the future, may adversely affect the marketability of products that we 
may develop.  Our competitors’ drugs may be more effective than any drug we may commercialize and may render 
our product candidates obsolete or non-competitive before we can recover the expenses of developing our product 
candidates.   

EMPLOYEES  

Our  work  force  currently  consists  of  124  full-time  employees  and  1  part-time  employee,  the  majority  of 
which are located in China. Certain of our activities, such as manufacturing and clinical trial operations, are outsourced 
at the present time.  We may hire additional personnel, in addition to utilizing part-time or temporary consultants, on 
an as-needed basis.  None of our employees are represented by a labor union, and we believe our relations with our 
employees are satisfactory. 

CORPORATE HEADQUARTERS 

We  were  incorporated  under  Delaware  law  in  1991.    In  2012,  we  refocused  our  clinical  and  regulatory 
strategy to leverage resources in China and implemented a name change in 2014 to “CASI Pharmaceuticals, Inc.” Our 
offices are located at 9620 Medical Center Drive, Suite 300, Rockville, Maryland 20850, and our telephone number 
is  (240)  864-2600.    Our  wholly-owned  subsidiary,  CASI  China,  is  headquartered  in  Beijing,  China.    We  conduct 
substantially all of our operations through CASI China, CASI China’s headquarters are located at 1701-1702, China 
Central Office Tower 1, No.81 Jianguo Road, Chaoyang District, Beijing, 100025 China.  CASI China also leases 
laboratory space in Beijing, China which serves as our R&D Center. Management decisions are primarily being made 
out of CASI China where our executive team spends a substantial amount of time.   

CHINA OPERATIONS 

In  August  2012,  we  established  a  wholly-owned  China-based  subsidiary  and  an  office  in  Beijing,  and  in 
2014, established a R&D Center in Beijing.  We also established a wholly-owned domestic China based subsidiary 
under which our preclinical activities are operated.  In addition, CASI Wuxi was established on December 26, 2018, 
to own and operate the Wuxi manufacturing facility.  Our staff in China currently consists of 112 full-time employees.  
Among its activities, our China operations help to oversee the Company’s anticipated commercial launch, sales and 
marketing of Melphalan Hydrochloride for Injection (EVOMELA), technology transfer and local manufacturing for 
our ANDA products, local preclinical and clinical operation activities, as well as its NMPA regulatory activities. In 
addition, the Beijing operations include business development activities and executive management activities.  We 
expect our operations in China to continue to grow.   

AVAILABLE INFORMATION 

Through our website at www.casipharmaceuticals.com, we make available, free of charge, our filings with 
the SEC, including our annual proxy statements, annual reports on Form 10-K, quarterly reports on Form 10-Q and 
current reports on Form 8-K, and all amendments thereto, as soon as reasonably practicable after such reports are filed 
with or furnished to the SEC.  Additionally, our board committee charters and code of ethics are available on our 

14 

 
 
 
 
 
 
 
 
 
 
 
 
website. We intend to post to this website all amendments to the charters and code of ethics.  Our filings are also 
available through the SEC via their website, http://www.sec.gov.  The information contained on our website is not 
incorporated by reference in this Annual Report on Form 10-K (this “Annual Report”) and should not be considered 
a part of this report. 

ITEM 1A.     RISK FACTORS.      

Risks Relating to our Financial Position and Need for Additional Capital 

We  have  incurred  significant  operating  losses  since  inception  and  anticipate  that  we  will  continue  to  incur 
operating losses for the foreseeable future and may never achieve or maintain profitability.  

To date, we have been engaged primarily in research and development activities. Although in the past we 
have  received  limited  revenues  on  royalties  from  the  sales  of  pharmaceuticals,  license  fees  and  research  and 
development  funding  from  a  former  collaborator  and  limited  revenues  from  certain  research  grants,  we  have  not 
derived significant revenues from operations. 

We  have  experienced  losses  in  each  year  since  inception.  Through  December  31,  2018  we  had  an 
accumulated deficit of approximately $478.9 million. We expect that we will seek to raise capital to continue  our 
operations  and  although  we  have  been  successfully  funded  to  date  through  the  sales  of  our  equity  securities  and 
through  limited  royalty  payments,  our  capital-raising  efforts  may  not  produce  the  funding  needed  to  sustain  our 
operations. If we are unable to obtain additional funding for operations, we may not be able to continue operations as 
proposed, requiring us to modify our business plan, curtail various aspects of our operations or cease operations. In 
any such event, investors may lose a portion or all of their investment. 

We expect that our ongoing clinical and corporate activities will result in operating losses for the foreseeable 
future. In addition, to the extent we rely on others to develop and commercialize our products, our ability to achieve 
profitability will depend upon the success of these other parties. To support our research and development of certain 
product candidates, we may seek and rely on cooperative agreements from governmental and other organizations as a 
source of support. If a cooperative agreement were to be reduced to any substantial extent, it may impair our ability 
to  continue  our  research  and  development  efforts.  To  become  and  remain  profitable,  we  must  successfully 
commercialize one or more product candidates with significant market potential. This will require us to be successful 
in  a  range  of  challenging  activities,  including  completing  clinical  trials  of  our  product  candidates,  developing 
commercial scale manufacturing processes, obtaining marketing approval, manufacturing, marketing and selling any 
current and future product candidates for which we may obtain marketing approval, and satisfying any post-marketing 
requirements.  We  may  never  succeed  in  any  or  all  of  these  activities  and,  even  if  we  do,  we  may  never  generate 
sufficient revenue to achieve profitability. 

Our common stock could be delisted from the Nasdaq Capital Market, which could affect our common stock’s 
market price and liquidity. 

Our listing on the Nasdaq Capital Market is contingent upon meeting all the continued listing requirements 
of the Nasdaq Capital Market. In the past, we have received written notices from Nasdaq for failing to maintain a 
minimum bid price of not less than $1.00 per share and a minimum of $2.5 million in stockholders’ equity. Although 
we have regained compliance with Nasdaq’s continued listing standards, there can be no assurance that we will remain 
in compliance in the future. 

If our common stock is delisted from the Nasdaq Capital Market, our ability to raise capital in the future may 

be limited. Delisting could also result in less liquidity for our stockholders and a lower stock price. 

We may engage in strategic and other corporate transactions, which could negatively affect our financial condition 
and prospects. 

We may consider strategic and other corporate transactions as opportunities present themselves. There are 
risks  associated  with  such  activities. These  risks  include,  among  others,  incorrectly  assessing  the  quality  of  a 
prospective  strategic  partner,  encountering  greater  than  anticipated  costs  in  integration,  being  unable  to  profitably 

15 

 
 
 
 
 
 
 
 
 
 
 
 
deploy assets acquired in the transaction, such as drug candidates, possible dilution to our stockholders, and the loss 
of key employees due to changes in management. Further, strategic transactions may place additional constraints on 
our  resources  by  diverting  the  attention  of  our  management  from  our  business  operations. To  the  extent  we  issue 
securities in connection with additional transactions, these transactions and related issuances may have a dilutive effect 
on existing shareholders. Our financial condition and prospects after an acquisition depend in part on our ability to 
successfully  integrate  the  operations  of  the  acquired  business  or  technologies. We  may  be  unable  to  integrate 
operations successfully or to achieve expected cost savings. Any cost savings which are realized may be offset by 
losses in revenues or other charges to earnings. 

The current capital and credit market conditions may adversely affect our access to capital, cost of capital, and 
ability to execute our business plan as scheduled. 

Access  to  capital  markets  is critical  to  our ability to operate.  Traditionally, biopharmaceutical  companies 
have funded their research and development expenditures through raising capital in the equity markets. Declines and 
uncertainties  in  these  markets  over  the past  few  years  have  restricted  raising  new  capital  in  amounts  sufficient  to 
conduct our current operations and have affected our ability to continue to expand or fund research and development 
efforts  with  our  product  candidates.  We  require  significant  capital  for  research  and  development  for  our  product 
candidates and clinical trials. In recent years, the general economic and capital market conditions in the United States 
have deteriorated significantly and have adversely affected our access to capital and increased the cost of capital, and 
there is no certainty that a recovery in the capital and credit markets, enabling us to raise capital in an amount to 
sufficiently fund our short-term and long-term plans, will occur in 2018. If these economic conditions continue or 
become worse, our future cost of equity or debt capital and access to the capital markets could be adversely affected. 
In addition, our inability to access the capital markets on favorable terms because of our low stock price, or upon our 
delisting from the Nasdaq Capital Market if we fail to satisfy a listing requirement, could affect our ability to execute 
our business plan as scheduled. Moreover, we rely and intend to rely on third parties, including our clinical research 
organizations, third party manufacturers, and certain other important vendors and consultants. As a result of the current 
volatile and unpredictable global economic situation, there may be a disruption or delay in the performance of our 
third-party  contractors  and  suppliers.  If  such  third  parties  are  unable  to  adequately  satisfy  their  contractual 
commitments to us in a timely manner, our business could be adversely affected. 

We do not have any active revenue streams and we are uncertain whether additional funding will be available for 
our future capital needs and commitments. If we cannot raise additional funding, or access the capital markets, we 
may be unable to complete the development of our product candidates.  

We will require substantial funds in addition to our existing working capital to develop our product candidates 
and otherwise to meet our business objectives. We have never generated sufficient revenue during any period since 
our inception to cover our expenses and have spent, and expect to continue to spend, substantial funds to continue our 
clinical development programs. Any one of the following factors, among others, could cause us to require additional 
funds or otherwise cause our cash requirements in the future to increase materially: 

progress of our clinical trials or correlative studies; 
results of clinical trials; 
changes in or terminations of our relationships with strategic partners; 
changes in the focus, direction, or costs of our research and development programs; 
competitive and technological advances; 
establishment of marketing and sales capabilities; 

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the regulatory approval process; or 
product launch. 

At December 31, 2018, we had cash and cash equivalents of approximately $84.2 million. We may continue 
to seek additional capital through public or private financing or collaborative agreements in 2019 and beyond. Our 
operations require significant amounts of cash. We may be required to seek additional capital for the future growth 
and  development  of  our  business. We  can give  no  assurance  as  to  the  availability  of  such  additional  capital  or,  if 
available, whether it would be on terms acceptable to us. If we are not successful in obtaining sufficient capital because 

16 

 
 
 
 
 
 
 
we are unable to access the capital markets on favorable terms, it could reduce our research and development efforts 
and materially adversely affect our future growth, results of operations and financial results. 

Governmental control of currency conversion and payments of RMB out of mainland China may limit our ability 
to utilize our cash balances effectively and affect the value of your investment. 

Our China subsidiary has assets that include approximately 106.1 million China Renminbi (“RMB”), valued 
at approximately $15.4 million in U.S. dollars. On a consolidated basis this balance accounts for approximately 18% 
of our total cash and cash equivalents. The Chinese government imposes controls on the convertibility of RMB into 
foreign currencies and, in certain cases, the remittance of RMB out of mainland China. Control on payments out of 
mainland China may restrict the ability of our China subsidiary to remit RMB to us. Approval from China’s State 
Administration of Foreign Exchange (“SAFE”) and the People’s Bank of China (“PBOC”) may be required where 
RMB are to be converted into foreign currencies, including U.S. dollars, and approval from SAFE and the PBOC or 
their branches may be required where RMB are to be remitted out of mainland China. Specifically, under the existing 
restrictions,  without  a  prior  approval  from  SAFE  and  the  PBOC,  the  cash  balance  of  our  China  subsidiary  is  not 
available  to  us  for  activities  outside  of  China  including  support  of  our  in-licensing  efforts.  Furthermore,  because 
repatriation of funds requires the prior approval of SAFE and PBOC, such repatriation could be delayed, restricted or 
limited. 

Risks Relating to Our Business 

The regulatory approval process of the regulatory authorities in the United States and China are lengthy, time-
consuming and inherently unpredictable. If we are ultimately unable to obtain regulatory approval for our drug 
candidates, our business will be substantially harmed.  

The time required to obtain approval by FDA and NMPA is unpredictable and typically takes many years 
following the commencement of preclinical studies and clinical trials and depends on numerous factors, including the 
substantial discretion of the regulatory authorities. 

Our drug candidates could be delayed or fail to receive regulatory approval for many reasons, including: 

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failure to begin or complete clinical trials due to disagreements with regulatory authorities; 
failure to demonstrate that a drug candidate is safe and effective or that a biologic candidate is safe, 
pure, and potent for its proposed indication; 
failure of clinical trial results to meet the level of statistical significance required for approval; 
reporting or data integrity issues related to our clinical trials; 
disagreement with our interpretation of data from preclinical studies or clinical trials; 
changes in approval policies or regulations that render our preclinical and clinical data insufficient 
for approval or require us to amend our clinical trial protocols; 
regulatory requests for additional analyses, reports, data, nonclinical studies and clinical trials, or 
questions  regarding  interpretations  of  data  and  results  and  the  emergence  of  new  information 
regarding our drug candidates or other products; 
failure to satisfy regulatory conditions regarding endpoints, patient population, available therapies 
and  other  requirements  for  our  clinical  trials  in  order  to  support  marketing  approval  on  an 
accelerated basis or at all; 
our failure to conduct a clinical trial in accordance with regulatory requirements or our clinical trial 
protocols; and 
clinical sites, investigators or other participants in our clinical trials deviating from a trial protocol, 
failing to conduct the trial in accordance with regulatory requirements, or dropping out of a trial. 

The FDA, NMPA or a comparable regulatory authority may require more information, including additional 
preclinical,  chemistry,  manufacturing  and  controls,  and/or  clinical  data,  to  support  approval,  which  may  delay  or 
prevent approval and our commercialization plans, or we may decide to abandon the development program. 

Changes in regulatory requirements and guidance may also occur, and we may need to amend clinical trial 
protocols  submitted  to  applicable  regulatory  authorities  to  reflect  these  changes.  Amendments  may  require  us  to 
17 

 
 
  
 
 
 
 
  
 
 
resubmit clinical trial protocols to IRBs or ethics committees for re-examination, which may impact the costs, timing 
or successful completion of a clinical trial.  

If  we  experience  delays  in  the  completion  of,  or  the  termination  of,  a  clinical  trial  of  any  of  our  drug 
candidates, the commercial prospects of that drug candidate may be harmed, and our ability to generate product sales 
revenues from any of those drug candidates may be delayed. In addition, any delays in completing our clinical trials 
will increase our costs, slow down our drug candidate development and approval process, and jeopardize our ability 
to commence product sales and generate related revenues for that candidate. Any of these occurrences may harm our 
business, financial condition and prospects significantly. In addition, many of the factors that cause, or lead to, a delay 
in the commencement or completion of clinical trials may also ultimately lead to the denial of regulatory approval of 
our drug candidates. 

The  recent  restructure  of  the  Chinese  drug  regulatory  authorities  may  delay  approval  of  our  products  or  drug 
candidates in China. 

On March 17, 2018, China’s highest legislative body, the National People’s Congress, approved a sweeping 
government restructuring plan.  This is generally considered to be the most comprehensive government restructuring 
that  China  has  undertaken  since  its  “Open  Door”  policy  in  the  late  1970s.    As  part  of  the  new  plan,  China  has 
established a SAMR, which merges and undertakes the responsibilities previously held by the China Food and Drug 
Administration,  the  State  Administration  for  Industry  and  Commerce  (SAIC),  General  Administration  of  Quality 
Supervision, Inspection and Quarantine (AQSIQ), the Certification and Accreditation Administration (CAC), and the 
Standardization Administration of China (SAC). The central government expects to complete the restructuring at the 
state level by the end of 2018. Municipal and county level authorities must complete the restructure by the first quarter 
of 2019.   

The new NMPA reports to the SAMR, is responsible for the review and approval of drugs, medical devices 
and  cosmetics,  and  maintains  its  own  branches  at  the  provincial  level  and  leave  the  post-approval  enforcement 
authorities at the local level to the consolidated SAMR branches.   

Although the NMPA is fully functional as of 2018, the reorganization will continue at the provincial and local levels 
through the first quarter of 2019.  This massive restructuring exercise could result in the delay of key decision-
making in various sectors, including the pharmaceutical and medical device industry.  In addition, there could be 
delays in the NMPA’s implementation of the new reform initiatives and disruption in the NMPA’s routine 
operations due to personnel reshuffle. 

We may not be able to commercialize our drugs or drug candidates in China without obtaining regulatory approval 
from NMPA. 

We  have  exclusive  licenses  to  develop  and  commercialize  Melphalan  Hydrochloride  For  Injection 
(EVOMELA),  ibritumomab  tiuxetan  (ZEVALIN)  and  vinCRIStine  sulfate  LIPOSOME  injection  (MARQIBO)  in 
Greater China. On December 3, 2018, we received NMPA’s approval for importation, marketing and sales in China 
for  Melphalan  Hydrochloride  for  Injection  (EVOMELA).  In  addition,  we  acquired  a  portfolio  of  25  U.S.  FDA-
approved ANDAs, four ANDAs that are pending FDA approval, and one ANDA for tenofovir disoproxil fumarate 
(TDF) indicated for hepatitis B virus. An ANDA contains data that is submitted to FDA for the review and potential 
approval  of  a  generic  drug  product.  Once  approved,  the  applicant  may  manufacture  and  market  the  generic  drug 
product to provide a safe, effective, lower cost alternative to the brand-name drug it references. We intend to select 
and  pursue  commercialization  of  certain  products  from  our  ANDA  portfolio  that  offer  unique  market  and  cost-
effective manufacturing opportunities in China and/or in the U.S. However, the majority of our drug candidates are 
still in clinical or pre-clinical development in China.  

Our success in commercializing these drugs may be inhibited by a number of factors, including:  

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our inability to obtain/maintain regulatory approvals; 
our inability to recruit, train and retain adequate numbers of effective sales and marketing personnel; 
the  inability  of  sales  personnel  to  obtain  access  to  or  educate  physicians  on  the  benefits  of  our 
products; 

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our lack of experience in manufacturing drugs for commercial sales; 
our  or  our  partners’  inability  to  secure  widespread  acceptance  of  our  products  from  physicians, 
healthcare payors, patients and the medical community; 
our ability to win tenders through the collective tender processes in which we decide to participate; 
the  lack  of  complementary  products  to  be  offered  by  sales  personnel,  which  may  put  us  at  a 
competitive disadvantage relative to companies with more extensive product lines; and 
unforeseen  costs  and  expenses  associated  with  creating  an  independent  sales  and  marketing 
organization. 

If we decide  to rely on  third parties  to  manufacture,  sell,  market  and distribute our  products  and product 
candidates, we may not be successful in entering into arrangements with such third parties or may be unable to do so 
on terms that are favorable to us. In addition, our product revenues and our profitability, if any, may be lower if we 
rely on third parties for these functions than if we were to market, sell and distribute any products that we develop 
ourselves. We likely will have little control over such third parties, and any of them may fail to devote the necessary 
resources  and  attention  to  sell  and  market  our  products  effectively.  If  we  do  not  establish  sales,  marketing  and 
distribution capabilities successfully, either on our own or in collaboration with third parties, we will not be successful 
in commercializing our product candidates, which would adversely affect our business and financial condition. 

The commercial success of Melphalan Hydrochloride for Injection (EVOMELA) in China may be slow or limited 
for a variety of reasons. 

On  December  3,  2018,  we  received  NMPA’s  approval  for  importation,  marketing  and  sales  in  China  for 
Melphalan  Hydrochloride  For  Injection  (EVOMELA).    We  will  spend  our  time,  resources  and  effort  on  the 
commercialization of our approved drug in China in the near future. However, there are no guarantees that we will be 
successfully commercialize the medicine in China.   

Reimbursement and hospital listing may be the most critical market access factors for our commercialization 
success in China. There is no regular update schedule for the NRDL.  The government has committed to updating the 
NRDL in 2019. Given that Melphalan Hydrochloride For Injection (EVOMELA) was approved in 2018, we may or 
may not qualify for the next NDRL update should it be implemented in 2019. Provincial governments have some 
discretion to add Melphalan Hydrochloride For Injection (EVOMELA) to provincial reimbursement drug lists.  With 
or without being listed on the NRDL, we can apply for inclusion in the provincial reimbursement drug lists of selected 
provinces.    Until  Melphalan  Hydrochloride  For  Injection  (EVOMELA)  is  listed  in  the  NRDL  or  the  majority  of 
provincial reimbursement drug lists, our market will be extremely limited given only a small portion of the Chinese 
population would be able to afford our drug through self-pay.   

Even when Melphalan Hydrochloride For Injection (EVOMELA) has been included in a government hospital 
formulary, the NDRL or the provincial reimbursement drug list, we need to win tenders during the collective tender 
process  in  order  to  supply  the  drug to  state-owned  or  state-controlled  hospitals.  If  we  are  unable  to  win  purchase 
contracts through the collective tender processes in which we decide to participate, there will be limited demand for 
Melphalan  Hydrochloride  For  Injection  (EVOMELA),  and  sales  revenues  from  the  drug  will  be  materially  and 
adversely affected. Last but not least, we need to ensure that Melphalan Hydrochloride For Injection (EVOMELA) 
has  been  quickly  added  to  hospitals’  formulary.    If  we were  unable  to  quickly  add  Melphalan  Hydrochloride  For 
Injection (EVOMELA) to hospitals’ formulary, doctors and patients will not have access to our drug through hospital 
pharmacies.  

We conduct development and operations in China, which exposes us to risks associated with operating outside of 
the United States. Changes in international trade and economic policy by the U.S. and Chinese governments could 
have a material adverse effect on our business and operations. 

We  have  operations  and  conduct  business  in  China  and  we  plan  to  continue  to  expand  these  operations. 
Therefore, we are subject to risks related to operating in foreign countries, which include unfamiliar foreign laws or 
regulatory requirements or unexpected changes to those laws or requirements; other laws and regulatory requirements 
to which our business activities abroad are subject, such as the Foreign Corrupt Practices Act; changes in the political 
or economic condition of a specific country or region; fluctuations in the value of foreign currency versus the U.S. 
dollar; our ability to deploy overseas funds in an efficient manner; tariffs, trade protection measures, import or export 

19 

 
 
 
 
 
 
 
 
licensing requirements, trade embargoes, and sanctions (including those administered by the Office of Foreign Assets 
Control  of  the  U.S.  Department  of  the  Treasury),  and  other  trade  barriers;  difficulties  in  attracting  and  retaining 
qualified personnel; and cultural differences in the conduct of business. There is currently significant uncertainty about 
the future relationship between the U.S. and various other countries, including China, with respect to trade policies, 
treaties,  government  regulations  and  tariffs.  The  Trump  Administration  has  called  for  substantial  changes  to  U.S. 
foreign trade policy, including the possibility of imposing greater restrictions on international trade and significant 
increases in tariffs. Any of the foregoing could harm our business and we cannot anticipate all of the ways in which 
the current political climate could adversely impact our business. 

We are establishing a joint venture to build and operate a manufacturing facility in the Wuxi Huishan Economic 
Development Zone. The success of this joint venture is subject to uncertainty and may reduce our earnings, be 
difficult to accomplish, take longer than expected or require us to obtain additional financing. 

We have invested approximately $21 million and intend to invest a total of approximately $80 million, of 
which  $30  million  is  intended  to  be  an  investment  in  the  value  of  certain  ANDA  products  to  be  determined  and 
transferred to the joint venture, proceeds to be used in the building and operating a manufacturing facility in the Wuxi 
Huishan Economic Development Zone in Jiangsu Province, China.  The Company’s total investment is intended to 
account for 80% of the equity of the joint venture.  This joint venture may not achieve the expected goal as the planned 
manufacturing  facility  will  not  be  entirely  within  our  control.  It  can  take  years  to  build  and  establish  a  new 
manufacturing  facility.  Once  built,  the  new  facility  might  fail  validation  or  not  meet  regulatory  standards  for  a 
commercial manufacturing facility. In addition, we may not obtain or retain the requisite legal permits to manufacture 
in China, and costs or operational limitations may be imposed in connection with obtaining and complying with such 
permits. Our ability to establish and operate a manufacturing facility in China may be adversely affected by changes 
in  Chinese  laws  and  regulations  such  as  those  related  to,  among  other  things,  taxation,  import  and  export  tariffs, 
environmental regulations, land use rights, intellectual property, employee benefits and other matters. The success of 
this joint venture also relies on our ability to make additional payments in the future, which is uncertain. Our plan may 
require us to obtain  additional debt or equity financing,  resulting  in  additional  debt  obligations,  increased  interest 
expense  or  dilution  of  equity  ownership.  If  we  are  unable  to  establish  a  new  manufacturing  facility,  purchase 
equipment,  hire  adequate  personnel  to  support  our  manufacturing  efforts  or  implement  necessary  process 
improvements, we may be unable to produce commercial materials or meet demand, if any should develop, for our 
product candidates. Any one of the factors cited above, or a combination of them, could result in unanticipated costs, 
which could materially and adversely affect our business and planned operations and development in China. 

The retail prices of any product candidates that we develop may be subject to control, including periodic downward 
adjustment, by Chinese government authorities. 

The price for pharmaceutical products is highly regulated in China, both at the national and provincial level. 
Price controls may reduce prices to levels significantly below those that would prevail in less regulated markets, or 
limit the volume of products that may be sold, either of which may have a material and adverse effect on potential 
revenues from sales of our drug products in China. Moreover, the process and timing for the implementation of price 
restrictions is unpredictable, which may cause potential revenues from the sales of our drug product to fluctuate from 
period to period. 

The existence of counterfeit pharmaceutical products in pharmaceutical markets may compromise our brand and 
reputation and have a material adverse effect on our business, operations and prospects. 

Counterfeit products, including counterfeit pharmaceutical products, are a significant problem, particularly 
in  China.  Counterfeit  pharmaceuticals  are  products  sold  or  used  for  research  under  the  same  or  similar  names,  or 
similar mechanism of action or product class, but which are sold without proper licenses or approvals. Such products 
may  be  used  for  indications  or  purposes  that  are  not  recommended  or  approved  or  for  which  there  is  no  data  or 
inadequate data with regard to safety or efficacy. Such products divert sales from genuine products, often are of lower 
cost, often are of lower quality (having different ingredients or formulations, for example), and have the potential to 
damage the reputation for quality and effectiveness of the genuine product. If counterfeit pharmaceuticals illegally 
sold or used for research result in adverse events or side effects to consumers, we may be associated with any negative 
publicity resulting from such incidents. Consumers may buy counterfeit pharmaceuticals that are in direct competition 
with our pharmaceuticals, which could have an adverse impact on our revenues, business and results of operations. In 
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addition, the use of counterfeit products could be used in non-clinical or clinical studies, or could otherwise produce 
undesirable side effects or adverse events that may be attributed to our products as well, which could cause us or 
regulatory  authorities  to  interrupt, delay or  halt  clinical  trials  and  could result  in  the delay  or denial of  regulatory 
approval by  the FDA or other  regulatory authorities  and  potential  product  liability  claims.  With  respect  to  China, 
although the government has recently been increasingly active in policing counterfeit pharmaceuticals, there is not yet 
an effective counterfeit pharmaceutical regulation control and enforcement system in China. As a result, we may not 
be able to prevent third parties from selling or purporting to sell our products in China. The proliferation of counterfeit 
pharmaceuticals has grown in recent years and may continue to grow in the future. The existence of and any increase 
in the sales and production of counterfeit pharmaceuticals, or the technological capabilities of counterfeiters, could 
negatively impact our revenues, brand reputation, business and results of operations. 

Uncertainties with respect to the China legal system could have a material adverse effect on us. 

The legal system of China is a civil law system primarily based on written statutes. Unlike in a common law 
system, prior court decisions may be cited for reference but are not binding. Because the China legal system continues 
to rapidly evolve, the interpretations of many laws, regulations and rules are not always uniform and enforcement of 
these laws, regulations and rules involve uncertainties, which may limit legal protections available to us. Moreover, 
decision makers in the China judicial system have significant discretion in interpreting and implementing statutory 
and  contractual  terms,  which  may  render  it  difficult  for us  to  enforce  the  contracts  entered  into  with our  business 
partners,  customers  and  suppliers.  Different  government  departments  may  have  different  interpretations  of  certain 
laws and regulations, and licenses and permits issued or granted by one government authority may be revoked by a 
higher government authority at a later time. Navigating the uncertainty and change in the China legal system will 
require the devotion of significant resources and time, and there can be no assurance that our contractual and other 
rights will ultimately be enforced. 

Changes in China’s economic, political or social conditions or government policies could have a material adverse 
effect on our business and operations. 

Chinese society and the Chinese economy continue to undergo significant change. Adverse changes in the 
political  and  economic  policies  of  the  Chinese  government  could  have  a  material  adverse  effect  on  the  overall 
economic  growth  of  China,  which  could  adversely  affect  our  ability  to  conduct  business  in  China.  The  Chinese 
government continues to adjust economic policies to promote economic growth. Some of these measures benefit the 
overall Chinese economy, but may also have a negative effect on us. For example, our financial condition and results 
of operations in China may be adversely affected by government control over capital investments or changes in tax 
regulations. As the Chinese pharmaceutical industry grows and evolves, the Chinese government may also implement 
measures to change the structure of foreign investment in this industry. We are unable to predict the frequency and 
scope of such policy changes, any of which could materially and adversely affect our liquidity, access to capital and 
its ability to conduct business in China. Any failure on our part to comply with changing government regulations and 
policies could result in the loss of our ability to develop and commercialize our product candidates in China.  

We are currently building our sales and distribution infrastructure. If we are unable to develop our sales, marketing 
and distribution capability on our own or through collaborations with marketing partners, we will not be successful 
in commercializing Melphalan Hydrochloride For Injection (EVOMELA) or any other product candidates. 

In  December  of  2018,  we  received  NMPA’s  approval  for  importation,  marketing  and  sales  in  China  for 
Melphalan Hydrochloride For Injection (EVOMELA). We are in the process of establishing a sales and marketing 
team with technical expertise and supporting distribution capabilities to successfully commercialize EVOMELA, or 
to outsource this function to a third party. Both of these options can be expensive and time consuming. In addition, 
we may not be able to hire a sales force in the China that is large enough or has adequate expertise in the medical 
markets that we intend to target. Any failure or delay in the development of our sales, marketing and distribution 
capabilities would adversely impact the commercialization of Melphalan Hydrochloride For Injection (EVOMELA) 
and other product candidates.  

We have limited experience in the sale, marketing or distribution of pharmaceutical products. To achieve 
commercial success for any approved product, we must either develop a sales and marketing organization or outsource 
these functions to third parties. We will need to commit significant time and financial and managerial resources to 

21 

 
 
 
 
 
 
 
 
maintain and further develop our marketing and sales force to ensure they have the technical expertise required to 
address  any  challenges  we  may  face  with  the  commercialization  of  Melphalan  Hydrochloride  For  Injection 
(EVOMELA). 

Factors that may inhibit our efforts to maintain and develop our commercialization capabilities include: 

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our ability to retain an adequate number of effective commercial personnel in the medical markets 
we intend to target; 
our  ability  to  train  sales  personnel,  who  may  have  limited  experience  with  our  company  or 
Melphalan Hydrochloride For Injection (EVOMELA), to deliver a consistent message regarding the 
medicine and be effective in convincing physicians to prescribe it; 
a  lack  of  complementary  products  to  be  offered  by  sales  personnel,  which  may  put  us  at  a 
competitive disadvantage relative to companies with more extensive product lines; 
unforeseen costs and expenses associated with maintaining and further developing an independent 
sales and marketing organization. 

If we are not successful in establishing and maintaining an effective sales and marketing infrastructure, we 
will  have  difficulty  commercializing  Melphalan  Hydrochloride  For Injection (EVOMELA) and our future product 
revenue will suffer, which would adversely affect our business and financial condition. If we enter into arrangements 
with third parties to perform sales, marketing and distribution services, our product revenues or the profitability of 
these product revenues to us are likely to be lower than if we were to market and sell any products that we develop 
ourselves. In addition, we likely will have little control over such third parties, and any of them may fail to devote the 
necessary  resources  and  attention  to  sell  and  market  our  products  effectively.  If  we  are  not  successful  in 
commercializing any approved products, either on our own or through collaborations with one or more third parties, 
our future product revenue will suffer, and we may incur significant additional losses. 

We may need new collaborative partners to further develop and commercialize products, and if we enter into such 
arrangements, we may lose control over the development and approval process. 

We plan to develop and commercialize our product candidates both with and without corporate alliances and 
partners. Nonetheless, we intend to explore opportunities for new corporate alliances and partners to help us develop, 
commercialize and market our product candidates. We expect to grant to our partners certain rights to commercialize 
any products developed under these agreements, and we may rely on our partners to conduct research and development 
efforts and clinical trials on, obtain regulatory approvals for, and manufacture and market any products licensed to 
them.  Each  individual  partner  will  seek  to  control  the  amount  and  timing  of  resources  devoted  to  these  activities 
generally. We  anticipate  obtaining  revenues  from  our  strategic  partners  under  such  relationships  in  the  form  of 
research and development payments and payments upon achievement of certain milestones. Since we generally expect 
to obtain a royalty for sales or a percentage of profits of products licensed to third parties, our revenues may be less 
than if we retained all commercialization rights and marketed products directly. In addition, there is a risk that our 
corporate partners will pursue alternative technologies or develop competitive products as a means for  developing 
treatments for the diseases targeted by our programs. 

We  may  not  be  successful  in  establishing  any  collaborative  arrangements.  Even  if  we  do  establish  such 
collaborations,  we  may  not  successfully  commercialize  any  products  under  or  derive  any  revenues  from  these 
arrangements. There is a risk that we will be unable to manage simultaneous collaborations, if any, successfully. With 
respect  to  existing  and  potential  future  strategic  alliances  and  collaborative  arrangements,  we  will  depend  on  the 
expertise and dedication of sufficient resources by these outside parties to develop, manufacture, or market products. If 
a strategic alliance or collaborative partner fails to develop or commercialize a product to which it has rights, we may 
not recognize any revenues on that particular product. 

We may not be able to successfully identify and acquire new product candidates. 

Our growth strategy relies on our in-license of new product candidates from third parties. Our pipeline will 
be dependent upon the availability of suitable acquisition candidates at favorable prices and upon advantageous terms 
and  conditions.  Even  if  such  opportunities  are  present,  we  may  not  be  able  to  successfully  identify  appropriate 

22 

 
 
 
 
 
 
  
 
 
  
acquisition candidates. Moreover, other companies, many of which may have substantially greater financial resources 
are competing with us for the right to acquire such product candidates. 

If a product candidate is identified, the third parties with whom we seek to cooperate may not select us as a 
potential  partner  or  we  may  not  be  able  to  enter  into  arrangements  on  commercially  reasonable  terms  or  at  all. 
Furthermore,  the  negotiation  and  completion  of  collaborative  and  license  arrangements  could  cause  significant 
diversion of management’s time and resources and potential disruption of our ongoing business. 

We face significant competition from other biotechnology and pharmaceutical companies and our business will 
suffer if we fail to compete effectively.  

If competitors were to develop superior drug candidates, our products could be rendered noncompetitive or 
obsolete, resulting in a material adverse effect to our business. Developments in the biotechnology and pharmaceutical 
industries are expected to continue at a rapid pace. Success depends upon achieving and maintaining a competitive 
position in the development of products and technologies. Competition from other biotechnology and pharmaceutical 
companies  can  be  intense.  Many  competitors  have  substantially  greater  research  and  development  capabilities, 
marketing, financial and managerial resources and experience in the industry.  

In the generic products market, we face competition from other generic pharmaceutical companies, which 
may impact our selling price and revenues from such products. The FDA approval process often results in the FDA 
granting final approval to a number of ANDAs for a given product at the time a patent for a corresponding brand 
product  or  other  market  exclusivity  expires.  This  may  force  us  to  face  immediate  competition  when  we  seek  to 
introduce a generic product into the market. If competition from other generic pharmaceutical companies intensifies, 
revenues may decline. 

The availability of our competitors’ products could limit the demand, and the price we are able to charge, for 
product candidate we develop. We will not achieve our business plan if the acceptance of our products is inhibited by 
price competition or reimbursement issues or if physicians switch to other new drug products or choose to reserve our 
product candidates for use in limited circumstances. The inability to compete with existing or subsequently introduced 
drug products would have a material adverse impact on our business, financial condition and prospects. 

We must show the safety and efficacy of our product candidates through clinical trials, the results of which are 
uncertain.  

Before obtaining regulatory approvals for the commercial sale of our products, we must demonstrate, through 
preclinical studies (animal testing) and clinical trials (human testing), that our proposed products are safe and effective 
for use in each target indication. Testing of our product candidates will be required, and failure can occur at any stage 
of testing. Clinical trials may not demonstrate sufficient safety and efficacy to obtain the required regulatory approvals 
or result in marketable products. The failure to adequately demonstrate the safety and efficacy of a product under 
development could delay or prevent regulatory approval of the potential product. 

Clinical trials for the product candidates we are developing may be delayed by many factors, including that 
potential  patients  for  testing are  limited  in  number. The  failure  of  any  clinical  trials  to  meet  applicable  regulatory 
standards could cause such trials to be delayed or terminated, which could further delay the commercialization of any 
of our product candidates. Newly emerging safety risks observed in animal or human studies also can result in delays 
of ongoing or proposed clinical trials. Any such delays will increase our product development costs. If such delays 
are significant, they could negatively affect our financial results and the commercial prospects for our products. 

Compliance with ongoing post-marketing obligations for our approved ANDAs or NDAs may uncover new safety 
information that could give rise to a product recall, updated warnings, or other regulatory actions that could have 
an adverse impact on our business.  

After the FDA approves a drug for marketing under an NDA or ANDA, the product’s sponsor must comply 
with several post-marketing obligations that continue until the product is discontinued. These post-marking obligations 
include the prompt reporting of serious adverse events to the agency, the submission of product-specific annual reports 
that include changes in the distribution, manufacturing, and labeling information, and notification when a drug product 
23 

 
  
 
 
 
 
 
 
 
  
 
is found to have significant deviations from its approved manufacturing specifications (among others). Our ongoing 
compliance with these types of mandatory reporting requirements could result in additional requests for information 
from the FDA and, depending on the scope of a potential product issue that the FDA may decide to pursue, potentially 
also result in a request from the agency to conduct a product recall or to strengthen warnings and/or revise other label 
information about the product. Any of these post-marketing regulatory actions could materially affect our sales and, 
therefore, they have the potential to adversely affect our business, financial condition, results of operations and cash 
flows. 

We depend on patents and other proprietary rights, some of which are uncertain. 

Our success will depend in part on our ability to obtain and maintain patents for our products in the United 
States, China and elsewhere. The patent position of biotechnology and pharmaceutical companies in general is highly 
uncertain and involves complex legal and factual questions. Risks that relate to patenting our products include the 
following: 

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our failure to obtain additional patents; 
challenge, invalidation, or circumvention of patents already issued to us; 
failure of the rights granted under our patents to provide sufficient protection; 
independent development of similar products by third parties; or 
ability of third parties to design around patents issued to our collaborators or us. 

Our potential products may conflict with composition, method, and use of patents that have been or may be 
granted to competitors, universities or others. As the biotechnology industry expands and more patents are issued, the 
risk increases that our potential products may give rise to claims that may infringe the patents of others. Such other 
persons could bring legal actions against us claiming damages and seeking to enjoin clinical testing, manufacturing 
and marketing of the affected products. Any such litigation could result in substantial cost to us and diversion of effort 
by our management and technical personnel. If any of these actions are successful, in addition to any potential liability 
for  damages,  we  could  be  required  to  obtain  a  license  in  order  to  continue  to  manufacture  or  market  the  affected 
products. We may  not prevail  in  any  action  and  any  license  required under  any needed patent might not be made 
available on acceptable terms, if at all. 

We  also  rely  on  trade  secret  protection  for  our  confidential  and  proprietary  information. However,  trade 
secrets are difficult to protect and others may independently develop substantially equivalent proprietary information 
and techniques and gain access to our trade secrets and disclose our technology. We may be unable to meaningfully 
protect  our  rights  to  unpatented  trade  secrets. We  require  our  employees  to  complete  confidentiality  training  that 
specifically addresses trade secrets. All employees, consultants, and advisors are required to execute a confidentiality 
agreement when beginning an employment or a consulting relationship with us. The agreements generally provide 
that all trade secrets and inventions conceived by the individual and all confidential information developed or made 
known to the individual during the term of the relationship automatically become our exclusive property. Employees 
and consultants must keep such information confidential and may not disclose such information to third parties except 
in specified circumstances. However, these agreements may not provide meaningful  protection for our proprietary 
information in the event of unauthorized use or disclosure of such information. 

To  the  extent  that  consultants,  key  employees,  or  other  third  parties  apply  technological  information 
independently developed by them or by others to our proposed projects, disputes may arise as to the proprietary rights 
to such information. Any such disputes may not be resolved in our favor. Certain of our consultants are employed by 
or have consulting agreements with other companies and any inventions discovered by them generally will not become 
our property. 

Potential products may subject us to product liability for which insurance may not be available.  

The use of our potential products in clinical trials and the marketing of any pharmaceutical products may 
expose  us  to  product  liability  claims. We  have  obtained  a  level  of  liability  insurance  coverage  that  we  believe  is 
adequate in scope and coverage for our current stage of development. However, our present insurance coverage may 
not be adequate to protect us from liabilities we might incur. In addition, our existing coverage will not be adequate 
as we further develop products and, in the future, adequate insurance coverage and indemnification by collaborative 

24 

 
  
 
 
 
 
 
 
 
partners may not be available in sufficient amounts or at a reasonable cost. If a product liability claim or series of 
claims are brought against us for uninsured liabilities, or in excess of our insurance coverage, the payment of such 
liabilities could have a negative effect on our business and financial condition. 

We are subject to certain U.S. healthcare laws, regulation and enforcement; our failure to comply with those laws 
could have a material adverse effect on our results of operations and financial condition. 

We are subject to certain U.S. healthcare laws and regulations and enforcement by the federal government 
and  the  states in  which  we  conduct our  business.  The  laws  that  may  affect our  ability  to operate include, without 
limitation: 

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(cid:120) 

(cid:120) 

(cid:120) 

(cid:120) 

the  federal  Anti-Kickback  Statute  (AKS),  which  governs  our  business  activities,  including  our 
marketing  practices,  educational  programs,  pricing  policies,  and  relationships  with  healthcare 
providers  or  other  entities.  The  AKS  prohibits,  among  other  things,  persons  and  entities  from 
knowingly and willfully soliciting, receiving, offering or paying remuneration, directly or indirectly, 
in  exchange  for  or  to  induce  either  the  referral  of  an  individual  for,  or  the  purchase,  order  or 
recommendation of, any good or service for which payment may be made under federal healthcare 
programs such as the Medicare and Medicaid programs. Remuneration is not defined in the AKS 
and  has  been  broadly  interpreted  to  include  anything  of  value,  including  for  example,  gifts, 
discounts, coupons, the furnishing of supplies or equipment, credit arrangements, payments of cash, 
waivers of payments, ownership interests and providing anything at less than its fair market value. 
This statute has been broadly interpreted to apply to manufacturer arrangements with prescribers, 
purchasers and formulary managers, among others; 
the  federal  Food, Drug,  and  Cosmetic  Act,  or  FDCA,  and  its  regulations which  prohibit,  among 
other things, the introduction or delivery for introduction into interstate commerce of any food, drug, 
device, or cosmetic that is adulterated or misbranded; 
federal civil and criminal false claims laws and civil monetary penalty laws, which prohibit, among 
other things, individuals or entities from knowingly presenting, or causing to be presented, claims 
for payment from Medicare, Medicaid, or other third-party payers that are false or fraudulent, or 
making a false statement to avoid, decrease or conceal an obligation to pay money to the federal 
government; 
federal criminal laws that prohibit executing a scheme to defraud any healthcare benefit program or 
making false statements relating to healthcare matters; 
the Health  Insurance  Portability  and  Accountability  Act  of 1996, or HIPAA,  as  amended  by  the 
Health  Information  Technology  for  Economic  and  Clinical  Health  Act,  and  their  implementing 
regulations, which impose certain requirements relating to the privacy, security and transmission of 
individually identifiable health information;  
state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws, 
which may apply to items or services reimbursed by any third-party payer, including commercial 
insurers,  and  state  laws  governing  the  privacy  and  security  of  health  information  in  certain 
circumstances, many of which differ from each other in significant ways and may not have the same 
effect, thus complicating compliance efforts; 
the Foreign Corrupt Practices Act, a U.S. law which regulates certain financial relationships with 
foreign government officials (which could include, for example, certain medical professionals); 
federal  and  state  consumer  protection  and  unfair  competition  laws,  which  broadly  regulate 
marketplace activities and activities that potentially harm consumers; 
federal and state government price reporting laws that require us to calculate and report complex 
pricing metrics to government programs, where such reported prices may be used in the calculation 
of  reimbursement  and/or  discounts  on  our  marketed  drugs  (participation  in  these  programs  and 
compliance with the applicable requirements may subject us to potentially significant discounts on 
our products, increased infrastructure costs, and could potentially affect our ability to offer certain 
marketplace discounts); and 
federal and state financial transparency laws, which generally require certain types of expenditures 
in the United States to be tracked and reported (compliance with such requirements may require 
investment in infrastructure to ensure that tracking is performed properly, and some of these laws 
result  in  the  public  disclosure  of  various  types  of  payments  and  relationships  with  healthcare 

25 

 
 
 
providers and healthcare entities, which could potentially have a negative effect on our business 
and/or increase enforcement scrutiny of our activities). 

In addition, certain marketing practices, including off-label promotion, may also violate certain federal and 
state healthcare fraud and abuse laws, FDA rule and regulations, as well as false claims laws. If our operations are 
found to be in violation of any of the laws described above or any other governmental regulations that apply to us, we, 
or  our  officers  or  employees,  may  be  subject  to  penalties,  including  administrative  civil  and  criminal  penalties, 
damages, fines, withdrawal of regulatory approval, the curtailment or restructuring of our operations, the exclusion 
from participation in federal and state healthcare programs and imprisonment, any of which could adversely affect our 
ability to sell our products or operate our business and also adversely affect our financial results. 

If we are unable to obtain both adequate coverage and adequate reimbursement from third-party payers for our 
products, our revenues and prospects for profitability will suffer. 

Successful  commercialization  of  our  products  is  highly  dependent  on  the  extent  to  which  coverage  and 
reimbursement is, and will be, available from third-party payers, including governmental payers, such as Medicare 
and Medicaid, and private health insurers. Patients may not be capable of paying for our products themselves and may 
rely on third-party payers to pay for, or subsidize, the costs of their medications, among other medical costs. If third-
party payers do not provide coverage or reimbursement for our products, our revenues and prospects for profitability 
will  suffer.  In  addition,  even  if  third-party  payers  provide  some  coverage  or  reimbursement  for  our  products,  the 
availability of such coverage or reimbursement for prescription drugs under private health insurance and managed 
care plans often varies based on the type of contract or plan purchased.  

Current healthcare laws and regulations and future legislative or regulatory reforms to the healthcare system may 
affect our ability to sell our products profitably. 

The United States and some foreign jurisdictions are considering or have enacted a number of legislative and 
regulatory  proposals  to  change  the  healthcare  system  in  ways  that  could  affect  our  ability  to  sell  our  products 
profitably.  Among  policy  makers  and  payers  in  the  United  States  and  elsewhere,  there  is  significant  interest  in 
promoting changes in healthcare systems with the stated goals of containing healthcare costs, improving quality and/or 
expanding access. In the United States, the pharmaceutical industry has been a particular focus of these efforts and 
has been significantly affected by major legislative initiatives. 

We expect that healthcare reform  measures, including the potential repeal and replacement of  the Patient 
Protection and Affordable Care Act (PPACA), that may be adopted in the future, may have a significant impact on 
our business. Most recently, the Tax Cuts and Jobs Acts was enacted, which, among other things, removed penalties 
for not complying with the individual mandate to carry health insurance. Additionally, all or a portion of PPACA and 
related subsequent legislation may be modified, repealed or otherwise invalidated through judicial challenge, which 
could result in lower numbers of insured individuals, reduced coverage for insured individuals and adversely affect 
our business. If PPACA is repealed or replaced, it is unclear how the replacement statute may impact our business. If 
PPACA is not repealed or replaced, it will continue to impose requirements on our business.     

Moreover, certain politicians, including the President, have announced intentions to propose initiatives to 
regulate  the  prices  of  pharmaceutical  products.  We  cannot  know  what  form  any  such  legislation  may  take  or  the 
market’s  perception  of  how  such  legislation  would  affect  us.  Any  reduction  in  reimbursement  from  government 
programs may result in a similar reduction in payments from private payors. The implementation of cost containment 
measures  or  other  healthcare  reforms  may  prevent  us  from  being  able  to  generate  revenue,  attain  profitability,  or 
commercialize our current products and/or those for which we may receive regulatory approval in the future. 

In China, the newly created National Healthcare Security Administration (NHSA), an agency responsible for 
administering  China’s  social  security  system,  organized a  price  negotiation  with  drug  companies  for  18  oncology 
drugs in October 2018, which resulted in a price reduction by over 50%. The NHSA included 17 of the 18 oncology 
drugs on the NRDL after the price negotiation. We may also be invited to attend the price negotiation with NHSA 
upon receiving regulatory approval in China, but we will likely need to significantly reduce our prices, and to negotiate 
with each of the provincial healthcare security administrations on reimbursement ratios.  If we were to successfully 
launch  commercial  sales of  Melphalan Hydrochloride  For Injection  (EVOMELA),  our  revenue from  such  sales  is 

26 

 
 
 
 
 
 
 
 
 
largely expected to be self-paid by patients, which may make our drug candidates less desirable. On the other hand, if 
the NHSA or any of its local counterpart includes our Melphalan Hydrochloride For Injection (EVOMELA) in the 
NRDL or provincial RDL, which may increase the demand for our drug candidates, our potential revenue from the 
sales of our drug candidates may still decrease as a result of lower prices. 

The success of our business depends upon the members of our senior management team and our ability to continue 
to attract and retain qualified clinical, technical and business personnel. 

We are dependent on the principal members of our senior management team and clinical development team 
for  our  business  success. The  loss  of  any  of  these  people  could  impede  the  achievement  of  our  development  and 
business objectives. We do not carry key man life insurance on the lives of any of our key personnel. There is intense 
competition for human resources, including management, in the scientific fields in which we operate and there can be 
no  assurance  that  we  will  be  able  to  attract  and  retain  qualified  personnel  necessary  for  the  successful 
commercialization of our ANDA portfolio, development of our product candidates, and any expansion into areas and 
activities requiring additional expertise. In addition, there can be no assurance that such personnel or resources will 
be available when needed. We also rely on a significant number of consultants to assist us in formulating our clinical 
strategy  and  other  business  activities. All  of  our  consultants  may  have  commitments  to,  or  advisory  or  consulting 
agreements with, other entities that may limit their availability to us. 

Risks Relating to Our Reliance on Third Parties 

Independent clinical investigators and contract research organizations that we engage to conduct our clinical trials 
may not devote sufficient time or attention to our clinical trials or be able to repeat their past success. 

We depend on independent clinical investigators and contract research organizations (“CROs”) to assist in 
the conduct of our clinical trials under their agreements with us. The investigators are not our employees, and we 
cannot control the amount or timing of resources that they devote to our programs. If independent investigators fail to 
devote sufficient time and resources to our drug development programs, or if their performance is substandard, it could 
delay the approval of our FDA applications and our introduction of new drugs. The CROs we contract with to assist 
with the execution of our clinical trials play a significant role in the conduct of the trials and the subsequent collection 
and analysis of data. Failure of the CROs to meet their obligations could adversely affect clinical development of our 
products. 

We have no current manufacturing or marketing capacity and rely on only one supplier for some of our products.    

We plan to build and operate a manufacturing facility in the Wuxi Huishan Economic Development Zone in 
Jiangsu Province, China. We do not currently have the capacity to manufacture or market products and we have limited 
experience in these activities. The manufacturing processes for all of the small molecules we are developing have not 
yet been tested at commercial levels, and it may not be possible to manufacture these materials in a cost-effective 
manner. If we elect to perform these functions, we will be required to either develop these capacities, or contract with 
others  to  perform  some  or  all  of  these  tasks.  We  may  be  dependent  to  a  significant  extent  on  corporate  partners, 
licensees, or other entities for manufacturing and marketing of products. If we engage directly in manufacturing or 
marketing, we will require substantial additional funds and personnel and will be required to comply with extensive 
regulations. We may be unable to develop or contract for these capacities when required to do so in connection with 
our business. 

We depend on our third-party manufacturers to perform their obligations effectively and on a timely basis. 
These third parties may not meet their obligations and any such non-performance may delay clinical development or 
submission of products for regulatory approval, or otherwise impair our competitive position. Any significant problem 
experienced by one of our suppliers could result in a delay or interruption in the supply of materials to us until such 
supplier resolves the problem or an alternative source of supply is located. Any delay or interruption would likely lead 
to a delay or interruption of manufacturing operations, which could negatively affect our operations. Although we 
have  identified  alternative  suppliers  for  our  product  candidates,  we  have  not  entered  into  contractual  or  other 
arrangements with them. If we needed to use an alternate supplier for any product, we would experience delays while 
we negotiated an agreement with them for the manufacture of such product. In addition, we may be unable to negotiate 
manufacturing terms with a new supplier as favorable as the terms we have with our current suppliers. 

27 

 
 
 
 
 
 
 
 
 
Problems with any manufacturing processes could result in product defects, which could require us to delay 
shipment of products or recall products previously shipped. In addition, any prolonged interruption in the operations 
of the manufacturing facilities of one of our sole-source suppliers could result in the cancellation of shipments. A 
number of factors could cause interruptions, including equipment malfunctions or failures, or damage to a facility due 
to natural disasters or otherwise. Our manufacturing processes are, and we expect future manufacturing processes to 
be, highly complex and subject to a lengthy regulatory approval process.  Alternative qualified production capacity 
may not be available on a timely basis or at all. Difficulties or delays in our manufacturing could increase our costs 
and damage our reputation. 

The manufacture of pharmaceutical products can be an expensive, time consuming, and complex process. 
Manufacturers often encounter difficulties in scaling-up production of new products, including quality control and 
assurance and shortages of personnel. Delays in formulation and scale-up to commercial quantities could result in 
additional expense and delays in our clinical trials, regulatory submissions, and commercialization. 

Failure of manufacturing facilities producing our product candidates to maintain regulatory approval could delay 
or otherwise hinder our ability to market our product candidates.  

Any  manufacturer  of  our  product  candidates  will  be  subject  to  applicable  Good  Manufacturing  Practices 
(GMP) prescribed by the FDA or other rules and regulations prescribed by the NMPA and other foreign regulatory 
authorities. We and any of our collaborators may be unable to enter into or maintain relationships either domestically 
or abroad with manufacturers whose facilities and procedures comply or will continue to comply with GMP and who 
are able to produce our small molecules in accordance with applicable regulatory standards. Failure by a manufacturer 
of  our  products  to  comply  with  GMP  could  result  in  significant  time  delays  or  our  inability  to  obtain  marketing 
approval or, should we have market approval, for such approval to continue. Changes in our manufacturers could 
require new product testing and facility compliance inspections. In the United States, failure to comply with GMP or 
other applicable legal requirements can lead to federal seizure of violated products, injunctive actions brought by the 
federal government, inability to export product, and potential criminal and civil liability on the part of a company and 
its officers and employees. 

Risks Relating to Our Auditors 

The Audit Report Included in this Annual Report on Form 10-K is Prepared by Auditors Who Are Not Currently 
Inspected by the Public Company Accounting Oversight Board and, as such, Our Stockholders are Deprived of the 
Benefits of Such Inspection. 

As an auditor of companies that are publicly traded in the United States and a firm registered with the Public 
Company Accounting Oversight Board (“PCAOB”), our independent registered public accounting firm is required 
under  the  laws  of  the  United  States  to  undergo  regular  inspections  by  the  PCAOB.  However,  because  we  have 
substantial operations within China, our independent registered public accounting firm’s audit documentation related 
to their audit report included in this Annual Report on Form 10-K is located in China. The PCAOB is currently unable 
to  conduct  full  inspections  in  China  or  review  audit  documentation  located  within  China  without  the  approval  of 
Chinese authorities. 

Inspections of other auditors conducted by the PCAOB outside of China have at times identified deficiencies 
in those auditors’ audit procedures and quality control procedures, which may be addressed as part of the inspection 
process to improve future audit quality. The lack of PCAOB inspections of audit work undertaken in China prevents 
the PCAOB from regularly evaluating our auditor’s audits and its quality control procedures. As a result, stockholders 
may be deprived of the benefits of PCAOB inspections, and may lose confidence in our reported financial information 
and procedures and the quality of our financial statements. 

28 

 
 
 
  
 
 
 
  
  
Proceedings Instituted by the SEC Against Certain China-Based Accounting Firms, Including Our Independent 
Registered  Public  Accounting  Firm,  Could  Result  in  our  Financial  Statements  being  Determined  to  Not  be  in 
Compliance with the Requirements of the Exchange Act. 

In late 2012, the SEC commenced administrative proceedings under Rule 102(e) of its Rules of Practice and 
also under the Sarbanes-Oxley Act of 2002 against the Chinese member firms of the “big four” accounting firms, 
including our independent registered public accounting firm. The Rule 102(e) proceedings initiated by the SEC relate 
to the failure of these firms to produce certain documents, including audit work papers, in response to a request from 
the SEC pursuant to Section 106 of the Sarbanes-Oxley Act of 2002. The auditors located in China claim they are not 
in a position lawfully to produce such documents directly to the SEC because of restrictions under Chinese law and 
specific  directives  issued  by  the  China  Securities  Regulatory  Commission  (“CSRC”).  The  issues  raised  by  the 
proceedings are not specific to our auditor or to us, but potentially affect equally all PCAOB-registered audit firms 
based in China and all businesses based in China (or with substantial operations in China) with securities listed in the 
United States. In addition, auditors based outside of China are subject to similar restrictions under Chinese law and 
CSRC directives in respect of audit work that is carried out in China which supports the audit opinions issued on 
financial statements of entities with substantial China operations. 

If our independent registered public accounting firm were denied, even temporarily, the ability to practice 
before the SEC, and we are unable to timely find another independent registered public accounting firm to audit and 
issue an opinion on our financial statements, our financial statements could be determined not to be in compliance 
with the requirements of the Exchange Act. Such a determination could ultimately lead to delisting of our common 
stock from Nasdaq. Moreover, any negative news about the proceedings against these audit firms may adversely affect 
investor confidence in companies with substantial China-based operations listed on securities exchanges in the United 
States. All of these factors could materially and adversely affect the market price of our common stock and our ability 
to access the capital markets. 

Risks Relating to Our Common Stock 

The  market  price  of  our  common  stock  may  be  highly  volatile  or  may  decline  regardless  of  our  operating 
performance. 

The volatile price of our stock makes it difficult for investors to predict the value of their investments, to sell shares 
at a profit at any given time, or to plan purchases and sales in advance. Our common stock price has fluctuated from year-
to-year and quarter-to-quarter and will likely continue to be volatile. During 2018, our stock price has ranged from $2.77 
to $8.23. We expect that the trading price of our common stock is likely to be highly volatile in response to a variety of 
factors that are beyond our control, such as:   

(cid:120) 

(cid:120) 
(cid:120) 

(cid:120) 
(cid:120) 
(cid:120) 

(cid:120) 

(cid:120) 
(cid:120) 

(cid:120) 
(cid:120) 
(cid:120) 
(cid:120) 

our ability to maintain regulatory approval for Melphalan Hydrochloride For Injection (EVOMELA) and 
obtain regulatory approval for our other product candidates;  
issues in importation, marketing and sales of Melphalan Hydrochloride For Injection (EVOMELA); 
the results of our current and any future clinical trials of Ibritumomab Tiuxetan (ZEVALIN) or our other 
product candidates; 
the success of our joint venture to build and operate a manufacturing facility in China;  
the commercialization of our portfolio of ANDAs;  
publicity regarding actual or potential clinical test results relating to products under development by our 
competitors or us; 
initiating, completing or analyzing, or a delay or failure in initiating, completing or analyzing, pre-clinical 
or clinical trials or animal trials or the design or results of these trials for products in development; 
the entry into, or termination of, key agreements, including key commercial partner agreements; 
the initiation of, material developments in, or conclusion of litigation to enforce or defend any of our 
intellectual property rights or defend against the intellectual property rights of others; 
achievement or rejection of regulatory approvals for products in development by our competitors or us; 
announcements of technological innovations or new commercial products by our competitors or us; 
developments concerning our collaborations and supply chain; 
regulatory developments in the United States and foreign countries; 

29 

 
  
  
  
 
 
 
 
(cid:120) 
(cid:120) 
(cid:120) 
(cid:120) 
(cid:120) 

economic or other crises and other external factors; 
the loss of key employees; 
period-to-period fluctuations in our revenues and other results of operations; 
changes in financial estimates by securities analysts; or 
publicity  or  activity  involving  possible  future  acquisitions,  strategic  investments,  partnerships  or 
alliances. 

We will not be able to control many of these factors, and we believe that period-to-period comparisons of 
our  financial  results  will  not  necessarily  be  indicative  of  our  future  performance.  The  valuations  of  many 
biotechnology  companies  without  consistent  product  revenues  and  earnings  are  extraordinarily  high  based  on 
conventional valuation standards, such as price to earnings and price to sales ratios. These trading prices and valuations 
may not be sustained. In the future, our operating results in a particular period may not meet the expectations of any 
securities  analysts  whose  attention we  may  attract,  or  those of  our  investors, which  may  result  in  a decline  in  the 
market price of our common stock. Any negative change in the public’s perception of the prospects of biotechnology 
companies could depress our stock price regardless of our results of operations. These factors may  materially and 
adversely affect the market price of our common stock. 

If securities or industry analysts publish inaccurate or unfavorable research about our business, our stock price 
could decline. 

The trading market for our common stock will depend in part on the research and reports that securities or 
industry analysts publish about us or our business. If one or more of the analysts who may cover us downgrade our 
common stock or publish inaccurate or unfavorable research about our business, our common stock price would likely 
decline.  

Our largest holders of common stock may have different interests than our other stockholders.  

A  small  number  of  our  stockholders  hold  a  significant  amount  of  our  outstanding  common  stock.  These 
stockholders may have interests that are different from the interests of our other stockholders. We cannot assure that 
our largest stockholders will not seek to influence our business in a manner that is contrary to our goals or strategies 
or the interests of our other stockholders. In addition, the significant concentration of ownership in our common stock 
may adversely affect the trading price for our common stock because investors often perceive disadvantages in owning 
stock in companies with significant stockholders. Our largest stockholders, if they acted together, could significantly 
influence all matters requiring approval by our stockholders, including the election of directors and the approval of 
mergers or other business combination transactions. Our largest stockholders together may be able to determine all 
matters requiring stockholder approval. 

Subsequent resales of shares of our common stock in the public market may cause the market price of our common 
stock to fall.  

The market value of our common stock could decline as a result of sales by investors from time to time, or 

perceptions that such sales may occur, of a substantial amount of the shares of common stock held by them. 

Issuances of additional shares of our common stock may cause substantial dilution of existing stockholders. 

We may issue additional shares of common stock or other securities that are convertible into or exercisable 
for common stock in connection with future acquisitions, future sales of our securities for capital raising purposes, 
future  strategic  relationships,  or  for  other  business  purposes.  The  future  issuance  of  any  additional  shares  of  our 
common stock may create downward pressure on the trading price of our common stock. There can be no assurance 
that  we  will  not  be  required  to  issue  additional  shares,  warrants  or  other  convertible  securities  in  the  future  in 
conjunction with any capital raising efforts, including at a price (or exercise prices) below the price at which shares 
of our common stock are then traded. 

30 

 
 
 
 
 
  
 
  
 
 
 
 
 
 
ITEM 1B.   UNRESOLVED STAFF COMMENTS. 

  We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and 

are not required to provide the information under this item. 

ITEM 2.     PROPERTIES. 

The headquarters of CASI China are currently located in Beijing, China with approximately 12,100 square 
feet of office space and with approximately 11,000 square feet of laboratory space. In addition, as of December 31, 
2018, we leased approximately 6,068 square feet of office space in Rockville, Maryland. Our lease on behalf of CASI 
Wuxi for buildings to be developed and constructed for the Wuxi manufacturing facility covers approximately 214,500 
square feet.  We believe that our facilities are adequate for current needs; however, the Company is in the process of 
expanding operations in China and, accordingly, intends to increase facilities to meet our foreseeable and long-term 
needs.  We do not own any real property. 

ITEM 3.     LEGAL PROCEEDINGS.           

CASI is subject in the normal course of business to various legal proceedings in which claims for monetary 
or other damages may be asserted.  Management does not believe such legal proceedings, unless otherwise disclosed 
herein, are material. 

ITEM 4.     MINE SAFETY DISCLOSURES. 

Not applicable. 

PART II 

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

Market for Common Equity   

Our common stock trades on The Nasdaq Capital Market under the symbol “CASI.”  As of March 25, 2019, 

there were approximately 302 holders of record of our common stock. 

ITEM 6.     SELECTED FINANCIAL DATA. 

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and 

are not required to provide the information under this item. 

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

The  following  discussion  should  be  read  in  conjunction  with  the  Consolidated  Financial  Statements  and 

Notes thereto appearing elsewhere in this report. See also “Risk Factors” in Item 1A of this Annual Report.  

OVERVIEW 

We  are  a  U.S.  pharmaceutical  company  with  a  platform  to  develop  and  accelerate  the  launch  of 
pharmaceutical products and innovative therapeutics in China, U.S., and throughout the world. We are focused on 
acquiring, licensing, developing and commercializing products that address areas of unmet medical need.  We intend 
to execute our plan to become a leading platform to launch medicines in the greater China market leveraging our 
China-based  regulatory  and  commercial  competencies  and  our  global  drug  development  expertise.  We  conduct 
substantially  all  of  our  operations  through  our  wholly-owned  subsidiary,  CASI  China,  which  is  headquartered  in 
Beijing, China.  CASI China has established China operations that are growing as we continue to further in-license or 
acquire products for our pipeline.  

31 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our product pipeline features the following: (1) U.S. FDA-approved hematology oncology drugs in-licensed 
from  Spectrum  for  the  greater  China  market,  consisting  of  Melphalan  Hydrochloride  For  Injection  (EVOMELA), 
Ibritumomab Tiuxetan (ZEVALIN) and Vincristine Sulfate Liposome Injection (MARQIBO), (2) a portfolio of 26 
FDA-approved abbreviated new drug applications (“ANDAs”), including entecavir and TDF indicated for hepatitis B 
virus; and (3) four pipeline ANDAs that are pending FDA approval.  We intend to prioritize a select subset of the 
ANDAs for product registration and commercialization in China. In addition to these advanced products, our pipeline 
includes a proprietary Phase 2 drug candidate, ENMD-2076, that we have previously determined not to pursue as a 
single  agent,  and  instead  we  are  exploring  the  feasibility  of  combination  as  a  clinical  strategy.    We  also  have 
proprietary early-stage immune-oncological potential candidates in preclinical development.  

We  believe  our  product  mix  reflects  a  risk-balanced  approach  between  products  in  various  stages  of 
development,  between  products  that  are  branded  and  non-branded,  and  between  products  that  are  proprietary  and 
generic.  We intend to continue building a significant product pipeline of high quality pharmaceuticals, as well as 
innovative drug candidates for commercialization in China and for the rest of the world.  For in-licensed products, we 
use a market-oriented approach to identify pharmaceutical candidates that we believe have the potential for gaining 
widespread market acceptance, either globally or in China, and for which development can be accelerated under our 
drug development strategy.  For our FDA-approved ANDAs, we intend to select and commercialize certain niche 
products from the portfolio that complement our therapeutic focus areas and which offer unique market and cost-
effective manufacturing opportunities in China and/or in the U.S. 

We believe the China operations offer a significant market and growth potential due to extraordinary increase 
in  demand  for  high  quality  medicine  coupled  with  regulatory  reforms  in  China  that  make  it  easier  for  global 
pharmaceutical companies to introduce new pharmaceutical products into the country.  We will continue to in-license 
clinical-stage and late-stage drug candidates, and leverage our platform and expertise, and hope to be the partner of 
choice to provide access to the China market.  We expect the implementation of our plans will include leveraging our 
resources  and  expertise  in  both  the  U.S.  and  China  so  that  we  can  maximize  development  and  clinical  strategies 
concurrently under U.S. FDA and China NMPA regulatory regimes. 

In order to capitalize on the drug development and capital resources available in China, we are doing business 
in  China  through  our  wholly-owned  China-based  subsidiary  that  will  execute  the  China  portion  of  our  drug 
development strategy, including conducting clinical trials in China, pursuing local funding opportunities and strategic 
collaborations,  and  implementing  our  commercial  launches.  In  December  2018,  we  received  NMPA  approval  of 
Melphalan Hydrochloride For Injection (EVOMELA), for: 

(cid:120) 

(cid:120) 

use  as a high-dose  conditioning  treatment  prior  to hematopoietic progenitor (stem) cell  transplantation in 
patients with multiple myeloma, and 
the palliative treatment of patients with multiple myeloma for whom oral therapy is not appropriate.  

We intend to begin commercializing this drug through CASI China beginning in 2019 using EVOMELA 

supplied through Spectrum and its suppliers. All future needs will be sourced from Acrotech and its suppliers. 

The  Company  is  building  an  internal  commercial  team  to  prepare  for  the  launch  of  our  first  commercial 
product, Melphalan Hydrochloride for Injection (EVOMELA) in 2019.  As part of the strategy to support our future 
clinical and commercial manufacturing needs and to manage our supply chain for certain products, the Company has 
established CASI Wuxi to construct a cGMP manufacturing facility in Wuxi, China.  The site is currently in the design 
and engineering phase with construction expected to begin in 2019. Through CASI China, we will focus on China 
market devoting more resources and investment going forward. 

Since  inception,  the  Company  has  incurred  significant  losses  from  operations  and  has  incurred  an 
accumulated deficit of  $478.9 million.   The Company expects to continue to incur operating losses for the foreseeable 
future due to, among other factors, its continuing clinical and development activities. In September 2018, the Company 
entered  into  securities  purchase  agreements  with  certain  institutional  investors,  accredited  investors  and  current 
stockholders,  pursuant  to  which  the  Company  agreed  to  sell  up  to  9,048,504  shares  of  its  common  stock  with 
accompanying warrants to purchase 2,714,548 shares of its common stock in a $48.5 million private placement (the 
“September 2018 Financing”).  The Company held its initial closing on September 24, 2018 and second closing on 

32 

 
 
 
 
 
 
 
October 10, 2018 (the “September and October 2018 Closings”). The Company has received gross proceeds of $37.5 
million. The Company does not expect to receive any further proceeds from the September 2018 Financing.  

Additionally, in March 2018, the Company entered into securities purchase agreements pursuant to which 
the Company issued 15,432,091 shares of its common stock with accompanying warrants to purchase 6,172,832 shares 
of its common stock and received $50 million in gross proceeds in a private placement (the “March 2018 Financing”). 
The March 2018 Financing closing included an investment from ETP Global Fund, L.P., a healthcare investment fund. 
The managing member of Emerging Technology Partners, LLC (“ETP”), which is the general partner of ETP Global 
Fund, L.P., is also the Executive Chairman of the Company.  The March 2018 Financing also included an investment 
from IDG-Accel China Growth Fund III L.P. (“IDG-Accel Growth”) and IDG-Accel China III Investors L.P. (“IDG-
Accel Investors”). A director and shareholder of IDG-Accel China Growth Fund GP III Associates Ltd., which is the 
ultimate general partner of IDG-Accel Growth and IDG-Accel Investors, is also a member of the Company’s Board 
of Directors. Net proceeds from the September and October 2018 Closings, and the March 2018 Financing are being 
used to prepare for the launch of the Company’s first commercial product in China, Melphalan Hydrochloride For 
Injection (EVOMELA), to support the Company’s business development activities, to advance the development of 
the Company’s pipeline, to support its marketing and commercial planning activities, and for other general corporate 
purposes.  

Taking  into  consideration  the  cash  balance  as  of December 31,  2018  and  its  commitments  to  fund  CASI 
Wuxi, the Company believes that it has sufficient resources to fund its operations at least through March 29, 2020.  
As of December 31, 2018, approximately $15.4 million of the Company’s cash balance was held by CASI China.  The 
Company  intends  to  continue  to  exercise  tight  controls  over  operating  expenditures  and  will  continue  to  pursue 
opportunities, as required, to raise additional capital and will also actively pursue non- or less-dilutive capital raising 
arrangements in China to support the Company’s dual-country approach to drug development.   

Additional funds raised by issuing equity securities may result in dilution to existing stockholders.   

CRITICAL ACCOUNTING POLICIES AND THE USE OF ESTIMATES  

The preparation of our financial statements in conformity with accounting principles generally accepted in 
the United States requires management to make estimates and assumptions that affect the amounts reported in our 
consolidated  financial  statements  and  accompanying  notes.    Actual  results  could  differ  materially  from  those 
estimates.    Our  critical  accounting  policies,  including  the  items  in  our  financial  statements  requiring  significant 
estimates and judgments, are as follows:   

- 

Impairment  of  Long-lived  Assets  -  the  Company  evaluates  the  value  reflected  in  its  consolidated  balance 
sheets  of  long-lived  assets,  such  as  property  and  equipment  and  definitive-lived  intangible  assets,  when 
events and circumstances indicate that the carrying amount of an asset may not be recovered.  Such events 
and circumstances include the use of the asset in current research and development projects, any potential 
alternative uses  of  the  asset  in  other  research  and  development  projects  in  the  short  to  medium  term  and 
restructuring plans entered into by the Company.  No impairment charges were recorded in 2018 and 2017. 

-  Research and Development - Research and development expenses consist primarily of compensation and 
other expenses related to research and development personnel, research collaborations, costs associated with 
preclinical testing and clinical trials of our product candidates, including the costs of manufacturing drug 
substance  and  drug  product,  regulatory  maintenance  costs,  and  facilities  expenses.    Research  and 
development costs are expensed as incurred.  Expenses for clinical trials are incurred from planning through 
patient enrollment to reporting of the data.  We estimate expenses incurred for clinical trials that are in process 
based on patient enrollment and based on clinical data collection and management.  Costs that are associated 
with patient enrollment are recognized as each patient in the clinical trial completes the enrollment process.  
Estimated clinical trial costs related to enrollment can vary based on numerous factors, including expected 
number of patients in trials, the number of patients that do not complete participation in a trial, and when a 
patient drops out of a trial.  Costs that are based on clinical data collection and management are recognized 
in the reporting period in which services are provided.  In the event of early termination of a clinical trial, we 
accrue an amount based on estimates of the remaining non-cancelable obligations associated with winding 
down the clinical trial. 

33 

 
 
 
 
 
 
  
- 

Stock-Based  Compensation  -  The  Company  records  compensation  expense  associated  with  service  and 
performance-based stock options in accordance with provisions of authoritative guidance.  The estimated fair 
value of service-based awards is determined using option pricing models that use unobservable inputs and is 
generally amortized on a straight-line basis over the requisite service period and is recognized based on the 
proportionate amount of the requisite service period that has been rendered during each reporting period.  The 
estimated fair value of performance-based awards is measured on the grant date and is recognized when it is 
determined that it is probable that the performance condition will be achieved.   

RESULTS OF OPERATIONS   

Years Ended December 31, 2018 and 2017.     

Revenues and Cost of Product Sales.  There were no revenues recorded for the years ended December 31, 

2018 and 2017. 

Research and Development Expenses. Our 2018 research and development expenses totaling $8,507,000 as 
compared to $7,595,000 in 2017, a 12% increase. Research and development expenses totaling $8,507,000 for the 
year ended December 31, 2018 included direct project costs of $2,405,000 related to our ANDAs acquired in 2018, 
$244,000 related to ENMD-2076, $1,247,000 for drugs in-licensed from Spectrum, and $1,670,000 for preclinical 
development activities primarily in China.  In 2017, our research and development expenses reflect direct project costs 
of  $856,000  for  ENMD-2076,  $3,603,000  for  drugs  in-licensed  from  Spectrum,  and  $1,301,000  for  preclinical 
development activities primarily in China. The increase in research and development costs in 2018, as compared to 
2017,  primarily  reflects  expenses  associated  with  regulatory  costs  for  the  ANDAs  in  2018,  offset  by  higher  costs 
related to the quality testing phase of the NMPA regulatory review of ZEVALIN and EVOMELA in 2017.   

At December 31, 2018, and, since acquired, accumulated direct project expenses for our ANDAs acquired in 
2018  totaled  $2,405,000;  $28,755,000  for  ENMD-2076;  $5,783,000  for  drugs  in-licensed  from  Spectrum;  and  for 
preclinical development activities primarily in China, accumulated project expenses totaled $5,035,000.  Our research 
and  development  expenses  also  include  non-cash  stock-based  compensation  totaling  $740,000  and  $272,000, 
respectively, for 2018 and 2017.  The balance of our research and development expenditures includes facility costs 
and  other  departmental  overhead,  expenditures  related  to  the  non-clinical  support  of  our  programs,  and  non-cash 
amortization expense of $1,305,000 related to our acquired ANDAs. 

  We expect the majority of our research and development expenses for 2019 to be devoted to advancing our in-
licensed  products  towards  market  approval  in  China,  the  technology  transfer  activities  and  regulatory  support 
associated  with  our  ANDA  portfolio,  and  our  early-stage  candidates  in  preclinical  development.    We  expect  our 
expenses  for  2019  to  increase  based  on  our  commercial  and  clinical  development  plan.    Completion  of  clinical 
development may take several years or more, but the length of time generally varies substantially according to the 
type, complexity, novelty and intended use of a product candidate.   

  We estimate that clinical trials of the type we generally conduct are typically completed over the following 

timelines:  

Global FDA Trial: 

CLINICAL PHASE 
Phase 1 
Phase 2 
Phase 3 

ESTIMATED 
COMPLETION 
PERIOD 
1-2 Years 
2-3 Years 
2-4 Years 

34 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Local NMPA Trial: 

CLINICAL PHASE 
Phase 1 
Phase 2 
Phase 3 

ESTIMATED 
COMPLETION 
PERIOD 
1 Year                  
2 Years 
2-3 Years 

  The duration and the cost of clinical trials may vary significantly over the life of a project as a result of 

differences arising during the clinical trial protocol, including, among others, the following:  

-       the number of patients that ultimately participate in the trial; 

-       the duration of patient follow-up that seems appropriate in view of the results; 

-       the number of clinical sites included in the trials; and 

- 

 the length of time required to enroll suitable patient subjects. 

  We test our potential product candidates in numerous preclinical studies to identify indications for which they 
may be product candidates.  We may conduct multiple clinical trials to cover a variety of indications for each product 
candidate.  As we obtain results from trials, we may elect to discontinue clinical trials for certain indications in order 
to focus our resources on more promising indications. 

  Our proprietary product candidates have also not yet achieved regulatory approval, which is required before we 
can  market  them  as  therapeutic  products.  In  order  to  proceed  to  subsequent  clinical  trial  stages  and  to  ultimately 
achieve regulatory approval, regulatory agencies must conclude that our clinical data establish safety and efficacy.  
Historically,  the  results  from  preclinical  testing  and  early  clinical  trials  have  often  not  been  predictive  of  results 
obtained in later clinical trials.  A number of new drugs and biologics have shown promising results in clinical trials, 
but subsequently failed to establish sufficient safety and efficacy data to obtain necessary regulatory approvals. 

  Our  business  strategy  includes  being  opportunistic  with  collaborative  arrangements  with  third  parties  to 
complete the development and commercialization of our product candidates.  In the event that third parties take over 
the clinical trial process for one of our product candidates, the estimated completion date would largely be under the 
control of that third party rather than us.  We cannot forecast with any degree of certainty which proprietary products 
or  indications,  if  any,  will  be  subject  to  future  collaborative  arrangements,  in  whole  or  in  part,  and  how  such 
arrangements would affect our capital requirements.  

  As  a  result  of  the  uncertainties  discussed  above,  among  others,  we  are  unable  to  estimate  the  duration  and 
completion costs of our research and development projects.  Our inability to complete our research and development 
projects in a timely manner or our failure to enter into collaborative agreements, when appropriate, could significantly 
increase our capital requirements and could adversely impact our liquidity.  These uncertainties could force us to seek 
additional, external sources of financing from time to time in order to continue with our business strategy.  There can 
be no assurance that we will be able to successfully access external sources of financing in the future.  Our inability 
to raise additional capital, or to do so on terms reasonably acceptable to us, would jeopardize the future success of our 
business.  

  Research and development expenses consist primarily of compensation and other expenses related to research 
and development personnel, research collaborations, costs associated with internal and contract preclinical testing and 
clinical  trials  of  our  product  candidates,  including  the  costs  of  manufacturing  drug  substance  and  drug  product, 
regulatory  maintenance  costs,  and  facilities  expenses.    Overall  research  and  development  expenses  increased  to 
$8,507,000 in 2018 from $7,595,000 in 2017.     

35 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  The fluctuations in research and development expenses were specifically impacted by the following: 

-  Outside  Services  –  We  utilize  outsourcing  to  conduct  our  product  development  activities.  We  spent 
$1,455,000 in 2018 and $333,000 in 2017.  The increase in 2018 as compared to 2017 primarily reflects 
regulatory costs associated with our ANDAs acquired in January 2018.        

-  Clinical Trial Costs – Clinical trial costs, which include clinical site fees, monitoring costs and data 

management costs, decreased to ($18,000) in 2018 from $417,000 in 2017.  This decrease primarily relates 
to higher patient costs and clinical trial management costs associated with our Phase 2 clinical trial in 
advanced fibrolamellar carcinoma (FLC) during the 2017 period compared to the 2018 period as the trial 
has completed.  

-  Lab Supplies – Laboratory supplies associated with our pre-clinical activities increased to $308,000 in 2018 

from $294,000 in 2017 due to the continued activities in our China research and development lab. 

-  Contract Manufacturing Costs – The costs of manufacturing or acquiring the material used in development 
activities  associated  with  our  ANDAs  as  well  as  clinical  trials  for  our  product  candidates  is  reflected  in 
contract manufacturing. These costs include bulk manufacturing, encapsulation and fill and finish services, 
and product release costs.  Contract manufacturing costs decreased in 2018 to $418,000 from $2,987,000 in 
2017.    The  higher  cost  in  2017  primarily  reflects  costs  associated  with  the  purchase  of  ZEVALIN  and 
EVOMELA  in  2017  from  our  partner  Spectrum  for  NMPA  quality  testing  purposes  to  support  CASI’s 
application for import drug registration.  

-  Personnel Costs – Personnel costs increased to $3,666,000 in 2018 from $2,644,000 in 2017.  This variance 
is primarily attributed to increased salary and benefit costs associated with new employees in China, as well 
as an increase in non-cash stock compensation expense of $468,000 in 2018 as compared to 2017. 

-  Also reflected in our 2018 research and development expenses are outsourced consultant costs of $242,000, 
facility and related expenses of $793,000, and amortization of acquired ANDAs of $1,305,000.  In the 
corresponding 2017 period, these expenses totaled $213,000, $485,000, and $0, respectively.  The variance 
in outsourced consultant costs reflect the timing of services related to regulatory activities. The increase in 
facilities and related expenses is primarily due to a full year of leased lab space in China in 2018 compared 
to a partial year in 2017, as well as new leased office space in China in April 2018 and October 2018. The 
increase in amortization of acquired ANDAs is due to the January 2018 and October acquisition of 
ANDAs. 

 General and Administrative Expenses.

  General and administrative expenses include compensation and other 
expenses  related  to  finance,  business  development  and  administrative  personnel,  professional  services,  investor 
relations and facilities. 

General and administrative expenses increased to $17,997,000 in 2018 from $3,156,000 in 2017. The increase 
in expenses in 2018, compared to 2017 reflects an increase in non-cash stock-based compensation expense totaling 
$4,997,000, primarily associated with stock option awards issued to the Company’s Executive Chairman; an increase 
in salary, benefits and recruitment expense totaling $2,553,000, primarily related to sales and marketing efforts to 
prepare for the anticipated launch of the Company’s first commercial product in China, as well as other general and 
administrative functions; approximately $1,747,000 associated with additional professional services fees and investor 
and public relations activities; and increased facility cost of $435,000 due to new leased office space in China. The 
increase in general and administrative expenses for the 2018 also includes $1,380,000 associated with our Executive 
Chairman’s  services  in  connection  with  the  September  and  October  2018  Closings,  and  increased  costs  of 
approximately $2,636,000 associated with business development and exploratory acquisition activities, including $1.5 
million related to due diligence and related services for certain business development activities incurred by ETP on 
our behalf.   

Interest income, net.  Interest income, net for the years ended December 31, 2018 and 2017 was $39,988 and 
$1,009, respectively.  This includes interest income of $48,196 and $15,985, respectively, offset by interest expense 
on  our  note  payable  of  $7,500  for  both  years  and  non-cash  interest  expense  of  $708  and  $7,476,  respectively, 
36 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
representing the amortization of the debt discount.   

   Change in fair value of contingent rights.  As consideration for the licensing arrangements with Spectrum, 
the  Company  issued  Spectrum  certain  contingent  rights  (“Contingent  Rights”)  to  purchase  additional  shares  of  its 
common  stock.  The  Contingent  Rights  were  considered  derivative  liabilities  and  were  recorded  initially  at  their 
estimated fair value and were marked to market each reporting period until settlement. The Contingent Rights were 
fully settled during 2017, so there was no change in the fair value of the Contingent Right for the year ended December 
30, 2018.  The change in fair value of the Contingent Rights for the years ended December 31, 2017 was $19,891. 

LIQUIDITY AND CAPITAL RESOURCES   

To  date,  we  have  been  engaged  primarily  in  research  and  development  activities.    As  a  result,  we  have 
incurred and expect to continue to incur operating losses in 2019 and the foreseeable future before we commercialize 
any  products  and  penetrate  significant  markets  such  as  China.  Based  on  our  current  plans,  we  expect  our  current 
available cash and cash equivalents to meet our cash requirements for at least through March 29, 2020.   

We  will  require  significant  additional  funding  to  fund  operations  until  such  time,  if  ever,  we  become 
profitable.  We intend to augment our cash balances by pursuing other forms of capital infusion, including strategic 
alliances or collaborative development opportunities with organizations that have capabilities and/or products that are 
complementary  to  our  capabilities  and  products  in  order  to  continue  the  development  of  our  potential  product 
candidates that we intend to pursue to commercialization.  If we seek strategic alliances, licenses, or other alternative 
arrangements, such as arrangements with collaborative partners or others, to raise further financing, we may need to 
relinquish rights to certain of our existing product candidates, or products we would otherwise seek to develop or 
commercialize on our own, or to license the rights to our product candidates on terms that are not favorable to us.     

We  will  continue  to  seek  to  raise  additional  capital  to  fund  our  commercialization  efforts,  potential 
acquisition  activities,  research  and  development,  and  the  China  clinical  development  of  Ibritumomab  Tiuxetan 
(ZEVALIN) and Vincristine Sulfate Liposome Injection (MARQIBO) and new product candidates, if any.  We intend 
to explore one or more of the following alternatives to raise additional capital: 

(cid:120) 
(cid:120) 
(cid:120) 
(cid:120) 

selling additional equity securities; 
out-licensing product candidates to one or more corporate partners; 
completing an outright sale of non-priority assets; and/or 
engaging in one or more strategic transactions. 

We also will continue to manage our cash resources prudently and cost-effectively. 

There can be no assurance that adequate additional financing under such arrangements will be available to 
us on terms that we deem acceptable, if at all.  If additional funds are raised by issuing equity securities, dilution to 
existing shareholders may result, or the equity securities may have rights, preferences, or privileges senior to those of 
the holders of our common stock.  If we fail to obtain additional capital when needed, we may be required to delay or 
scale  back  our  commercialization  efforts,  our  advancement  of  the  Acrotech  products  or  plans  for  other  product 
candidates, if any, and potential acquisition activities. 

At  December  31,  2018,  we  had  cash  and cash  equivalents  of  approximately  $84.2  million,  with working 
capital of approximately $88.7 million.  As of December 31, 2018, approximately $15.4 million of the Company’s 
cash balance was held by the Company’s wholly-owned subsidiary in China.  In February 2019, the Company funded 
its $21 million investment in CASI Wuxi. 

As a result of the Company’s acquisition of a portfolio of ANDAs, we believe that this transaction provides 
significant and permanent changes to our operations in China, allowing our subsidiary in China to generate operating 
revenues from the China marketplace in the future and potentially to sustain their own operations without the necessity 
of parent support.  Accordingly, effective January 1, 2018, the functional currency of the Company’s subsidiary based 
in China has been changed to the local currency of the China RMB.  Upon the change in functional currency, there 
was no material impact on the consolidated financial statements. 

37 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FINANCING ACTIVITIES 

“Shelf” Registration Statement 

On  December  13,  2017,  we  filed  a  Form  S-3  registration  statement  with  the  SEC  utilizing  a  “shelf” 
registration process.  On December 22, 2017, the Form S-3 registration statement was declared effective by the SEC.  
Pursuant to this shelf registration statement, we may sell debt or equity securities in one or more offerings up to a total 
public offering price of  $100 million.  We believe that this shelf registration statement currently provides us additional 
flexibility with regard to potential financings that we may undertake when market conditions permit or our financial 
condition may require.   

Securities Purchase Agreements 

As  discussed  above,  in  September  2018,  the  Company  entered  into  securities  purchase  agreements  (the 
“September  SPAs”)  with  certain  institutional  investors,  accredited  investors  and  current  stockholders,  pursuant  to 
which  the  Company  agreed  to  sell  up  to  9,048,504  shares  of  its  common  stock  with  accompanying  warrants  to 
purchase 2,714,548 shares of its common stock in a $48.5 million private placement.   The purchase price for each 
share of common stock and warrant was $5.36. The warrants are exercisable on March 23, 2019 at a $7.19 per share 
exercise price and  expire on September  24,  2021.   In  September  and  October  2018,  the  Company  completed  two 
closings and issued a total of 6,996,266 shares of its common stock with accompanying warrants to purchase 2,098,877 
shares of its common stock and received $37.5 million in gross proceeds. The fair value of the warrants issued is 
$6,254,653 or $2.98 per warrant, calculated using the Black-Scholes-Merton valuation model with a contractual life 
of 3 years, an assumed volatility of 88.39%, and a risk-free interest rate of 2.89%. The Company does not expect to 
receive any further proceeds from the September 2018 Financing. The September SPAs and warrants each include 
additional customary representations, warranties and covenants. The Company has filed a resale registration covering 
the shares of common stock issued and the shares of common stock underlying the warrants issued on Form S-3 (File 
No. 333-228383) which became effective on November 29, 2018. 

Additionally, in March 2018, the Company entered into securities purchase agreements (the “March SPAs”) 
with  certain  institutional  investors,  accredited  investors  and  current  stockholders,  pursuant  to  which  the  Company 
issued  15,432,091  shares  of  its  common  stock  with  accompanying  warrants  to  purchase  6,172,832  shares  of  its 
common stock and received $50 million in gross proceeds in a private placement. The purchase price for each share 
of common stock and warrant was $3.24. The warrants became exercisable on September 17, 2018 at a $3.69 per 
share exercise price, and will expire on March 21, 2023.  The fair value of the warrants issued is $15,062,000, or $2.44 
per warrant, calculated using the Black-Scholes-Merton valuation model with a contractual life of 5 years, an assumed 
volatility of 75.4%, and a risk-free interest rate of 2.69%.  The  March SPAs and warrants each include additional 
customary representations, warranties and covenants. The Company has filed a resale registration covering the shares 
of common stock issued and the shares of common stock underlying the warrants on Form S-3 (File No. 333-226206) 
which became effective on August 8, 2018. 

Common Stock Sales Agreement 

On February 23, 2018, the Company entered into a Common Stock Sales Agreement (the “Sales Agreement”) 
with H.C. Wainwright & Co., LLC (“HCW”). Pursuant to the terms of the Sales Agreement, the Company may sell 
from  time  to  time,  at  its  option,  shares  of  the  Company’s  common  stock,  through  HCW,  as  sales  agent,  with  an 
aggregate sales price of up to $25 million. 

Any sales of shares pursuant to the Sales Agreement will be made under the Company’s effective “shelf” 
registration statement on Form S-3 (File No. 333-222046) which became effective on December 22, 2017 and the 
related prospectus supplement and the accompanying prospectus, as filed with the SEC on February 23, 2018. 

In 2018,  the  Company  issued  143,248  shares  under  the Sales  Agreement  resulting  in net  proceeds  to the 
Company of approximately $475,000. As of December 31, 2018, approximately $24.5 million remained available 
under the Sales Agreement. 

38 

 
 
 
 
 
 
 
 
 
  
  
  
 
INFLATION AND INTEREST RATE CHANGES 

Management does not believe that our working capital needs are sensitive to inflation and changes in interest 

rates. 

TABLE OF CONTRACTUAL OBLIGATIONS 

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and 

are not required to provide the information under this item. 

OFF-BALANCE-SHEET ARRANGEMENTS 

We had no off-balance sheet arrangements during fiscal year 2018. 

ITEM 7A.   QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.  

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and 

are not required to provide the information under this item. 

ITEM 8.     FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA. 

The response to this item is submitted in a separate section of this report. See Index to Consolidated Financial 

Statements on page F-1.  

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

None. 

ITEM 9A.    CONTROLS AND PROCEDURES. 

Disclosure Controls and Procedures 

  As of December 31, 2018, we carried out an evaluation, under the supervision and with the participation of 
our management, including our Chief Executive Officer and Chief Financial Officer (our principal executive officer 
and principal financial officer, respectively) and our Chief Operating Officer & General Counsel, of the effectiveness 
of the design and operation of our disclosure controls and procedures (as defined in the Securities Exchange Act of 
1934  Rules 13a-15(e)  and  15d-15(e)).    Our  Chief  Executive  Officer,  Chief  Financial  Officer  and  Chief  Operating 
Officer & General Counsel have concluded that our disclosure controls and procedures are effective to ensure that 
information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, 
processed, summarized and reported within the time periods specified in the rules and forms of the Securities and 
Exchange Commission and that such information is accumulated and communicated to our management (including 
our Chief Executive Officer, Chief Financial Officer, and Chief Operating Officer & General Counsel) to allow timely 
decisions regarding required disclosures.    Based  on  such  evaluation, our  Chief Executive Officer, Chief Financial 
Officer, and Chief Operating Officer & General Counsel have concluded these disclosure controls and procedures are 
effective as of December 31, 2018. 

Changes in Internal Control Over Financial Reporting  

There have not been any changes in our internal control over financial reporting during the  fourth quarter 
ended  December  31,  2018  that  have  materially  affected,  or  are  reasonably  likely  to  materially  affect,  our  internal 
control 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 such term is defined in Securities Exchange Act Rules 13a-15(f) and 15d-15(f).  Our internal control over 
financial reporting is designed to provide reasonable assurance to our management and board of directors regarding 

39 

 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
the  reliability  of  financial  reporting  and  the  preparation  and  fair  presentation  of  financial  statements  for  external 
purposes in accordance with generally accepted accounting principles. Any internal control over financial reporting, 
no matter how well designed, has inherent limitations.  As a result of these inherent limitations, internal control over 
financial reporting may not prevent or detect misstatements.  Therefore, even those internal controls determined to be 
effective can provide only reasonable assurance with respect to reliability of financial reporting and the preparation 
of financial statements for external purposes in accordance with generally accepted accounting principles. 

Under the supervision and with the participation of our management, including our Chief Executive Officer, 
Chief  Financial  Officer,  and  Chief  Operating  Officer  &  General  Counsel,  we  conducted  an  assessment  of  the 
effectiveness of our internal control over financial reporting using the criteria set forth by the Committee of Sponsoring 
Organizations of the Treadway Commission (COSO) in Internal Control — Integrated Framework 2013.  Based on 
our assessment, we concluded that our internal control over financial reporting was effective as of December 31, 2018.   
The effectiveness of our internal control over financial reporting as of December 31, 2018 has been audited by KPMG 
Huazhen LLP, our independent registered public accounting firm, as stated in their report, which appears herein. 

Report of Independent Registered Public Accounting Firm 

To the Stockholders and Board of Directors 
CASI Pharmaceuticals, Inc.: 

Opinion on Internal Control Over Financial Reporting  

We  have  audited  CASI  Pharmaceuticals,  Inc.  and  subsidiaries’  (“the  Company”)  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. 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 the Committee of Sponsoring 
Organizations of the Treadway Commission.   

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United 
States) (“PCAOB”), the consolidated balance sheet of the Company as of December 31, 2018, the related consolidated 
statements of operations and comprehensive loss, stockholders’ equity, and cash flows for the year then ended, and 
the related notes (collectively, the “consolidated financial statements”), and our report dated March 29, 2019 expressed 
an unqualified opinion on those consolidated 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 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  of  internal  control  over  financial  reporting  included  obtaining  an 
understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing 
and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit also 
included 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 

40 

 
  
  
 
 
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/ KPMG Huazhen LLP 

Beijing, China 
March 29, 2019  

ITEM 9B.   OTHER INFORMATION. 

Our  2019  Annual  Meeting  of  Stockholders  will  be  held  on  June  20,  2019.    Further  information  will  be 
provided  in  our  proxy  statement  that  will  be  filed  with  the  SEC  and  mailed  to  stockholders  of  record  as  soon  as 
practicable. 

PART III   

ITEM 10.     DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE. 

The information required under this item is incorporated herein by reference to the Company’s 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 the Company’s fiscal year ended December 31, 2018. 

We have adopted a Code of Ethics, as defined in applicable SEC rules, that applies to directors, officers and 
employees, including our principal executive officer and principal financial officer.  The Code of Ethics is available 
on the Company’s website at www.casipharmaceuticals.com.   

ITEM 11.     EXECUTIVE COMPENSATION. 

The information required under this item is  incorporated herein by reference to the Company’s 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 the Company’s 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, with the exception of information relating to compensation plans 
under which equity securities of the Company are authorized for issue, which appears below, is incorporated herein 
by reference to the Company’s 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 the Company’s fiscal year ended December 31, 2018. 

Options under Employee Benefit Plans     The  following  table  discloses  certain  information  about  the  options 
issued and available for issuance under all outstanding Company option plans, as of December 31, 2018.  

41 

 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
Plan category 

(a) 
Number of securities to 
be issued upon exercise 
of outstanding options, 
warrants and rights 

(b) 

Weighted-average 
exercise price of 
outstanding options, 
warrants and rights 

(c) 

Number of securities 
remaining available for 
future issuance under 
equity compensation 
plans [excluding 
securities reflected in 
column (a)] 

Equity compensation 
plans approved by 
security holders 
Equity compensation 
plans not approved by 
security holders 
Total 

             18,429,308 

                    $2.44 

6,834,234 

                             0 

                    $0.00 

              0 

               18,429,308 

                    $2.44 

6,834,234 

Warrants issued under the unauthorized plans represent compensation for consulting services rendered by 

the holders. 

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

The information required under this item is incorporated herein by reference to the Company’s 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 the Company’s 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 the Company’s 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 the Company’s fiscal year ended December 31, 2018.  

PART IV 

ITEM 15.     EXHIBITS AND FINANCIAL STATEMENT SCHEDULES. 

(a) 1. FINANCIAL STATEMENTS - See index to Consolidated Financial Statements.  

      2. Schedules 

All  financial  statement  schedules  are  omitted  because  they  are  not  applicable,  not  required  under  the 

instructions or all the information required is set forth in the financial statements or notes thereto.  

      3. Exhibits    

1.1 

2.1 

3.1 

Common Stock Sales Agreement, dated February 23, 2018, by and between CASI Pharmaceuticals, Inc. 
and H.C. Wainwright & Co., LLC (incorporated by reference to Exhibit 1.1 of our Form 8-K filed with 
the Securities and Exchange Commission on February 23, 2018) 

Agreement and Plan of Merger, dated as of December 22, 2005 among EntreMed, Inc., E.M.K. Sub, 
Inc., Miikana Therapeutics, Inc., and Andrew Schwab (incorporated by reference to Exhibit 2.1 of our 
Form 8-K filed with the Securities and Exchange Commission on December 29, 2005) 

Amended  and  Restated  Certificate  of  Incorporation  of  EntreMed,  Inc.  (incorporated  by  reference  to 
Exhibit 3.1 of our Form 10-Q for the quarter ended June 30, 2006 filed with the Securities and Exchange 
Commission)    

42 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3.2 

3.3 

3.4 

4.1 

4.2  

4.3 

4.4 

4.5 

4.6 

4.7 

4.8 

4.9 

4.10 

4.11  

4.12 

4.13 

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  (incorporated  by 
reference to Exhibit 3.1 of our Form 8-K filed with the Securities and Exchange Commission on July 7, 
2010) 

Amended and Restated Bylaws of EntreMed, Inc. (incorporated by reference to Exhibit 3.1 of our Form 
8-K filed with the Securities and Exchange Commission on December 12, 2007)  

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  (incorporated  by 
reference to Exhibit 3.1 of our Form 8-K filed with the Securities and Exchange Commission on June 
13, 2014) 

Certificate of Elimination of Series A Preferred Stock filed with the Secretary of State of Delaware on 
September 13, 2012. (Incorporated by reference to Exhibit 3.1 of our Form 8-K filed with the Securities 
and Exchange Commission on September 20, 2012.) 

Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 10.1 of our Form 8-K 
filed with the Securities and Exchange Commission on January 26, 2012) 

Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K 
filed with the Securities and Exchange Commission on March 6, 2013) 

Form of Agent’s Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.2 of our 
Form 8-K filed with the Securities and Exchange Commission on March 6, 2013) 

Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.2 (included in 
Exhibit 10.1) of our Form 10-Q filed with the Securities and Exchange Commission on November 13, 
2015) 

Certificate of Designation of Series A Preferred Stock (incorporated by reference to Exhibit 4.1 of our 
Form 8-K filed with the Securities and Exchange Commission on September 19, 2014) 

Secured Promissory Note, dated as of September 17, 2014, issued to Talon Therapeutics, Inc. 
(incorporated by reference to Exhibit 4.2 of our Form 8-K filed with the Securities and Exchange 
Commission on September 19, 2014) 

First Amendment to Secured Promissory Note, dated as of September 28, 2015, by and between CASI 
Pharmaceuticals, Inc. and Talon Therapeutics, Inc. (incorporated by reference to Exhibit 4.2 of our 
Form 8-K filed with the Securities and Exchange Commission on October 1, 2015) 

Second Amendment to Secured Promissory Note, dated as of December 13, 2016, by and between 
CASI Pharmaceuticals, Inc. and Talon Therapeutics, Inc. (incorporated by reference to Exhibit 4.3 of 
our Form 8-K filed with the Securities and Exchange Commission on December 16, 2016) 

Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K 
filed with the Securities and Exchange Commission on October 19, 2017) 

Form of Wainwright Warrant (incorporated by reference to Exhibit 4.2 of our Form 8-K filed with the 
Securities and Exchange Commission on October 19, 2017) 

Third Amendment to Secured Promissory Note, dated as of December 20, 2017, by and between CASI 
Pharmaceuticals, Inc. and Talon Therapeutics, Inc. (incorporated by reference to Exhibit 4.4 of our Form 
8-K filed with the Securities and Exchange Commission on December 22, 2017) 

Form of Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K filed with the Securities and 
Exchange Commission on March 23, 2018) 

43 

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
4.14 

10.1 

10.2 

10.3 

Form of Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K filed with the Securities and 
Exchange Commission on September 14, 2018) 

Form of Change in Control Agreement* (incorporated by  reference to Exhibit 10.1 of our Form 8-K 
filed with the Securities and Exchange Commission on April 17, 2007) 

Employment  Agreement  by  and  between  EntreMed  and  Cynthia  W.  Hu,  dated  as  of  June  1,  2006* 
(incorporated  by  reference  to  Exhibit  10.1  of  Form  8-K  filed  with  the  Securities  and  Exchange 
Commission on June 6, 2006)  

Amendment to Employment Agreement by and between the Company and Cynthia W. Hu, effective 
April 16, 2007* (incorporated by reference to Exhibit 10.5 of our Form 8-K filed with the Securities and 
Exchange Commission on April 17, 2007) 

10.4     

Employment  Agreement, by and between EntreMed, Inc. and Sara Capitelli, dated as of January 10, 
2011* (incorporated by reference to Exhibit 10.33 of our Form 10-K for the fiscal year ended December 
31, 2010 filed with the Securities and Exchange Commission) 

10.5               Convertible Note and Warrant Purchase Agreement, dated January 20, 2012, by and among EntreMed,  

Inc. and the investors party thereto (incorporated by reference to Exhibit 10.1 of our Form 8-K filed 
with the Securities and Exchange Commission on January 26, 2012) 

10.6 

10.7 

10.8 

10.9 

10.10 

10.11 

10.12 

10.13 

10.14 

Employment Agreement by and between EntreMed, Inc. and Ken K. Ren, dated as of April 2, 2013* 
(incorporated by reference to Exhibit 10.1 of our Form 10-Q filed with the Securities and Exchange 
Commission on May 15, 2013) 

Investment Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. 
and Spectrum Pharmaceuticals, Inc. (incorporated by reference to Exhibit 10.1 of our Form 8-K filed 
with the Securities and Exchange Commission on September 19, 2014) 

Investment Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. the 
Company and Spectrum Pharmaceuticals Cayman, L.P (incorporated by reference to Exhibit 10.2 of our 
Form 8-K filed with the Securities and Exchange Commission on September 19, 2014) 

License Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. and 
Spectrum Pharmaceuticals, Inc. + (incorporated by reference to Exhibit 10.3 of our Form 10-Q/A filed 
with the Securities and Exchange Commission on January 21, 2015) 

License Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. and 
Spectrum Pharmaceuticals Cayman, L.P. + (incorporated by reference to Exhibit 10.4 of our Form 10-
Q/A filed with the Securities and Exchange Commission on January 21, 2015) 

License Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. and 
Talon Therapeutics, Inc. + (incorporated by reference to Exhibit 10.5 of our Form 10-Q/A filed with the 
Securities and Exchange Commission on January 21, 2015) 

CASI Pharmaceuticals, Inc. 2011 Long-Term Incentive Plan, as amended* (incorporated by reference 
to Appendix A to the Company’s Definitive Proxy Statement  filed with the Securities and Exchange 
Commission on April 17, 2018) 

Form of Securities Purchase Agreement, dated September 20, 2015, by and among CASI 
Pharmaceuticals, Inc. and the investors thereto (incorporated by reference to Exhibit 10.1 of our Form 
10-Q filed with the Securities and Exchange Commission on November 13, 2015) 

Employment Agreement by and between CASI Pharmaceuticals, Inc. and Alex Zukiwski, dated as of 
April 3, 2017* (incorporated by reference to Exhibit 10.1 of our Form 10-Q filed with the Securities 
and Exchange Commission on August 14, 2017) 

44 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.15 

10.16 

10.17 

10.18 

10.19 

10.20 

10.21 

10.22  

10.23 

10.24 

10.25 

10.26  

16.1 

Form of Securities Purchase Agreement (incorporated by reference to Exhibit 10.1 of our Form 8-K 
filed with the Securities and Exchange Commission on October 19, 2017) 

Asset Purchase Agreement, dated as of January 26, 2018, by and between CASI Pharmaceuticals, Inc. 
and Sandoz Inc. + (incorporated by reference to Exhibit 10.26 of our Form 10-K filed with the 
Securities and Exchange Commission on March 29, 2018) 

Form of Securities Purchase Agreement (incorporated by reference to Exhibit 10.1 of our Form 8-K 
filed with the Securities and Exchange Commission on March 23, 2018) 

Form of Securities Purchase Agreement (incorporated by reference to Exhibit 10.1 of our Form 8-K 
filed with the Securities and Exchange Commission on September 14, 2018) 

Employment Agreement, effective as of September 28, 2018, between CASI Pharmaceuticals, Inc.  and 
George Chi* (incorporated by reference to Exhibit 10.1 of our Form 8-K/A filed with the Securities 
and Exchange Commission on October 24, 2018) 

Memorandum of Understanding, dated November 16, 2018, by and between Management Committee 
of Wuxi Hui-shan Economic Development Zone and CASI Pharmaceuticals, Inc.** 

Investment Agreement, dated November 16, 2018, by and between Administrative Committee of Wuxi 
Huishan Economic Development Zone, Jiangsu Province and CASI Pharmaceuticals, Inc.** 

Supplementary Agreement, dated November 16, 2018, by and between Administrative Committee of 
Wuxi Huishan Economic Development Zone, Jiangsu Province and CASI Pharmaceuticals, Inc.** 

Shareholders’ Agreement, dated November 16, 2018, between CASI Pharmaceuticals, Inc. and Wuxi 
Jintou Huicun Investment Enterprise (Limited Partnership) ** 

Lease Contract, by and between Wuxi Huishan New City Life Science & Technology Industry 
Development Co., Ltd. and CASI Pharmaceuticals, Inc. ** 

Joint Venture Contract on Establishment of CASI (Wuxi) Pharmaceuticals Co. Ltd. by and between 
CASI Pharmaceuticals, Inc. and Wuxi Jintou Huicun Investment Enterprise Limited Partnership, dated 
as of November 16, 2018 ** 

Labor Contract, effective as of September 1, 2018, between CASI (Beijing) Pharmaceuticals, Inc. and 
Wei (Larry) Zhang*  ** 

Letter from CohnReznick dated September 27, 2018 (incorporated by reference to Exhibit 16.1 of our 
Form 8-K filed with the Securities and Exchange Commission on September 28, 2018) 

21 

Subsidiaries of the Registrant ** 

23.1              Consent of Independent Registered Public Accounting Firm ** 

23.2              Consent of Independent Registered Public Accounting Firm ** 

31.1 

31.2 

32.1 

32.2 

Rule 13a-14(a) Certification of Chief Executive Officer ** 

Rule 13a-14(a) Certification of Chief Financial Officer ** 

Rule 13a-14(b) Certification by Chief Executive Officer ** 

Rule 13a-14(b) Certification by Chief Financial Officer ** 

45 

 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
 
 
 
 
 
101** 

Interactive  Data  Files  The  following  financial  information  from  the  Registrant’s  Annual  Report  on 
Form 10-K  for  the  year  ended  December  31,  2018,  formatted  in  eXtensible  Business  Reporting 
Language  (XBRL):  (i) Consolidated  Balance  Sheets  as  of  December 31,  2018  and  2017, 
(ii)  Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 
2018 and 2017, (iii)  Consolidated Statements of Stockholders’ Equity for the years ended December 31, 
2018 and 2017 (iv)  Consolidated Statements of Cash Flows for the years ended December 31, 2018 and 
2017 and (v) Notes to Consolidated Financial Statements. 

*                   Management Contract or any compensatory plan, contract or arrangement.  

+                 Certain portions of this exhibit have been omitted based upon a request for confidential treatment under 
17 C.F.R. §§200.80(b)(4) and 230.406. The confidential portions of this exhibit have been omitted and 
are  marked  accordingly.  The  confidential  portions  have  been  filed  separately  with  the  Commission 
pursuant to our confidential treatment request.  

** 

Filed herewith 

46 

 
 
 
 
 
SIGNATURES 

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

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

Date:  March 29, 2019 

              CASI Pharmaceuticals, Inc. 

By: /s/Ken K. Ren          
Ken K. Ren 
Chief Executive Officer     

Pursuant to the requirements of the Securities Act of 1934, this report has been signed below by the following 

persons in the capacities and on the dates indicated.  

SIGNATURE 

/s/Ken K. Ren 

Ken K. Ren 

/s/George Chi 
George Chi 

/s/Wei-Wu He 
Wei-Wu He 

/s/James Z. Huang 
James Z. Huang 

/s/Franklin C. Salisbury 
Franklin C. Salisbury 

/s/Rajesh C. Shrotriya 
Rajesh C. Shrotriya 

/s/Y. Alexander Wu 
Y. Alexander Wu 

/s/ Quan Zhou 
Quan Zhou 

TITLE 

DATE 

Chief Executive Officer 
and Director 
(Principal Executive 
Officer) 

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

March 29, 2019 

March 29, 2019 

Executive Chairman 

  March 29, 2019 

Director 

March 29, 2019 

Director 

March 29, 2019 

Director 

March 29, 2019 

Director 

March 29, 2019 

Director  

   March 29, 2019 

47 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
[This page intentionally left blank.] 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following consolidated financial statements of CASI Pharmaceuticals, Inc. are included in Item 8:  

Report of Independent Registered Public Accounting Firm ........................................................................................  
Report of Independent Registered Public Accounting Firm ........................................................................................  
Consolidated Balance Sheets as of December 31, 2018 and 2017 ...............................................................................  
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2018 and 2017 
Consolidated Statements of Stockholders' Equity for the years ended December 31, 2018 and 2017 .......................  
Consolidated Statements of Cash Flows for the years ended December 31, 2018 and 2017 ......................................  
Notes to Consolidated Financial Statements ................................................................................................................  

F-2 
F-3 
F-4 
F-5 
F-6 
F-7 
F-8 

F-1 

 
 
 
 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

To the Stockholders and Board of Directors 
CASI Pharmaceuticals, Inc.: 

Opinion on the Consolidated Financial Statements 

We have audited the accompanying consolidated balance sheet of CASI Pharmaceuticals, Inc. and subsidiaries (the 
“Company”)  as  of  December 31,  2018,  the  related  consolidated  statements  of  operations  and  comprehensive  loss, 
stockholders’  equity,  and  cash  flows  for  the  year  then  ended,  and  the  related  notes  (collectively,  the  consolidated 
financial statements). In our opinion, the consolidated financial statements present fairly, in all material respects, the 
financial position of the Company as of December 31, 2018, and the results of its operations and its cash flows for the 
year then ended, in conformity with U.S. generally accepted accounting principles. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United 
States)  (“PCAOB”),  the  Company’s  internal  control  over  financial  reporting  as  of  December 31,  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 March 29, 2019 expressed an unqualified opinion 
on the effectiveness of the Company’s internal control over financial reporting. 

Basis for Opinion 

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to 
express an opinion on these consolidated 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 audit in accordance with the standards of the PCAOB. Those standards require that we plan and 
perform  the  audit  to  obtain  reasonable  assurance  about  whether  the  consolidated  financial  statements  are  free  of 
material misstatement, whether due to error or fraud. Our audit included performing procedures to assess the risks of 
material  misstatement  of  the  consolidated  financial  statements,  whether  due  to  error  or  fraud,  and  performing 
procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the 
amounts and disclosures in the consolidated financial statements. Our audit also included evaluating the accounting 
principles used and significant estimates made by management, as well as evaluating the overall presentation of the 
consolidated financial statements. We believe that our audit provides a reasonable basis for our opinion. 

/s/ KPMG Huazhen LLP 

We have served as the Company’s auditor since 2019. 

Beijing, China 
March 29, 2019  

F-2 

 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

The Board of Directors and Stockholders  
CASI Pharmaceuticals, Inc. 

Opinion on the Financial Statements 

We have audited the accompanying consolidated balance sheet of CASI Pharmaceuticals, Inc. and subsidiaries (the 
“Company”) as of December 31, 2017, and the related consolidated statement of operations and comprehensive loss, 
stockholders’ equity and cash flows for the year then ended, including the related notes (collectively referred to as the 
“consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material 
respects, the financial position of the Company as of December 31, 2017, and the results of its operations and its cash 
flows for the year then ended, in conformity with accounting principles generally accepted in the United States of 
America. 

Basis for Opinion 

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to 
express an opinion on the Company’s consolidated financial statements based on our audit. We are a public accounting 
firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are required 
to be independent with respect to the Company in accordance with the U.S. Federal securities laws and the applicable 
rules and regulations of the Securities and Exchange Commission and the PCAOB.  

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and 
perform  the  audit  to  obtain  reasonable  assurance  about  whether  the  consolidated  financial  statements  are  free  of 
material misstatement, whether due to fraud or error. The Company is not required to have, nor were we engaged to 
perform, an audit of its internal control over financial reporting. As part of our audit, we are required to obtain an 
understanding of internal control over financial reporting, but not for the purposes of expressing an opinion on the 
effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.  

Our audit included performing procedures to assess the risks of material misstatement of the consolidated financial 
statements, whether due to error or fraud, and performing procedures that respond to those risks.  Such procedures 
included  examining,  on  a  test  basis,  evidence  regarding  amounts  and  disclosures  in  the  consolidated  financial 
statements.    Our  audit  also  included  evaluating  the  accounting  principles  used  and  significant  estimates  made  by 
management, as well as evaluating the overall presentation of the consolidated financial statements.  We believe that 
our audit provides a reasonable basis for our opinion.   

/s/ CohnReznick LLP 

We have served as the Company’s auditor since 2012. 

Roseland, New Jersey 
March 29, 2018 

F-3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Balance Sheets 

ASSETS 
Current assets: 
   Cash and cash equivalents 
   Investment in equity securities, at fair value 
   Prepaid expenses and other 
Total current assets 

December 31, 

 2018 

 2017 

 $       84,204,809 
912,200 
7,447,611 
92,564,620 

 $       43,489,935 
- 
322,493 
43,812,428 

Property and equipment, net 
Intangible assets, net                                                                                                        
Other assets 
Total assets 

1,750,630

18,784,727        
310,024 
$  113,410,001 

1,046,514 
                                  - 
242,023 
45,100,965 

$ 

LIABILITIES AND STOCKHOLDERS' EQUITY  
Current liabilities: 
   Accounts payable 
   Payable to related party 
   Accrued liabilities 
   Note payable, net of discount 
Total current liabilities 

Note payable, net of discount 
Other liabilities 
Total liabilities 

Commitments and contingencies (Note 17) 

Stockholders' equity: 
   Preferred stock, $1.00 par value; 
      5,000,000 shares authorized and 0 shares issued and  

outstanding at December 31, 2018 and 2017 

$ 

968,048 
                                  - 
                   1,406,434 
1,499,462 
3,873,944 

$ 

2,087,770 
                   2,228,366 
                      745,961 
- 
5,062,097 

                                 - 
                        73,591 
                   3,947,535 

                   1,498,754 
                                 - 
                   6,560,851 

                                  - 

                                  - 

   Common stock, $.01 par value: 
      170,000,000 shares authorized at December 31, 2018 and 2017;   
      95,366,813 shares and 69,901,625 shares issued at December 31, 2018                  
      and 2017; 95,287,268 shares and 69,822,080 shares outstanding  
      at December 31, 2018 and 2017, respectively 
   Additional paid-in capital 
   Treasury stock, at cost:  79,545 shares held at December 31, 2018 and 2017                
   Accumulated other comprehensive loss 
   Accumulated deficit 
Total stockholders' equity 
Total liabilities and stockholders' equity 

                      953,667 
596,710,648 
(8,034,244) 
                  (1,226,320) 
(478,941,285) 
       109,462,466 
$     113,410,001 

                      699,015  
498,577,372 
(8,034,244) 
                                  - 
(452,702,029) 
38,540,114 
45,100,965 

$ 

    See accompanying notes. 

F-4 

 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                 
                                   
                                 
                                   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Statements of Operations and Comprehensive Loss  

Revenues: 

   Product sales 

Costs and expenses: 
   Research and development  

   General and administrative 

   Acquired in-process research and development  

         Year Ended December 31, 

2018 

2017 

       $                     - 
- 

       $                     - 
- 

8,507,377 

7,595,182 

             17,997,069 

               3,156,138 

686,998 

27,191,444 

- 

10,751,320 

Interest income, net 

                  (39,988) 

                    (1,009) 

Change in fair value of investment in equity securities 

                   320,112 

                              - 

Change in fair value of contingent rights 

                               - 

                     19,891 

Net loss  

$  (27,471,568) 

$  (10,770,202) 

Net loss per share (basic and diluted) 
Weighted average number of shares outstanding (basic  

$ 

(0.32) 

$ 

(0.18) 

and diluted) 

 84,752,152 

  61,513,988 

Comprehensive loss: 
Net loss 
Foreign currency translation adjustment 
Total comprehensive loss 

       $   (27,471,568) 
(1,226,320) 
$  (28,697,888) 

       $   (10,770,202) 
- 
$  (10,770,202) 

         See accompanying notes. 

F-5 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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S

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Statements of Cash Flows 

CASH FLOWS FROM OPERATING ACTIVITIES 
Net loss 
Adjustments to reconcile net loss to net cash used in operating 
   activities: 
      Depreciation and amortization for property and equipment 
      Net loss on disposal of furniture and equipment 
      Amortization of intangible assets 
      Stock-based compensation expense 
      Acquired in-process research and development 
      Change in fair value of investment in equity securities 
      Non-cash interest 
      Change in fair value of contingent rights 
      Changes in operating assets and liabilities: 
        Prepaid expenses and other 
        Accounts payable 
        Payable to related party 
        Accrued liabilities 
Net cash used in operating activities 

CASH FLOWS FROM INVESTING ACTIVITIES 
Proceeds from sale of furniture and equipment 
Purchases of property and equipment 
Acquisition of abbreviated new drug applications and related items 
Net cash used in investing activities 

CASH FLOWS FROM FINANCING ACTIVITIES 
Stock issuance costs 
Proceeds from sale of common stock and warrants 
Proceeds from exercise of stock options 
Repurchase of stock options to satisfy tax withholding obligations 
Proceeds from exercise of warrants 
Net cash provided by financing activities 

Effect of exchange rate change on cash and cash equivalents 
Net increase in cash and cash equivalents 

Cash and cash equivalents at beginning of year 
Cash and cash equivalents at end of year 

Supplemental disclosure of cash flow information: 
     Interest paid 

                         Year Ended December 31, 

                        2018   

                                            2017   

$  (27,471,568) 

$  (10,770,202) 

365,555 
5,346 
1,305,379 
6,118,121 
552,863 
320,112 
708 
- 

117,779 
- 
- 
650,440 
- 
- 
7,476 
19,891 

(7,226,256) 
(1,097,170) 
(2,228,366) 
                771,348 
       (28,583,928) 

(361) 
849,365 
2,228,366 
                495,011 
       (6,402,235) 

590 
(1,131,113) 
               (20,642,969) 
               (21,773,492) 

- 
(934,702) 
                                  - 
          (934,702) 

  (821,780) 
87,990,216 
257,948 
(117,194) 
                    4,960,617 
                  92,269,807 

  (462,841) 
23,870,786 
325,999 
- 
                          - 
                                  23,733,944 

                (1,197,513) 
40,714,874 

             43,489,935 
$       84,204,809  

                          - 
16,397,007 

           27,092,928 
$     43,489,935 

         $                       - 

                          $                       - 

     Income taxes paid 

         $                       - 

                          $                       - 

     Non-cash financing activity: 
        Warrant issued to placement agent 

$                       - 

$             28,880 

        Partial settlement of contingent rights derivative  

          $                      -   

                           $       4,142,157 

     Non-cash investing activity:  
        Disposal of fully depreciated property and equipment, at cost       

          $             14,997 

                           $              7,523 

See accompanying notes. 

F-7 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
      
 
 
      
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        
 
      
 
 
 
 
 
       
            
 
   
 
 
 
       
            
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CASI Pharmaceuticals, Inc. 

Notes to Consolidated Financial Statements 
December 31, 2018 and 2017 

1.  DESCRIPTION OF BUSINESS  

CASI Pharmaceuticals, Inc. (“CASI” or the “Company”) (Nasdaq: CASI) is a U.S. pharmaceutical company 
with a platform to develop and accelerate the launch of pharmaceutical products and innovative therapeutics in China, 
U.S., and throughout the world. The Company is focused on acquiring, licensing, developing and commercializing 
products that address areas of unmet medical needs.  The Company intends to execute its plan to become a leading 
platform  to  launch  medicines  in  the  greater  China  market  leveraging  its  China-based  regulatory  and  commercial 
competencies and its global drug development expertise.  The Company conducts substantially all of its operations 
through  its  wholly-owned  subsidiary,  CASI  Pharmaceuticals  (Beijing)  Co.,  Ltd.  (“CASI  China”),  which  is 
headquartered in Beijing, China.  CASI China has established China operations that are growing as  the Company 
continues to further in-license or acquire products for its pipeline.  On December 26, 2018, the Company established 
CASI Pharmaceuticals (Wuxi) Co., Ltd. (“CASI Wuxi”) in China that will begin to develop a manufacturing capability 
in China in 2019.  The Company currently operates in one operating segment, which is the development of innovative 
therapeutics addressing cancer and other unmet medical needs for the global market. 

In September 2014, the Company acquired from Spectrum Pharmaceuticals, Inc. and certain of its affiliates 
(together referred to as “Spectrum”) exclusive rights in greater China (including Taiwan, Hong Kong and Macau) to 
three in-licensed oncology products, including Melphalan Hydrochloride For Injection (EVOMELA®) approved in 
the  U.S.  primarily  for  use  as  a  high-dose  conditioning  treatment  prior  to  hematopoietic  progenitor  (stem)  cell 
transplantation  in  patients  with  multiple  myeloma,  Ibritumomab  Tiuxetan  (ZEVALIN®)  approved  in  the  U.S.  for 
advanced non-Hodgkin’s lymphoma, and Vincristine Sulfate Liposome Injection (MARQIBO®) approved in the U.S. 
for advanced adult Ph- acute lymphoblastic leukemia (ALL).  On March 1, 2019, Spectrum sold these products, along 
with the licenses and contracts relating thereto, to Acrotech Biopharma L.L.C. (“Acrotech”). The Company does not 
expect any material adverse effect on its operations to result from the sale. 

In  January  2018,  the  Company  acquired  a  portfolio  of  25  U.S.  Food  and  Drug  Administration  (“FDA”) 
approved  abbreviated  new  drug  applications  (ANDAs),  and  four  ANDAs  that  are  pending  FDA  approval,  from 
Sandoz, Inc. (“Sandoz”).  CASI intends to select and commercialize certain products from the portfolio that  offer 
unique market and cost-effective manufacturing opportunities in China and/or in the U.S. 

In October 2018, the Company entered into an agreement with Laurus Labs Limited (“Laurus”), a company 
organized under the Laws of India, pursuant to which the Company acquired one U.S. FDA-approved ANDA for 
tenofovir disoproxil fumarate (“TDF”), which is indicated for the treatment of hepatitis B virus. 

As  a  result,  the  Company’s  product  pipeline  features  the  following:  (1)  U.S.  FDA  approved  hematology 
oncology  drugs  in-licensed  for  the  greater  China  market,  consisting  of  Melphalan  Hydrochloride  For  Injection 
(EVOMELA), Ibritumomab Tiuxetan (ZEVALIN) and Vincristine Sulfate Liposome Injection (MARQIBO), (2) a 
portfolio of 26 FDA-approved abbreviated new drug applications (“ANDAs”), including entecavir and TDF indicated 
for hepatitis B virus; and (3) four pipeline ANDAs that are pending FDA approval.  The Company intends to prioritize 
a select subset of the ANDAs for product registration and commercialization in China. In addition to these advanced 
products, the Company’s pipeline includes a proprietary Phase 2 drug candidate, ENMD-2076, that the Company has 
previously determined not to pursue as a single agent, and instead is exploring the feasibility of combination as a 
clinical  strategy.    The  Company  also  has  proprietary  early-stage  immune-oncological  potential  candidates  in 
preclinical development. 

The  Company’s  product  mix  reflects  a  risk-balanced  approach  between  products  in  various  stages  of 
development,  between  products  that  are  branded  and  non-branded,  and  between  products  that  are  proprietary  and 
generic. The Company intends to continue building a significant product pipeline of high quality, as well as innovative 
drug candidates for commercialization in China and for the rest of the world.  For in-licensed products, the Company 
uses a market-oriented approach to identify pharmaceutical candidates that it believes have the potential for gaining 
F-8 

 
 
 
 
 
 
widespread market acceptance, either globally or in China, and for which development can be accelerated under the 
Company’s drug development strategy.  For the Company’s FDA-approved ANDAs, the Company intends to select 
and commercialize certain niche products from the portfolio that complements its therapeutic focus areas and which 
offer unique market and cost-effective manufacturing opportunities in China and/or in the U.S. 

The  Company  believes  the  China  operations  offer  a  significant  market  and  growth  potential  due  to 
extraordinary increase in demand for high quality medicine coupled with regulatory reforms in China that make it 
easier for global pharmaceutical companies to introduce new pharmaceutical products into the country.  The Company 
will continue to in-license clinical-stage and late-stage drug candidates, and leverage its platform and expertise, and 
hope to be the partner of choice to provide access to the China market.  The Company expects the implementation of 
its plans will include leveraging the Company’s resources and expertise in both the U S and China so that the Company 
can maximize development and clinical strategies concurrently under U.S. FDA and China National Medical Products 
Administration (NMPA, formerly the China Food and Drug Administration) regulatory regimes. In order to capitalize 
on the drug development and capital resources available in China, the Company is doing business in China through 
its wholly-owned China-based subsidiary that will execute the China portion of the Company’s drug development 
strategy,  including  conducting  clinical  trials  in  China,  pursuing  local  funding  opportunities  and  strategic 
collaborations, and implementing the Company’s commercial launches.  In December 2018, the Company received 
NMPA approval of Melphalan Hydrochloride For Injection (EVOMELA), for: 

(cid:120) 

(cid:120) 

use  as a high-dose  conditioning  treatment  prior  to hematopoietic progenitor (stem) cell  transplantation  in 
patients with multiple myeloma, and 
the palliative treatment of patients with multiple myeloma for whom oral therapy is not appropriate.  

The  Company  intends  to  begin  commercializing  this  drug  through  CASI  China  beginning  in  2019  using 
EVOMELA  supplied  through  Spectrum  and  its  suppliers.  All  future  needs  will  be  sourced  from  Acrotech  and  its 
suppliers.  

The  Company  is  building  an  internal  commercial  team  to  prepare  for  the  launch  of  its  first  commercial 
product,  Melphalan  Hydrochloride  for  Injection  (EVOMELA)  in  2019.    As  part  of  the  strategy  to  support  the 
Company’s future clinical and commercial manufacturing needs and to manage its supply chain for certain products, 
the Company has established CASI Wuxi to construct a cGMP manufacturing facility in Wuxi, China.  The site is 
currently in the design and engineering phase with construction expected to begin in 2019.  Through CASI China, the 
Company will focus on China market devoting more resources and investment going forward. 

Liquidity Risks and Management’s Plans 

Since  inception,  the  Company  has  incurred  significant  losses  from  operations  and  has  incurred  an 
accumulated deficit of $478.9 million as of December 31, 2018.  The Company expects to continue to incur operating 
losses for the foreseeable future due to, among other factors, its continuing clinical and development activities.  

In  September  2018,  the  Company  entered  into  securities  purchase  agreements  with  certain  institutional 
investors, accredited investors and current stockholders, pursuant to which the Company agreed to sell up to 9,048,504 
shares of its common stock with accompanying warrants to purchase 2,714,548 shares of its common stock in a $48.5 
million private placement (the “September 2018 Offering”).  The Company held its initial closing on September 24, 
2018 and second closing on October 10, 2018, receiving total gross proceeds of $37.5 million.  The Company does 
not expect to receive any further proceeds from the September 2018 Offering.  

In March 2018, the Company entered into securities purchase agreements pursuant to which the Company 
issued  15,432,091  shares  of  its  common  stock  with  accompanying  warrants  to  purchase  6,172,832  shares  of  its 
common  stock  and  received  $50  million  in  gross  proceeds  in  a  private  placement.  This  financing  included  an 
investment  from  ETP  Global  Fund,  L.P.,  a  healthcare  investment  fund;  the  managing  member  of  Emerging 
Technology Partners, LLC (the general partner of ETP Global Fund, L.P.) is the Company’s Executive Chairman of 
the  Board  of  Directors.    The  financing  also  included  an  investment  from  IDG-Accel China  Growth  Fund  III  L.P. 
(“IDG-Accel Growth”) and IDG-Accel China III Investors L.P. (“IDG-Accel Investors”); a director and shareholder 
of IDG-Accel China Growth Fund GP III Associates Ltd. (the ultimate general partner of IDG-Accel Growth and 
IDG-Accel Investors) is a member of the Company’s Board of Directors.  

F-9 

 
 
 
 
 
 
 
 
Net  proceeds  from  the  2018  financings  are  being  used  to  prepare  for  the  launch  of  the  Company’s  first 
commercial  product  in  China,  Melphalan  Hydrochloride  For  Injection  (EVOMELA),  to  support  the  Company’s 
business development activities, to advance the development of the Company’s pipeline, to support its marketing and 
commercial planning activities, and for other general corporate purposes.  

In order to capitalize on the drug development and capital resources available in China, the Company is doing 
business  in  China  through  its  wholly-owned  China-based  subsidiary  that  will  execute  the  China  portion  of  the 
Company’s drug development strategy, including commercialization and conducting clinical trials in China, pursuing 
local funding opportunities and strategic collaborations, and implementing the Company’s plan for development and 
commercialization in the Chinese market. In November 2018, the Company committed to invest up to $80 million in 
cash  and  assets  in  CASI  Wuxi  in  furtherance  of  its  drug  development  strategy  in  China  and  made  an  initial  cash 
investment of $21 million in February 2019 (see Note 8).  The remaining investment will be made over the next three 
years. 

Taking  into  consideration  the  cash  balance  as  of December 31,  2018  and  its  commitments  to  fund  CASI 
Wuxi, the Company believes that it has sufficient resources to fund its operations at least through March 29, 2020.  
The Company intends to continue to exercise tight controls over operating expenditures and will continue to pursue 
opportunities, as required, to raise additional capital and will also actively pursue non- or less-dilutive capital raising 
arrangements in China to support the Company’s dual-country approach to drug development.  The Company intends 
to pursue additional financing opportunities as well as opportunities to raise capital through forms of non- or less- 
dilutive  arrangements,  such  as  partnerships  and  collaborations  with  organizations  that  have  capabilities  and/or 
products that are complementary to the Company’s capabilities and products in order to continue the development of 
the product candidates that the Company intends to pursue to commercialization. 

2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES 

Basis of Presentation 

The accompanying consolidated financial statements have been prepared in accordance with accounting 

principles generally accepted in the United States of America (“U.S. GAAP”).  

Use of Estimates 

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management 
to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying 
notes. The Company’s most critical accounting estimates relate to accounting policies for fair value determination and 
recoverability of intangible assets, clinical trial accruals, deferred tax assets and liabilities and valuation allowance, 
and  stock-based  arrangements.  Management  bases  its  estimates  on  historical  experience  and  on  various  other 
assumptions that it believes are reasonable under the circumstances. Actual results may differ from those estimates, 
and such differences may be material to the consolidated financial statements.      

Consolidation and Foreign Currency Matters 

The accompanying consolidated financial statements include the accounts of CASI Pharmaceuticals, Inc. and 
its  subsidiaries,  Miikana  Therapeutics,  Inc.  (“Miikana”)  and  CASI  Pharmaceuticals  (Beijing)  Co.,  Ltd.  (“CASI 
China”).  CASI China is a non-stock Chinese entity with 100% of its interest owned by CASI.  CASI China received 
approval for a business license from the Beijing Industry and Commercial Administration in August 2012 and has 
operating facilities in Beijing.  All inter-company balances and transactions have been eliminated in consolidation.   

The Company’s reporting currency is the U.S. dollar. Prior to 2018, the functional currency of the Company’s 
subsidiary based in China was the U.S dollar.  However, as discussed in Note 3, on January 26, 2018, the Company 
acquired a portfolio of ANDAs. Management believes that this transaction provides significant and permanent changes 
to its operations in China, and that it may allow its subsidiary in China to generate operating revenues from the China 
marketplace  in  the  future  and  potentially  sustain  its  own  operations  without  the  necessity  of  parent  support. 
Accordingly,  effective  January  1,  2018,  the  functional  currency  of  the  Company’s  subsidiary  based  in  China  was 

F-10 

 
 
 
 
 
 
 
 
 
changed to the local currency of the China Renminbi (“RMB”). Upon the change in functional currency, there was no 
material impact on the consolidated financial statements. Accordingly, beginning January 1, 2018 translation gains 
and losses relating to the financial statements of the Company’s China subsidiaries are included as accumulated other 
comprehensive loss in the accompanying consolidated balance sheets. Assets and liabilities are translated using the 
exchange rates in effect at the consolidated balance sheet date and revenues and expenses at the rates of exchange 
prevailing when the transactions occurred  estimated using an average periodic exchange rate.  Net gains or losses 
resulting from foreign currency denominated transactions are included in the consolidated statements of operations. 
There were no material gains or losses from foreign currency exchange transactions for the years ended December 31, 
2018 and 2017.   

Concentrations of Risk 

Credit Concentration Risk 

Financial instruments that potentially subject the Company to concentrations of credit risk consist principally 
of cash and cash equivalents.  The Company maintains its U.S. and RMB cash in bank deposit accounts, which, at 
times, may exceed regulated insured limits. The Company believes it is not exposed to significant credit risk on cash 
and cash equivalents.  

Vendor Concentration Risk 

The  Company  has  a  sole  supplier  for  its  EVOMELA  product.  To  date,  it  has  been  sourced  solely  from 
Spectrum and its suppliers, and all future needs will be sourced from Acrotech and its suppliers.  The Company’s 
ability to qualify other providers of EVOMELA is limited by FDA regulations.     

Fair Value of Financial Instruments 

The majority of the Company’s financial instruments (consisting principally of cash and cash equivalents, 
prepaid expenses, accounts payable, and accrued liabilities) are carried at cost which approximates their fair values 
due to the short-term nature of the instruments.  The Company’s investment in equity securities is carried at fair value 
(see Note 5).  The Company’s Note Payable is carried at amortized cost which approximates fair value due to its 
classification as a short-term note payable.   

See Note 14 for additional fair value disclosures. 

Cash and Cash Equivalents 

Cash and cash equivalents include cash and highly liquid investments with original maturities of less than 90 

days.  

Inventories 

            Inventories  consist  of  raw  materials  and  are  stated  at  the  lower  of  cost  or  net  realizable  value.  Cost  is 
determined  using  a  first-in,  first-out  method.    The  carrying  value  of  raw  materials  inventory  was  approximately 
$283,000  as  of  December  31,  2018  and  is  included  in  “prepaid  expenses  and  other  assets”  in  the  accompanying 
consolidated balance sheets. 

Impairment of Long-Lived Assets 

In accordance with authoritative guidance issued by the Financial Accounting Standards Board (“FASB”), 
the Company evaluates the value reflected in its consolidated balance sheets of long-lived assets, such as property and 
equipment and definitive-lived intangible assets, when events and circumstances indicate that the carrying amount of 
an asset may not be recovered.  Such events and circumstances include the use of the asset in current research and 
development projects, any potential alternative uses of the asset in other research and development projects in the 
short to medium term and restructuring plans entered into by the Company.  Recoverability of the long-lived asset is 
measured by a comparison of the carrying amount of the asset to future undiscounted net cash flows expected to be 

F-11 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by 
the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets.  No impairment 
charges were recorded in 2018 and 2017. 

Research and Development Expenses 

             Research and development expenses consist primarily of compensation and other expenses related to research 
and development personnel, research collaborations, costs associated with pre-clinical testing and clinical trials of the 
Company’s  product  candidates,  including  the  costs  of  manufacturing  drug  substance  and  drug  product,  regulatory 
maintenance  costs,  and  facilities  expenses,  along  with  the  amortization  of  acquired  ANDAs.  Research  and 
development costs are expensed as incurred. 

Expenses for clinical trials are incurred from planning through patient enrollment to reporting of the data.  
The Company estimates expenses incurred for clinical trials that are in process based on patient enrollment and based 
on clinical data collection and management.  Costs that are associated with patient enrollment are recognized as each 
patient in the clinical trial completes the enrollment process.  Estimated clinical trial costs related to enrollment can 
vary based on numerous factors, including expected number of patients in trials, the number of patients that do not 
complete participation in a trial, and when a patient drops out of a trial.  Costs that are based on clinical data collection 
and  management  are  recognized  in  the  reporting  period  in  which  services  are  provided.    In  the  event  of  early 
termination of a clinical trial, the Company accrues an amount based on estimates of the remaining non-cancelable 
obligations associated with winding down the clinical trial.  At December 31, 2018 and 2017, clinical trial accruals 
were $150,893 and $402,773, respectively, and are included in accounts payable in the accompanying consolidated 
balance sheets. 

Stock-Based Compensation  

The Company records compensation expense associated with service and performance-based stock options 
in accordance with provisions of authoritative guidance.  The estimated fair value of service-based awards is generally 
amortized on a straight-line basis over the requisite service period and is recognized based on the proportionate amount 
of  the  requisite  service  period  that  has  been  rendered  during  each  reporting  period.    The  estimated  fair  value  of 
performance-based awards is measured on the grant date and is recognized when it is determined that it is probable 
that the performance condition will be achieved. 

Income Taxes 

Income tax expense is recognized using the asset and liability method.  Deferred tax assets and liabilities are 
determined based on the difference between the financial statement and tax bases of assets and liabilities and operating 
loss and tax credit carryforwards as measured by the enacted tax rates that will be in effect when these differences 
reverse. The  Company  provides  a valuation  allowance  against net  deferred  tax  assets if,  based  upon  the  available 
evidence, it is not more likely than not that the deferred tax assets will be realized. 

The  Company  uses  a  recognition  threshold  and  a  measurement  attribute  for  the  financial  statement 
recognition and measurement of tax positions taken or expected to be taken in a tax return.  For those benefits to be 
recognized, a tax position must be more-likely-than-not to be sustained upon examination by taxing authorities.  The 
Company recognizes interest and penalties related to uncertain tax positions, if any, in income tax expense. As of 
December 31, 2018 and 2017, the Company did not accrue any interest related to uncertain tax positions. To date, 
there have been no interest or penalties charged to the Company in relation to the underpayment of income taxes.  

Net Loss Per Share 

Net loss per share (basic and diluted) was computed by dividing net loss attributable to common shareholders 
by the weighted average number of shares of common stock outstanding. Outstanding options and warrants totaling 
30,211,133 and 17,849,331 as of December 31, 2018 and 2017, respectively, were anti-dilutive and, therefore, were 
not included in the computation of weighted average shares used in computing diluted loss per share.  

F-12 

 
 
 
 
 
 
  
 
  
   
 
 
 
New Accounting Pronouncements  

Recently Adopted Pronouncements 

In  January  2016,  the  FASB  issued  ASU  2016-01,  “Financial  Instruments–Overall:  Recognition  and 
Measurement  of  Financial  Assets  and  Financial  Liabilities.”    In  February  2018,  the  FASB  issued  ASU  2018-03, 
“Technical  Corrections  and  Improvements  to  Financial  Instruments–Overall:  Recognition  and  Measurement  of 
Financial  Assets  and  Financial  Liabilities.”  The  accounting  standards  primarily  affect  the  accounting  for  equity 
investments,  financial  liabilities  under  the  fair  value  option,  and  the  presentation  and  disclosure  requirements  for 
financial  instruments.  In  addition,  it  includes  a  clarification  related  to  the  valuation  allowance  assessment  when 
recognizing deferred tax assets resulting from unrealized losses on available-for-sale debt securities. The accounting 
guidance is effective for annual reporting periods (including interim periods within those periods) beginning after 
December  15,  2017.  The  Company  adopted  ASU  2016-01  and  ASU  2018-03  on  January  1,  2018  and  recorded  a 
cumulative effect adjustment that decreased accumulated deficit by approximately $1.2 million. Effective January 1, 
2018, the adoption date, changes in the fair value of the Company’s investments in equity securities are recognized in 
the consolidated statements of operations and comprehensive loss (see Note 5).   

In January 2017, the FASB issued ASU No. 2017-01, Clarifying the Definition of a Business (Topic 805). 
The amendments in the update provide a screen to determine when a set is not a business. If the screen is not met, the 
amendments in the update (1) require that to be considered a business, a set must include, at a minimum, an input and 
a substantive process that together significantly contribute to the ability to create output and (2) remove the evaluation 
of  whether  a  market  participant  could  replace  missing  elements.  The  amendments  provide  a  framework  to  assist 
entities in evaluating whether both an input and a substantive process are present. Lastly, the amendments in the update 
narrow the definition of the term output so that the term is consistent with how outputs are described in Topic 606. 
The ASU is effective for annual periods and interim periods within those annual periods beginning after December 
15, 2017; earlier adoption is permitted under certain criteria. The Company adopted this ASU on January 1, 2018.  
While this ASU did not have a material effect on the Company’s financial statements on the date of adoption, the 
Company did follow the new guidance in determining that its acquisition of ANDAs from Sandoz in January 2018 
and from Laurus Labs in October 2018 were asset acquisitions (see Notes 3 and 4). 

In  May  2017,  the  FASB  issued  ASU  2017-09,  Compensation-Stock  Compensation  (Topic  718)  Scope  of 
Modification Accounting. ASU 2017-09 provides clarification on when modification accounting should be used for 
changes to the terms or conditions of a share-based payment award. This ASU does not change the accounting for 
modifications but clarifies that modification accounting guidance should only be applied if there is a change to the 
value,  vesting  conditions,  or  award  classification  and  would  not  be  required  if  the  changes  are  considered  non-
substantive. This ASU is effective for fiscal years beginning after December 15, 2017, including interim periods within 
those fiscal years.  The Company adopted ASU 2017-09 in the first quarter of 2018 and the adoption of this ASU did 
not have a material effect on the consolidated financial statements.  

In June 2018, the FASB issued ASU 2018-07, Compensation-Stock Compensation (Topic 718) Improvements 
to Nonemployee Share-Based Payment Accounting which includes updated guidance for share-based payment awards 
issued  to  non-employees.  The  updated  standard  aligns  the  accounting  for  share-based  payment  awards  for  non-
employees with employees, except for guidance related to the attribution of compensation costs for non-employees. 
This  ASU  is  effective  for  fiscal  years  beginning  after  December  15,  2018,  including  interim  periods  within  those 
annual periods for public business entities, with early adoption permitted. The Company early adopted this standard 
on October 1, 2018. The adoption of this ASU did not have a material impact on the Company’s consolidated financial 
statements. 

Unadopted Pronouncements 

In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842). ASU 2016-02 supersedes existing 
lease  guidance,  including  Accounting  Standards  Codification  (ASC)  840  -  Leases.  Among  other  things,  the  new 
standard requires recognition of a right-of-use asset and liability for future lease payments for contracts that meet the 
definition of a lease. This ASU is effective for fiscal years beginning after December 15, 2018, including interim 
periods within those fiscal years. The standard must be applied using a modified retrospective approach. In July 2018, 
the  FASB  issued  ASU  2018-11,  Leases  (Topic  842)  Targeted  Improvements,  which  offers  a  transition  option  to 
entities  adopting  the  new  lease  standard.  Under  the  transition  option,  entities  can  recognize  a  cumulative  effect 
F-13 

 
 
 
 
 
 
 
adjustment to the opening balance of retained earnings of the year in which the new lease standard is adopted, rather 
than in the earliest period presented in their financial statements.  

The Company plans to elect the transition option provided, which will not require adjustments to comparative 
periods nor require modified disclosures in those comparative periods. Upon adoption, the Company expects to elect 
the transition package of practical expedients permitted within the new standard, which among other things, allows 
the carryforward of the historical lease classification.  While the Company has not completed its analysis, based on its 
current lease portfolio the Company currently estimates that the adoption ASC 842 will result in approximately $2.5 
million to $3.5 million of right of use assets and lease liabilities being reflected on its Consolidated Balance Sheet. 

  There are no other recently issued accounting pronouncements that are expected to have a material effect on 

the Company's financial position, results of operations or cash flows. 

3.  ACQUISITION OF ABBREVIATED NEW DRUG APPLICATIONS FROM SANDOZ 

On  January  26,  2018,  the  Company  entered  into  an  Asset  Purchase  Agreement  (the  “Asset  Purchase 
Agreement”)  with  Sandoz.    Pursuant  to  the  Asset  Purchase  Agreement,  the  Company  acquired  a  portfolio  of  29 
ANDAs,  including  25  ANDAs  approved  by  the  FDA  and  four  pipeline  ANDAs  that  are  pending  FDA  approval, 
limited  quantities  of  certain  active  pharmaceutical  ingredient  (“API”),  and  certain  manufacturing  and  other 
information  related  to  the  products  (collectively,  the  ANDAs,  API  and  other  information  are  referred  to  as  the 
“Acquired Assets”).  To facilitate the sale and transition, the parties also entered into several limited term ancillary 
arrangements.   

The Acquired Assets enhance the Company’s strategic focus to build a robust pipeline and commercialize 
quality  drug  candidates  in  China.    The  Company  intends  to  select  and  commercialize  certain  products  from  the 
portfolio that have unique market and cost-effective manufacturing opportunities in China (and potentially in the U.S.).     

The total purchase price for the Acquired Assets was $18.0 million in cash.  The Company accounted for the 
purchase of the Acquired Assets as an asset acquisition (consisting of a concentrated group of similar identifiable 
assets, including ANDAs and API).  The total purchase price, along with approximately $1.2 million of transaction 
expenses, was allocated to the Acquired Assets based on their relative estimated fair values, as follows: 

ANDAs  
API 
Total value 

$18,608,000 
       564,000 
$19,172,000 

Of the total value allocated to the ANDAs, approximately $553,000 was immediately expensed as acquired 
in-process  research  and  development  since  the  4  underlying  ANDAs  have  not  been  approved  by  the  FDA  upon 
acquisition. Of the total value allocated to the API, approximately $134,000 was immediately expensed as acquired 
in-process research and development since the Company does not intend to use all of the API.  The allocated cost of 
the capitalized ANDAs will be amortized over their estimated useful lives of 13 years.  The capitalized API will be 
expensed in the period it is used or if its value is otherwise impaired. 

The fair values of certain acquired ANDAs were estimated using the discounted cash flow method (an income 
approach),  which  involves  the  use  of  unobservable  Level  3  inputs  (see  Note  14).  The  ANDAs  will  be  tested  for 
impairment when events or circumstances indicate that the carrying value of the asset may not be recoverable; no such 
triggering events were identified during the period from the date of acquisition to December 31, 2018.   

4.  ACQUISITION OF ABBREVIATED NEW DRUG APPLICATION FROM LAURUS LABS  

In  October  2018,  the  Company  entered  into  an  agreement  with  Laurus,  pursuant  to  which  the  Company 
acquired from Laurus one U.S. FDA-approved ANDAs for TDF, which is indicated for the treatment of hepatitis B 
virus. The total purchase consideration was $3.0 million.  

In October 2018, the Company made an initial payment of $700,000, and in December 2018, CASI paid $1.3 
million as the second milestone was achieved.  The Company accounted for the purchase of the TDF ANDA as an 
F-14 

 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
asset acquisition and recognized both payments to Laurus, along with $35,121 of transaction expenses, as the cost of 
the acquired intangible asset (see Note 14). The remaining $1.0 million of contingent consideration will be recorded 
as  an  increase  to  the  intangible  asset  when  the  subsequent  milestones  are  probable  to  be  met.  The  Company  is 
amortizing the acquired intangible asset over its estimated useful life of 13 years; any subsequent increase in asset 
cost as a result of recognizing the contingent consideration will be expensed on a straight-line basis over the asset’s 
remaining life.   

5.   INVESTMENT IN EQUITY SECURITIES 

The Company has an equity investment in the common stock of a publicly traded company. Before January 
1, 2018, the Company recorded the investment at its cost basis of $0. Because the fair value of this equity investment 
was readily determinable as of December 31, 2017, the investment would have been accounted for as available-for-
sale  securities  with  any  unrealized  holding  gains  and  losses  reported  through  accumulated  other  comprehensive 
income (“AOCI”) as of December 31, 2017.  The fair value of the investment was approximately $1.2 million as of 
December  31,  2017.  As  a  result  of  the  error,  the  investment  and  AOCI  were  understated  by  $1.2  million  as  of 
December  31,  2017.  The  Company  corrected  the  consolidated  balance  sheet  as  of  January  1,  2018,  by  increasing 
investment in equity securities and AOCI by $1.2 million.  The Company evaluated the error on both quantitative and 
qualitative basis and determined that the error was not material and did not affect the trend of net loss or cash flows 
in previously issued financial statements. Additionally, the Company determined that correcting the error in 2018 did 
not have a material impact to the consolidated financial statements for 2018.  Beginning on January 1, 2018 with the 
adoption of ASU 2016-01, changes in the fair value of the Company's investments in equity securities are recognized 
in the consolidated statements of operations. Upon adoption on January 1, 2018, the Company recorded a cumulative 
effect adjustment that decreased AOCI and accumulated deficit by $1.2 million.  The combined effect of correction 
of the immaterial error and the adoption of the ASU 2016-01 is to increase investment in equity securities and decrease 
accumulated deficit by $1.2 million as of January 1, 2018.  The fair value of this security was measured using its 
quoted market price, a Level 1 input as of December 31, 2018 and 2017 (see Note 14).  The following table summarizes 
the Company’s investment as of December 31, 2018: 

Description

Classification

Cost

Gross 
unrealized 
gains

Aggregate fair 
value

Common stock

Investment

$              
-

$          

912,200

$           

912,200

Unrealized loss on the Company’s equity investment for year ended December 31, 2018 was $320,112 and 
is recognized as change in fair value of investment in equity securities in the accompanying consolidated statements 
of operations and comprehensive loss. 

6. PROPERTY AND EQUIPMENT      

Furniture and equipment are stated at cost and are depreciated over their estimated useful lives of 3 to 5 years. 
Leasehold improvements are stated at cost and are amortized over the shorter of their useful lives or the lease term 
(see  Note  17).    Depreciation  and  amortization  expense  is  determined  on  a  straight-line  basis.    Depreciation  and 
amortization expense was $365,555 and $117,779 in 2018 and 2017, respectively.   

Property and equipment consists of the following:  

Furniture and equipment 
Leasehold improvements 

Less: accumulated depreciation and amortization 

F-15 

December 31, 

2018 

         $1,697,294  
              739,390  
           2,436,684  

2017 

     $ 1,150,052  
           268,734  
        1,418,786  

            (686,054) 
         $1,750,630  

          (372,272) 
      $1,046,514  

 
 
 
 
 
 
 
 
 
 
 
The Company did not identify and recognize any impairment of its property and equipment in 2018 and 2017. 

7.  INTANGIBLE ASSETS 

Intangible assets were acquired as part of the 2018 asset acquisitions from Sandoz and Laurus and include 
ANDAs  for  a total  of  26  previously  marketed generic  products (see Notes 3  and 4).  These  intangible  assets  were 
originally recorded at relative estimated fair values based on the purchase price for the asset acquisitions and are stated 
net of accumulated amortization.  

The ANDAs are being amortized over their estimated useful lives of 13 years, using the straight-line method. 
Management  reviews  finite-lived  intangible  assets  for  impairment  whenever  events  or  changes  in  circumstances 
indicate that the carrying amount may not be recoverable, in a manner similar to that for property and equipment. No 
impairment losses related to intangible assets were recognized in the year ended December 31, 2018. 

Net definite-lived intangible assets at December 31, 2018 consists of the following: 

Asset 
ANDAs  
TDF ANDA 
Total 

Gross Value 
$18,054,985 
$  2,035,121 
$20,090,106 

Accumulated Amortization 
       ($1,291,775)  
       ($     13,604)  
       ($1,305,379) 

Estimated useful lives 

13 years 
13 years 

Expected future amortization expense is as follows for the years ending December 31: 

2019  
2020  
2021  
2022  
2023 
2024 and thereafter  

  $1,546,691 
    1,546,691 
    1,546,691 
    1,546,691 
    1,546,691 
                11,051,272 

8. ESTABLISHMENT OF CASI WUXI 

  On December 26, 2018, the Company established CASI Wuxi to build and operate a manufacturing facility 
in the Wuxi Huishan Economic Development Zone in Jiangsu Province, China. The Company will invest, over time, 
$80 million in CASI Wuxi. The Company’s investment will consist of (i) $21 million in cash (paid in February 2019), 
(ii) a transfer of selected ANDAs valued at $30 million, and (iii) an additional $29 million cash payment within three 
years from the date of establishment of CASI Wuxi. Additionally, Wuxi Jintou Huicun Investment Enterprise (Limited 
Partnership), a limited partnership organized under Chinese law, shall contribute the equivalent in RMB of USD $20 
million in cash in CASI Wuxi.  As of December 31, 2018, both parties have not made their first contribution. 

9.  NOTE PAYABLE 

As part of the license arrangements with Spectrum (see Note 16), the Company issued to Spectrum a $1.5 
million 0.5% secured promissory note originally due March 17, 2016, which was subsequently amended and extended 
to  September  17,  2019.    The  promissory  note  was  recorded  initially  at  its  fair  value,  giving  rise  to  a  discount  of 
approximately  $136,000;  the  promissory  note  is  presented  as  note  payable,  net  of  discount  in  the  accompanying 
Consolidated Balance Sheets. For each of the years ended December 31, 2018 and 2017, the Company recognized 
$7,500 of interest expense related to the promissory note.   

10.  STOCKHOLDERS' EQUITY 

The Company had 170 million of authorized common stock and 5 million of authorized preferred stock at 
December 31, 2018 and 2017.  The Company held 79,545 of shares of common stock in treasury at its acquisition cost 
at December 31, 2018 and 2017. 

F-16 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
In  September  2018,  the  Company  entered  into  securities  purchase  agreements  with  certain  institutional 
investors, accredited investors and current stockholders, pursuant to which the Company agreed to sell up to 9,048,504 
shares of its common stock with accompanying warrants to purchase 2,714,548 shares of its common stock in a $48.5 
million private placement.   The purchase price for each share of common stock and warrant was $5.36. The warrants 
are exercisable on March 23, 2019 at a $7.19 per share exercise price and expire on September 24, 2021.  In September 
and October 2018, the Company completed two closings and issued a total of 6,996,266 shares of its common stock 
with accompanying warrants to purchase 2,098,877 shares of its common stock and received $37.5 million in gross 
proceeds.  The  estimated  fair  value  of  the  equity-classified  warrants  issued  is  $6,254,653  or  $2.98  per  warrant, 
calculated using the Black-Scholes-Merton valuation model with a contractual life of 3 years, an assumed volatility 
of 88.39%, and a risk-free interest rate of 2.89%.  

In March 2018, the Company entered into securities purchase agreements with certain institutional investors, 
accredited investors and current stockholders, pursuant to which the Company issued 15,432,091 shares of its common 
stock with accompanying warrants to purchase 6,172,832 shares of its common stock and received $50 million in 
gross proceeds in a private placement. The purchase price for each share of common stock and warrant was $3.24. 
The warrants became exercisable on September 17, 2018 at a $3.69 per share exercise price and will expire on March 
21,  2023.    The  estimated  fair  value  of  the  equity-classified  warrants  issued  is  $15,062,000,  or  $2.44  per  warrant, 
calculated using the Black-Scholes-Merton valuation model with a contractual life of 5 years, an assumed volatility 
of 75.4%, and a risk-free interest rate of 2.69%.   

In February 2018, the Company entered into a Common Stock Sales Agreement (the “Sales Agreement”) 
with H.C. Wainwright & Co., LLC (“HCW”). Pursuant to the terms of the Sales Agreement, the Company may sell 
from  time-to-time,  at  its  option,  shares  of  the  Company’s  common  stock  through  HCW,  as  sales  agent,  with  an 
aggregate sales price of up to $25 million.  Any sales of shares pursuant to the Sales Agreement will be made under 
the Company’s effective “shelf” registration statement (the “Registration Statement”) on Form S-3 (File No. 333-
222046) which became effective on December 22, 2017 and the related prospectus supplement and the accompanying 
prospectus, as filed with the Securities and Exchange Commission (the “SEC”) on February 23, 2018.  In 2018, the 
Company  issued  143,248  Shares  under  the  Sales  Agreement  resulting  in  net  proceeds  to  the  Company  of 
approximately $475,000. As of December 31, 2018, approximately $24.5 million remained available under the Sales 
Agreement. 

In  October  2017,  the  Company  entered  into  securities  purchase  agreements  with  certain  institutional 
investors,  accredited  investors  and  current  stockholders  pursuant  to  which  the  Company  agreed  to  sell  7,951,865 
shares of its common stock and warrants exercisable for up to 1,590,373 shares of its common stock (exclusive of the 
Agent  Warrants  described  below)  in  a  registered  direct  offering  (the  “2017  Offering”)  for  gross  proceeds  of 
$23,855,595. The Company received approximately $23.4 million after offering expenses and issued 7,951,865 shares 
of common stock. The shares and warrants were sold together, consisting of one share of common stock and a warrant 
to purchase 0.20 shares of common stock for each share of common stock purchased, at a combined offering price of 
$3.00. The warrants are exercisable beginning on April 17, 2018 and expire on April 17, 2020. The warrants have an 
exercise  price  of  $3.75  per  share.  The  estimated  fair  value  of  the  equity-classified  warrants  issued  is  $1,558,566, 
calculated using the Black-Scholes-Merton valuation model value of $0.98 with a contractual life of 2.5 years, an 
assumed volatility of 85.4%, and a risk-free interest rate of 1.54%.  In connection with the 2017 Offering, the Company 
issued to its placement agent or its designees warrants to purchase 48,133 shares of common stock at an exercise price 
of $3.75 per share of common stock (the “Agent Warrants”), representing the number of warrants equal to an aggregate 
of  4%  of  the  number  of  shares  sold  to  investors  placed  by  the  placement  agent  in  the  2017  Offering,  excluding 
investments  made  by  certain  China-focused  investors  that  were  placed  by  the  Company.  The  Agent  Warrants  are 
exercisable beginning on April 17, 2018 and expire on April 17, 2019. The estimated fair value of the equity-classified 
warrants  issued  is  $28,880,  calculated  using  the  Black-Scholes-Merton  valuation  model  value  of  $0.60  with  a 
contractual life of 1.5 years, an assumed volatility of 77.8%, and a risk-free interest rate of 1.54%. 

F-17 

 
 
 
 
 
 
 
 
Stock purchase warrants activity for 2018 and 2017 is as follows: 

Outstanding at December 31, 2016 

   Issued 
   Exercised 
   Expired 

Outstanding at December 31, 2017 

   Issued 
   Exercised 
   Expired 

Outstanding at December 31, 2018 

Exercisable at December 31, 2018 

Number of Shares 

               6,388,501  

               1,638,506  
 -  
  (1,762,991) 

               6,264,016  

               8,271,709  
             (2,753,900) 
                   -  

  11,781,825  

    9,682,948  

Weighted Average 
Exercise Price 

$1.60  

$3.75  
$ - 
$1.46  

$2.23  

$4.58  
$1.80  
- 

$3.98  

$3.28  

All outstanding warrants are equity classified. 

11.  EMPLOYEE RETIREMENT PLAN 

The Company sponsors the CASI Pharmaceuticals, Inc. 401(k) Plan and Trust. The plan covers substantially 
all  U.S.  employees  and  enables  participants  to  contribute  a  portion  of  salary  and  wages  on  a  tax-deferred  basis.  
Contributions to the plan by the Company are discretionary.  Contributions by the Company totaled $151,148 and 
$70,167 in 2018 and 2017, respectively.  

12.  STOCK-BASED COMPENSATION  

The  Company  has  adopted  various  stock  compensation  plans  for  executive,  scientific  and  administrative 
personnel of the Company, as well as outside directors and consultants. In June 2018, the Company’s stockholders 
approved an amendment to the 2011 Long-Term Incentive Plan, increasing the number of shares of common stock 
reserved for issuance from 14,230,000 to 20,230,000 to be available for grants and awards.  Stock options granted 
under the plans generally vest over periods varying from immediately to one to five years, are not transferable and 
generally expire ten years from the date of grant.  As of December 31, 2018, a total of 6,834,234 shares remained 
available for grant under the Company’s 2011 Long-Term Incentive Plan.   

The Company’s net loss for the twelve months ended December 31, 2018 and 2017 includes $6,118,121 and 
$650,440,  respectively,  of  non-cash  compensation  expense  related  to  the  Company’s  share-based  compensation 
awards.  The compensation expense related to the Company’s share-based compensation arrangements is recorded as 
components of general and administrative expense and research and development expense, as follows: 

Research and development 
General and administrative 
    Total share-based compensation expense 

2018 

2017 

$740,398  
5,377,723 
$6,118,121  

$271,733  
378,707 
$650,440  

Compensation  expense  related  to  stock  options  is  recognized  over  the  requisite  service  period,  which  is 
generally the option vesting term of up to five years. Awards with performance conditions are expensed when it is 
probable that the performance condition will be achieved. For the years ended December 31, 2018 and 2017, $643,875 
and $30,500, respectively was expensed for share awards with performance conditions that became probable during 
that period.   

The Company uses the Black-Scholes-Merton valuation model to estimate the fair value of service-based and 
performance-based stock options granted to employees. Option valuation models, including Black-Scholes-Merton, 
require the input of highly subjective assumptions, and changes in the assumptions used can materially affect the grant 
date fair value of an award. These assumptions include the risk free rate of interest, expected dividend yield, expected 
volatility, and the expected life of the award. 

F-18 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Expected Volatility—Volatility is a measure of the amount by which a financial variable such as a share price 
has fluctuated (historical volatility) or is expected to fluctuate (expected volatility) during a period. The Company uses 
the  historical  volatility  based  on  the  daily  price  observations  of  its  common  stock  during  the  period  immediately 
preceding the share-based award grant that is equal in length to the award’s expected term. The Company believes that 
historical volatility represents the best estimate of future long term volatility.  

Risk-Free Interest Rate—This is the average interest rate consistent with the yield available on a U.S. Treasury 

note (with a term equal to the expected term of the underlying grants) at the date the option was granted. 

Expected  Term  of  Options—This  is  the  period  of  time  that  the  options  granted  are  expected  to  remain 
outstanding. The Company uses a simplified method for estimating the expected term of service based awards granted.  
For performance based awards, the expected term of service is based on the derived service period.  

Expected Dividend Yield—The Company has never declared or paid dividends on its common stock and does 
not anticipate paying any dividends in the foreseeable future. As such, the dividend yield percentage is assumed to be 
zero. 

Following  are  the  weighted-average  assumptions  used  in  valuing  the  stock  options  granted  to  employees 

during the years ended December 31, 2018 and 2017: 

Expected volatility 
Risk free interest rate 
Expected term of option 
Expected dividend yield                                                                              0.00%                  0.00%                           

     78.78% 
2.80% 
5.77 years 

Year ended December 31,  
    2018   

2017 
78.88% 
1.96% 
6.29 years 

The weighted average fair value of stock options granted was $4.49 and $0.73 in 2018 and 2017, respectively. 

A summary of the Company's stock option plans and of changes in options outstanding under the plans during 

the years ended December 31, 2018 and 2017 is as follows: 

Number of Options 

Weighted Average 
Exercise Price 

Weighted Average Remaining 
Contractual Term in Years 

Aggregate Intrinsic Value 

Outstanding at December 31, 2016 
   Exercised 
   Granted 

   Expired 
   Forfeited 
Outstanding at December 31, 2017 
   Exercised 
   Granted 
   Expired 

   Forfeited 
Outstanding at December 31, 2018 
Exercisable at December 31, 2018 

                 9,535,306  
                   (154,545) 
                 3,199,500  

                   (978,070) 
                     (16,876) 
               11,585,315  
                   (156,283) 
                 7,336,000  
                   (285,594) 

                     (50,130) 
               18,429,308  
                 9,755,668  

$1.57  
$2.11  
$1.05  

$1.64  
$0.92  
$1.42  
$1.65  
$4.01  
$1.55  

$3.28  
$2.44  
$1.57  

                          $168,000 

                     $643,000 

7.61 
6.21 

$33,694,004  
$24,728,420  

The aggregate intrinsic value is calculated as the difference between (i) the closing price of the common stock 
at December 31, 2018 and (ii) the exercise price of the underlying awards, multiplied by the number of options that 
had an exercise price less than the closing price on the last trading day of the year.  Cash received from option exercises 
under  all  share-based  payment  arrangements  for  the  year  ended  December 31,  2018  and  2017  was  approximately 
$258,000 and $326,000, respectively.  

In March 2018, the Compensation Committee of the Board of Directors (the “Board”) approved a grant of 
stock options to the Company’s Executive Chairman exercisable for 1.0 million shares of common stock that will vest 
and become exercisable on the first anniversary date of the grant.  In addition, the Board approved the grant of a 
performance-based option covering 4.0 million shares of common stock that will vest if, within 18 months of the date 
of grant, specific operational and strategic milestones are achieved. 

F-19 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following summarizes information about stock options that are outstanding at December 31, 2018:  

Range of 
Exercise Prices 
    $0.00 - $1.00 
     $1.01 - $2.00 
    $2.01 - $4.00 
    $4.01 - $7.00 
    $7.01 - $9.00 

Number 
Outstanding at 
December 31, 2018 
3,754,554 
6,859,938 
5,931,000 
1,642,000 
241,816 
_________ 
18,429,308 

Options Outstanding 
Weighted 
Average 
Remaining 
Contractual 
Life in Years 
7.95 
5.98 
8.83 
9.10 
8.22 

Weighted 
Average 
Exercise 
Price 
 $       0.93  
 $       1.53  
 $       3.18  
 $       6.25  
 $       8.01  

7.61 

 $       2.44  

Options Exercisable 

Number 
Exercisable at 
December 31, 2018 
2,458,613 
6,606,410 
425,788 
125,541 
139,316 
________ 
9,755,668 

Weighted 
Average 
Exercise 
Price 
 $       0.90  
 $       1.54  
 $       2.44  
 $       6.25  
 $       8.00  

 $       1.57  

As  of  December  31,  2018,  there  was  approximately  $8,844,000  of  total  unrecognized  compensation  cost 
related to non-vested stock options, excluding not-probable performance condition options. That cost is expected to 
be recognized over a weighted-average period of 3 years. 

13.  INCOME TAXES   

As a result of net operating losses, the Company did not recognize a  consolidated provision (benefit) for 
income taxes in either period.  For financial reporting purposes, loss before taxes includes the following components: 

United States 
China 

Total 

  2018  

  2017  

$ (19,819,835)    $(8,658,120) 
     (7,651,733)   
  (2,112,082) 
 $(27,471,568)    $(10,770,202) 

Deferred income taxes reflect the net effect of temporary differences between the carrying amounts of assets 
and liabilities for financial reporting purposes and the amounts used for income tax purposes and operating loss and 
tax credit carryforwards.  Significant components of the Company's deferred income tax assets and liabilities as of 
December 31, 2018 and 2017 are as follows:  

December 31, 

2018 

2017 

Deferred income tax assets: 
Net operating loss carryforwards 
   Research and development credit carryforward 
   Intangible assets 
   Equity-based compensation 
   Other 
   Valuation allowance for deferred income tax assets 
Net deferred income tax assets 

$     97,701,000 
                 8,957,000 
                 4,378,000 
                 4,075,000 
                      81,000 
    (115,192,000) 
$                      - 

  $   96,786,000 
                 9,592,000 
                 4,184,000 
                 3,812,000 
                    164,000 
           (114,538,000) 
$                      - 

The  Company  has  U.S.  federal  and  state  net  operating  loss  (NOL)  carryforwards  of  approximately 
$380,904,000 at December 31, 2018.  The Company also has People’s Republic of China (“PRC”) NOL carryforwards 
of approximately $13,066,000 at December 31, 2018. 

U.S. federal NOL carryforwards generated prior to 2018 begin to expire in 2019. The Company also has 
research  and  experimentation  (“R&E”)  tax  credit  carryforwards  of  approximately  $8,957,000  as  of  December  31, 
2018  that  begin  to  expire  in  2019.    Under  the  provisions  of  the  Internal  Revenue  Code,  the  NOL  and  tax  credit 
carryforwards are subject to review and possible adjustment by the Internal Revenue Service and state tax authorities. 
NOL  and  tax  credit  carryforwards  may  become  subject  to  an  annual  limitation  in  the  event  of  certain  cumulative 
changes in the ownership interest of significant shareholders over a three-year period in excess of 50%, as defined 
under Sections 382 and 383 of the Internal Revenue Code of 1986, respectively, as well as similar state tax provisions. 

F-20 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
This could limit the amount of tax attributes that the Company can utilize annually to offset future taxable income or 
tax liabilities. The amount of the annual limitation, if any, will be determined based on the value of the Company 
immediately prior to the ownership change. Subsequent ownership changes may further affect the limitation in future 
years.  For financial reporting purposes, a valuation allowance has been recognized to reduce the net deferred tax 
assets  to  zero  due  to  uncertainties  with  respect  to  the  Company's  ability  to  generate  taxable  income  in  the  future 
sufficient to realize the benefit of deferred income tax assets.  

On December 22, 2017, H.R.1, known as the “Tax Act,” was signed into law and makes broad and complex 
changes to the U.S. tax code, including, but not limited to, (1) reducing the U.S. federal corporate tax rate to a flat rate 
of  21%  for  periods  after  December  31,  2017  and  (2)  requiring  a  one-time  transition  tax  on  certain  un-repatriated 
earnings of foreign subsidiaries that is payable over eight years. As a result of the reduction of the corporate tax rate 
to  21%,  U.S. generally  accepted  accounting  principles  require  companies  to  re-value  their  deferred  tax  assets  and 
liabilities as of the date of enactment, with resulting tax effects accounted for in the reporting period of enactment. As 
a result of this revaluation, the Company reduced its pre-valuation allowance deferred tax asset by $52,258,000 in the 
year ended December 31, 2017, with a corresponding decrease in the valuation allowance on its net deferred tax assets.  
The Company has no unrepatriated earnings in any of its foreign subsidiaries as they incurred losses since inception. 

A reconciliation of the provision for income taxes to the federal statutory rate is as follows:  

Tax benefit at statutory rate 
Effect of tax law change 
State taxes 
Net R&E credit adjustment 
Net operating loss expiration 
Nondeductible expenses 
Change in valuation allowance 
Other 
Changes in applicable tax rates 

                 2018 
$ (5,769,000) 
- 
       (1,098,000)  
(7,000) 
         7,200,000 
             29,000 
654,000 
      (75,000) 
          (934,000) 
- 

$   

     2017 
$ (3,662,000) 
52,258,000 
(290,000) 
(185,000) 
50,000 
6,000 
(48,117,000) 
125,000 
         (185,000) 
- 

$ 

The Company had $3,198,000 of unrecognized tax benefits as of December 31, 2017 related to net R&E tax 
credit carryforwards.  For the year ended December 31, 2018, there were net reduction of unrecognized tax benefits 
of $212,000 related to R&E tax credits.  The Company has a full valuation allowance at December 31, 2018 and 2017 
against the full amount of its net deferred tax assets and, therefore, there was no impact on the Company’s financial 
position. The Company does not expect significant changes to the unrecognized benefit during 2019. 

A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows: 

Unrecognized tax benefits balance at January 1 
              Additions for Tax Positions of Prior Periods                       

Reductions for Tax Positions of Prior Periods 
(214,000) 
Additions for Tax Positions of Current Period                          2,000 

2018 
$3,198,000 

2017 
$3,133,000 
-                    3,000 
- 
         62,000 

Unrecognized tax benefits balance at December 31 

  $2,986,000           $3,198,000            

Due to the existence of tax attribute carryforwards (which are currently offset by a full valuation allowance), 

all of the Company’s tax returns since 1998 are open to examination by the taxing authorities. 

14.  FAIR VALUE MEASUREMENTS 

Fair value is the price that would be received from the sale of an asset or paid to transfer a liability assuming 
an orderly transaction in the most advantageous market at the measurement date. U.S. GAAP establishes a hierarchical 
disclosure framework which prioritizes and ranks the level of observability of inputs used in measuring fair value. 
These tiers include: 

F-21 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  Level 1—Quoted  prices  (unadjusted)  in  active  markets  that  are  accessible  at  the  measurement  date  for 

identical assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs.  

  Level 2—Observable market-based inputs other than quoted prices in active markets for identical assets or 

liabilities.  

  Level 3—Unobservable inputs are used when little or no market data is available. The fair value hierarchy 

gives the lowest priority to Level 3 inputs.  

Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis   

The Company evaluates financial assets and liabilities subject to fair value measurements on a recurring basis 
to determine the appropriate level at which to classify them each reporting period. This determination requires the 
Company to make subjective judgments as to the significance of inputs used in determining fair value and where such 
inputs lie within the hierarchy.  

The Company has an equity investment in the common stock of publicly traded company.  Beginning on 
January 1, 2018 with the adoption of ASU 2016-01, the Company’s investment in this equity security is considered a 
trading  security  and  is  carried  at  its  estimated  fair  value,  with  changes  in  fair  value  reported  in  the  consolidated 
statement of operations and comprehensive loss each reporting period (see Note 5).   

As part of the consideration for the licensing arrangements with Spectrum (see Note 16), the Company issued 
Spectrum certain contingent rights (“Contingent Rights”) to purchase additional shares of its common stock, which 
Contingent Rights expire upon the occurrence of certain events.  The Contingent Rights provided Spectrum with the 
option to acquire, at a strike price of par value, a variable number of additional shares of common stock that allows 
Spectrum to maintain its fully-diluted ownership percentage for a certain time period and under certain terms and 
conditions, and expired on the earlier of raising an aggregate of $50 million or September 17, 2019.   Based on the 
terms and conditions of the Contingent Rights, the Company determined that the Contingent Rights were a derivative 
financial instrument that is not indexed to its common stock and therefore was required to be accounted for at fair 
value,  initially  and  on  a  recurring  basis.    The  fair  value  of  the  Contingent  Rights  was  measured  using  Level  3 
unobservable inputs; the unobservable inputs included estimates of the Company’s future capital requirements, and 
the timing, probability, size and characteristics of those capital raises, among other inputs.  Spectrum exercised its 
Contingent Rights and the Company issued Spectrum 1,519,096 shares of common stock during 2017.  As a result of 
the exercise, the contingent right liability was fully settled as of December 31, 2018 and 2017.   

The following tables presents the Company’s financial assets and liabilities accounted for at fair value on a 

recurring basis as of December 31, 2018 and December 31, 2017, by level within the fair value hierarchy: 

Description

Fair Value at 
December 31, 
2018

Level 1

Level 2

Level 3

Investment in common stock
Contingent Rights

$            
912,200
$                    
-

$    
912,200
$           
-

-
$              
$              
-

$               
-
$               
-

Description

Fair Value at 
December 31, 
2017

Level 1

Level 2

Level 3

Investment in common stock
Contingent Rights

1,232,312

$         
$                    
-

1,232,312

$ 
$           
-

$              
-
$              
-

$               
-
$               
-

The following table sets forth a summary of changes in the fair value of Level 3 liabilities measured at fair 

value on a recurring basis for the year ended December 31, 2017: 

F-22 

 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
Description

Balance at 
December 
31, 2016

Change in 
Fair value

Settled in 
2017

Balance at 
December 
31, 2017

Contingent Rights

$    

4,122,266

$      

19,891

$ 

(4,142,157)

$              
-

Financial Liabilities Measured at Fair Value on a Non-Recurring Basis   

In connection with entering into the various securities purchase agreements in 2018 and 2017, the Company 
issued  shares  of  its  common  stock  along  with  detachable  stock  purchase  warrants.    The  Company  allocates  the 
proceeds received to the common stock and warrants on a relative fair value basis.  The fair value of the common 
stock is based on quoted market price for the Company’s common stock, a Level 1 input.  The fair value of the stock 
purchase  warrants  is  determined  using  the  Black-Scholes-Merton  option  pricing  model  which  uses  Level  3 
unobservable inputs.  See Note 10 for discussion of the unobservable inputs used to estimate the fair value of the 
equity-classified stock purchase warrants. 

Non-Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis 

The Company has no non-financial assets and liabilities that are measured at fair value on a recurring basis. 

Non-Financial Assets and Liabilities Measured at Fair Value on a Non-Recurring Basis 

The Company measures its long-lived assets, including property and equipment and intangible assets, at fair value 
on  a  non-recurring  basis.  These  assets  are  recognized  at  fair  value  when  they  are  deemed  to  be  other-than-temporarily 
impaired. No such fair value impairment was recognized in the years ended December 31, 2018 and 2017. 

In 2018 the Company acquired certain ANDAs pursuant to transactions accounted for as asset acquisitions.  
The intangible assets acquired from Sandoz (see Note 3) were estimated using the discounted cash flow method (an 
income approach), which involves the use of Level 3 inputs such as estimates for projected sales, expenses, and cash 
flows,  expected  income  and  value-added  tax  rates,  and  a  required  rate  of  return  adjusted  for  both  industry  and 
Company-specific risks, among other inputs. The fair values of the remaining ANDAs were estimated using a multiple 
of values method (an income approach), which involved using Level 3 inputs such as estimated addressable markets 
and market penetration rates.  The fair value of the API was estimated using Level 2 inputs, such as quoted market 
prices for similar API from various suppliers or other sources.   

The intangible asset acquired from Laurus (see Note 4) was recognized at its estimate fair value which was 

determined based on the total purchase price paid (including transaction expenses) since only one asset was acquired.     

15.  RELATED PARTY TRANSACTIONS  

The  Company  has  supply  agreements  with  Spectrum  for  the  purchase  of  EVOMELA,  ZEVALIN,  and 
MARQIBO in China for quality testing purposes to support CASI’s application for import drug registration and for 
commercialization purposes.  The former CEO of Spectrum is also a member of CASI’s Board and Spectrum is the 
Company’s largest shareholder. In 2018, the Company entered into commercial purchase obligation commitments for 
EVOMELA from Spectrum for approximately $9.2 million. As of December 31, 2018, the Company paid $4,850,000 
as  a  deposit  for  the  purchase  of  EVOMELA  expected  to  be  delivered  in  2019.    The  advance  payments  made  to 
Spectrum are reflected as prepaid expense and other in the accompanying consolidated balance sheet as of December 
31, 2018.  Additionally, the Company incurred and paid $120,000 to Spectrum in 2018 for services to support the 
development of MARQIBO, which is included in research and development expense for the year ended December 31, 
2018.  In 2017, under supply agreements with Spectrum, the Company received shipments of EVOMELA, ZEVALIN, 
and MARQIBO, in China for quality testing purposes to support CASI’s application for import drug registration. The 
total cost of the materials was approximately $2,705,000, which is included in research and development expense for 
the year ended December 31, 2017. As of December 31, 2017, the amount payable to Spectrum totaling $2,228,366 
is reflected as a related party payable in the accompanying consolidated balance sheet. As of December 31, 2018, 
there were no material amounts payable to Spectrum.  

F-23 

 
 
 
 
  
 
 
 
 
 
 
 
Emerging  Technology  Partners,  LLC  (“ETP”)  incurred  approximately  $1.5  million  of  expenses  on  the 
Company’s behalf for due diligence and related services (the “Services”) for certain business development activities. 
The  Company’s  Executive  Chairman  is  the  founder  and  managing  member  of  ETP.    The  expenses  incurred  in 
connection with the Services is included as general and administrative expenses in the accompanying consolidated 
statement of operations for the year ended December 31, 2018; the amount was paid in October 2018. 

The  Company’s  Executive  Chairman,  and  the  Company’s  Chief  Executive  Officer  played  a  key  role  in 
identifying and securing potential investors for the September 2018 Offering. As a result, the Company did not have 
to pay a commission to, or incur additional expenses for, a placement agent.  In exchange for their services, which 
were deemed to be outside the scope of their responsibilities as officers and directors of the Company, the Company 
paid  $1,380,000  and  $120,000  to  the  Executive  Chairman  and  the  Chief  Executive  Officer,  respectively.  These 
payments  are  included  as  general  and  administrative  expenses  in  the  accompanying  consolidated  statement  of 
operations for the year ended December 31, 2018; the amount was paid in October 2018. 

16.   LICENSE ARRANGEMENTS 

The  Company  has  certain  product  rights  and  perpetual  exclusive  licenses  from  Acrotech  to  develop  and 
commercialize  the  following  commercial  oncology  drugs  and  drug  candidates  in  the  greater  China  region  (which 
includes China, Taiwan, Hong Kong and Macau) (the “Territories”): 

Melphalan Hydrochloride For Injection (EVOMELA)(“EVOMELA”); 
Ibritumomab Tiuxetan (ZEVALIN) (“ZEVALIN”); and 
Vincristine Sulfate Liposome Injection (MARQIBO), (“MARQIBO”). 

CASI is responsible for developing and commercializing these three drugs in the Territories, including the 

submission of import drug registration applications and conducting confirmatory clinical trials as needed. 

In  March  2016,  Spectrum  received  notification  from  the  FDA  of  the  grant  of  approval  of  its  New  Drug 
Application (NDA) for EVOMELA primarily for use as a high-dose conditioning treatment prior to hematopoietic 
progenitor (stem) cell transplantation in patients with multiple myeloma. In December 2016, the NMPA accepted for 
review the Company’s import drug registration application for EVOMELA and in 2017 granted priority review of the 
import  drug  registration  clinical  trial  application  (CTA).    On  December  3,  2018  the  Company  received  NMPA’s 
approval  for  importation,  marketing  and  sales  in  China  for  EVOMELA.    The  Company  is  building  an  internal 
commercial team to prepare for the commercial launch EVOMELA in 2019.  The Company is also preparing for a 
post-marketing study.  

The Company is in various stages of the regulatory and development process to obtain marketing approval 
for ZEVALIN and MARQIBO in its territorial region, with ZEVALIN commercially available in Hong Kong.  In 
2017,  the  NMPA  accepted  for  review  the  Company’s  import  drug  registration  for  ZEVALIN  including  both  the 
antibody  kit  and  the  radioactive  Yttrium-90  component.  On  February  12,  2019,  the  Company  received  NMPA’s 
approval of the Company’s CTA to allow for a confirmatory registration trial to evaluate the efficacy and safety of 
ZEVALIN.  In  2016,  the  NMPA  accepted  for  review  the  Company’s  import  drug  registration  application  for 
MARQIBO.   On  March  4, 2019  the  Company received  NMPA’s  approval of  the  Company’s  CTA  to  allow  for  a 
confirmatory registration trial to evaluate the efficacy and safety of MARQIBO.   The Company intends to advance 
both of these products. 

17.  COMMITMENTS AND CONTINGENCIES 

In 2018, the Company entered into purchase obligation commitments for EVOMELA from Spectrum for 
approximately $9.2 million.  In March 2019, the Company entered into an additional purchase obligation commitment 
for EVOMELA from Spectrum for approximately $3.1 million.  The Company expects all of the EVOMELA product 
to be delivered in 2019.  As of December 31, 2018, the Company paid $4.8 million as a deposit for the purchase of 
EVOMELA.    The  deposits  made  to  Spectrum  are  reflected  as  prepaid  expense  and  other  in  the  accompanying 
consolidated balance sheet. 

In 2018, the Company committed to invest $80 million in CASI Wuxi, of which $21 million was invested 

in February 2019 (see Note 8). 

F-24 

 
 
 
 
 
 
 
 
 
 
In  2006,  the  Company  acquired  Miikana,  a  private  biotechnology  company.    Pursuant  to  the  Merger 
Agreement, the Company acquired all of the outstanding capital stock of Miikana Therapeutics, Inc.  In 2008, the 
Company initiated a Phase 1 clinical trial with its Aurora A and angiogenic kinase inhibitor, ENMD-2076, in patients 
with solid tumors.  A dosing of the first patient with ENMD-2076 triggered a purchase price adjustment milestone of 
$2 million, which the Company opted to pay in stock.  As ENMD-2076 successfully completed Phase 1 clinical trials 
and advanced to Phase 2, the dosing of the first patient in 2010 triggered an additional purchase price adjustment 
milestone of $3 million, which was paid in stock in 2010. Under the terms of the merger agreement, the former Miikana 
stockholders may earn up to an additional $4 million of potential payments upon the satisfaction of additional clinical 
and regulatory milestones for ENMD-2076. As of December 31, 2018, the $4 million potential milestone payment 
remains, payable in cash or shares of stock at the Company’s option, related to the ENMD-2076 program and the 
dosing of the first patient in a Phase 3 pivotal trial.   

With respect to the Company’s in-licensed drug candidates from Spectrum for the Greater China market, the 
Company does not have to pay any milestone payments or royalties to Spectrum; however, CASI is responsible for 
paying royalties or milestones, if and when applicable, owed by Spectrum to upstream licensors that licensed related 
technology to Spectrum in accordance with the terms of the relevant upstream licenses, and only to the extent of the 
Greater China portion of such upstream royalties or milestones. The Company’s sales of Zevalin in Hong Kong, if 
any, are subject to royalties. The Company does not expect to pay royalties for ZEVALIN in China and Taiwan until 
commercial  activities  begin  which  will  not  occur  until  after  ZEVALIN  receives  marketing  approval  from  the 
regulatory  agencies  and  which  is  not  expected  to  occur  in  2019.   The  Company  does  not  anticipate  any  payment 
obligations for its MARQIBO program in 2019.  The Company does anticipate sales of EVOMELA in 2019 which is 
expected to result in royalty payment obligations in 2019. 

In April 2018, the Company entered into a lease agreement for office space in China that continues through 
April 2021.  In October 2018, the Company entered into a lease agreement for additional office space in China that 
continues through November 2021. The Company also leases lab space in China that continues through May 2022.  
In  October  2018,  the  Company  amended  the  lease  for  its  principal  executive  offices  in  Rockville,  MD,  effective 
November 1, 2018 to increase the total space covered under the lease to 6,068 square feet.  The Company also extended 
the lease term from December 31, 2019 to July 31, 2022.  

The future minimum payments under its facilities leases are as follows:  

2019 
2020 
2021 
2022 
Thereafter 
Total minimum payments 

$1,311,707 
 1,297,102 
    856,832 
    129,918 
          - 
$3,595,559 

Rental expense for the years ended December 31, 2018 and 2017 was approximately $916,000 and $440,000, 
respectively. In 2018 the Company entered into a lease on behalf of CASI Wuxi; the minimum lease payments for this 
lease, totaling approximately $3,789,000 beginning in November 2019 and expiring in 2024 are not included in the 
above table. 

The Company is subject in the normal course of business to various legal proceedings in which claims for 
monetary or other damages may be asserted.  Management does not believe such legal proceedings, unless otherwise 
disclosed herein, are material. 

18.  SUBSEQUENT EVENT  

In  March  2019,  the  Company  entered  into  an  exclusive  distribution  agreement  with  China  Resources 
Guokang  Pharmaceuticals  Co.,  Ltd.  (“CRGK”),  pursuant  to  which  CRGK  will  be  the  exclusive  distributor  of 
EVOMELA in the People’s Republic of China (excluding Hong Kong, Macau and Taiwan). 

F-25 

 
 
 
 
 
 
 
 
 
 
 
 
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