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Catalyst Pharmaceuticals

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FY2017 Annual Report · Catalyst Pharmaceuticals
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2017 ANNUAL REPORT

Dear Stockholders: 

I am pleased to report on the progress that Catalyst Pharmaceuticals has made throughout 2017, as we 
move closer to having an FDA approved treatment for patients with Lambert-Eaton myasthenic syndrome 
(LEMS).  At the end of 2016, we announced that the first patient had been enrolled in our confirmatory 
Phase 3 trial (LMS-003) of Firdapse® in patients with LEMS. Subsequently, in October 2017, we announced 
that we had completed enrollment in this trial, and we released positive top-line results from this trial in 
November 2017. The FDA had previously granted us a Special Protocol Assessment (SPA) agreement for 
this  trial,  and,  following  a  successful  Type  3  meeting  with  the  FDA  in  early  2017,  we  completed  the 
resubmission of our NDA for Firdapse® for the treatment of LEMS in March 2018. We look forward to 
working collaboratively with the FDA to bring this product to market. 

Regulatory and Clinical Programs 
One of the defining events for Catalyst in 2017 was the release in November of the positive top-line results 
from our LMS-003 clinical trial. The trial, conducted at sites in Miami, Florida and Los Angeles, California, 
was  a  double-blind,  randomized,  “withdrawal  trial”  for  26  patients  with  LEMS.    Patients  who  were 
receiving Firdapse® in our Expanded Access Program (EAP) were invited to participate in the LMS-003 trial.  
The results of this trial met both of the two prospectively defined co-primary endpoints, as well as the 
prospectively defined secondary endpoint. Catalyst believes that these positive results will support our 
recent NDA resubmission.   

In addition to developing Firdapse® for LEMS, we are continuing to develop Firdapse® for the treatment 
of congenital myasthenic syndromes (CMS).  We are currently conducting a Phase 3 study for Firdapse® 
in patients suffering from CMS, and anticipate completing enrollment by the end of 2018 (and reporting 
top-line results in the first quarter of 2019).  This Phase 3 trial is a randomized, double-blind, controlled, 
outpatient two period, two treatment crossover study that is designed to evaluate the efficacy and safety 
of Firdapse® in patients aged 2 years and above diagnosed with certain genetic subtypes of CMS. Assuming 
that the trial results are positive, we plan to seek to add CMS to the product label for Firdapse®. 

In  2016,  Catalyst  supported  an  investigator-sponsored  proof  of  concept  (POC)  trial  for  Firdapse®  in 
patients with MuSK antibody positive Myasthenia Gravis (MuSK-MG). The results of this trial, which were 
announced last year, were quite positive and demonstrated a large clinical benefit for patients in the trial. 
To further the evaluation of Firdapse® for the treatment of MuSK-MG, we have initiated a Phase 3 pivotal 
trial,  which  we  expect  to  complete  in  about  12  months.  The  trial  is  being  conducted  under  a  SPA 
agreement with the FDA and is a multi-site, double-blind, placebo-controlled, clinical trial that is targeted 
to enroll about 70 subjects in the U.S. and in Italy. We anticipate reporting top-line results from this study 
in the first half of 2019. Our market research, interviews with neuromuscular specialists, and discussions 
with patient organizations indicate that there is an important unmet medical need for this well-defined 
patient population. 

We also recently announced that we have initiated a Catalyst-sponsored Phase 2 POC trial with a team of 
researchers at the Carlo Besta Institute in Milan, Italy evaluating Firdapse® in ambulatory patients with 
Spinal Muscular Atrophy, Type 3. We anticipate beginning enrollment in this trial in the second quarter of 
2018, and we expect to announce top-line results in the second half of 2019.  

In addition to the Firdapse® programs, we are continuing our development and regulatory activities of the 
other drug candidates in our pipeline. We are developing CPP-115 to treat refractory infantile spasms, for 
which we have received orphan drug designation in the U.S. and E.U. We are also continuing our efforts 
to develop a generic equivalent of Sabril® (vigabatrin). Finally, we continue to explore potential strategic 
alternatives for both of these programs. 

Commercialization: Launch Readiness 
In preparation for a potential launch of Firdapse® in early 2019, we are diligently working on our launch 
readiness plan. We believe that we can very effectively bring Firdapse® to market with 15-20 specialized 
sales representatives and 4 Medical Science Liaisons. We are currently refreshing our market research 
regarding reimbursement, market access, medical affairs and communications, distribution logistics and 
field sales force sizing. We are also working to develop a very comprehensive patient services program, 
as  we  are  committed  to  providing  all  patients  affordable  access  to  Firdapse®,  with  a  goal  of  making 
Firdapse® the standard of care in the treatment of LEMS patients. 

Finance and Capital Needs 
In November 2017, we raised net proceeds of approximately $53.8 million in a public offering. We intend 
to  use the  proceeds  from  this  offering  to  fund  the  continued  development  of Firdapse®,  to  fund  pre-
commercialization  activities  for  Firdapse®,  and  for  general  corporate  purposes.  As  a  result  of  this 
financing, we ended 2017 with approximately $84 million in cash and investments. We were also pleased 
to join the Russell 3000 index mid-way through last year, which enhances our visibility in the investment 
community.  

Catalyst Culture  
Lastly,  the  Catalyst  culture  extends  to  our  commitment  to  being  responsible  corporate  citizens.    We 
continue  to  provide  Firdapse®  to  patients  through  our  Expanded  Access  Program  (EAP),  which  allows 
patients suffering from LEMS, CMS or downbeat nystagmus to access amifampridine phosphate at no cost 
to the  patient.  This program continues  to grow  as  patients  await access  to  an FDA approved therapy. 
Additionally, to further support patients and healthcare providers, we have provided grants and donations 
to organizations supporting patients with rare diseases like Global Genes, the National Organization of 
Rare  Diseases  (NORD),  the  Myasthenia  Gravis  Foundation  of  America,  as  well  as  Medical  Students  in 
Action. 

I want to close by thanking all of our employees for their commitment to Catalyst’s purpose, strategic 
imperatives and culture, and by thanking all of the patients who participated in our clinical trials, their 
caregivers, and our clinical investigators. Thanks also to our Board of Directors for their confidence in our 
leadership team, and their hard work and continued stewardship on behalf of our stockholders. And on 
behalf of everyone at Catalyst and our Board, I thank you, our stockholders, for your continued support 
of the work that we do to improve the lives of patients suffering with rare neuromuscular diseases. 

Sincerely, 

Patrick J. McEnany 
Chairman and CEO 
April 13, 2018

2 

UNITED STATES  
SECURITIES AND EXCHANGE COMMISSION  
Washington, D.C. 20549  

FORM 10-K  

[Mark One]  

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

For the Fiscal Year Ended December 31, 2017  

OR  

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

Commission File No. 001-33057  

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

Delaware 
(State of jurisdiction of incorporation or organization) 

76-0837053 
(IRS Employer Identification No.) 

355 Alhambra Circle, Suite 1250 
Coral Gables, Florida 
(Address of principal executive offices) 

33134 
(Zip Code) 

Registrant’s telephone number, including area code: (305) 420-3200 

Securities Registered Pursuant to Section 12(b) of the Act.  

Common Stock, par  
value $0.001 per share 
(Title of each class) 

Nasdaq Capital Market 
(Name of exchange on which registered) 

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

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

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

  No  

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

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate web site, if any, 
every Interactive Data File required to be submitted and posted pursuant to rule 405 of Regulation S-T ((§232.405 of 
this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and 
post such files).    Yes 

  No 

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405 of this 
chapter) is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy 
or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-
K.   

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

Large accelerated filer  

Accelerated filer  

Non-accelerated filer  

(Do not check if a smaller reporting company)  Smaller reporting company  

Emerging Growth Company 

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

As of June 30, 2017, the last business day of the Registrant’s most recently completed second quarter, the aggregate 
market value of all voting, and non-voting common equity held by non-affiliates was $216,521,603. 

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

  No  

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable 
date: 102,556,164 shares of common stock, $0.001 par value per share, were outstanding as of March 9, 2018.  

Part III incorporates certain information by reference from the registrant’s definitive proxy statement for the 2017 
annual meeting of stockholders. The proxy statement with respect to the 2018 annual meeting of stockholders will be 
filed no later than 120 days after the close of the registrant’s fiscal year ended December 31, 2017. 

ii 

Table of Contents 

PART I............................................................................................................................................................................
Item 1.  Business……………………………………………………………………………………………………….. 
Item 1A.  Risk Factors…………………………………………………………………………………………………. 
Item 1B.  Unresolved Staff Comments………………………………………………………………………………....
Item 2.  Properties……………………………………………………………………………………………………… 
Item 3.  Legal Proceedings…………………………………………………………………………………………….. 
Item 4.  Mine Safety Disclosure………………………………………………………………………………………... 

PART II………………………………………………………………………………………………………………... 
Item 5.  Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 

Securities…………………………………………………………………………………………………........ 
Item 6.  Selected Financial Data……………………………………………………………………………………….. 
Item 7.  Management's Discussion and Analysis of Financial Condition and Results of Operations…………………. 
Item 7A.  Quantitative and Qualitative Disclosures about Market Risk………………………………………………. 
Item 8.  Financial Statements and Supplementary Data………………………………………………………………. 
Item 9.  Changes in and Disagreements with Accountants on Accounting and Financial Disclosure………………… 
Item 9A.  Controls and Procedures…………………………………………………………………………………….. 
Item 9B.  Other Information…………………………………………………………………………………………… 

PART III……………………………………………………………………………………………………………… 
Item 10.  Directors and Executive Officers of the Registrant…………………………………………………………. 
Item 11.  Executive Compensation……………………………………………………………………………………. 
Item 12.  Security Ownership of Certain Beneficial Owners and Management………………………………………. 
Item 13.  Certain Relationships and Related Transactions…………………………………………………………….. 
Item 14.  Principal Accounting Fees and Services…………………………………………………………………….. 

PART IV………………………………………………………………………………………………………………. 
Item 15.  Exhibits and Financial Statement Schedules………………………………………………………………… 
               Financial Statements…………………………………………………………………………………………. 

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F-1 

EXHIBITS FILED WITH FORM 10-K 

Ex. 21.1 Subsidiaries of the registrant 
Ex. 23.1 Consent of Independent Registered Public Accounting Firm 
EX 31.1 Section 302 Certification of CEO 
EX 31.2 Section 302 Certification of CFO 
EX 32.1 Section 906 Certification of CEO 
EX 32.2 Section 906 Certification of CFO 

iii 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
[This page intentionally left blank] 

iv 

PART I 

You are urged to read this Annual Report on Form 10-K (“Form 10-K”) in its entirety. This Form 10-K 
contains  forward-looking  statements  that  involve  risks  and  uncertainties.  Our  actual  results  may  differ 
significantly from the projected results discussed in these forward-looking statements. Factors that may 
cause  such  a  difference  include,  but  are  not  limited  to,  those  discussed  below  and  in  Item  1A,  “Risk 
Factors.”  

“We,” “our,” “ours,” “us,” “Catalyst,” or the “Company,” when used herein, refers to Catalyst 
Pharmaceuticals, Inc., a Delaware corporation. 

Forward-Looking Statements  

This Annual Report on Form 10-K contains "forward-looking statements", as that term is defined in the 
Private  Securities  Litigation  Reform  Act  of  1995. These include  statements regarding  our expectations, 
beliefs, plans or objectives for future operations and anticipated results of operations. For this purpose, any 
statements contained herein that are not statements of historical fact may be deemed to be forward-looking 
statements.  Without  limiting  the  foregoing,  "believes",  "anticipates",  "proposes",  "plans",  "expects", 
"intends", "may", and other similar expressions are intended to identify forward-looking statements. Such 
statements involve known and unknown risks, uncertainties and other factors that may cause our actual 
results, performance or other achievements to be materially different from any future results, performances 
or achievements expressed or implied by such forward-looking statements. Factors that might cause such 
differences include, but are not limited to, those discussed in the section entitled “Item 1A – Risk Factors” 
and those discussed in the section entitled “Item 7 – Management’s Discussion and Analysis of Financial 
Condition and Results of Operations – Caution Concerning Forward-Looking Statements.”  

The successful development and commercialization of our current drug candidates is highly uncertain. We 
cannot reasonably estimate or know the nature, timing, or estimated expenses of the efforts necessary to 
complete the development of, or the period in which material net cash inflows are expected to commence 
due  to  the  numerous  risks  and  uncertainties  associated  with  developing  such  products,  including  the 
uncertainty of: 

•

•

•

•

•

our estimates regarding anticipated capital requirements and our need for additional funding; 

the risk that another pharmaceutical company (Jacobus Pharmaceuticals) will receive an approval 
for  its  formulation  of  3,4-diaminopyridine  (3,4-DAP)  for  the  treatment  of  Lambert-Eaton 
Myasthenic  Syndrome  (LEMS),  Congenital  Myasthenic  Syndromes  (CMS),  or  any  other 
indication, before we do; 

whether the clinical studies or trials that are required to be completed before the U.S. Food and 
Drug Administration (FDA) will accept an NDA submission for Firdapse® for the treatment of 
either LEMS or CMS will be acceptable to the FDA; 

what additional supporting information, including any additional clinical studies or trials, will be 
required before the FDA will accept our New Drug Application (NDA) submission for Firdapse® 
for the treatment of either LEMS or CMS (or any other condition or disease);  

whether any NDA that we may submit for Firdapse® will be accepted for filing by the FDA, and 
if accepted, whether it will be granted a priority review; 

1 

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

whether,  even  if  the  FDA  accepts  an  NDA  submission  for  Firdapse®,  such  product  will  be 
determined to be safe and effective and approved for commercialization for any of the submitted 
indications; 

whether the receipt of breakthrough therapy designation for Firdapse® for LEMS will result in 
an expedited review of Firdapse® by the FDA or affect the likelihood that the product will be 
found to be safe and effective; 

whether, assuming Firdapse® is approved for commercialization, we will be able to develop or 
contract with a sales and marketing organization that can successfully market Firdapse® while 
maintaining full compliance with applicable federal and state laws, rules and regulations; 

whether any future trial that we undertake evaluating Firdapse® for the treatment of anti-MuSK 
antibody positive Myasthenia Gravis (MuSK-MG) or Spinal Muscular Atrophy (SMA) Type 3 
will be successful and whether we can obtain the funding required to conduct such trials; 

whether as part of the FDA review of any NDA that we may submit for filing for Firdapse®, the 
tradename  Firdapse®,  which  is  the  tradename  used  for  the  same  product  in  Europe,  will  be 
approved for use for the product in the United States; 

whether CPP-115 will be determined to be safe for humans; 

whether CPP-115 will be determined to be effective for the treatment of infantile spasms; 

whether any bioequivalence study of our version of vigabatrin (CPP-109) compared to Sabril®
that we submit as part of an Abbreviated New Drug Application (ANDA) for this product will be 
acceptable to the FDA; 

whether any ANDA that we submit for a generic version of Sabril® will be accepted by the FDA 
for review and approved (and the timing of any such approval); 

the scope, rate of progress and expense of our clinical trials and studies, pre-clinical studies, proof-
of-concept studies, and our other drug development activities; 

our ability to complete our trials and studies on a timely basis and within the budgets we establish 
for such trials and studies and whether our trials and studies will be successful; 

the ability of our third-party suppliers and contract manufacturers to maintain compliance with 
current Good Manufacturing Practices (cGMP); 

whether our estimates of the size of the market for our drug candidates will turn out to be accurate; 

the  pricing  of  our  products  that  we  may  be  able  to  achieve  if  we  are  granted  the  ability  to 
commercialize our drug candidates; and 

changes  in  the  healthcare  industry  occasioned  by  any  future  repeal  and  replacement  of  the 
Affordable Care Act, in laws relating to the pricing of drug products, or in the healthcare industry 
generally.   

2 

Our current plans and objectives are based on assumptions relating to the development of our current drug 
candidates. Although we believe that our assumptions are reasonable, any of our assumptions could prove 
inaccurate. In light of the significant uncertainties inherent in the forward-looking statements we have made 
herein, which reflect our views only as of the date of this report, you should not place undue reliance upon 
such statements. We undertake no obligation to update or revise publicly any forward-looking statements, 
whether as a result of new information, future events or otherwise. Our current plans and objectives are 
based on assumptions relating to the development of our current drug candidates. Although we believe that 
our  assumptions  are  reasonable,  any  of  our  assumptions  could  prove  inaccurate.  The  significant 
uncertainties inherent in the forward-looking statements we have made herein, which reflect our views only 
as of the date of this report, suggest that you should not place undue reliance upon such statements. We 
undertake no obligation to update or revise publicly any forward-looking statements, whether as a result of 
new information, future events or otherwise. 

Item 1. Business  

Overview 

We are a biopharmaceutical company focused on developing and commercializing innovative therapies for 
people with rare, debilitating, chronic neuromuscular and neurological diseases. We currently have three 
drug candidates in development. 

Firdapse® 

In October 2012, we licensed the North American rights to Firdapse®, a proprietary form of amifampridine 
phosphate,  or  chemically  known  as 3,4-diaminopyridine phosphate,  from  BioMarin  Pharmaceutical  Inc. 
(BioMarin). In August 2013, we were granted “breakthrough therapy designation” by the U.S. Food and 
Drug Administration (FDA) for Firdapse® for the treatment of patients with Lambert-Eaton Myasthenic 
Syndrome, or LEMS, a rare and sometimes fatal autoimmune disease characterized by muscle weakness. 
Further,  the  FDA  has  previously  granted  Orphan  Drug  Designation  for  Firdapse® for  the  treatment  of 
patients with LEMS, Congenital Myasthenic Syndromes, or CMS, and Myasthenia Gravis (MG). 

The chemical entity, amifampridine (3,4-diaminopyridine, or 3,4-DAP), has never been approved by the 
FDA  for  any  indication.  Because  amifampridine  phosphate (Firdapse®)  has  been  granted three  separate 
Orphan Drug designations for the treatment of LEMS, CMS and MG by the FDA, the product is also eligible 
to receive  seven  years  of marketing  exclusivity  upon  approval  of amifampridine  for any  or  all  of  these 
indications.  Further,  if  we  are  the  first  pharmaceutical  company  to  obtain  approval  for  marketing  an 
amifampridine product, of which there can be no assurance, we will be eligible to receive five years of 
marketing exclusivity with respect to the use of this product for any indication, running concurrently with 
the seven years of orphan marketing exclusivity described above (if both exclusivities are granted). 

We  previously  sponsored  a  multi-center,  randomized,  placebo-controlled  Phase  3  trial  evaluating 
Firdapse® for the treatment of LEMS. This Phase 3 trial, which involved 38 subjects, was designed as a 
randomized “withdrawal” trial in which all patients were treated with Firdapse® during a 7 to 91-day run-
in-period followed by treatment with either Firdapse® or placebo over a two-week randomization period. 
The co-primary endpoints for this Phase 3 trial were the comparison of changes in patients randomized to 
continue  Firdapse® versus  those  who  transitioned  to  placebo  that  occurred  in  both  the  Quantitative 
Myasthenia Gravis Score (QMG), which measures muscle strength, and subject global impression score 
(SGI), on which the subjects rate their global impression of the effects of a study treatment during the two-
week randomization period. In September 2014, we reported positive top-line results from this Phase 3 trial, 
and the successful results of this study were published in 2016 in Muscle & Nerve (Muscle Nerve, 2016, 
53(5):717-725). 

3 

During  2014,  we  established  an  expanded  access  program  (EAP)  to  make  Firdapse® available  to  any 
patients diagnosed with LEMS, CMS, or Downbeat Nystagmus in the United States, who meet the inclusion 
and exclusion criteria, with Firdapse® being provided to patients for free until sometime after new drug 
application (NDA) approval, should we receive such approval (of which there can be no assurance). We 
continue to inform neuromuscular physicians on the availability of the Firdapse® EAP and also to work 
with various rare disease advocacy organizations to inform patients and other physicians about the program. 

On  December 17,  2015,  we  announced  completion  of  the  submission  of  an  NDA  for  Firdapse® for  the 
treatment  of  LEMS  and  CMS.  However,  on  February 17,  2016,  we  announced  that  we  had  received  a 
“refusal-to-file” (RTF) letter from the FDA regarding our NDA submission. In early April 2016, we met 
with  the  FDA  to  obtain  greater  clarity  regarding  what  would  be  required  by  the  FDA  to  accept  the 
Firdapse® NDA for filing. Following the receipt of the formal minutes of that meeting, on April 26, 2016, 
we  issued  a  press  release  reporting  that  the  FDA  had  advised  us  that  in  addition  to  the  results  of  our 
previously submitted multi-center, randomized, placebo-controlled Phase 3 trial, we would need to submit 
positive results from a second adequate and well-controlled study in patients with LEMS. Additionally, 
there was a requirement for us to perform three abuse liability studies for Firdapse®. 

In October 2016, we announced that we had reached an agreement with the FDA under a Special Protocol 
Assessment (SPA) for the protocol design, clinical endpoints, and statistical analysis approach to be taken 
in our second Phase 3 study evaluating Firdapse® for the symptomatic treatment of LEMS. A SPA is a 
process by which sponsors ask the FDA to evaluate the protocol of a proposed clinical trial to determine 
whether it adequately addresses scientific and regulatory requirements for the purpose identified by the 
sponsor.  A  SPA  agreement  indicates  FDA  concurrence  with  the  adequacy  and  acceptability  of  specific 
critical elements of protocol design, endpoints and analysis. Additionally, it provides a binding agreement 
with FDA’s review division that critical design elements of a pivotal trial adequately address the scientific 
and  regulatory  objectives  in  support  of  a  regulatory  submission  for  drug  approval.  However,  even  if  a 
clinical trial is conducted pursuant to a SPA, it does not mean that the NDA will meet the standard for 
approval.  Moreover, the FDA may rescind a SPA agreement when the division director determines that a 
substantial scientific issue essential to determining the safety or efficacy of the product has been identified 
after the trial has begun. 

Our second Phase 3 trial evaluating Firdapse® for the treatment of LEMS (designated as LMS-003) was 
conducted at sites in Miami, Florida and Los Angeles, California. This double-blind, placebo-controlled 
withdrawal trial had the same co-primary endpoints as our first Phase 3 trial evaluating Firdapse® for the 
treatment of LEMS. Further, the FDA allowed us to enroll patients from our expanded access program as 
study subjects in this second trial. Enrollment in this trial, which included 26 subjects, was completed in 
October 2017. Details of the Phase 3 clinical trial are available on www.clinicaltrials.gov (NCT02970162).  

On November 27, 2017, we reported positive top-line results from the LMS-003 trial. This trial had two 
prospectively  defined  co-primary  endpoints.  The  first  of  these,  quantitative  myasthenia  gravis  score 
(QMG), achieved a statistically significant p-value of 0.0004, and the second, subject global impression 
(SGI),  achieved  a  statistically  significant  p-value  of  0.0003.  More  importantly,  a  clinically  significant 
difference of 6.4 points was observed between the Firdapse® and placebo groups for the QMG endpoint. 
Firdapse® was well tolerated and showed a similar safety profile to that seen in earlier studies. All p-values 
reported are based on the entire intent to treat (ITT) population of patients that enrolled in this trial.  

The prospectively defined secondary endpoint for the physician's clinical global impression of improvement 
(CGI-I) achieved statistical significance (p-value 0.0020).  Further, the exploratory endpoints of triple timed 
up and go (3TUG, p-value 0.0112) and the evaluation of the QMG-Limb domains endpoint (p-value 0.0010) 
were also statistically significant.  The exploratory endpoint of most bothersome symptom (MBS) (p-value 
0.0572) was not significant, but showed a trend. 

4 

We  were  also  required  to  conduct  three pre-clinical abuse  liability  studies  under  the  FDA  guidance  for 
“Assessment  of  Abuse  Potential  of  Drugs”  that  was  finalized  in  January  2017  (Self-Administration, 
Physical Dependence and Drug Discrimination). All three studies have now been completed, and results 
indicate that amifampridine phosphate does not exhibit abuse potential in these assessment models. 

On February 12, 2018, after receipt of the minutes of our recently held Type C meeting with the FDA, we 
issued a press release reporting on the results of the meeting. Prior to the meeting, we had provided the 
FDA with our preliminary data package for our proposed NDA resubmission, including the positive top-
line results from our LMS-003 trial, as well as the FDA-required abuse liability studies that we recently 
completed demonstrating that Firdapse® does not have abuse liability potential. The minutes of the meeting 
reflect the FDA's advice to us that our proposed filing package will be sufficient for resubmission of an 
NDA for Firdapse®, and we currently anticipate resubmitting our NDA for Firdapse® for LEMS to the FDA 
by the end of the first quarter of 2018. Notwithstanding, there can be no assurance that any NDA that we 
submit for Firdapse® for LEMS will be accepted for filing or approved. 

Our original NDA submission for Firdapse® included data and information (including data from a currently 
ongoing investigator treatment IND) providing evidence supporting the benefits of Firdapse® for treating 
certain types of CMS, and requested that CMS be included in our initial label for Firdapse®. To provide 
additional support for our submission of an NDA for Firdapse® for the treatment of CMS, in October 2015 
we initiated a small blinded clinical trial at four academic centers of up to 10 subjects in the pediatric CMS 
population,  ages  2  to  17.  However,  after  considering  comments  from  the  FDA  about  this  study,  we 
determined to enroll both adult and pediatric subjects with CMS in this trial and to expand the number of 
subjects  to  be  evaluated  in  the  trial  to  an  aggregate  of  approximately  20  subjects.  We  are  currently 
conducting this study at five sites around the United States, and we are currently working on adding several 
available  on 
sites  outside 
additional 
www.clinicaltrials.gov (NCT02562066). 

the  United  States.  Details  of 

trial 

this 

are 

Based on currently available information, we expect to complete enrollment in this trial before the end of 
2018 and to report top-line results from this trial in the first quarter of 2019. If the results of the trial are 
successful, we hope to add the CMS indication to our labeling for Firdapse®. There can be no assurance 
that any trial we perform for Firdapse® for the treatment of CMS will be successful or whether any NDA 
or NDA supplement that we may submit for Firdapse® for the treatment of CMS in the future will be filed 
by the FDA for review and approved. 

In  February  2016,  we  announced  the  initiation  of  an  investigator-sponsored,  randomized,  double-blind, 
placebo-controlled,  crossover  Phase  2/3  clinical  trial  evaluating  the  safety,  tolerability  and  potential 
efficacy  of  Firdapse® as  a  symptomatic  treatment  for  patients  with  anti-MuSK  antibody  positive 
Myasthenia Gravis (MuSK-MG). MuSK-MG is a particularly severe form of myasthenia gravis that affects 
about 3,000 to 4,800 patients in the U.S., for which there are no approved effective therapies (and therefore 
it is an unmet medical need). Seven patients participated in this proof-of-concept trial. We provided study 
drug, placebo, and financial support for this study. 

On March 15, 2017, we reported top-line results from this trial. Both of the co-primary efficacy endpoints 
of change from baseline (CFB) in total Quantitative Myasthenia Gravis (QMG) score (p=0.0003) and CFB 
in total Myasthenia Gravis Activities of Daily Living (MG-ADL) score (p=0.0006) were statistically and 
clinically significant in this trial. Several secondary efficacy measures also achieved statistical significance. 
Amifampridine phosphate was well tolerated in this population of patients. 

5 

On August 30, 2017, we announced that we had reached an agreement with the FDA on a SPA for the 
protocol design, clinical endpoints, and statistical analysis approach to be taken in our proposed Phase 3 
registration trial evaluating the safety and efficacy of amifampridine phosphate treatment in patients with 
MuSK-MG. The  protocol  that  the  FDA  has  reviewed  is  for  a  multi-site,  international  (U.S.  and  Italy), 
double-blind, placebo-controlled, clinical trial that is targeted to enroll approximately 60 subjects diagnosed 
with MuSK-MG. The trial  will  employ  a  primary  endpoint  of  Myasthenia  Gravis  Activities  of  Daily 
Living (MG-ADL) and  a  secondary  endpoint  of  Quantitative  Myasthenia  Gravis  Score  (QMG). At  the 
FDA’s request, the trial will also enroll up to 10 generalized myasthenia gravis patients who will be assessed 
with the same clinical endpoints, but achieving statistical significance in this subgroup of patients is not 
required and only summary statistics will be provided.  

We initiated this trial in January 2018 and expect to begin enrolling subjects in this trial during the first half 
of 2018. We anticipate that it will take about 12 months to complete the enrollment for the trial and we 
expect to report top-line results from the trial in the first half of 2019. Details of this trial are available 
on www.clinicaltrials.gov (NCT03304054). 

On November 21, 2017, we announced the initiation of a company-sponsored, proof-of-concept clinical 
trial evaluating safety, tolerability and efficacy of Firdapse® as a symptomatic treatment for patients with 
Spinal Muscular Atrophy (SMA) Type 3. The study is being conducted by a team of researchers led by 
Lorenzo Maggi, MD, and Giovanni Baranello, MD, of the Fondazione Istituto Neurologico Carlo Besta in 
Milan, Italy, a major referral center for SMA patients. The study is designed as a randomized (1:1), double-
blind, 2-period, 2-treatment, crossover, outpatient proof-of-concept study to evaluate the safety, tolerability 
and potential efficacy of amifampridine in ambulatory patients diagnosed with SMA Type 3. The study is 
planned to include approximately 12 patients, and we anticipate reporting top-line results from the study in 
the second half of 2019. 

There can be no assurance that any trial that we initiate to evaluate Firdapse® for MuSK-MG or SMA Type 
3 will be successful. Further, there can also be no assurance that the FDA will ever approve Firdapse® for 
these indications. 

Finally, we may seek to evaluate Firdapse® for the treatment of other treatment-refractory types of MG or 
other rare, similar neuromuscular diseases, although we have not yet begun to develop clinical programs 
for these other indications, and all such programs are subject to the availability of funding. There can be no 
assurance that Firdapse® will be an effective treatment for other treatment-refractory types of MG or for 
any other rare, similar neuromuscular diseases. 

Prior to the receipt of the RTF letter, we had actively been taking steps to prepare for the commercialization 
of Firdapse® in the United States. However, in light of the receipt of the RTF letter, in the first quarter of 
2016 we put most of our commercialization activities on hold in order to conserve cash. During the fourth 
quarter of 2017, we restarted the development of our commercialization plans for Firdapse®. We are also 
continuing to work with several rare disease advocacy organizations to help increase awareness of LEMS, 
CMS and MuSK-MG, and to provide awareness and outreach support for the physicians who treat these 
rare diseases and the patients they treat. 

CPP-115 

We are developing CPP-115, a GABA aminotransferase inhibitor that, based on our preclinical studies to 
date, we believe is a more potent form of vigabatrin, and may have fewer side effects (e.g., visual field 
defects)  than  those  associated  with  vigabatrin.  We  are  hoping  to  develop CPP-115 for  the  treatment  of 
refractory  infantile  spasms. CPP-115 has  been  granted  Orphan  Drug  Designation  by  the  FDA  for  the 
treatment of infantile spasms and Orphan Medicinal Product Designation in the European Union, or EU, 
for West syndrome (a form of infantile spasms). 

6 

We are currently refining our development plans for this product. We are also working with one or more 
potential investigators who have expressed an interest in evaluating our product for particular indications 
(particularly infantile spasms). 

Finally,  we  are  continuing  our  efforts  to  seek  a  partner  to  work  with  us  in  furthering  the  development 
of CPP-115. However, no agreements have been entered into to date. 

There can be no assurance that we will ever successfully commercialize CPP-115. 

Generic Sabril® 

In  September  2015,  we  announced  the  initiation  of  a  project  to  develop  generic  versions  of 
Sabril® (vigabatrin) in two dosage forms: tablets and powder sachets. Sabril® is marketed by Lundbeck Inc. 
in  the  United  States in  both  dosage  forms  for  the  treatment  of  infantile spasms  and refractory  complex 
partial seizures. There can be no assurance that we will be successful in these efforts or that any abbreviated 
new drug applications (ANDAs) that we submit for vigabatrin will be accepted for review or approved. 

We are also continuing our efforts to seek a partner to work with us in furthering the development of 
generic Sabril®. However, no agreements have been entered into to date. 

There can be no assurance that we will ever successfully commercialize a generic version of Sabril®. 

Capital Resources 

At December 31, 2017, we had cash and investments of approximately $84.0 million. Based on our current 
financial condition and forecasts of available cash, we believe that we have sufficient funds to support our 
operations through 2019 (without considering revenues and cash receipts that may be received in 2019 if 
we are successful in obtaining an approval of Firdapse® and launching the product in 2019, of which there 
can be no assurance). There can be no assurance that we will ever be in a position to commercialize any of 
our drug candidates or that we will obtain any additional funding that we require in the future. See Item 7. 
"Management's Discussion and Analysis of Financial Condition and Results of Operations -- Liquidity and 
Capital Resources" below for further information on our liquidity and cash flow. 

Our Strategy  

Our goal is to develop and commercialize novel prescription drugs targeting rare (orphan) diseases with an 
initial focus on neuromuscular and neurological diseases and disorders.  Specifically, we intend to: 

•

•

•

•

Pursue approval of Firdapse® for LEMS, CMS and MuSK-MG. We are continuing our efforts to 
seek approval to commercialize Firdapse® for LEMS. We are also taking steps that we hope will 
allow us to include CMS and MuSK-MG in the labeling of Firdapse®. 

Seek  additional  orphan  drug  indications  for  Firdapse®.  We  intend  to  take  steps  to  evaluate 
Firdapse® as a treatment for additional neuromuscular indications, including SMA Type 3. 

Seek a partner for CPP-115 and generic Sabril®. We are seeking partners to work with us in furthering 
the development of CPP-115 and generic Sabril®. However, no agreements have been entered into to 
date. 

Seek to acquire additional products.  We continue to seek to acquire additional relatively late stage 
orphan  drug  opportunities  to  add  to  our  product  portfolio.  However,  no  agreements  have  been 
entered  into  to  date  to  acquire  additional  products  and  any  such  product  acquisitions  would  be 
subject to the availability of funding. 

7 

Firdapse®

Product overview 

Firdapse®  is  Catalyst's  and  BioMarin's  (depending  on  market  region)  registered  trade  name  for 
amifampridine phosphate tablets. Amifampridine is the WHO (World Health Organization) registered INN 
(International Nonproprietary Name) and United States Adopted Name (USAN) for the chemical entity, 
3,4-diaminopyridine,  often  abbreviated  as  3,4-DAP  or  DAP.  Firdapse®  contains  the  phosphate  salt  of 
amifampridine, hence the name "amifampridine phosphate."  We will refer to our drug by its proposed trade 
name in the United States (Firdapse®), by the INN/USAN (amifampridine), or by the specific salt in our 
product (amifampridine phosphate), throughout this Form 10-K. 

In addition to the positive results we reported from our Phase 3 trials of amifampridine phosphate described 
below, clinical efficacy information for the symptomatic treatment of LEMS patients with amifampridine 
have been derived from several published randomized, double-blind, placebo-controlled studies and one 
published  randomized,  double-blind,  active-control  study  in  patients  with  LEMS.  The  data  from  the 
randomized controlled studies generally show statistically significant improvements across a number of 
measures of neurological function, including Quantitative Myasthenia Gravis (QMG) score and compound 
muscle action potential (CMAP), which have been demonstrated to be clinically relevant in patients with 
LEMS. Results of these studies suggest that amifampridine is more effective for the symptomatic treatment 
of LEMS compared with placebo or active investigational comparator (pyridostigmine). Additionally, data 
from  multiple  published  uncontrolled  investigations  and  case  reports  support  the  long-term  benefits  of 
treatment with amifampridine in patients with LEMS. In some cases, removal of patients from drug can 
lead to a recurrence of underlying symptoms, but with reintroduction of amifampridine improvement of 
muscle function is regained. Amifampridine has been recommended as the first-line symptomatic treatment 
for LEMS by the European Federation of Neurological Societies (now known as the European Academy of 
Neurology). In December 2009, amifampridine phosphate received marketing approval from the European 
Commission (with the trade name Firdapse®) for the symptomatic treatment of patients with LEMS.  

Safety data from clinical data published over the last 30 years in patients with LEMS or other neurological 
disorders treated with amifampridine show that amifampridine is well tolerated at doses ≤80 mg per day. 
Among the 1,279 patients or healthy subjects assessed in the literature, the most frequently reported adverse 
events  (AEs)  were  perioral  and  peripheral  paresthesias  (unusual  sensations  like  pins  and  needles),  and 
gastrointestinal disorders (abdominal pain, nausea, diarrhea, and epigastralgia (pain around the upper part 
of the stomach)). These events were typically mild or moderate in severity, and transient, seldom requiring 
dose reduction or withdrawal from treatment.  

Lambert-Eaton Myasthenic Syndrome

Lambert-Eaton  Myasthenic  Syndrome,  or  LEMS,  is  a  rare  autoimmune  neuromuscular  disorder 
characterized primarily by muscle weakness of the limbs. The disease is caused by an autoimmune reaction 
where antibodies are formed against voltage-gated calcium channels on nerve endings, which damages the 
channels.  These calcium channels are responsible for the transport of charged calcium atoms that activate 
the biochemical machinery responsible for releasing acetylcholine.  Acetylcholine is the neurotransmitter 
responsible for causing muscles to contract and the failure to release enough of this neurotransmitter results 
in  muscle  weakness  in  LEMS  patients.    Additionally,  LEMS  is  often  associated  with  an  underlying 
malignancy, most commonly small-cell lung cancer (SCLC), and in some individuals, LEMS is the first 
symptom of such malignancy.  

8 

LEMS generally affects the extremities, especially the legs. As LEMS most affects the parts of limbs closest 
to  the  trunk,  difficulties  with  climbing  stairs  or  rising  from  a  sitting  position  are  commonly  reported. 
Physical exercise and high temperatures tend to worsen the symptoms. Other symptoms often seen include 
weakness of the muscles of the mouth, throat, and eyes.  Individuals affected with LEMS also may have a 
disruption of the autonomic nervous system, including dry mouth, constipation, blurred vision, impaired 
sweating, and/or hypotension.  

LEMS is managed by treating the symptoms or treating the underlying autoimmune attack on voltage gated 
calcium channels. Unapproved treatments include steroids, azathioprine and intravenous immunoglobulin, 
which work by suppressing the immune system; and pyridostigmine and amifampridine, which enhance 
neuromuscular transmission. Plasma exchange has also been used to attempt to remove antibodies from the 
body. Firdapse® is a symptomatic treatment and does not alter the underlying autoimmune condition.  As a 
voltage gated potassium blocker, Firdapse® prevents charged potassium atoms from leaving the nerve cells, 
which prolongs the period of depolarization. This allows more charged calcium atoms to enter the nerves, 
which enables the nerves to release acetylcholine and causes muscles to contract and to restore lost muscle 
strength in LEMS patients. 

Based on currently available information, we estimate that there are approximately 3,000 LEMS patients 
in  the  United  States.    However,  until  an  amifampridine  product  is  finally  approved  by  the  FDA  and 
awareness of the disease is increased, it is unlikely that the total number of LEMS patients in the United 
States can  be  determined with better certainty (as  is typical  of rare  diseases),  and  the  actual  number  of 
patients in the United States with LEMS may be higher or lower than our estimate. Some of the factors that 
affect the size of the population with a rare disease such as LEMS include, without limitation, the number 
of patients actually diagnosed with the disease, the number of patients who were misdiagnosed with other 
diseases (such as MG) before it is determined that they have the disease, and the number of patients who 
have the disease whose doctors do not become aware of the availability of a treatment for the disease until 
after a product is approved or, even if they are aware of the product, are unwilling or unable to prescribe 
the product until it is approved and generally available in the commercial marketplace. Additionally, while 
there  is  an  antibody  test  that  positively  identifies  patients  with  LEMS,  we  believe  that  the  test  is  not 
particularly well known or utilized at this time by many neurologists. Further, we believe that many patients 
with small cell lung cancer, or SCLC, some of whom also have LEMS, are not being treated for LEMS 
because many of the oncology medical professionals who treat SCLC patients are generally not familiar 
with  how  to  diagnose  and  treat  LEMS.  All  of  these  factors  are  likely  to  affect  the  ultimate  number  of 
patients, either up or down, who are indicated and in need of treatment with an amifampridine product. 

Congenital Myasthenic Syndromes

Congenital  Myasthenic  Syndromes  are  rare  neuromuscular  disorders  comprising  a  spectrum  of  genetic 
defects and are characterized by fatigable weakness of skeletal muscles with onset at or shortly after birth 
or early childhood; in rare cases symptoms may not manifest themselves until later in childhood. Certain 
types of CMS are thought to be hereditary (autosomal recessive), while others have no known cause. The 
severity and course of the genetic disease types are variable, ranging from minor symptoms to progressive 
disabling weakness; symptoms may be mild, but sudden severe exacerbations of weakness or even sudden 
episodes of respiratory insufficiency also occur. 

Many patients with CMS may respond to unapproved pharmacologic intervention, including cholinesterase 
inhibitors,  amifampridine  (i.e.  3,4-DAP),  ephedrine,  fluoxetine  or  quinidine,  and  albuterol,  alone  or  in 
combinations.  The particular therapy is dictated by the diagnosed CMS type, as drugs beneficial in treating 
one type of CMS can be detrimental in patients with another type of CMS. 

9 

Congenital myasthenic syndrome(s) is rare, estimated at around one-tenth that of MG, which in itself is 
rare.  Based on currently available information, we estimate that there are between 1,000 and 1,500 CMS 
patients in the United States. 

Myasthenia Gravis

Myasthenia Gravis is a chronic autoimmune neuromuscular disorder that is characterized by fluctuating 
weakness of the voluntary muscle groups. The prevalence of MG in the United States is estimated to be 
about  20/100,000  population  (equating  to  an  estimate  of  approximately  64,000  patients  in  the  United 
States).  However,  according  to  the  Myasthenia  Gravis  Foundation  of  America,  MG  is  probably  under 
diagnosed and the prevalence may be higher. For example, patients with MuSK-MG may have focal or 
regional  weakness  and  muscle  atrophy  that  are  more  suggestive  of  motor  neuron  or  muscle  membrane 
(myopathy) disease. MG occurs in all races, both genders, and at any age. MG is not thought to be directly 
inherited (although it occasionally occurs in more than one member of the same family), nor is it contagious.  

The voluntary muscles of the entire body are controlled by nerve impulses that arise in the brain. These 
nerve impulses travel down the nerves to the place where the nerves meet the muscle fibers. Nerve fibers 
do not actually connect with muscle fibers. There is a space between the nerve ending and muscle fiber; 
this space is called the neuromuscular junction. When the nerve impulse originating in the brain arrives at 
the nerve ending, it releases a chemical called acetylcholine. Acetylcholine travels across the space to the 
muscle  fiber  side  of  the  neuromuscular  junction  where  it  attaches  to  many  receptor  sites.  The  muscle 
contracts when enough of the receptor sites have been activated by the acetylcholine. In MG, there can be 
as much as an 80% reduction in the number of these receptor sites. The reduction in the number of receptor 
sites is caused by an antibody that destroys or blocks the receptor site. Antibodies are proteins that play an 
important role in the immune system. They are normally directed at foreign proteins called antigens that 
attack the body. Such foreign proteins include bacteria and viruses. Antibodies help the body to protect 
itself from these foreign proteins. For reasons not well understood, the immune system of the person with 
MG makes antibodies against the receptor sites of the neuromuscular junction. Abnormal antibodies can be 
measured in the blood of many people with MG. The antibodies destroy the receptor sites more rapidly than 
the body can replace them. Muscle weakness occurs when acetylcholine cannot activate enough receptor 
sites at the neuromuscular junction. 

Anti-MuSK antibody positive MG 

About  15%  of  MG  patients  test  negative  for  the  acetylcholine  receptor  antibody.  These  patients  have 
seronegative (SN) MG. Approximately 40-50% of these patients with SNMG (equating to an estimate of 
approximately  4,500  patients  in  the  United  States)  test  positive  for  antibodies  against  muscle-specific 
receptor  tyrosine  kinase  (MuSK),  a  surface  membrane  component  essential  in  the  development  of  the 
neuromuscular junction. These patients are identified as having MuSK-MG. Anti-MuSK antibodies identify 
a clinically distinguishable, more severe form of MG. The disease is characterized by a prominent weakness 
of the neck, oro-bulbar and sometimes respiratory musculature. Although many patients with MuSK-MG 
are  presently 
inhibitors  or 
immunosuppressants, such patients do not generally respond adequately to these treatments.  

treatments  such  as  anticholinesterase 

treated  with  standard  MG 

Spinal Muscular Atrophy 

Spinal Muscular Atrophy is a spectrum of genetic disorders of the Survival Motor Neuron (SMN) protein 
that affects the function of the neuromuscular junction.  The pathogenesis may, in part, progress due to the 
lack  of  retrograde  signaling  from  dysfunctional  neuromuscular  junctions  leading  to  nerve  damage  and 
ultimately nerve cell death.  As a spectrum of genetic disorders of the SMN protein, the condition varies in 
severity and the disease has been classified into Types (SMA Types 1 through 4), based primarily on clinical 

10 

symptoms of the disease.  The overall incidence of SMA is believed to be 1 in 6,000 to 10,000 live births, 
with over half of the cases diagnosed as SMA Type 1.  Due to the poor prognosis of SMA Type 1 patients, 
the actual prevalence is lower, since well over half of the SMA patients are Type 1 and have a very short 
life  span.   Due  to  the  heterogeneity  of  the  disease  and  the  variations  in  life  expectancy,  prevalence  is 
difficult to determine and not well defined for the different types of SMA.  Current estimates place  the 
prevalence of SMA Types 2 and 3 at about 1.5 per 100,000 people, with the majority of these being SMA 
Type 3 due to the longer life span of SMA Type 3 patients.  Based on currently available data, Catalyst 
estimates the prevalence of SMA Type 3 in the United States to be between 2,500 and 3,500 patients. 

SMA  Type  3  (sometimes  called  Kugelberg-Welander  disease)  includes  clinically  heterogeneous 
patients.   They  typically  reach  all  major  motor  milestones  in  childhood  and  independent  walking  by 
adulthood.  However, during infancy they typically have proximal muscular weakness.  Some might need 
wheelchair assistance in childhood, whereas others might continue to walk and live productive adult lives 
with minor muscular weakness.  Patients who lose ambulation often develop scoliosis and other medical 
problems related to poor mobility and muscle tone, such as obesity and osteoporosis.  Two subgroups of 
severity have been suggested based on the probability of being able to walk by age 10 and on the subsequent 
probability of losing the ability to walk by age 40.  Significant differences in losing the ability to walk have 
been observed in relation to those with an onset of weakness before (SMA 3a) and after (SMA 3b) age 3. 

License Agreement with BioMarin for Firdapse®

On October 26, 2012, we licensed the exclusive North American rights to Firdapse® pursuant to a License 
Agreement between us and BioMarin (the BioMarin License Agreement). BioMarin holds the worldwide 
rights  to  Firdapse® and  sells the  product in  the  EU. We  believe that  we  remain  in  compliance  with the 
BioMarin License Agreement. 

Under the BioMarin License Agreement, we have agreed to make certain payments:  

• Royalties: We  have  agreed  to  pay  (i) royalties  to  BioMarin  for  seven  years  from  the  first 
commercial  sale  of  Firdapse® equal to 7% of  net sales  (as  defined in the  BioMarin  License 
Agreement) in North America for any calendar year for sales up to $100 million, and 10% of 
net sales in North America in any calendar year in excess of $100 million; and (ii) royalties to 
the third-party licensor of the rights sublicensed to us for seven years from the first commercial 
sale  of  Firdapse ® equal  to  7%  of  net  sales  (as  defined  in  the  license  agreement  between 
BioMarin and the third-party licensor) in any calendar year. 

• Milestone  Payments. Under  our  license  agreement  with  BioMarin,  we  have  agreed  to  pay 
certain milestone payments that BioMarin is obligated to pay to both a third-party licensor of 
the  rights  that  have  been  sublicensed  to  us  and  to  the  former  stockholders  of  Huxley 
Pharmaceuticals (“Huxley”) under an earlier stock purchase agreement between BioMarin and 
the former Huxley stockholders. These milestones aggregate (i) approximately $2.6 million 
due upon acceptance by the FDA of a filing of an NDA for Firdapse® for the treatment of 
LEMS or CMS (approximately $150,000 of which will be due to the third party licensor and 
approximately $2,425,000 of which will be due to the former Huxley stockholders), and (ii) 
approximately $7.2 million due upon the unconditional approval by the FDA of an NDA for 
Firdapse® for the treatment of LEMS (approximately $3.0 million of which will be due to the 
third party licensor and approximately $4.2 million of which will be due to the former Huxley 
stockholders).  However,  under  BioMarin’s  agreement  with  the  former  Huxley  stockholders 
(and under our license agreement with BioMarin), BioMarin’s obligation to pay the milestone 
payments due to the former Huxley stockholders (and our corresponding obligation to pay such 

11 

milestone payments) expressly expires if these milestones have not been not satisfied by April 
20, 2018.  

BioMarin has recently advised us that the former Huxley stockholders may take legal action 
seeking payment of the milestone payments due to them from BioMarin if these milestones are 
achieved after April 20, 2018, notwithstanding the express termination date in the agreements. 
BioMarin has also advised us that we could become involved in any such legal action. While 
it  is  too  early  to  determine  how  this  matter  will  affect  us,  based  on  currently  available 
information  we  do  not  believe  that  this  matter  will  have  a  material  adverse  effect  on  our 
financial position or results of operations. 

• Cost Sharing Payments. In the BioMarin License Agreement, we agreed to share in the cost of 
certain post-marketing studies of Firdapse® that were being conducted by BioMarin, and, as of 
December  31,  2017,  we  had  fulfilled  our  commitment  to  BioMarin  regarding  all  such 
payments. 

Breakthrough therapy designation

Firdapse® for LEMS has been granted Breakthrough Therapy Designation by the FDA. A breakthrough 
therapy is defined as a drug that is "intended, alone or in combination with one or more other drugs, to treat 
a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the drug 
may  demonstrate  substantial  improvement  over  existing  therapies  on  one  or  more  clinically  significant 
endpoints, such as substantial treatment effects observed early in clinical development." 

A  Breakthrough  Therapy  Designation  conveys  all  of  the  fast  track  program  features,  as  well  as  more 
intensive FDA guidance on an efficient drug development program. The FDA also has an organizational 
commitment to involve senior management in such guidance. The Breakthrough Therapy Designation is a 
distinct status from use of surrogate endpoints and priority review, which can also be granted to the same 
drug if relevant criteria are met. 

Orphan drug designation

The FDA has granted Orphan Drug Designation for amifampridine phosphate for the treatment of LEMS, 
CMS and MG, making the drug eligible to be granted seven-year marketing exclusivity for these indications 
if  we  are  the  first  pharmaceutical  company  to  obtain  approval  of  an  NDA  for  a  product  containing 
amifampridine as the active moiety for the treatment of LEMS, CMS or MG. In addition, the FDA has also 
granted  Jacobus  Pharmaceutical’s  Orphan  Drug  Designation  request  for  3,4-diaminopyridine  for  the 
treatment  of  LEMS,  which  means  that  if  Jacobus  Pharmaceuticals  were  to  be  the  first  pharmaceutical 
company to obtain approval of an NDA for a product containing amifampridine as the active moiety for the 
treatment of LEMS, we would not be able to obtain FDA approval for that indication for seven years.  

Our first Phase 3 clinical trial

As part of our License Agreement with BioMarin, we took over a Phase 3 clinical trial that BioMarin had 
previously begun in the United States and Europe evaluating Firdapse® for the treatment of LEMS. The 
trial was designed as a randomized double-blind, placebo-controlled discontinuation trial in approximately 
36 LEMS patients. After patients were treated with amifampridine phosphate for at least 91 days, they were 
randomly assigned to either continue on amifampridine phosphate or be discontinued to placebo over a 2-
week  period. They  were then  returned to  open  label amifampridine phosphate  treatment  for a  two-year 
follow-up period.  

12 

On September 29, 2014, we reported top-line results from this trial. A summary of the results is as follows: 

•

Primary endpoints: 

o The primary endpoint of change in quantitative myasthenia gravis score, or QMG, at day 
14 reached statistical significance (p=0.0452), with a worsening of 2.2 points observed in 
the placebo group and a worsening of 0.4 points observed in the treatment group. 

o The primary endpoint of change in subject global impression, or SGI, at day 14 was highly 
statistically significant (p=0.0028), with a worsening of 2.6 points observed in the placebo 
group and a worsening of 0.8 points observed in the treatment group. 

•

Secondary endpoints: 

o The secondary endpoint for the physician's clinical global impression of improvement, or 
CGI-I, reached statistical significance (p=0.0267), with a worsening at day 14 of 1.1 points 
between the placebo group and the treatment group. 

o The  secondary  endpoint  of  change  in  walking  speed  at  day  14  was  not  statistically 

significant. 

•

Patient tolerance of Firdapse®: 

o Firdapse®  was  generally  safe  and  well  tolerated.  During  the  91-day  open  label  run-in 
period,  treatment  emergent  adverse  events  occurred  more  frequently  in  treatment-naïve 
patients than in previously treated patients (approximately 10% of treatment naïve patients 
withdrew during this part of the study). During the placebo-controlled portion of the study, 
side effects occurring more frequently in the Firdapse® group were benign and consisted 
primarily of perioral and digital paresthesia and infections. No patients withdrew during 
this period. 

o All subjects who were randomized into the trial elected to continue with Firdapse® in the 

two-year safety follow-up phase of the trial. 

The results of the Phase 3 trial were first presented in October 2014 at the 139th Annual Meeting of the 
American Neurological Association (ANA).  They have subsequently been presented at the 2014 and 2015 
annual meeting of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) 
and at the 2015 meeting of the American Academy of Neurology (AAN). The results were also published 
in 2016 in Muscle & Nerve (Muscle Nerve, 2016, 53(5):717-725).

First NDA submission and Refusal-to-File Letter 

On July 22, 2015, we announced that we had initiated a rolling submission of an NDA for Firdapse® for 
the  treatment  of  LEMS  and  CMS,  and  on  December  17,  2015,  we  announced  the  completion  of  that 
submission.    On  February  17,  2016,  we  announced  that  we  had  received  an  RTF  letter  from  the  FDA 
regarding our NDA submission. The RTF letter stated that after a preliminary review, the FDA has found 
that  our  application  was  not  sufficiently  complete  and  requested  additional  supporting  information. 
Additionally, there was a requirement for us to perform three abuse liability studies for Firdapse®. The letter 
did not comment on the acceptability of the submitted clinical data, and no judgment was made in the letter 
on the efficacy or safety of Firdapse®. 

On April 26, 2016, we announced that we met with the FDA to discuss the FDA's RTF letter. During that 
meeting,  the FDA advised us that in addition to the results of our first Phase 3 trial, we would need to 
submit positive results from a second adequate and well-controlled study in patients with LEMS.  

13 

Our second Phase 3 clinical trial (LMS-003) 

Our second Phase 3 trial evaluating Firdapse® for the treatment of LEMS (designated as LMS-003) was 
conducted at sites in Miami, Florida and Los Angeles, California. The double-blind, placebo-controlled 
withdrawal trial had the same co-primary endpoints as our first Phase 3 trial evaluating Firdapse® for the 
treatment of LEMS. Further, the FDA allowed us to enroll patients from our expanded access program as 
study  subjects  in  this  second  trial.  This  second  Phase  3  trial  was  conducted  under  a  Special  Protocol 
Assessment  (SPA)  with  the  FDA  for  the  protocol  design,  clinical  endpoints,  and  statistical  analysis 
approach 
available 
trial.  Details  of 
on www.clinicaltrials.gov (NCT02970162).  Enrollment  in  this  trial,  which  included  26  subjects,  was 
completed in October 2017.  

the  LMS-003 

to  be 

taken 

trial 

the 

are 

in 

On November 27, 2017, we reported positive top-line results from this trial. This trial had two prospectively 
defined co-primary endpoints. The first of these, quantitative myasthenia gravis score (QMG), achieved a 
statistically  significant  p-value  of  0.0004,  and  the  second,  subject  global  impression  (SGI),  achieved  a 
statistically significant p-value of 0.0003. More importantly, a clinically significant difference of 6.4 points 
was  observed  between  the  Firdapse®  and  placebo  groups  for  the  QMG  endpoint.  Firdapse®  was  well 
tolerated and showed a similar safety profile to that seen in earlier studies. All p-values reported are based 
on the entire intent to treat (ITT) population of patients that enrolled in this trial.  

The prospectively defined secondary endpoint for the physician's clinical global impression of improvement 
(CGI-I) achieved statistical significance (p-value 0.0020).  Further, the exploratory endpoints of triple timed 
up and go (3TUG, p-value 0.0112) and the evaluation of the QMG-Limb domains endpoint (p-value 0.0010) 
were also statistically significant.  The exploratory endpoint of most bothersome symptom (MBS) (p-value 
0.0572) was not significant, but shows a trend. 

Recent Type C meeting with the FDA and anticipated resubmission of an NDA for Firdapse®

On February 12, 2018, after receipt of the minutes of our recently held Type C meeting with the FDA, we 
issued a press release reporting on the results of the meeting. Prior to the meeting, we had provided the 
FDA with our preliminary data package for our proposed NDA resubmission, including the positive top-
line results from our LMS-003 trial, as well as the FDA-required abuse liability studies that we recently 
completed demonstrating that Firdapse® does not have abuse liability potential. The minutes of the meeting 
reflect the FDA's advice to us that our proposed filing package will be sufficient for resubmission of an 
NDA for Firdapse®, and we currently anticipate resubmitting our NDA for Firdapse® for LEMS to the FDA 
by the end of the first quarter of 2018. Notwithstanding, there can be no assurance that any NDA that we 
submit for Firdapse® for LEMS will be accepted for filing or approved. 

Expanded access program 

We  currently  operate an  expanded  access  program  (EAP)  that  makes  Firdapse® available to all  patients 
diagnosed with LEMS,  CMS, or Downbeat Nystagmus in the United States who meet the inclusion and 
exclusion criteria, with Firdapse® being provided to patients at no cost until sometime after FDA approval, 
should  we  receive  such  approval  (of  which  there  can  be  no  assurance).  We  continue  to  inform 
neuromuscular  physicians  on  the  availability  of  the  Firdapse® EAP  and  also  to  work  with  various  rare 
disease advocacy organizations to inform patients and other physicians about the program. 

MuSK-MG Proof-of-Concept Study

In  February  2016,  we  announced  the  initiation  of  an  investigator-sponsored,  randomized,  double-blind, 
placebo-controlled,  crossover  Phase  2/3  clinical  trial  evaluating  the  safety,  tolerability  and  potential 
efficacy of Firdapse® as a symptomatic treatment for patients with anti-MuSK antibody positive myasthenia 

14 

gravis (MuSK-MG). There are no approved effective therapies for MuSK-MG (and therefore it is an unmet 
medical need). Seven patients participated in this proof-of-concept trial. We provided study drug, placebo, 
and financial support for this study. 

On March 15, 2017, we reported top-line results from this trial. Both of the co-primary efficacy endpoints 
of change from baseline (CFB) in total Quantitative Myasthenia Gravis (QMG) score (p=0.0003) and CFB 
in total Myasthenia Gravis Activities of Daily Living (MG-ADL) score (p=0.0006) were statistically and 
clinically significant in this trial. Several secondary efficacy measures also achieved statistical significance. 
Amifampridine phosphate was well tolerated in this population of patients. 

Ongoing clinical trials

Phase 3 clinical trial evaluating Firdapse® for the treatment of CMS 

Our original NDA submission for Firdapse® included data and information (including data from a currently 
ongoing investigator treatment IND) providing evidence supporting the benefits of Firdapse® for treating 
certain types of CMS, and requested that CMS be included in our initial label for Firdapse®. To provide 
additional support for our submission of an NDA for Firdapse® for the treatment of CMS, in October 2015 
we initiated a small blinded clinical trial at four academic centers of up to 10 subjects in the pediatric CMS 
population, ages 2 to 17. However, after considering comments from the FDA, we determined to enroll 
both adult and pediatric subjects with CMS in this trial and to expand the number of subjects to be evaluated 
in the trial to an aggregate of approximately 20 subjects. We are currently conducting this study at five sites 
around the United States, and we are currently adding several additional sites outside the United States. 
Details of this trial are available on www.clinicaltrials.gov (NCT02562066). 

Based on currently available information, we expect to complete enrollment in this trial before the end of 
2018 and to report top-line results from this trial in the first quarter of 2019. If the results of the trial are 
successful, we hope to add the CMS indication to our labeling for Firdapse®. There can be no assurance 
that any trial we perform for Firdapse® for the treatment of CMS will be successful or whether any NDA 
or NDA supplement that we may submit for Firdapse® for the treatment of CMS in the future will be filed 
by the FDA for review and approved. 

Phase 3 clinical trial evaluating Firdapse® for the treatment of MuSK-MG 

On August 30, 2017, we announced that we had reached an agreement with the FDA on a SPA for the 
protocol design, clinical endpoints, and statistical analysis approach to be taken in our proposed Phase 3 
registration trial evaluating the safety and efficacy of amifampridine phosphate treatment in patients with 
MuSK-MG. The  protocol  that  the  FDA  has  reviewed  is  for  a  multi-site,  international  (U.S.  and  Italy), 
double-blind, placebo-controlled, clinical trial that is targeted to enroll approximately 60 subjects diagnosed 
with MuSK-MG. The trial  will  employ  a  primary  endpoint  of  Myasthenia  Gravis  Activities  of  Daily 
Living (MG-ADL) and  a  secondary  endpoint  of  Quantitative  Myasthenia  Gravis  Score  (QMG). At  the 
FDA’s request, the trial will also enroll up to 10 generalized myasthenia gravis patients who will be assessed 
with the same clinical endpoints, but achieving statistical significance in this subgroup of patients is not 
required and only summary statistics will be provided.  

We initiated this trial in January 2018 and expect to begin enrolling subjects in this trial during the first half 
of 2018. We anticipate that it will take about 12 months to complete the enrollment for the trial and we 
expect to report top-line results from this trial in the first half of 2019. Details of this trial are available 
on www.clinicaltrials.gov (NCT03304054). 

15 

Proof-of-concept clinical trial evaluating Firdapse® for the treatment of SMA Type 3 

On November 21, 2017, we announced the initiation of a company-sponsored, proof-of-concept clinical 
trial evaluating safety, tolerability and efficacy of Firdapse® as a symptomatic treatment for patients with 
Spinal Muscular Atrophy (SMA) Type 3. The study will be conducted by a team of researchers led by 
Lorenzo Maggi, MD, and Giovanni Baranello, MD, of the Fondazione Istituto Neurologico Carlo Besta in 
Milan, Italy, a major referral center for SMA patients. The study is designed as a randomized (1:1), double-
blind, 2-period, 2-treatment, crossover, outpatient proof-of-concept study to evaluate the safety, tolerability 
and potential efficacy of amifampridine in ambulatory patients diagnosed with SMA Type 3. The study is 
planned to include approximately 12 patients, and we anticipate reporting top-line results from this study 
in the second half of 2019. 

Pre-commercialization efforts 

Prior to the receipt of the RTF letter, we had been actively taking steps to prepare for the commercialization 
of Firdapse® in the United States, including the hiring of a Chief Commercial Officer. However, due to the 
receipt of an RTF letter, the need to complete a second Phase 3 trial evaluating Firdapse® for the treatment 
of LEMS, and the need to conserve cash, we underwent a reduction-in-force in May 2016 and terminated 
most of our commercial staff.  

During  the  fourth  quarter  of  2017,  we  restarted  the  development  of  our  commercialization  plans  for 
Firdapse ®.  We  are  currently  refreshing  our  previous  market  assumptions  for  launch  planning  and 
developing  a  comprehensive  marketing  plan,  a  comprehensive  medical  communications  plan  and 
distribution  and  reimbursement  assistance  plans.  We  currently  expect  to  market  the  product  to 
approximately 750 neuromuscular physicians around the U.S., along with general neurologists, with a sales 
force of up to 20 specialized sales representatives and up to four medical science liaisons (MSLs). While 
we have not yet hired our sales force, we are beginning to initiate the hiring of our commercial team.

We continue to work with several rare disease advocacy organizations to help increase awareness of LEMS, 
CMS and MuSK-MG and to provide awareness and outreach support for the physicians who treat these rare 
diseases and the patients they treat. 

Future pricing of and access to Firdapse®

We have not yet established our pricing for Firdapse®. However, the independent market research that we 
have conducted to date indicates that we should be able to obtain typical orphan disease pricing for our 
product and that our product will likely be widely reimbursed by private and public payors for the indicated 
small populations of LEMS, CMS, and MuSK-MG. There can be no assurance, however, as to the pricing 
of our product that we may be able to obtain or as to whether payors will agree to cover our product. 

The pricing of pharmaceutical products, in general, and of specialty drugs, in particular, has been a topic of 
concern in the U.S. Congress, where hearings have been held on the topic, and a topic of recent statements 
made by the President of the United States. There can be no assurance as to how this scrutiny on pricing of 
pharmaceutical  products  will  impact  future  pricing  of  our  products,  of  orphan  drugs  generally,  or  of 
pharmaceutical products generally. 

While our proposed pricing for Firdapse® has not been established, we recognize the importance of access 
to our medicines and, if Firdapse® is approved by the FDA, we expect to work with insurers to gain broad 
patient access in the U.S. market for the small patient populations of LEMS and CMS. We also expect to 
introduce and support comprehensive patient assistance programs and charitable access programs to assist 
eligible patients.  

16 

There is a vocal group of neuromuscular physicians who have raised public concerns in a letter to the editor 
of  a  medical  journal,  and  some  LEMS  patients  and  neuromuscular  physicians  who  have  raised  public 
concerns in interviews quoted in articles published in the press, that LEMS patients may not be able to get 
amifampridine treatment if we receive an approval of our product.  Their overarching concern appears to 
be that our product will be priced too high as an orphan drug if we are the first pharmaceutical company to 
receive  an  FDA  approval  for  an  amifampridine  product,  thereby  giving  us  the  seven-year  orphan  drug 
exclusivity and the five-year new chemical entity exclusivity for our product. Stories about their concerns 
have  been  published  in  several  national  publications  and  some  in  the  press  have  sought  to  tie  their 
expectations about the anticipated pricing of Firdapse® to stories about perceived abusive price increases 
of  drug  products  by  other  pharmaceutical  companies.  This  vocal  group  has  also  questioned  the 
appropriateness of the provisions of the Orphan Drug Act that would grant us exclusivity if our product 
were to be the first amifampridine product approved by the FDA and whether this exclusivity should be 
eliminated from the law. We have directly responded to these concerns in a letter to the editor in this same 
medical publication. However, there can be no assurance as to the ultimate impact of these activities on us 
or our products or the extent to which these issues will be raised again in the future.

Third-Party Reimbursement 

Sales of pharmaceutical products depend in significant part on the availability of coverage and adequate 
reimbursement  by  third  party  payors,  such  as  state  and  federal  governments,  including  Medicare  and 
Medicaid, managed care providers, private commercial insurance plans and pharmacy benefit management 
(PBM) plans. Decisions regarding the extent of coverage and the amount of reimbursement to be provided 
for Firdapse® are expected to be made on a plan-by-plan, and in some cases, on a patient-by-patient basis. 
Particularly  given  the  rarity  of  LEMS  and  CMS,  we  anticipate  that  securing  coverage  and  appropriate 
reimbursement from third-party payors will require targeted education. To that end, we expect to hire a 
dedicated  team  of  field-based  market  access  account  managers  and  reimbursement  experts  focused  on 
ensuring that clinically-qualified patients have access to our product. 

Intellectual property protections for Firdapse®

Under  the  BioMarin  License  Agreement,  we  licensed  two  pending  patents  and  certain  trademarks  for 
Firdapse®. One of the licensed patents is a pending composition of matter patent that, if issued, will protect 
Firdapse® until February 2027, which includes five years of patent term extension that is expected under 
the Patent Term Restoration Act. This application was initially rejected following an appeal to the Patent 
Trial and Appeal Board.  The application was refiled with new claims. The new claims were the subject of 
an office action in which the claims were rejected. A response to the rejection was filed and a final rejection 
was issued.  The application was refiled and is under a final rejection, to which a response is in progress. 
There can be no assurance that this patent will be issued. The second patent claims methods of administering 
Firdapse®.  Substantive  examination  has  begun  on  this  patent  application  and  a  final  rejection  has  been 
issued, to which a response is in progress.  We may also pursue other patents in order to seek to protect the 
exclusivity of the drug, dosage forms and methods of administration. 

No drug product containing amifampridine for any indication has been approved by the FDA. Therefore, 
our version of amifampridine, if we are the first to obtain approval of the product in the U.S., will be eligible 
for five-year new chemical entity exclusivity, which provides a five-year period of marketing exclusivity 
for all indications. 

We  have  licensed  the  Firdapse®  trademark  from  BioMarin.  A  trademark  application  for  Firdapse® was 
allowed,  but  did  not  register  due  to  the  inability  to  show  use  of  the  mark  in  interstate  shipment.    The 
application was refiled and a Statement of Use was submitted and accepted by the Trademark Office, and 
the mark was registered in March 2015.  

17 

In  January  2014,  the  FDA  provisionally  approved  Firdapse®  as  a  proprietary  name  for  amifampridine 
phosphate tablets.  This provisional approval by the FDA would not prevent the agency from rejecting the 
name Firdapse® at a later date as part of the NDA review and approval process. 

CPP-115 

Current status of our development efforts for CPP-115 

We are developing CPP-115, a GABA aminotransferase inhibitor that, based on our preclinical studies to 
date, we believe is a more potent form of vigabatrin, and may have fewer side effects (e.g., visual field 
defects)  than  those  associated  with  vigabatrin.  We  are  hoping  to  develop CPP-115 for  the  treatment  of 
refractory  infantile  spasms. CPP-115 has  been  granted  Orphan  Drug  Designation  by  the  FDA  for  the 
treatment of infantile spasms and Orphan Medicinal Product Designation in the European Union, or EU, 
for West syndrome (a form of infantile spasms). 

We are currently refining our development plans for this product. We are also working with one or more 
potential investigators who have expressed an interest in evaluating our product for particular indications 
(particularly infantile spasms). 

We are also continuing our efforts to seek a partner to work with us in furthering the development of CPP-
115. However, no agreements have been entered into to date. 

There can be no assurance that we will ever successfully commercialize CPP-115. 

Product Overview 

In August 2009, we licensed the exclusive worldwide rights to commercialize certain composition of matter 
patents relating to a new class of novel GABA aminotransferase inhibitors and derivatives of vigabatrin. 
We intend to develop these compounds for a broad range of neurological illnesses that could benefit from 
the inhibition of GABA aminotransferase. CPP-115 is our lead compound from this group of composition 
of matter patents.  

The  development  efforts  of  CPP-115  were  led  by  Dr.  Richard  B.  Silverman,  the  Patrick  G.  Ryan/Aon 
Professor of Chemistry at Northwestern University (Northwestern). Dr. Silverman, who holds 75 patents, 
is the inventor of pregabalin, also known as Lyrica®, which is marketed by Pfizer. His goal in inventing the 
compound that became CPP-115 was to mimic the mechanism of action of vigabatrin, while making it both 
more potent and specific.   

CPP-115  works  by  the  same  mechanism  of  action  as  vigabatrin;  that  is,  the  inhibition  of  GABA 
aminotransferase, which leads to increased brain GABA levels that reduce epileptogenesis.  Due to these 
similarities,  we  believe  that  these  two  drugs  will  likely  share  certain  biochemical  features  related  to 
absorption,  metabolism,  and  elimination,  and  our  pre-clinical  studies  of  CPP-115  to  date  support  our 
expectations. However, based upon our pre-clinical studies of CPP-115 to date, we expect that there will 
be a significant reduction, and possibly elimination, of visual field defects (VFDs) from the use of CPP-
115 compared to vigabatrin. However, there can be no assurance that this will ultimately prove to be the 
case.  

Further, based on animal testing to date, CPP-115 has been shown to be at least 200 times more potent than 
vigabatrin in both in-vitro and animal model studies. The increased potency could enable the development 
of dosage forms potentially administrable by other routes of administration compared with the marketed 

18 

oral, immediate release formulation of vigabatrin, Sabril®. Further, based on non-clinical testing completed 
to date, CPP-115 appears to have superior specificity to GABA aminotransferase and we believe, will have 
a better side effect profile (e.g. less VFDs) compared with Sabril®. 

Mechanism of action for CPP-115

We believe that CPP-115 will be an effective treatment for refractory infantile spasms because it increases 
endogenous  GABA  levels  in  the  brain  through  the  inhibition  of  GABA-aminotransferase  (GABA-AT). 
GABA-AT is responsible for the eventual breakdown of GABA and helps to balance its inhibitory effects.  

CPP-115  is  a  GABA  analog  that  is  readily  absorbed  and  promptly  available  to  the  nervous  system, 
producing effects that last for many hours after a single dose. Due to the fact that this drug is not “receptor 
active”, its administration does not appear to affect the baseline levels of dopamine, nor those variations in 
dopamine levels caused by normal stimuli.  

Epilepsy and Infantile Spasms 

Epilepsy  is  a  brain  disorder  in  which  clusters  of  nerve  cells,  or  neurons,  in  the  brain  sometimes  signal 
abnormally.  In  epilepsy,  the  normal  pattern  of  neuronal  activity  becomes  disturbed,  causing  strange 
sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. 
Epilepsy  is  a  disorder  with  many  possible  causes.  Anything  that  disturbs  the  normal  pattern  of  neuron 
activity - from illness to brain damage to abnormal brain development - can lead to seizures. Epilepsy may 
develop  because  of  an  abnormality  in  brain  wiring,  an  imbalance  of  nerve  signaling  chemicals  called 
neurotransmitters, imbalance of sensitivity to neurotransmitters, or some combination of these factors. We 
intend to focus our development efforts for CPP-115 on its use as a treatment for refractory infantile spasms. 

An infantile spasm is a specific type of seizure seen in an epilepsy syndrome of infancy and childhood. The 
onset of infantile spasms is usually in the first year of life, typically between 4-8  months. The seizures 
primarily  consist  of  a  sudden  bending  forward  of  the  body  with  stiffening  of  the  arms  and  legs;  some 
children arch their backs as they extend their arms and legs. Spasms tend to occur upon awakening or after 
feeding, and often occur in clusters of up to 100 spasms at a time. Infants may have dozens of clusters and 
several hundred spasms per day. Infantile spasms usually stop by age five, but may be replaced by other 
seizure types.  

In  complex  partial  seizures,  consciousness  is  altered.  Patients  may  exhibit  automatisms  (automatic 
repetitive behavior) such as walking in a circle, sitting and standing, or smacking their lips together. Often 
accompanying  these  symptoms  are  the  presence  of  unusual  thoughts,  such  as  the  feeling  of  déjà  vu, 
uncontrollable  laughing,  fear,  visual  hallucinations,  and  experiencing  unusual  unpleasant  odors.  These 
symptoms are thought to be caused by abnormal discharges in the temporal lobe.  

According to the Epilepsy Foundation, there are about 3.0 million epilepsy patients in the United States, 
with approximately 150,000 new cases diagnosed in the U.S. each year. Worldwide, 65 million people are 
estimated  to  have  epilepsy.  The  incidence  of  epilepsy  appears  to  depend  somewhat  on  the  age  of  the 
individual. The risk of epilepsy from birth through age 20 is approximately 1%. Within this group, incidence 
is highest during the first year of life and increases somewhat at the onset of puberty. From age 20 to 55 it 
decreases again, but increases after age 55.  

Anti-epileptic drugs work through a variety of mechanisms, including inhibition of sodium ion channels 
and  the  enhancement  of  GABA  mechanisms.  Although  the  different  types  of  epilepsy  vary  greatly,  in 
general,  available  medications  can  only  control  seizures  in  about  two-thirds  of  patients.  CPP-115,  like 
vigabatrin, is a GABA-AT inhibitor, and we are developing it for refractory infantile spasms. Based on the 
historic use of vigabatrin in treating epilepsy, we believe that CPP-115  may ultimately work best as an 
adjunct therapy to existing drugs. 

19 

Vigabatrin has been marketed for decades in over 30 countries by Lundbeck and Sanofi-Aventis and their 
predecessors and licensees under the brand names Sabril®, Sabrilex® and Sabrilan® (hereinafter referred to 
as  “Sabril®”)  as  an  adjunct  (add-on)  treatment  for  adult  epilepsy  and  as  a  primary  treatment  for  the 
management of infantile spasms. The composition of matter patents for Sabril® in the U.S. expired many 
years ago. On August 21, 2009, the FDA approved two NDAs for Sabril® for the treatment of infantile 
spasms and as an adjunctive therapy for adult patients with refractory complex partial seizures who have 
failed treatments with several other anti-epileptic drugs. The NDAs are for different formulations of Sabril®
and both NDAs are held by Lundbeck. Due to the risks of visual field damage associated with vigabatrin, 
Sabril® was approved under an FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) program 
and is only available through a special restricted distribution program approved by the FDA. In 2016, the 
FDA authorized changes to the REMS program for Sabril® to make it less onerous and to make it easier for 
patients to obtain their medication. 

In chronic use for the treatment of epilepsy, vigabatrin has been generally well tolerated with lower than 
average neurological side effects compared to other approved epilepsy therapies. The most common side 
effects reported have been drowsiness and fatigue. However, one clearly established adverse side effect is 
the development of peripheral visual field defects, or VFDs. These VFDs are manifest as a constriction of 
the  peripheral  field  of  vision  (i.e.,  "tunnel  vision").  VFDs  occur  in  approximately  33%  of  users  when 
cumulative dosage levels of vigabatrin approach approximately 1,500 grams.  

Our previous clinical and non-clinical studies of CPP-115 

On November 1, 2010, we announced key results for our initial series of safety and efficacy evaluations in 
a number of animal and in-vitro laboratory studies. These results included superior visual safety of CPP-
115,  compared  to  vigabatrin,  pharmacokinetic  data  supporting  oral  administration  of  CPP-115, 
pharmacologic  target  specificity,  metabolic  profile,  and  an  absence  of  genotoxic,  cardiovascular, 
respiratory, and liver enzyme side effects.  It was also shown to be effective in multiple animal models for 
epilepsy and cocaine addiction. 

On May 22, 2012, we reported positive results from a Phase 1a double-blind, placebo-controlled clinical 
trial evaluating the safety, tolerability and pharmacokinetic profile of CPP-115. The study evaluated single 
ascending doses ranging from 5 mg to 500 mg (a dose greater than ten times the predicted effective dose of 
15-30 mg/day derived from animal data) of CPP-115 solution administered orally to 55 healthy volunteers. 
CPP-115 was found to be well tolerated with no side effects, rapidly absorbed and eliminated, and exhibited 
linear, dose dependent pharmacokinetics. 

In December 2015 we announced top line results from a Phase 1b double-blind, placebo controlled safety 
and tolerance study of CPP-115 in six normal healthy adult male volunteers.  The results showed significant 
increases in brain levels of the surrogate marker for potential efficacy, gamma-aminobutyric acid (GABA), 
a mechanism known to effectively treat epilepsy and infantile spams.  The main adverse effect of prolonged 
elevated brain GABA, somnolence, was also observed.  

While the primary objective of this study was to obtain safety and tolerance data for CPP-115 administered 
over 14 days, brain GABA levels were measured as a surrogate marker of potential efficacy, since CPP-
115 is a second generation GABA aminotransferase inhibitor.  Specifically, this study examined GABA 
levels in both the POC (Parietal-Occipital Cortex), a grey matter rich region thought to be associated with 
epilepsy, and which was previously studied for vigabatrin.  The maximum brain GABA increases, in both 
brain regions, ranged from about 150% to over 200% of baseline levels, as measured by magnetic resonance 
spectroscopy (MRS). 

20 

Previous clinical and pre-clinical studies of CPP-115 undertaken by others  

An animal study reporting positive pre-clinical efficacy in a "rat multiple hit model" in which the use of 
CPP-115 was evaluated for the treatment of infantile spasms was published in the January 2014 issue of 
the journal, Epilepsia, The study was authored by Stephen W. Briggs, Tomonori Ono, MD, PhD, Solomon 
L. Moshe, MD and Aristea S. Galanopoulou, MD, PhD of the Saul R. Korey Department of Neurology, 
Dominick  P.  Purpura  Department  of  Neuroscience,  Laboratory  of  Developmental  Epilepsy,  The 
Comprehensive Epilepsy Center (CEC) at Montefiore Medical Center / Albert Einstein College of Medicine 
of Yeshiva University, Bronx, New York. The study concluded that (i) CPP-115 suppresses spasms in the 
multiple-hit model of infantile spasm, with onset of effect as early as the day after the first dose; (ii) the 
therapeutic doses of CPP-115 were well tolerated in developing rat pups; and (iii) CPP-115 showed efficacy 
for  a  longer  duration  at  lower  doses  that  were  better  tolerated  than  the  previously  tested  therapeutic 
vigabatrin doses. 

In September 2016, the Journal of Epilepsy & Behavior Case Reports published a case report of a child 
treated with CPP-115 in an investigator-sponsored, investigational new drug protocol. Based on treatment 
with CPP-115, this particular child experienced a significant reduction of seizures, with no evidence of 
retinal dysfunction. According to the case report, prior to treatment with CPP-115, the patient had failed 
ten drugs and the ketogenic diet, and had approximately 100 seizures per day. One year after starting CPP-
115 and coming off of clobazam and vigabatrin, the patient's reported seizures have seen a marked reduction 
in frequency and his cognition and behavior have improved. 

Northwestern University License Agreement 

On August 27, 2009, we entered into a license agreement with Northwestern University (Northwestern), 
under which we acquired worldwide rights to commercialize new GABA aminotransferase inhibitors and 
derivatives of vigabatrin which had been discovered and patented by Northwestern. Under the terms of the 
license agreement, Northwestern granted us an exclusive worldwide license to United States composition 
of matter patents related to the new class of inhibitors and a patent application relating to derivatives of 
vigabatrin. This includes U.S. patent number 6,794,413 covering the composition of matter for CPP-115. 
We have designated the lead compound to be developed under this license as CPP-115. 

Under  our  license  agreement  with  Northwestern,  we  will  be  responsible  for  continued  research  and 
development of any resulting drug candidates. We have the right to terminate the agreement in whole or in 
part  upon  written  notice.  As  of  December  31,  2017,  we  have  paid  Northwestern  upfront  payments, 
milestone fees and maintenance and patent fees aggregating $424,885 and we are obligated to pay certain 
additional fees and milestone payments in future years relating to our clinical development activities under 
this license or payable upon passage of time (the next milestone payment, in the amount of $300,000, is 
due on the earlier of completion of the first Phase 3 clinical trial of CPP-115 or August 27, 2018). We are 
also obligated to pay Northwestern royalties on any products resulting from the license agreement. We also 
have the right to enter into sub-license agreements, and if we do, a royalty on any sub-license fees will be 
payable to Northwestern.

Patent protection for CPP-115 

In addition to the exclusively licensed U.S. Patent 6,794,413, in March 2015, the U.S. Patent & Trademark 
Office (US PTO) issued patent 8,969,413 for the method of use patent for CPP-115 for neurological and 
psychological uses.  This patent will expire in 2032, subject to potential extensions allowed under the patent 
term restoration act.  A continuation application was filed to capture additional methods of using CPP for 
neurological  and  psychological  conditions.    This  continuation  application  is  undergoing  substantive 
examination.  Patents  for  the  same  coverage  remain  pending  in  the  European  Patent  Office,  Japan  and 
Canada. There can be no assurance that the claims of this patent will be allowed, or if allowed, that such 
claims will provide adequate patent protection for CPP-115. 

21 

Generic Sabril®

In September 2015, we announced the launch of a program to develop our version of vigabatrin (CPP-109) 
as a generic version of Sabril®, which is marketed in the United States by Lundbeck.  Lundbeck's exclusivity 
for Sabril® expired on April 26, 2017. 

As  part  of  our  development  of  this  product,  we  have  obtained  the  reference  listed  drug  and  the  active 
pharmaceutical  ingredient,  entered  into  an  exclusive  supply  agreement  for  the  vigabatrin  active 
pharmaceutical  ingredient  with  a  manufacturer  that  has  submitted  a  DMF  to  the  FDA,  validated  the 
manufacturing process, and prepared a number of batches of vigabatrin for us on a commercial scale in the 
past, developed and validated quality control and stability test methods, and collected stability data showing 
that CPP-109 has an acceptable shelf life in two container closure systems. We are also taking the steps that 
will be required for us to obtain the rights to commercialize generic versions of this product. 

There can be no assurance that we will be successful in these efforts or that any ANDA that we submit for 
vigabatrin will be accepted for review or approved. There can also be no assurance that any bioequivalence 
studies that we submit to the FDA in support of an ANDA for this product will be acceptable to the FDA.  
Finally, any approved generic version of vigabatrin that we are approved to commercialize will, consistent 
with  Sabril®,  only  be  available  subject  to  an  FDA-mandated  Risk  Evaluation  and  Mitigation  Strategy 
(REMS) program. 

We are continuing our efforts to seek a partner to work with us in furthering the development of generic 
Sabril®. However, no agreements have been entered into to date. 

Intellectual Property Rights 

Protection of our intellectual property and proprietary technology is a strategic priority for our business. 
We rely on a combination of patent, trademark, copyright and trade secret laws along with institutional 
know-how and continuing technological advancement, to develop and maintain our competitive position. 
Our  ability  to  protect  and  use  our  intellectual  property  rights  in  the  future  development  and 
commercialization of our products, operate without infringing the proprietary rights of others, and prevent 
others from infringing our proprietary rights, is crucial to our future success. See Item 1A. “Risk Factors 
— Risks Related to Our Intellectual Property.” 

Manufacturing and Supply 

We  have  no  plans  to  build  or  acquire  the  manufacturing  capability  needed  to  manufacture  any  of  our 
research materials or commercial products.  We expect that our drug products and drug substances will be 
prepared by contractors with suitable capabilities for these tasks and that we will enter into appropriate 
supply agreements with these contractors at appropriate times in the development and commercialization 
of our products. Because we will use contractors to manufacture and supply our products, we will be reliant 
on such contractors. Further, the contractors selected would have to be inspected by the FDA and found to 
be in substantial compliance with federal regulations in order for a drug application for one of our drug 
candidates to be approved, and there can be no assurance that the contractors we select would pass such an 
inspection. 

Firdapse®

We have entered into agreements with a supplier of the active pharmaceutical ingredient (API) contained 
in Firdapse® for future requirements and we have contracted with third-party contract manufacturers who 
will manufacture Firdapse® tablets for us assuming Firdapse® is approved for commercialization.

22 

Any NDA that we submit for Firdapse® must include a manufacturing plan. If the manufacturing plan and 
data are insufficient,  any  NDA  we  submit  will  not be  approved.  Before  an  NDA  can  be  approved,  our 
manufacturers  must  also  demonstrate  compliance  with  FDA's  current  Good  Manufacturing  Practices 
(cGMPs) regulations and policies. Further, even if we receive approval of an NDA for Firdapse®, if our 
manufacturers do not follow cGMPs in the manufacture of our products, it may delay product launches or 
shipments and adversely affect our business.  

Since  we  contract  with  third  parties  to  manufacture  our  products,  if  the  FDA  approves  an  NDA  for 
Firdapse®, our contract manufacturers will be required to comply with all applicable environmental laws 
and regulations that affect the manufacturing process. As a result, we do not believe that Catalyst will have 
any significant direct exposure to environmental issues.  

CPP-115 

We have entered into a contract to manufacture the API sufficient to meet the needs of our development 
plans for CPP-115. While we believe that we have ordered and obtained sufficient API for our planned 
upcoming studies, there can be no assurance of this. 

Generic Sabril®

In preparation for the potential future marketing of our version of vigabatrin as a generic version of Sabril®, 
we have entered into supply agreements for the required API. Additionally, our contract manufacturer of 
CPP-109 tablets previously developed a manufacturing process for vigabatrin tablets and prepared several 
commercial scale batches. Our current contract manufacturer also has, based on their experience with CPP-
109  tablets,  the  necessary  experience  and  capability  to  produce  generic  vigabatrin  for  oral  solution 
product.  Additionally, we have entered in to an agreement to package vigabatrin for oral solution.  Finally, 
while we have not entered into a contract for commercial production of this product, we believe that our 
current  contract  manufacturer  and  packagers  have  the  capability  to  produce  the  product  for  us  for 
commercial distribution. 

Sales and Marketing

We have not yet obtained regulatory approval for any of our drug candidates.  

Until the receipt of an RTF letter regarding our first NDA for Firdapse® for the treatment of LEMS, we had 
begun to hire a sales staff, including a Chief Commercial Officer. However, due to the receipt of an RTF 
letter and the Company's need to conserve funds, the Company underwent a reduction-in-force in May 2016 
and terminated most of its commercial staff. 

During  the  fourth  quarter  of  2017,  we  restarted  the  development  of  our  commercialization  plans  for 
Firdapse®.  We  are  currently  refreshing  our  previous  market  assumptions  for  launch  planning  and 
developing  a  comprehensive  marketing  plan,  a  comprehensive  medical  communications  plan  and 
distribution  and  reimbursement  assistance  plans.  We  currently  expect  to  market  the  product  to 
approximately 750 neuromuscular physicians around the U.S., along with general neurologists, with a sales 
force of up to 20 specialized sales representatives and up to four medical science liaisons (MSLs). While 
we have not yet hired our sales force, we are beginning to initiate the hiring of our commercial team.

We continue to work with several rare disease advocacy organizations to help increase awareness of LEMS, 
CMS and MuSK-MG and to provide awareness and outreach support for the physicians who treat these rare 
diseases and the patients they treat. 

23 

In the future, we may also consider entering into arrangements with other pharmaceutical or biotechnology 
companies for the marketing and sale of Firdapse® in Canada or Mexico, where we have also licensed the 
product. 

Competition 

The pharmaceutical industry is intensely competitive, and any product candidate developed or licensed by 
us would likely compete with currently marketed and potentially new drugs and therapies even though they 
are  not  indicated  for  these  conditions.  There  are  many  pharmaceutical  companies,  biotechnology 
companies, public and private universities, government agencies and research organizations that compete 
with us in developing various approaches to the treatment of orphan diseases. Many of these organizations 
have substantially greater financial, technical, marketing and manufacturing resources than we have. 

Firdapse® for LEMS 

LEMS  is  currently  treated  with  unapproved  drugs  and  therapies  including  steroids,  azathioprine,  other 
immunosuppressants and intravenous immunoglobulin, which work by suppressing the immune system, 
and pyridostigmine. Plasma exchange has also been used in an attempt to remove antibodies from the body. 
Further, one other product, guanidine HCl tablets, was approved many years ago (during a period when 
drugs  were  not  required  to  be  reviewed  by  the  FDA  for  both  safety  and  effectiveness)  for  use  in  the 
treatment  of  LEMS.  However,  this  drug  has  significant  side  effects  and  is  not  currently  viewed  as  an 
effective treatment for LEMS. Notwithstanding, drugs may be prescribed by physicians for the treatment 
of LEMS whether or not they are considered effective. 

Another  pharmaceutical  company,  Jacobus  Pharmaceutical,  has  completed  a  clinical  trial  studying  the 
safety  and  efficacy  of  its  own  formulation  of  amifampridine  for  the  treatment  of  LEMS.  Jacobus 
Pharmaceutical  is  a  privately  held  company  and  there  is  little  public  information  available  about  their 
development  plans.    While  there  can  be  no  assurance,  we  believe  that  Firdapse®  is  further  along  in 
development than this other company's version of amifampridine. Under the Orphan Drug Act of 1983, the 
first  pharmaceutical  product to  get approval  for  an  indication receives the  orphan  exclusivity  under the 
statute. If this other pharmaceutical company is able to receive approval of an NDA for its formulation of 
amifampridine for the treatment of LEMS before we are able to receive approval of Firdapse® for the same 
indication, we would be barred from marketing Firdapse® in the United States during the seven-year orphan 
exclusivity period, which would have a severe adverse effect on our results of operations. In addition, if 
this other company were to receive five-year new chemical entity exclusivity for amifampridine for any 
indication prior to approval of Firdapse®, and FDA determined that our NDA was a 505(b)(2) NDA, we 
would be barred from marketing Firdapse® in the United States during this five-year exclusivity period for 
any indication.  

Further, we are aware that Jacobus Pharmaceutical has been making its 3,4-DAP product available to LEMS 
patients under compassionate use Investigational New Drug applications (INDs) for a number of years and, 
based on current information, we believe that approximately 200 LEMS patients may currently be receiving 
the drug under their program. If we are the first to obtain an approval for this product and its associated 
exclusivity and patent protection, we may not be able to stop Jacobus Pharmaceutical from continuing to 
supply its existing patients under compassionate use INDs. 

Finally, we are aware that amifampridine has been available from compounding pharmacies for many years 
and  may  remain  available,  even  if  we  are  able  to  obtain  FDA  approval  of  Firdapse®.  Compounded 
amifampridine, if it remains available, is likely to be substantially less expensive than Firdapse®.  The Food 
and Drug Administration Modernization Act of 1997 included a new section, which clarified the status of 
pharmacy compounding under Federal law. Under Section 503A, drug products that are compounded by a 
pharmacist or physician for an individual patient may be entitled to exemptions from three key provisions 
of the act: (1) the adulteration provision of section 501(a)(2)(B) (concerning FDA’s cGMP regulations); 

24 

(2)  the  misbranding  provision  of  section  502(f)(1)  (concerning  the  labeling  of  drugs  with  adequate 
directions for use); and (3) the new drug provision of section 505 (concerning the approval of drugs under 
new drug or abbreviated new drug applications). 

To  qualify  for  these  statutory  exemptions,  a  compounded  drug  product  must  satisfy  several  legal 
requirements. One of these requirements restricted the universe of bulk drug substances that a compounder 
may use; i.e., that every bulk drug substance used in compounding: (1) must comply with an applicable and 
current  USP  or  NF  drug  monograph,  if  one  exists,  as  well  as  the  current  USP  chapters  on  pharmacy 
compounding; (2) if such a monograph does not exist, the bulk drug substance must be a component of an 
FDA-approved drug; or (3) if a monograph does not exist and the bulk drug substance is not a component 
of an FDA-approved drug, it must appear on a list of bulk drug substances that may be used in compounding 
(i.e., the bulk substances list).  While the advertising provisions in Section 503A were ruled unconstitutional 
in part of the United States by the Supreme Court in 2002, the FDA has in the last five years aggressively 
regulated  and  exercised  oversight  over  the  practice  of  pharmacy  compounding  since  a  compounding 
incident at the New England Compounding Center in Massachusetts sickened hundreds and killed over 60 
individuals.  In 2013, Congress removed the unconstitutional advertising provisions in Section 503A when 
it passed the Drug Quality and Security Act of 2013 (DQSA), Title I (The Compounding Quality Act).  The 
DQSA also created “outsourcing facilities” under Section 503B of the Federal Food, Drug, and Cosmetic 
Act,  which  are  drug  compounders  that  voluntarily  register  with  FDA  and  may  produce  compounded 
formulations for office use (at least one of which must be sterile), but must comply with FDA’s cGMP 
regulations and other requirements set forth in Section 503B.  Section 503B outsourcing facilities may also 
only compound from bulk substances if the product is on FDA’s drug shortage list, or the substance is on 
FDA’s Section 503B list of bulk substances that may be used in compounding (Bulk Substances List 1).   

While the FDA has been aggressively enforcing Section 503A since its re-enactment, compounders still 
may attempt to compound copies of approved drug products, under Section 503A, so long as the prescriber 
makes  a  change  to  the  compounded  formulation  that  produces  for  that  patient  a  significant  difference 
between  the  commercially  available  drug  and  the  compounded  version.    Compounders  may  also  copy 
commercially available products if they do not do so in “regular or inordinate amounts.”  In January 2018, 
FDA  published  a  Final  Guidance  document  titled,  “Compounded  Drug  Products  That  Are  Essentially 
Copies of a Commercially Available Drug Product Under Section 503A of the Federal Food, Drug, and 
Cosmetic Act.”  This Final Guidance sets forth FDA’s enforcement policy concerning those compounders 
that make essentially copies of commercially available drug products.  FDA has defined the term “regular 
or inordinate” in the Final Guidance to mean: “a drug product that is essentially a copy of a commercially 
available  drug  product  is  compounded  regularly  or  in  inordinate  amounts  if  it  is  compounded  more 
frequently  than  needed  to  address  unanticipated,  emergency  circumstances,  or  in  more  than  the  small 
quantities needed to address unanticipated, emergency circumstances.”  FDA has further stated it will not 
take enforcement action, considering all the facts and circumstances, against a compounder that compounds 
less than four “essentially copies” of a commercially available drug product in a calendar month.   

The  FDA’s  Pharmacy  Compounding  Advisory  Committee  at  its  meeting  on  May  6-7,  1999  voted  7-4 
against  inclusion  of  3,4-DAP  on  the  bulk  drugs  list,  largely  based  on  the  safety  concerns  and  the 
commitment of Jacobus Pharmaceutical to make the drug available under compassionate use INDs, while 
pursuing FDA approval.  Therefore, since 3,4-DAP  does not meet the requirements codified in Section 
503A described above, the individual or firm that compounds a drug product containing 3,4-DAP may be 
subject to a warning letter, seizure of product, injunction, and/or criminal prosecution for violations of the 
FD&C Act. After the re-enactment of Section 503A, and the enactment of new Section 503B of the DQSA, 
certain entities nominated 3,4 DAP as a bulk substance to be used in compounding under both reenacted 
section 503A and under the newly enacted Section 503B.  As of October 2015, FDA included 3,4-DAP in 
its interim Bulk Substance “List 3” under both Section 503A and Section 503B– which list includes bulk 
drug products that may not currently be used in compounding because there is insufficient clinical evidence 

25 

to support their use.  Although 3,4-DAP has not yet been presented to FDA’s Pharmacy Compounding 
Advisory Committee that was re-established with the passage of the DQSA, the entities that nominated the 
substance  will  be  required  to  show  additional  data  establishing  safety  and/or  clinical  need  for  the  drug 
pursuant to FDA’s guidelines for bulk substance nominations in order for the drug substance to move to 
Bulks “List 1” (i.e., bulk substances that may be used in compounding). 

We intend to take all available steps to try to enforce our marketing proprietary rights if we are the first 
company to obtain an approval for this product. We cannot determine with certainty what impact these 
factors will have on the market for our product. However, while there can be no assurance, we expect that 
despite these factors, we will be able to successfully market our product. 

Generic Sabril®

Sabril® is marketed by Lundbeck in the United States for infantile spasms and for refractory complex partial 
seizures. Lundbeck's sales of Sabril® (tablets and sachets) were approximately $193 million in 2016 and 
$250 million in 2017. No generic version of Sabril® tablets has been approved to date in the United States, 
although a generic version of the powder form was recently launched by Par (Endo). 

Factors affecting competition generally 

In general, our ability to compete will depend in large part upon: 

•

•

•

•

•

•

•

•

•

•

our  ability  to  complete  clinical  development  and  obtain  regulatory  approvals  for  our  drug 
candidates; 

the demonstrated efficacy, safety and reliability of our drug candidates; 

the timing and scope of regulatory approvals; 

product acceptance by physicians and other health care providers; 

protection of our proprietary rights and the level of generic competition; 

the speed at which we develop drug candidates; 

our ability to supply commercial quantities of a product to the market; 

our ability to obtain reimbursement from private and/or public insurance entities for product use in 
approved indications; 

our ability to recruit and retain skilled employees; and 

the  availability  of  capital  resources  to  fund  development  and  commercialization  activities, 
including the availability of funding from the federal government. 

26 

Regulatory Matters 

Government regulation and product approval 

Government  authorities  in  the  United  States,  at  the  federal,  state  and  local  level,  and  other  countries 
extensively regulate, among other things, the research, development, testing, manufacture, labeling, record-
keeping, promotion, storage, advertising, distribution, marketing and export and import of products such as 
those we are developing. Our drugs must be approved by the FDA through the NDA process before they 
may be legally marketed in the United States.  

In the United States, drugs are subject to rigorous regulation by the FDA under the Federal Food, Drug, and 
Cosmetic  Act,  or  FDCA,  and  implementing  regulations,  as  well  as  other  federal  and state  statutes. The 
process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, 
local,  and  foreign  statutes  and  regulations  require  the  expenditure  of  substantial  time  and  financial 
resources. Failure to comply with the applicable United States requirements at any time during the product 
development  process,  approval  process  or  after  approval,  may  subject  an  applicant  to  administrative  or 
judicial sanctions. These sanctions could include the FDA’s refusal to approve pending applications, license 
suspension  or  revocation,  withdrawal  of  an  approval,  a  clinical  hold,  warning  letters,  product  recalls, 
product seizures, total or partial suspension of production or distribution, injunctions, fines, civil penalties 
or criminal prosecution. Any agency or judicial enforcement action could have a material adverse effect on 
us. The process required by the FDA before a drug may be marketed in the United States generally involves 
the following:  

•

•

•

•

•

•

•

completion of pre-clinical laboratory tests, animal studies and formulation studies according to the 
FDA’s good laboratory practice, or GLP, regulations;  

submission of an investigational new drug application, or IND, which must become effective before 
human clinical trials may begin and which must include approval by an institutional review board, 
or IRB, at each clinical site before the trials are initiated;  

performance  of  adequate  and  well-controlled  human  clinical  trials  to  establish  the  safety  and 
efficacy of the proposed drug for its intended use conducted in compliance with federal regulations 
and good clinical practice, or GCP, an international standard meant to protect the rights and health 
of patients and to define the roles of clinical trial sponsors, administrators, and monitors;  

submission to, and acceptance by, the FDA of an NDA;  

satisfactory completion of an FDA inspection of the manufacturing facility or facilities at which 
the drug is produced to assess compliance with current good manufacturing practice, or cGMP, 
regulations to assure that the facilities, methods and controls are adequate to preserve the drug’s 
identity, strength, quality and purity;  

potential FDA audit of the non-clinical and clinical trial sites that generated the data in support of 
the NDA; and 

FDA review and approval of the NDA.  

United States drug development process 

Once a pharmaceutical candidate is identified for development it enters the pre-clinical testing stage. Pre-
clinical  tests  include  laboratory  evaluations  of  product  chemistry,  toxicity  and  formulation,  as  well  as 

27 

animal studies. Prior to beginning human clinical trials, an IND sponsor must submit an IND to the FDA. 
The IND sponsor must submit the results of the pre-clinical tests, together with manufacturing information 
and analytical data, to the FDA as part of the IND. Some pre-clinical or non-clinical testing may continue 
even after the IND is submitted. In addition to including the results of the pre-clinical studies, the IND will 
also include a protocol detailing, among other things, the objectives of the clinical trial, the parameters to 
be used in monitoring safety and the effectiveness criteria to be evaluated, if the trial lends itself to an 
efficacy evaluation. The IND automatically becomes effective 30 days after receipt by the FDA, unless the 
FDA, within the 30–day time period, raises concerns or questions about the conduct of the trial. In such a 
case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can 
begin. The FDA may, at any time, impose a clinical hold on ongoing clinical trials. If the FDA imposes a 
clinical hold, clinical trials cannot commence or recommence without FDA authorization and then only 
under terms authorized by the FDA.  

Clinical trials involve the administration of the investigational new drug to healthy volunteers or patients 
under the supervision of one or more qualified investigators in accordance with federal regulations and 
GCP.  

Clinical trials must be conducted under protocols detailing the objectives of the trial and the safety and 
effectiveness  criteria  to  be  evaluated.  Each  protocol must  be  submitted  to  the FDA  as  part  of  the  IND. 
Further, an Institutional Review Board (IRB) at each institution participating in the clinical trial must review 
and approve each protocol before any clinical trial commences at that institution. All research subjects must 
provide informed consent, and informed consent information must be submitted to the IRB for approval 
prior to initiation of the trial. Progress reports detailing the results of the clinical trials must be submitted at 
least annually to the FDA and more frequently if adverse events or other certain types of other changes 
occur.  

Human clinical trials are typically conducted in three phases. A fourth, or post-approval, phase may include 
additional clinical studies. These phases generally include the following, and may be sequential, or may 
overlap or be combined:  

•

•

•

•

Phase 1 clinical trials involve the initial introduction of the drug into human subjects. These studies 
are designed to determine the safety of usually single doses of the compound and determine any 
dose limiting intolerance, as well as evidence of the metabolism and pharmacokinetics of the drug 
in humans. 

Phase 2 clinical trials usually involve studies in a limited patient population to evaluate the safety 
and  efficacy  of  the  drug  for  specific,  targeted  indications,  to  determine  dosage  tolerance  and 
optimal dosage, and to identify possible adverse effects and safety risks. 

In Phase 3, if a compound is found to be potentially effective and to have an acceptable safety 
profile in Phase 2 (or occasionally Phase 1) studies, the Phase 3 studies will be conducted to further 
confirm  clinical  efficacy,  optimal  dosage  and safety within  an  expanded population  which  may 
involve geographically diverse clinical trial sites. Generally, but not always, two adequate and well-
controlled Phase 3 clinical trials are required by the FDA for approval of an NDA. 

Phase 4 clinical trials are studies required of or agreed to by a sponsor that are conducted after the 
FDA has approved a product for marketing. These studies are used to gain additional experience 
from  the  treatment of  patients  in  the intended therapeutic  indication  and to  document  a  clinical 
benefit in the case of drugs approved under accelerated approval regulations. If the FDA approves 
a  product  while  a  company  has  ongoing  clinical  trials  that  were  not  necessary  for  approval,  a 
company may be able to use the data from these clinical trials to meet all or part of any Phase 4 

28 

clinical trial requirement. Failure to promptly conduct Phase 4 clinical trials where necessary could 
result in withdrawal of approval for products approved under accelerated approval regulations. 

While Phase 1, Phase 2, and Phase 3 tests are generally required for approval of an NDA, certain drugs may 
not  require  one  or  more  steps  in  the  process  depending  on  other  testing  and  the  situation  involved. 
Additionally, the FDA, an IRB, or the sponsor may stop testing at any time if results show patients being 
exposed to unnecessary health risks or overly dangerous side effects.  

In addition, the manufacturer of an investigational drug in a Phase 2 or Phase 3 clinical trial for a serious 
or life-threatening disease is required to make available, such as by posting on its website, its policy on 
evaluating and responding to requests for expanded access to such investigational drug.   

Concurrent with clinical trials, companies usually complete additional animal studies and must also develop 
additional information about the chemistry and physical characteristics of the drug and finalize a process 
for manufacturing the product in accordance with cGMP requirements. The manufacturing process must be 
capable of consistently producing quality batches of the drug candidate and, among other requirements, the 
manufacturer must develop methods for testing the identity, strength, quality and purity of the final drug. 
Additionally, appropriate packaging must be selected and tested and stability studies must be conducted to 
demonstrate that the drug candidate does not undergo unacceptable deterioration over its shelf life.  

Special factors with respect to clinical trials and pre-clinical studies conducted by others 

The primary focus of our product development efforts is on our own clinical trials and pre-clinical studies. 
However, we have in the past supported and will continue in the future to support pre-clinical studies and 
clinical  trials  and  studies  by  academic  investigators  (including  members  of  our  scientific  advisory 
committee and academic institutions with which they are affiliated) of the use of our drug candidates that 
we believe might further the understanding or increase the value of our drug candidates.  

In some cases, in the past, we have provided unrestricted sponsorship funds for such studies and we may 
do  so  again  in  the  future.  In  other  cases,  we  have  provided,  and  may  in  the  future  provide,  alternative 
assistance to the investigator, most typically providing drug substance or dosage form as well as matching 
placebo. We expect to continue supporting investigator-sponsored studies in the future to the extent that 
they meet criteria acceptable to us. In all cases, we seek to assist investigators in designing their studies so 
that  such  studies  are  most  appropriately  conducted  and,  to  the  extent  possible,  to  make  sure  that  these 
investigator studies potentially complement, and do not adversely impact, our activities.  

United States review and approval process 

FDA approval of an NDA is required before marketing of the product may begin in the United States. The 
NDA must include the results of product development, pre-clinical studies and clinical studies, together 
with other detailed information, including information on the chemistry, manufacture and composition of 
the product. The FDA has 60 days from its receipt of the NDA to review the application to ensure that it is 
sufficiently complete for substantive review before accepting it for filing. The FDA may request additional 
information rather than accept an NDA for filing. In this event, the NDA must be resubmitted with the 
additional information. The resubmitted application also is subject to review before the FDA accepts it for 
filing.  Once  the  submission  is  accepted for filing,  the  FDA  begins  an  in-depth substantive  review. The 
submission of an NDA is also subject to the payment of a substantial application fee (for FDA fiscal year 
2018  this  fee  is  $2,421,495),  although  a  waiver  of  such  fee  may  be  obtained  under  certain  limited 
circumstances,  including  when  the  drug  that  is  subject  of  the  application  has  received  Orphan  Drug 
Designation for the indication sought. Further, the sponsor of an approved NDA is subject to an annual 
program fee, which for FDA fiscal year 2018 is $304,162 per prescription drug product. Beginning in fiscal 

29 

year 2018, this annual program fee replaces the annual product and establishment fees. User fees typically 
increase annually. The approval process is lengthy and difficult and the FDA may refuse to approve an 
NDA if the applicable regulatory criteria are not satisfied or may require additional clinical or other data 
and information. Even if such data and information is submitted, the FDA may ultimately decide that the 
NDA does not satisfy the criteria for approval. The FDA may also refer applications for novel drug products 
or drug products which present difficult questions of safety or efficacy to an advisory committee, typically 
a  panel  that  includes  clinicians  and  other  experts,  for  review,  evaluation  and  a  recommendation  as  to 
whether the application should be approved. The FDA is not bound by the recommendation of an advisory 
committee. The FDA reviews an NDA to determine, among other things, whether a product is safe and 
effective for its intended use. Before approving an NDA, the FDA will inspect the facility or facilities where 
the  product  is  manufactured  to  determine  whether  its  manufacturing  is  cGMP–compliant  to  assure  and 
preserve the product’s identity, strength, quality, purity and stability.  

If the FDA’s evaluation of the NDA submission or manufacturing facilities is not favorable, the FDA will 
issue a complete response letter. The complete response letter outlines the deficiencies in the submission 
and often requires additional testing or information in order for the FDA to reconsider the application. Even 
after submitting this additional information, the FDA ultimately may decide that the application does not 
satisfy the regulatory criteria for approval. With limited exceptions, the FDA may withhold approval of a 
NDA regardless of prior advice it may have provided or commitments it may have made to the sponsor.  

Special Protocol Assessments

An SPA is a process in which sponsors may request to meet with the FDA to reach agreement on the design 
and size of certain clinical trials, clinical studies, or animal trials to determine if they adequately address 
scientific and regulatory requirements. As part of this process, sponsors submit specific questions about 
protocol design and scientific and regulatory requirements. After the FDA completes the review of an SPA 
request,  the  FDA  may  issue  a  SPA  Letter,  including  an  assessment  of  the  protocol,  agreement  or  non-
agreement with the proposed protocol, and answers to the sponsor's relevant questions. 

An  SPA  agreement  indicates  concurrence  by  the  FDA  with  the  adequacy  and  acceptability  of  specific 
critical  elements  of  overall  protocol  design  (e.g.,  entry  criteria,  dose  selection,  endpoints,  and  planned 
analyses). These elements are critical to ensuring that the trial conducted under the protocol has the potential 
to support a future submitted application's ability to meet regulatory requirements for approval. Feedback 
on  these  issues  provides  the  greatest  benefit  to  sponsors  in  planning  late-phase  development  strategy. 
However, an SPA agreement does not indicate FDA concurrence on every protocol detail. Further, the FDA 
may rescind an SPA if the director of the FDA reviewing division determines that a substantial scientific 
issue essential to determining the safety or efficacy of the drug was identified after the trial began.  Thus, 
an SPA is not binding on the FDA if, for example, the Agency identifies a safety concern related to the 
product or its pharmacological class, if the FDA or the scientific community recognizes a paradigm shift in 
disease diagnosis or management, if the relevant data or assumptions provided by the sponsor in the SPA 
submission are found to be false or misstated, or if the sponsor fails to follow the protocol that was agreed 
upon with the FDA. The FDA retains significant latitude and discretion in interpreting the terms of an SPA 
agreement and the data and results from the applicable clinical trial. 

Because an SPA provides for the evaluation of protocols for trials that have not been initiated, the conduct 
and  results  of  the  subsequent  trial  are  not  part  of  the  evaluation.  Therefore,  the  existence  of  an  SPA 
agreement does not guarantee that the FDA will accept an NDA, or that the trial results will be adequate to 
support approval. Those issues are addressed during the review of a submitted application; however, it is 
hoped that trial quality will be improved by the SPA process. 

30 

Post-approval requirements and consideration

Once an NDA is approved, a product will be subject to certain post-approval requirements. For instance, 
the FDA closely regulates the post-approval marketing and promotion of drugs, including standards and 
regulations  for  direct-to-consumer  advertising,  off-label  promotion,  industry-sponsored  scientific  and 
educational activities and promotional activities involving the internet. As a condition of NDA approval, 
the  FDA  may  also  require  a  risk  evaluation  and  mitigation  strategy,  or  REMS,  to  help  ensure  that  the 
benefits of the drug outweigh the potential risks. REMS can include medication guides, communication 
plans for the healthcare professionals, and other Elements To Assure Safe Use, or ETASU. ETASU can 
include, but are not limited to, special training or certification for prescribing or dispensing, dispensing only 
under certain circumstances, special monitoring, and the use of patient registries. The requirement for a 
REMS can materially affect the potential market and profitability of the drug.  

Drugs may be marketed only for the approved indications and in accordance with the provisions of the 
approved labeling. Changes to some of the conditions established in an approved application, including 
changes  in  indications,  labeling,  or  manufacturing  processes  or  facilities,  require  submission  and  FDA 
approval of a new NDA or NDA supplement before the change can be implemented. An NDA supplement 
for a new indication typically requires clinical data similar to that in the original application, and the FDA 
uses the same procedures and actions in reviewing NDA supplements as it does in reviewing NDAs.  

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

The Hatch-Waxman Amendments 

Orange Book Listing 

In seeking approval for a drug through an NDA, applicants are required to list with the FDA each patent 
with claims covering the applicant’s product or approved methods of using the product.  Upon approval of 
a drug, each of the patents listed in the application for the drug is then published in the FDA’s Approved 
Drug Products with Therapeutic Equivalence Evaluations, commonly known as the Orange Book.  Drugs 
listed in the Orange Book can, in turn, be cited by potential generic competitors in support of approval of 
an abbreviated new drug application, or ANDA.  An ANDA provides for marketing of a drug product that 
has the same active ingredients in the same strengths and dosage form as the listed drug and has been shown 
to  be  bioequivalent  to  the  listed  drug.    Other  than  the  requirement  for  bioequivalence  testing,  ANDA 
applicants are not required to conduct, or submit results of, pre-clinical or clinical tests to prove the safety 
or effectiveness of their drug product.  Drugs approved in this way are commonly referred to as “generic 
equivalents” to the listed drug, and can often be substituted by pharmacists under prescriptions written for 
the original listed drug. 

31 

The  ANDA  applicant  is  required  to  certify  to  the  FDA  concerning  any  patents  listed  for  the  approved 
product in the FDA’s Orange Book.  Specifically, the applicant must certify that: (i) the required patent 
information has not been filed; (ii) the listed patent has expired; (iii) the listed patent has not expired, but 
will expire on a particular date and approval is sought after patent expiration; or (iv) the listed patent is 
invalid or will not be infringed by the new product.  The ANDA applicant may also elect to submit a section 
viii  statement  certifying  that  its  proposed  ANDA  label  does  not  contain  (or  carves  out)  any  language 
regarding the patented method-of-use rather than certify to a listed method-of-use patent.    If the applicant 
does not challenge the listed patents, the ANDA application will not be approved until all the listed patents 
claiming the referenced product have expired.  

A certification that the new product will not infringe the already approved product’s listed patents, or that 
such  patents  are  invalid,  is  called  a  Paragraph  IV  certification.    If  the  ANDA  applicant  has  provided  a 
Paragraph IV certification to the FDA, the applicant must also send notice of the Paragraph IV certification 
to the NDA and patent holders once the ANDA has been accepted for filing by the FDA.  The NDA and 
patent holders may then initiate a patent infringement lawsuit in response to the notice of the Paragraph IV 
certification.  The filing of a patent infringement lawsuit within 45 days of the receipt of a Paragraph IV 
certification automatically prevents the FDA from approving the ANDA until the earlier of 30 months, 
expiration of the patent, settlement of the lawsuit, or a decision in the infringement case that is favorable to 
the ANDA applicant.   

The ANDA application also will not be approved until any applicable non-patent exclusivity listed in the 
Orange Book for the referenced product has expired. 

Exclusivity 

Upon NDA approval of a new chemical entity or NCE, which is a drug that contains no active moiety that 
has been approved by FDA in any other NDA, that drug receives five years of marketing exclusivity during 
which FDA cannot receive any ANDA seeking approval of a generic version of that drug.  A drug may 
obtain a three-year period of exclusivity for a particular condition of approval, or change to a marketed 
product, such as a new formulation for the previously approved product, if one or more new clinical studies 
(other than bioavailability or bioequivalence studies) was essential to the approval of the application and 
was  conducted/sponsored  by  the  applicant.  During  this  period  of  exclusivity,  FDA  cannot  approve  an 
ANDA for a generic drug that includes the change. 

An ANDA may be submitted one year before NCE exclusivity expires if a Paragraph IV certification is 
filed.  If there is no listed patent in the Orange Book, there may not be a Paragraph IV certification, and, 
thus, no ANDA may be filed before the expiration of the exclusivity period. 

Section 505(b)(2) New Drug Applications 

Most drug products obtain FDA marketing approval pursuant to an NDA or an ANDA.  A third alternative 
is a special type of NDA, commonly referred to as a Section 505(b)(2), or 505(b)(2), NDA, which enables 
the applicant to rely, in part, on FDA’s previous approval of a similar product, or published literature, in 
support of its application. 

505(b)(2) NDAs often provide an alternate path to FDA approval for new or improved formulations or new 
uses of previously approved products.  Section 505(b)(2) permits the filing of an NDA where at least some 
of the information required for approval comes from studies not conducted by, or for, the applicant and for 
which the applicant has not obtained a right of reference.  If the Section 505(b)(2) applicant can establish 
that reliance on FDA’s prior findings of safety and effectiveness or published literature is scientifically 
appropriate, it may eliminate the need to conduct certain pre-clinical or clinical studies of the new product.  

32 

The FDA may also require companies to perform additional studies or measurements to support the change 
from the approved product.  The FDA may then approve the new product candidate for all, or some, of the 
label indications for which the referenced product has been approved, as well as for any new indication 
sought by the Section 505(b)(2) applicant. 

To the extent that the Section 505(b)(2) applicant is relying on studies conducted for an already approved 
product,  the  applicant  is  required  to  certify  to  the  FDA  concerning  any  patents  listed  for  the  approved 
product in the Orange Book to the same extent that an ANDA applicant would.  A Section 505(b)(2) NDA 
may be eligible for three years of marketing exclusivity to the same extent that a Section 505(b)(1) NDA 
is.

Abbreviated new drug applications

Generic  drugs  may  enter the  market  after the  approval  of an  ANDA. The  ANDA  development  process 
typically  does  not require new  pre-clinical  or  clinical  studies,  but it does typically  require  one or  more 
bioequivalence  studies to  show  that  the  ANDA  drug  is  bioequivalent  to the  previously  approved  brand 
name  reference  listed  drug.  Bioequivalence  studies  compare  the  bioavailability  of  the  proposed  drug 
product with that of the approved listed product containing the same active ingredient. Bioavailability is a 
measure  of the  rate  and  extent to  which  the  active  ingredient  or  active  moiety  is  absorbed from  a  drug 
product and becomes available at the site of action. A demonstration of bioequivalence means that the rate 
and  extent  of  absorption  of  the  ANDA  drug  is  not  significantly  different  from  the  rate  and  extent  of 
absorption of the brand name reference listed drug when administered at the same molar dose under similar 
experimental conditions. 

As  noted  above,  generic drug  products  are  generally  introduced  to  the  marketplace  at  the expiration  of 
patent protection and non-patent market exclusivity for the reference listed drug. However, if an ANDA 
applicant is the first ANDA applicant to submit an ANDA containing a Paragraph IV certification, that 
ANDA may be eligible for a period of generic marketing exclusivity on approval. This exclusivity, which 
under certain circumstances must be shared with other ANDA applicants with Paragraph IV certifications, 
lasts  for  180  days,  during  which  the  FDA  cannot  grant  final  approval  to  other  ANDA  sponsors  of  an 
application for a generic equivalent to the same reference drug.  Under certain circumstances, eligibility for 
180-day exclusivity may be forfeited. 

Various  types  of  changes  to  an  approved  ANDA  must  be  requested  in  a  prior  approval  supplement.  In 
addition, some changes may only be approved only after new bioequivalence studies are conducted or other 
requirements  are  satisfied.    In  addition,  the  ANDA  applicant  must  demonstrate  that  manufacturing 
procedures and operations conform to FDA cGMP requirements.  Facilities, procedures, operations and/or 
testing of products are subject to periodic inspection by the FDA and other authorities. In addition, the FDA 
conducts pre-approval and post-approval reviews and inspections to determine whether the systems and 
processes are in compliance with cGMP and other FDA regulations. 

There  are  also  user  fees  for  ANDA  applicants,  sponsors,  and  manufacturers.  For  fiscal  year  2018,  the 
application fees are $171,823 per ANDA application and the facility fees are $211,087 per domestic final 
dosage  form  facility,  $226,087  per  foreign  final  dosage  form  facility,  $45,367  per  domestic  active 
pharmaceutical ingredient facility, and $60,367 per foreign active pharmaceutical ingredient facility.  In 
addition, there is a new annual program fee based on the size of the generic drug applicant.  These user fees 
typically increase each fiscal year. 

33 

Other regulatory requirements

In addition to regulation by the FDA and certain state regulatory agencies, we are also subject to a variety 
of foreign regulations governing clinical trials and the marketing of other products. Outside of the United 
States,  our  ability  to  market  a  product  depends  upon  receiving  a  marketing  authorization  from  the 
appropriate  regulatory  agencies.  The  requirements  governing  the  conduct  of  clinical  trials,  marketing 
authorization, pricing and reimbursement vary widely from country to country. In any country, however, 
we will only be permitted to commercialize our products if the appropriate regulatory agency is satisfied 
that we have presented adequate evidence of safety, quality and efficacy. Whether or not FDA approval has 
been obtained, approval of a product by the comparable regulatory authorities of foreign countries must be 
obtained prior to the commencement of marketing of the product in those countries. The regulatory approval 
and oversight process in other countries includes all of the risks associated with regulation by the FDA and 
certain state regulatory agencies as described above. 

Under the European Union regulatory system, applications for drug approval may be submitted either in a 
centralized or decentralized manner. Under the centralized procedure, a single application to the European 
Medicines Agency leads to an approval granted by the European Commission which permits marketing of 
the product throughout the European Union. The decentralized procedure provides for mutual recognition 
of nationally approved decisions and is used for products that do not comply with requirements for the 
centralized procedure. Under the decentralized procedure, the holders of national marketing authorization 
in one of the countries within the European Union may submit further applications to other countries within 
the European Union, who will be requested to recognize the original authorization based on an assessment 
report provided by the country in which marketing authorization is held.

Pharmaceutical pricing and reimbursement 

In  both  US  and  foreign  markets,  our  ability  to  commercialize  our  products  successfully,  and  to  attract 
commercialization  partners  for  our  products,  depends  in  significant  part  on  the  availability  of  adequate 
financial  coverage  and  reimbursement  from  third-party  payors,  including,  in  the  United  States, 
governmental  payors  such  as  Medicare  and  Medicaid,  managed  care  organizations,  private  commercial 
health insurers and PBMs. Third party payors are increasingly challenging the prices charged for medicines 
and examining their cost effectiveness, in addition to their safety and efficacy. We may need to conduct 
expensive pharmacoeconomic or other studies in order to further demonstrate the value of our products. 
Even with the availability of such studies, our products may be considered less safe, less effective or less 
cost-effective  than  alternative  products,  and  third-party  payors  may  not  provide  coverage  and 
reimbursement for our drug candidates, in whole or in part. 

Political, economic and regulatory influences are subjecting the health care industry in the United States to 
fundamental changes. There have been, and we expect there will continue to be, legislative and regulatory 
proposals to change the healthcare system in ways that could significantly affect our business, including 
the Patient Protection and Affordable Care Act of 2010 (the "Affordable Care Act"). In fact, there continue 
to be efforts in Congress to repeal the Affordable Care Act and replace it with another law and President 
Trump has stated that he supports repeal of all or portions of the Affordable Care Act. As a result, there is 
great uncertainty as to what changes will be made to U.S. healthcare laws and there can be no assurance 
how changes to those laws may affect our business.  

We  anticipate  that  in  the  US,  Congress,  state  legislatures,  and  private  sector  entities  will  continue  to 
consider and may adopt healthcare policies intended to curb rising healthcare costs. These cost containment 
measures could include: 

•

controls on government-funded reimbursement for drugs; 

34 

•

•

•

•

•

•

controls on healthcare providers; 

controls on pricing of pharmaceutical products; 

challenges to the pricing of drugs or limits or prohibitions on reimbursement for specific 
products through other means; 

reform of drug importation laws; 

entering into contractual agreements with payors; and 

expansion of use of managed-care systems in which healthcare providers contract to 
provide comprehensive healthcare for a fixed cost per person. 

We are unable to predict what additional legislation, regulations or policies, if any, relating to the healthcare 
industry  or  third-party  coverage  and  reimbursement  may  be  enacted  in  the  future  or  what  effect  such 
legislation, regulations or policies would have on our business. Any cost containment measures, including 
those listed above, or other healthcare system reforms that are adopted may have a material adverse effect 
on our business prospects. 

Further, the pricing of pharmaceutical products generally, and particularly the pricing of orphan drugs, has 
recently received scrutiny from the press, from members of Congress in both parties, and from President 
Trump. Some members of the medical community have also weighed in in the press on the potential pricing 
of orphan drugs generally and our product specifically. The impact of this scrutiny on us and on the pricing 
of orphan drugs and other pharmaceutical products generally cannot be determined with any certainty at 
this time. 

Orphan Drug Exclusivity and Pediatric Exclusivity Designation 

Some jurisdictions, including the United States and Europe, may designate drugs for relatively small patient 
populations as orphan drugs. Under the Orphan Drug Act of 1983 (ODA), the FDA may grant Orphan Drug 
Designation to drugs intended to treat a rare disease or condition that affects fewer than 200,000 individuals 
in  the  United  States,  or  more  than  200,000  individuals  in  the  United  States  and  for  which  there  is  no 
reasonable expectation that the cost of developing and making available in the United States a drug for this 
type of disease or condition will be recovered from sales in the United States for that drug. In the United 
States,  Orphan  Drug  Designation  must  be  requested  before  submitting  an  application  for  marketing 
approval. An Orphan Drug Designation does not shorten the duration of the regulatory review and approval 
process.  The  grant  of  an  Orphan  Drug  Designation  request  does  not  alter  the  standard  regulatory 
requirements and process for obtaining marketing approval. Safety and efficacy of a compound must be 
established through adequate and well-controlled studies. If a product which has been granted Orphan Drug 
Designation  subsequently  receives  the  first  FDA  approval  for  the  indication  for  which  it  has  such 
designation, the product is entitled to an orphan drug exclusivity period, which means the FDA may not 
approve any other application to market the same drug for the same indication for a period of seven years, 
except in limited circumstances, such as where an alternative product demonstrates clinical superiority to 
the product with orphan exclusivity. In addition, holders of exclusivity for orphan drugs are expected to 
assure the availability of sufficient quantities of their orphan drugs to meet the needs of patients. Failure to 
do so could result in the withdrawal of marketing exclusivity for the drug.  

The orphan drug exclusivity contained in the ODA has been the subject of recent scrutiny from the press, 
from some members of Congress and from some in the medical community. There can be no assurance that 

35 

the exclusivity granted in ODA to orphan drugs approved by the FDA will not be modified in the future, 
and as to how any such change might affect our products, if approved. 

Pediatric exclusivity is another type of non-patent exclusivity in the U.S. and, if granted, provides for the 
attachment  of  an  additional  six  months  of  marketing  protection  to  the  term  of  any  existing  regulatory 
exclusivity, including the five-year and three-year non-patent and seven-year orphan exclusivities. This six-
month exclusivity may be granted if an NDA sponsor submits pediatric data that fairly responds to a written 
request from the FDA for such data. The data do not need to show the product to be effective in the pediatric 
population  studied.  If  the  FDA  determines  that  information  relating  to  the  use  of  the  new  drug  in  the 
pediatric population may produce health benefits in the population, the clinical study is deemed to fairly 
respond  to  the  FDA's  request  and  the  reports  of  FDA-requested  pediatric  studies  are  submitted  to  and 
accepted by the FDA within the statutory time limits, whatever statutory or regulatory periods of exclusivity 
or patent protection covering the product are extended by six months. This is not a patent term extension, 
but it effectively extends the regulatory period during which the FDA cannot approve another application 
relying on the NDA sponsor's data. 

The European Orphan Drug Regulation is considered for drugs intended to diagnose, prevent or treat a life-
threatening  or  very  serious  condition  afflicting  five  or  fewer  per  10,000  people  in  the  EU,  including 
compounds that for serious and chronic conditions would likely not be marketed without incentives due to 
low market return on the sponsor's development investment. The medicinal product considered should be 
of  significant  benefit  to  those  affected  by  the  condition.  Benefits  of  being  granted  Orphan  Medicinal 
Product  Designation  are  significant,  including  eight  years  of  data  exclusivity,  two  years  of  marketing 
exclusivity and a potential one-year extension of both. The EU Community and Member States may not 
accept or grant for ten years a new marketing authorization or application for another drug for the same 
therapeutic indication as the orphan drug, although the ten year period can be reduced to six years if, after 
the end of the  fifth  year,  available evidence  establishes that  the  product  is  sufficiently  profitable  not to 
justify maintenance of the marketing exclusivity. A supplementary protection certificate may extend the 
protection six months beyond patent expiration if that is later than the orphan drug exclusivity period. To 
apply for the supplementary protection, a pediatric investigation plan, or PIP, must be included in the market 
application. In Europe all drugs now seeking marketing authorization need to have a PIP agreed with the 
European  Medicines  Agency  (EMA)  before  it  can  be  approved,  even  if  it  is  a  drug  being  developed 
specifically for a pediatric indication. If a product is developed solely for use in the pediatric population, 
then a Pediatric Use Marketing Authorization, or PUMA, may provide eight years of data exclusivity and 
ten years of marketing exclusivity.  

Breakthrough Therapy Designation 

Breakthrough therapy designation is intended to expedite the development and review of drugs for serious 
or life-threatening conditions. The criteria for breakthrough therapy designation require preliminary clinical 
evidence that demonstrates the drug may have substantial improvement on at least one clinically significant 
endpoint over available therapy. A breakthrough therapy designation conveys all of the fast track program 
features (see below for more details on fast track designation), as well as more intensive FDA guidance on 
an efficient drug development program. The FDA also has an organizational commitment to involve senior 
management in such guidance.  Actions taken to expedite development may include the following actions, 
as appropriate: 

•

•

holding meetings with the sponsor and review team throughout the development of the drug; 

providing  timely  advice  to,  and  interactive  communication  with,  the  sponsor  regarding  the 
development of the drug to ensure that the development program to gather the non-clinical and 
clinical data necessary for approval is as efficient as possible; 

36 

•

•

•

taking  steps  to  ensure  that  the  design  of  the  clinical  trials  is  as  efficient  as  practicable,  when 
scientifically appropriate, such as by minimizing the number of patients exposed to a potentially 
less efficacious treatment; 

assigning a cross-disciplinary project lead for the FDA review team to facilitate an efficient review 
of  the  development  program  and  to  serve  as  a  scientific  liaison  between  the  cross-discipline 
members  of  the  review  team  (i.e.,  clinical,  pharmacology-toxicology,  chemistry,  manufacturing 
and control (CMC), compliance) for coordinated internal interactions and communications with the 
sponsor through the review division's Regulatory Health Project Manager; and 

involving senior managers and experienced review staff, as appropriate, in a collaborative, cross-
disciplinary review. 

Fast Track Designation and Accelerated Approval 

FDA is required to facilitate the development, and expedite the review, of drugs that are intended for the 
treatment of a serious or life-threatening disease or condition for which there is no effective treatment and 
which demonstrate the potential to address unmet medical needs for the condition.  Under the fast track 
program, the sponsor of a new drug candidate may request that FDA designate the drug candidate for a 
specific indication as a fast track drug concurrent with, or after, the filing of the IND for the drug candidate.  
FDA must determine if the drug candidate qualifies for fast track designation within 60 days of receipt of 
the sponsor’s request. 

Under the fast track program and FDA’s accelerated approval regulations, FDA may approve a drug for a 
serious  or  life-threatening  illness  that  provides  meaningful  therapeutic  benefit  to  patients  over  existing 
treatments  based  upon  a  surrogate  endpoint  that  is  reasonably  likely  to  predict  clinical  benefit,  or  on  a 
clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably 
likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account 
the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. 

In  clinical  trials,  a  surrogate  endpoint  is  a  measurement  of  laboratory  or  clinical  signs  of  a  disease  or 
condition that substitutes for a direct measurement of how a patient feels, functions, or survives.  Surrogate 
endpoints can often be measured more easily or more rapidly than clinical endpoints.  A drug candidate 
approved  on  this  basis  is  subject  to  rigorous  post-marketing  compliance  requirements,  including  the 
completion of Phase 4 or post-approval clinical trials to confirm the effect on the clinical endpoint.  Failure 
to conduct required post-approval studies, or confirm a clinical benefit during post-marketing studies, will 
allow FDA to withdraw the drug from the market on an expedited basis.  All promotional materials for drug 
candidates approved under accelerated regulations are subject to prior review by FDA. 

In addition to other benefits such as the ability to use surrogate endpoints and engage in more frequent 
interactions  with  FDA,  FDA  may  initiate  review  of  sections  of  a  fast  track  drug’s  NDA  before  the 
application is complete.  This rolling review is available if the applicant provides, and FDA approves, a 
schedule  for  the  submission  of  the  remaining  information  and  the  applicant  pays  applicable  user  fees.  
However, FDA’s time period goal for reviewing an application does not begin until the last section of the 
NDA is submitted.  Additionally, the fast track designation may be withdrawn by the FDA if the FDA 
believes that the designation is no longer supported by data emerging in the clinical trial process. 

37 

Priority Review 

Under FDA policies, a drug candidate is eligible for priority review, or review within a six to eight-month 
time frame from the time a complete NDA is submitted, if the drug candidate is intended for the treatment, 
diagnosis or prevention of a serious or life-threatening condition, demonstrates the potential to address an 
unmet medical need, or provides a significant improvement compared to marketed drugs.  

Disclosure of clinical trial information 

Sponsors of clinical trials of FDA-regulated products, including drugs, are required to register and disclose 
certain  clinical  trial  information.    Information  related  to  the  product,  patient  population,  phase  of 
investigation, study sites and investigators, and other aspects of the clinical trial is then made public as part 
of the registration.  Sponsors are also obligated to disclose the results of their clinical trials after completion. 
Disclosure of results of these trials can be delayed in certain circumstances for up to two years after the 
date of completion of the clinical trial. Competitors may use this publicly-available information to gain 
knowledge regarding the progress of development programs. 

Anti-Kickback, False Claims Laws & the Prescription Drug Marketing Act 

In addition to FDA restrictions on marketing of pharmaceutical products, other state and federal laws have 
been applied to restrict certain marketing practices in the pharmaceutical industry in recent years. These 
laws include anti-kickback statutes and false claims statutes. The federal healthcare program anti-kickback 
statute  prohibits,  among  other  things,  knowingly  and  willfully  offering,  paying,  soliciting  or  receiving 
remuneration to induce or in return for purchasing, leasing, ordering or arranging for the purchase, lease or 
order of any healthcare item or service reimbursable under Medicare, Medicaid or other federally financed 
healthcare programs. This statute has been interpreted to apply to arrangements between pharmaceutical 
manufacturers on the one hand and patients, prescribers, purchasers and formulary managers on the other. 
Violations  of  the  anti-kickback  statute  are  punishable  by  imprisonment,  criminal  fines,  civil  monetary 
penalties and exclusion from participation in federal healthcare programs. Although there are a number of 
statutory exemptions and regulatory safe harbors protecting certain common activities from prosecution or 
other regulatory sanctions, the exemptions and safe harbors are drawn narrowly, and practices that involve 
remuneration intended to induce prescribing, purchases or recommendations may be subject to scrutiny if 
they do not qualify for an exemption or safe harbor.  

Federal false claims laws prohibit any person from knowingly presenting, or causing to be presented, a false 
claim for payment to the federal government, or knowingly making, or causing to be made, a false statement 
to  have  a  false  claim  paid.  Recently,  several pharmaceutical and other  healthcare  companies have  been 
prosecuted under these laws for allegedly inflating drug prices they report to pricing services, which in turn 
were  used  by  the  government  to  set  Medicare  and  Medicaid  reimbursement  rates,  and  for  allegedly 
providing free product to customers with the expectation that the customers would bill federal programs for 
the product. In addition, certain marketing practices, including off-label promotion, may also violate false 
claims laws. The majority of states also have statutes or regulations similar to the federal anti-kickback law 
and  false  claims  laws,  which  apply  to  items  and  services  reimbursed  under  Medicaid  and  other  state 
programs, or, in several states, apply regardless of the payer.  

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule that requires manufacturers 
of  approved  prescription  drugs  to  collect  and  report  information  on  payments  or  transfers  of  value  to 
physicians and teaching hospitals, as well as investment interests held by physicians and their immediate 
family members. The information reported each year is made publicly available on a searchable website.  
Failure to submit required information may result in civil monetary penalties.   

38 

In  addition,  several  states  now  require  prescription  drug  companies  to  report  expenses  relating  to  the 
marketing and promotion of drug products and to report gifts and payments to individual physicians in these 
states.  Other states prohibit various other marketing-related activities.  Still other states require the posting 
of information relating to clinical studies and their outcomes.  In addition, California, Connecticut, Nevada, 
and Massachusetts require pharmaceutical companies to implement compliance programs and/or marketing 
codes.  Several additional states are considering similar proposals.  Compliance with these laws is difficult 
and time consuming, and companies that do not comply with these state laws face civil penalties. 

Prescription drug advertising is subject to federal, state and foreign regulations. In the United States, the 
FDA regulates prescription drug promotion, including direct-to-consumer advertising. Prescription drug 
promotional materials must be submitted to the FDA in conjunction with their first use. Any distribution of 
prescription  drug  products  and  pharmaceutical  samples  must  comply  with  the  U.S.  Prescription  Drug 
Marketing Act (PDMA), a part of the FDCA. In addition, Title II of the Federal Drug Quality and Security 
Act of 2013, known as the Drug Supply Chain Security Act (DSCSA), has imposed new “track and trace” 
requirements on  the  distribution  of  prescription  drug  products  by  manufacturers,  distributors, and  other 
entities  in  the  drug  supply  chain.  These  requirements  are  being  phased  in  over  a  ten-year  period.  The 
DSCSA ultimately will require product identifiers (i.e., serialization) on prescription drug products in order 
to  establish  an  electronic  interoperable  prescription  product  to  system  to  identify  and  trace  certain 
prescription  drugs  distributed  in  the  United  States.  The  DSCSA  replaced  the  prior  drug  “pedigree” 
requirements  under  the  PDMA,  and  preempts  existing  state  drug  pedigree  laws  and  regulations.   The 
DSCSA also establishes new requirements for the licensing of wholesale distributors and third party logistic 
providers.  These  licensing  requirements  preempt  states  from  imposing  licensing  requirements  that  are 
inconsistent with, less stringent than, directly related to, or otherwise encompassed by standards established 
by FDA pursuant to the DSCSA. Until FDA promulgates regulations to address the DSCSA’s new national 
licensing standard, current state licensing requirements typically remain in effect. 

Our Employees 

As of March 9, 2018 we had 21 employees.  We also utilize the services of consultants, including several 
members of our Scientific Advisory Board.  None of our employees are covered by a collective bargaining 
agreement.  We believe our relationship with our employees and consultants is good. 

Our Scientific Advisory Board 

We rely on prominent scientists and physicians to advise us on the development of our drug candidates.  
All  of  our  advisors  are  employed  by  organizations  other  than  ours  and  may  have  commitments  to  or 
consulting or advisory agreements with other entities that may limit their availability to us.  Our Scientific 
Advisory Board currently consists of the following members: 

•

Jonathan Brodie, PhD, MD, is the chairman of our Scientific Advisory Board and Professor Emeritus 
of  Psychiatry  at  New  York  University  School  of  Medicine.  Dr.  Brodie  completed  his  Bachelor  of 
Science degree in chemistry as a Ford Foundation Scholar and his PhD in Physiological Chemistry 
(Organic  Chemistry  minor)  at  the  University  of  Wisconsin-Madison.  He  was  an  NIH  postdoctoral 
Fellow in Biochemistry at Scripps Clinic and Research Foundation and a tenured associate professor 
of Biochemistry at the School of Medicine at SUNY at Buffalo. He then received his MD degree at 
New  York  University  School  of  Medicine  and  joined  the  faculty  after  completing  his  residency  in 
psychiatry at NYU/Bellevue Medical Center. He has been a member of the Promotions and Tenure 
Committee of the School of Medicine and co-chairman of the Executive Advisory Committee of the 
General  Clinical  Research  Center  and  the  Protocol  Review  Committee  of  the  Center  for  Advanced 
Brain Imaging (CABI) of Nathan Kline Institute. He also served as Interim Chairman of the Department 
of Psychiatry of the NYU School of Psychiatry at the NYU School of Medicine. For 15 years, he was 
the NYU Director of the Brookhaven National Laboratory/NYUSoM collaboration investigating the 
use of positron emitters and PET in neuroscience and psychiatry. In addition, Dr. Brodie serves as a 

39 

psychopharmacology  preceptor  to  psychiatry  residents.  As  a  clinician,  he  treats  patients  in  general 
issues of adult psychiatry including anxiety and depression. 

• Robert  D.  Fechtner,  MD,  is  Professor  and  Chair  of  Ophthalmology  at  SUNY  Upstate  Medical 
University, Syracuse, New York. Dr. Fechtner received his Bachelor of Science degree in biomedical 
science and his medical degree from the University of Michigan. He completed his residency at Albert 
Einstein College of Medicine in New York. A fellowship in glaucoma followed at the University of 
California, San Diego, under a National Research Service Award from the National Institutes of Health. 
Dr. Fechtner is the Executive Vice President of the World Glaucoma Association and has published 
more than 100 scientific articles and book chapters. 

• Eugene Laska, PhD, is a professor in the Department of Psychiatry at New York University and the 
former Director of the Statistical Sciences unit at the Nathan S. Kline Institute for Psychiatric Research. 
Dr. Laska was for 20 years the Director of the WHO Collaborating Center for Research and Training 
in  Mental  Health  Program  Management  and  has  served  as  a  statistical  consultant  to  many 
pharmaceutical companies (including us) both large and small with regard to biostatistics and clinical 
trial design. He is a fellow of the American Statistical Association and the American Association for 
the Advancement of Science. 

• Richard B. Silverman, Ph.D. is the Patrick G. Ryan/Aon Professor in the Department of Chemistry at 
Northwestern University. He is the inventor of Pfizer's $4.5 billion/year Lyrica® (pregabalin), marketed 
worldwide for the treatment of epilepsy, neuropathic pain, fibromyalgia, pain from spinal cord injury, 
and  (in  Europe)  for  generalized  anxiety  disorder.  He  has  received  numerous  awards,  most  recently 
American  Chemical  Society  Creative  Invention  Award  (2017),  Fellow  of the  National  Academy  of 
Inventors (2014), Fellow of the American Academy of Arts & Sciences (2014), iCON Innovator Award 
of  the  iBIO  Institute  (2014),  Northwestern  University  Trustee  Medal  for  Faculty  Innovation  and 
Entrepreneurship (2014), Medicinal Chemistry Prize of the Israel Chemistry Society (2014), Fellow of 
the Royal Society of Chemistry (UK, 2013), Centenary Prize of the Royal Society of Chemistry (2013), 
Bristol-Myers Squibb-Edward E. Smissman Award of the American Chemical Society (2013), Sato 
Memorial International Award of the Pharmaceutical Society of Japan (2012), Fellow of the American 
Chemical  Society  (2011),  E.B.  Hershberg  Award  for  Important  Discoveries  in  Medicinally  Active 
Substances from the American Chemical Society (2011), Perkin Medal from the Society of Chemical 
Industry (2009), Medicinal Chemistry Hall of Fame of the American Chemical Society (2009).  Dr. 
Silverman holds 88 patents, has published over 360 peer-reviewed articles and has written five books 
over his almost 42-year career in academia. 

We may add additional members to or revise the makeup of our Scientific Advisory Board in the future to 
add personnel who will assist us in the future development of Firdapse®. 

Available Information  

We make available free of charge on or through our Internet website our Annual Report on Form 10-K, 
Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and all amendments to those reports as 
soon as reasonably practicable after such material is electronically filed with or furnished to the Securities 
and Exchange Commission (SEC).  Our Internet address is www.catalystpharma.com.  The content on our 
website is not, nor should it be deemed to be, incorporated by reference into this Form 10-K. 

40 

Item 1A. 

Risk Factors 

Our  business involves a  high  degree  of  risk.   You  should carefully  consider  the  risks  and  uncertainties 
described below, and all of the other information contained in this Form 10-K in assessing the risks relating 
to  ownership  of  our  common  stock.    The  risks  described  below  could  cause  our  business,  results  of 
operations,  financial  condition  and  prospects  to  materially  suffer  and  the  market  price  of  our  stock  to 
decline. 

Risks Related to our Business 

We are a development stage company. Our limited operating history makes it difficult to evaluate our 
future performance.  

We are a development stage company and, as such, we have a limited operating history upon which you 
can evaluate our current business and our prospects. The likelihood of our future success must be viewed 
in light of the problems, expenses, difficulties, delays and complications often encountered in the operation 
of a business without revenues, especially in the pharmaceutical industry, where failures of companies are 
common.  We  are  subject  to  the  risks  inherent  in  the  ownership  and  operation  of  a  development  stage 
company,  including  availability  of  capital,  regulatory  setbacks  and  delays,  fluctuations  in  expenses, 
competition and government regulation. If we fail to address these risks and uncertainties our business, 
results of operations, financial condition and prospects would be adversely affected.  

We have no products currently available and we have never had any products available for commercial 
sale. 

We have had no revenues from product sales to date, currently have no products available for commercial 
sale, and have never had any products available for commercial sale. We expect to incur losses at least until 
we are in a position to commercialize Firdapse®, which may never occur. Our net loss was $18.4 million 
and $18.1 million for the years ended December 31, 2017 and December 31, 2016, respectively. We may 
never obtain approval of an NDA for any of our drug candidates and we may never achieve profitability.  

Our business will require additional capital.  

Based on our current financial condition and forecasts of available cash, we believe that we have sufficient 
funds to support our operations through 2019 (without considering revenues and cash receipts that may be 
received in 2019 if we are successful in obtaining an approval of Firdapse® and launching the product in 
2019,  of  which  there  can  be  no  assurance).  The  expectations  described  above  are  based  on  current 
information available to us. If the cost of our ongoing activities are greater than we expect, our assumptions 
may not prove to be accurate. There can be no assurance as to the exact amount of the funding we will 
require or as to whether any such required funding will be available to us when it is required.  

We plan to raise additional funds in the future through public or private equity offerings, debt financings, 
corporate collaborations, or other means. We may also seek governmental grants to support our clinical and 
pre-clinical trials. However, there is no assurance that any such grants will be available, and, if available, 
that  we  will  qualify  to  receive  any  such  grants.  We  may  also  seek  to  raise  additional  capital  to  fund 
additional product development efforts, even if we have sufficient funds for our planned operations. 

Any  sale  by  us  of  additional  equity  or  debt  securities  convertible  into  additional  equity  could  result  in 
dilution  to  our  stockholders.  There  can  be  no  assurance  that  any  required  additional  funding  will  be 
available to us at all or available on terms acceptable to us. Further, to the extent that we raise funds through 
collaborative  arrangements,  it  may  be  necessary  to  relinquish  some  rights  to  our  technologies  or  grant 
sublicenses on terms that are not favorable to us. If we are not able to secure funding when needed, we may 

41 

have to delay, reduce the scope of or eliminate one or more research and development programs, which 
could have an adverse effect on our business.  

If we are not the first to obtain approval for Firdapse® for the treatment of LEMS, we may not be able 
to bring it to market in the United States. 

Another pharmaceutical company, Jacobus Pharmaceutical, has completed its own clinical trial studying 
their own formulation of amifampridine (3,4-DAP) for the treatment of LEMS. Jacobus Pharmaceutical is 
a privately held company and there is little public information available about their development plans.  
While there can be no assurance, we believe that Firdapse® is further along in development and as a result 
we  expect that we will be in a position to obtain the first approval of an NDA for 3,4-DAP. Under the 
Orphan Drug Act of 1983, the first pharmaceutical product to obtain approval for an orphan designated 
indication receives the orphan exclusivity under the statute. If Jacobus Pharmaceutical receives approval of 
an NDA for its formulation of amifampridine for the treatment of LEMS before we are able to receive 
approval of Firdapse® for the same indication, we would be barred from marketing Firdapse® in the United 
States during the seven-year orphan exclusivity period, which would have a severe adverse effect on our 
results of operations. In addition, if Jacobus Pharmaceutical were to receive five-year new chemical entity 
exclusivity for amifampridine for any indication prior to approval of Firdapse®, we would be barred from 
marketing Firdapse® for any indication in the United States during this five-year exclusivity period.  

The development of CPP-115 is at an early stage.  

Our development of CPP-115 is at an early stage, and it is going to be several years before we are in a 
position to submit an NDA for CPP-115, assuming any future clinical trials of this product that we undertake 
are successful. At the present time, there can be no assurance that we will ever submit an NDA for CPP-
115 or successfully commercialize CPP-115.  

Our business is subject to substantial competition.  

The biotechnology and pharmaceutical industries are highly competitive. Many of our competitors have 
substantially  greater  financial  and  other  resources,  larger  research  and  development  staffs  and  more 
experience  developing  products,  obtaining  FDA  and  other  regulatory  approvals  of  products  and 
manufacturing and marketing products than we have. We compete against pharmaceutical companies that 
are developing or currently marketing therapies that will compete with our drug candidates. In addition, we 
compete  against  biotechnology  companies,  universities,  government  agencies,  and  other  research 
institutions in the development of pharmaceutical products. While we believe that our drug candidates will 
offer advantages over many of the currently available competing therapies, our business could be negatively 
impacted if our competitors’ present or future offerings are more effective, safer or less expensive than 
ours, or more readily accepted by regulators, healthcare providers or third-party payors. Further, if we are 
permitted to commence commercial sales of our drug candidates, we may also compete with respect to 
manufacturing efficiency and marketing capabilities.  

For example, amifampridine, the active ingredient in Firdapse®, despite not being FDA approved, has been 
available from compounding pharmacies and from Jacobus Pharmaceutical under compassionate use INDs 
for many years. Amifampridine from these sources can be expected to be substantially less expensive than 
Firdapse®. The FDA, however, has previously issued a list of drugs that were nominated without adequate 
clinical support (i.e., FDA’s Bulks List 3), and amifampridine was included on that list. However, that does 
not necessarily prevent pharmacists from compounding amifampridine, and we know of no enforcement 
action that FDA has taken concerning compounders that compound formulations using substances on List 
3.  In  addition,  drugs  that  are  not  approved  by  FDA  for  the  treatment  of  LEMS,  such  as  a  related 
aminopyridine  drug,  dalfampridine  (Ampyra®),  may  nonetheless  be  prescribed  by  physicians  for  the 

42 

treatment  of  LEMS.  Finally,  if  FDA  approves  Firdapse®,  the  ingredients  in  the  drug  may  be  used  by 
compounding pharmacies pursuant to Section 503A of the Federal Food, Drug, and Cosmetic Act because 
pharmacies that compound for individually identified patients under Section 503A may compound using 
components of approved drug products.   

For all of these reasons, we may not be able to compete successfully.  

We face a risk of product liability claims and may not be able to obtain adequate insurance.  

Our business exposes us to potential liability risks that may arise from the clinical testing, manufacture, 
and/or  sale  of  our  pharmaceutical  products.  Patients  have  received  substantial  damage  awards  in  some 
jurisdictions against pharmaceutical companies based on claims for injuries allegedly caused by the use of 
pharmaceutical products used in clinical trials or after FDA approval. Liability claims may be expensive to 
defend  and  may  result  in  large  judgments  against  us.  We  currently  carry  liability  insurance  with  an 
aggregate  annual  coverage  limit  of  $15,000,000  per  claim  and  $15,000,000  in  the  aggregate,  with  a 
deductible  of  $10,000  per  occurrence.  Our  insurance  may  not  reimburse  us  for  certain  claims  or  the 
coverage may not be sufficient to cover claims made against us. We cannot predict all of the possible harms 
or side effects that may result from the use of our current drug candidates, or any potential future products 
we may acquire and use in clinical trials or after FDA approval and, therefore, the amount of insurance 
coverage we currently hold may not be adequate to cover all liabilities we might incur. If we are sued for 
any  injury  allegedly  caused  by  our  products,  our  liability  could  exceed  our  ability  to  pay  the  liability. 
Whether  or  not  we  are  ultimately  successful  in  any  adverse  litigation,  such  litigation  could  consume 
substantial amounts of our financial and managerial resources, all of which could have a material adverse 
effect on our business, financial condition, results of operations, prospects and stock price.  

The obligations incident to being a public company place significant demands on our management.  

As a public reporting company, we are required to comply with the Sarbanes-Oxley Act of 2002 and the 
related  rules  and  regulations  of  the  SEC,  including  periodic  reports,  disclosures  and  more  complex 
accounting rules. As directed by Section 404 of Sarbanes-Oxley, the SEC adopted rules requiring public 
companies to include a report of management on a company’s internal control over financial reporting in 
their  Annual  Report  on  Form  10-K.  Based  on  current  rules,  we  are  required  to  annually  report  under 
Section 404(a) of Sarbanes-Oxley regarding our management’s assessment as to the effectiveness of our 
internal control over financial reporting. Further, under Section 404(b) of Sarbanes-Oxley, our auditors are 
required to report on their assessment as to the effectiveness of our internal control over financial reporting. 
If  we  or  our  auditors  are  unable  to  conclude  that  we  have  effective  internal  control  over  our  financial 
reporting, investors could lose confidence in the reliability of our consolidated financial statements, which 
could result in a decrease in the value of our common stock.  

We are highly dependent on our small number of key personnel and advisors.  

We are highly dependent on our officers and employees, on our Board of Directors and on our scientific 
advisors. The loss of the services of any of these individuals could significantly impede the achievement of 
our scientific and business objectives. Other than an employment agreement with Patrick J. McEnany, our 
Chairman, President and Chief Executive Officer with respect to his services, and the consulting agreements 
we have with several of our scientific advisors, we have no employment or retention agreements with our 
officers, directors or scientific advisors. If we lose the services of any of our existing officers, directors or 
scientific advisors, or if we were unable to recruit qualified replacements on a timely basis for persons who 
leave our employ, our efforts to develop our drug candidates might be significantly delayed. We do not 
carry key-man insurance on any of our personnel.  

43 

We have relationships with our scientific advisors and with collaborators at academic and other institutions. 
Such  individuals  are  employed  by  entities  other  than  us  and  may  have  commitments  to,  or  consulting 
advisory contracts with, such entities that may limit their availability to us. Although each scientific advisor 
and  collaborator  has  agreed  not  to  perform  services  for  another  person  or  entity  that  would  create  an 
appearance of a conflict of interest, conflicts may arise from the work in which other scientific advisors 
and/or collaborators are involved.  

Risks Related to the Development of Our Drug Candidates  

Our drug development efforts may fail.  

Development of our pharmaceutical drug candidates is subject to risks of failure. For example:  

•

•

•

our drug candidates may be found to be ineffective or unsafe, or fail to receive necessary regulatory 
approvals;  

our  drug  candidates  may  not  be  economical  to  market  or  take  substantially  longer  to  obtain 
necessary regulatory approvals than anticipated; or  

competitors may develop and market equivalent or superior products, including next generation 
products that act with the same mechanism of action as our drug candidates. 

As a result, our drug development activities may not result in any safe, effective and commercially viable 
products, and we may not be able to commercialize our products successfully. For example, for several 
years,  we  evaluated  CPP-109  (our  formulation  of  vigabatrin)  for  the  treatment  of  cocaine  addiction. 
However, CPP-109 failed to meet the primary and two key secondary endpoints in a Phase 2b trial for 
cocaine addiction, and we are no longer pursuing the evaluation of CPP-109 for addiction. Further, our lead 
compound, Firdapse®, is for very rare conditions for which there is no FDA-approved treatment. As such, 
the  clinical  development  plan  we  pursued  after  consulting  with  FDA,  including  the  clinical  endpoints, 
protocol design, and statistical analysis plan, may not allow the FDA to ultimately conclude that our NDA 
for Firdapse® meets the safety and efficacy standards for approval. For example, in 2015, we submitted an 
NDA for Firdapse® for the treatment of LEMS and CMS. However, we received a “refusal-to-file” (RTF) 
letter from the FDA regarding our NDA submission. FDA advised us that, in addition to the results of our 
previously submitted multi-center, randomized, placebo-controlled Phase 3 trial, we will need to submit 
positive results from a second adequate and well-controlled study in patients with LEMS and several abuse 
liability studies for Firdapse®.  Our failure to develop safe, effective, and/or commercially viable products 
would  have  a  material  adverse  effect  on  our  business,  prospects,  results  of  operations  and  financial 
condition.  

Our failure to develop safe, effective, and/or commercially viable products would have a material adverse 
effect on our business, prospects, results of operations and financial condition.  

Failure can occur at any stage of our drug development efforts.  

We will only obtain regulatory approval to commercialize our drug candidates if we can demonstrate to the 
satisfaction of the FDA (or the equivalent foreign regulatory authorities) in adequate and well-controlled 
clinical studies and trials that the drug is safe and effective for its intended use, that the clinical and other 
benefits  outweigh  the  safety  risks  and  that  it  otherwise  meets  approval  requirements.  As  we  have 
experienced in the past, a failure of one or more pre-clinical or clinical trials or studies can occur at any 
stage of drug development. We may experience numerous unforeseen events during, or as a result of, testing 
that  could  delay  or  prevent  us  from  obtaining  regulatory  approval  for,  or  commercializing  our  drug 
candidates, including but not limited to:  

44 

•

•

•

regulators or Institutional Review Boards (IRBs) may not authorize us to commence a clinical trial 
or conduct a clinical trial at a prospective trial site; 

conditions may be imposed upon us by the FDA regarding the scope or design of our clinical trials, 
or we may be required to resubmit our clinical trial protocols to IRBs for review due to changes in 
the regulatory environment; 

the number of subjects required for our clinical trials may be larger, patient enrollment may take 
longer, or patients may drop out of our clinical trials at a higher rate than we anticipate; 

• we may have to suspend or terminate one or more of our clinical trials if we, regulators, or IRBs 

determine that the participants are being subjected to unreasonable health risks;  

•

•

•

•

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

the FDA may not accept clinical data from trials that are conducted at clinical sites in countries 
where the standard of care is potentially different from the United States; 

our  tests  may  produce  negative  or  inconclusive  results,  and  we  may  decide,  or  regulators  may 
require us, to conduct additional testing; and 

the costs of our pre-clinical and/or clinical trials may be greater than we anticipate. 

We rely on third parties to conduct our pre-clinical studies and clinical studies and trials, and if they do 
not perform their obligations to us we may not be able to obtain approval for our drug candidates.  

We do not currently have the ability to independently conduct pre-clinical studies or clinical studies and 
trials for our drug candidates, and we typically rely on third parties, such as third-party contract research 
and governmental organizations, medical institutions and clinical investigators (including academic clinical 
investigators),  to  conduct  studies  and  trials  of  our  drug  candidates.  Our  reliance  on  third  parties  for 
development  activities  reduces  our  control  over  these  activities.  These  third  parties  may  not  complete 
activities  on  schedule,  or  may  not  conduct  our  pre-clinical  studies  and  our  clinical  studies  and  trials  in 
accordance with regulatory requirements or our study design. If these third parties do not successfully carry 
out their contractual duties or meet expected deadlines, we may be adversely affected, and our efforts to 
obtain regulatory approvals for and commercialize our drug candidates may be delayed.  

If we conduct studies with other parties, we may not have control over all decisions associated with that 
trial. To the extent that we disagree with the other party on such issues as study design, study timing and 
the like, it could adversely affect our drug development plans.  

Although we also rely on third parties to manage the data from our studies and trials, we are responsible 
for confirming that each of our studies and trials is conducted in accordance with its general investigational 
plan  and  protocol.  Moreover,  the  FDA  and  foreign  regulatory  agencies  will  require  us  to  comply  with 
applicable regulations and standards, including Good Laboratory Practice (GLP) and Good Clinical Practice 
(GCP), for conducting, recording and reporting the results of such studies and trials to assure that the data 
and  the  results  are  credible  and  accurate  and  that the human  study  and trial  participants  are adequately 
protected. Our reliance on third-parties does not relieve us of these obligations and requirements, and we 
may fail to obtain regulatory approval for our drug candidates if these requirements are not met. 

45 

We  will  need  to  develop  marketing,  distribution  and  production  capabilities  or  relationships  to  be 
successful.  

In order to generate sales of any products we may develop, we must either acquire or develop an internal 
marketing  force  with  technical  expertise  and  with  supporting  documentation  capabilities,  or  make 
arrangements  with third  parties to  perform  these  services  for  us. The  acquisition  and  development  of a 
marketing and distribution infrastructure requires substantial resources and compete for available resources 
with our drug development efforts. To the extent that we enter into marketing and distribution arrangements 
with third parties, our revenues will depend on the efforts of others. If we fail to enter into such agreements, 
or if we fail to develop our own marketing and distribution channels, we would experience delays in product 
sales and incur increased costs.  

We  have  no  in-house  manufacturing  capacity  and,  to  the  extent  we  are  successful  in  completing  the 
development of our drug candidates, we will be obligated to rely on contract manufacturers. We cannot be 
sure that we will successfully manufacture any product we may develop, either independently or under 
manufacturing arrangements, if any, with third party manufacturers. Moreover, if any manufacturer should 
cease  doing  business  with  us  or  experience  delays,  shortages  of  supply  or  excessive  demands  on  their 
capacity,  we  may  not  be  able  to  obtain  adequate  quantities  of  product  in  a  timely  manner,  or  at  all. 
Manufacturers,  and  in  certain  situations  their  suppliers,  are  required  to  comply  with  current  NDA 
commitments and current good manufacturing practices (cGMP) requirements enforced by the FDA, and 
similar requirements of other countries. The failure by a manufacturer to comply with these requirements 
could  affect  its  ability  to  provide  us  with  product.  Although  we  intend  to  rely  on  third-party  contract 
manufacturers, we are ultimately responsible for ensuring that our products are manufactured in accordance 
with  cGMP.  In  addition,  if,  during  a  preapproval  inspection  or  other  inspection  of  our  third-party 
manufacturers’ facility or facilities, the FDA determines that the facility is not in compliance with cGMP, 
any of our marketing applications that lists such facility as a manufacturer may not be approved or approval 
may  be  delayed  until  the  facility  comes  into  compliance  with  cGMP  and  completes  a  successful  re-
inspection by the FDA. 

Any manufacturing problem, natural disaster affecting manufacturing facilities, or the loss of a contract 
manufacturer could be disruptive to our operations and result in lost sales. Additionally, we will be reliant 
on third parties to supply the raw materials needed to manufacture our potential products. Any reliance on 
suppliers may involve several risks, including a potential inability to obtain critical materials and reduced 
control over production costs, delivery schedules, reliability and quality. Any unanticipated disruption to 
future contract manufacture caused by problems at suppliers could delay shipment of products, increase our 
cost of goods sold and result in lost sales. If our suppliers were to be unable to supply us with adequate 
supply of our drug candidates, it could have a material adverse effect on our ability to commercialize our 
drug candidates.  

If we rely on a sole source of supply to manufacture our products we could be impacted by the viability 
of our supplier.  

We intend to attempt to source our products from  more than one supplier. We also intend to enter into 
contracts  with  any  supplier  of  our  products  to  contractually  obligate  them  to  meet  our  requirements. 
However, if we are reliant on a single supplier and that supplier cannot or will not meet our requirements 
(for whatever reason), our business could be adversely impacted.  

46 

We may not be able to sufficiently scale-up manufacturing of our drug candidates. 

If our NDA for Firdapse® is approved, we will need to manufacture our product in larger quantities than we 
have in the past to launch the product and meet customer requirements. With respect to our other products, 
to date they have only been manufactured in small quantities for pre-clinical studies and clinical trials, and, 
in order to conduct large trials and commercialize these products, we will need to manufacture our products 
in larger quantities than we have in the past.  

We may not be able to successfully increase in a sufficient manner the manufacturing capacity for our drug 
candidates,  whether  in  collaboration  with  third-party manufacturers  or  on  our  own,  in  a timely  or cost-
effective manner or at all. If a contract manufacturer makes improvements in the manufacturing process for 
our  drug  candidates,  we  may  not  own,  or  may  have  to  share,  the  intellectual  property  rights  to  those 
improvements.  

Significant scale-up of manufacturing may require additional validation studies, which are costly and which 
the FDA must review and approve. In addition, quality issues may arise during those scale-up activities 
because of the inherent properties of a drug candidate itself or of a drug candidate in combination with other 
components added during the manufacturing and packaging process, or during shipping and storage of the 
finished product or active pharmaceutical ingredients. If we are unable to successfully scale-up manufacture 
of any of our drug candidates in sufficient quality and quantity, the development of that drug candidate and 
regulatory approval or commercial launch for any resulting drug products may be delayed or there may be 
a shortage in supply, which could significantly harm our business.  

We  may  encounter  difficulties  in  managing  our  growth,  which  would  adversely  affect  our  results  of 
operations.  

If we are successful in obtaining approval to commercialize Firdapse® or any of our other drug candidates, 
we will need to significantly expand our operations, which could put significant strain on our management 
and our operational and financial resources. We currently have 21 employees and conduct many of our 
activities  through  outsourcing  arrangements. To  manage  future  growth,  we  will  need  to  hire,  train,  and 
manage additional employees. Concurrent with expanding our operational and marketing capabilities, we 
will also need to increase our product development activities. We may not be able to support, financially or 
otherwise, future growth, or hire, train, motivate, and manage the required personnel. Our failure to manage 
growth effectively could limit our ability to achieve our goals.  

Our success in managing our growth will depend in part on the ability of our executive officers to continue 
to implement and improve our operational, management, information and financial control systems and to 
expand, train and manage our employee base, and particularly to expand, train and manage a specially-
trained sales force to market our products. We may not be able to attract and retain personnel on acceptable 
terms  given  the  intense  competition  for  such  personnel  among  biotechnology,  pharmaceutical  and 
healthcare  companies,  universities  and  non-profit  research  institutions.  Our  inability  to  manage  growth 
effectively could cause our operating costs to grow at a faster pace than we currently anticipate, and could 
have a material adverse effect on our business, financial condition, results of operations and prospects.  

Pressure on drug product third-party payor coverage, reimbursement and pricing may impair our ability 
to be reimbursed for any of our drug candidates which we commercialize in the future at prices or on 
terms sufficient to provide a viable financial outcome. 

The commercial success of Firdapse® will depend substantially on the extent to which the cost of Firdapse®
will be paid by health maintenance, managed care, pharmacy benefit and similar healthcare management 
organizations,  or  reimbursed  by  government  health  administration  authorities  (such  as  Medicare  and 

47 

Medicaid), private health coverage insurers and other third-party payors. If reimbursement is not available, 
or is available only to limited levels, we may not be able to successfully commercialize Firdapse®. Even if 
coverage  is  provided,  the  approved  reimbursement  amount  may  not  be  high  enough  to  establish  and 
maintain pricing sufficient to realize a meaningful return on our investment.   

Our ability to commercialize  Firdapse® or any other product candidate will depend in large part on the 
extent to which coverage and reimbursement for these products and related treatments will be available 
from  government  health  administration  authorities,  private  health  insurers  and  other  organizations. 
Government  authorities  and  third-party  payors,  such  as  private  health  insurers  and  health  maintenance 
organizations, decide which medications they will cover and establish reimbursement levels. The healthcare 
industry  is  acutely  focused  on  cost  containment,  both  in  the  United  States  and  elsewhere.  Government 
authorities and third-party payors have attempted to control costs by limiting coverage and the amount of 
reimbursement  for  particular  medications,  which  could  affect  our  ability  to  sell  our  product  candidate 
profitably.  These  payors  may  not  view  our  products,  if  any,  as  cost-effective,  and  coverage  and 
reimbursement may not be available to our customers, or may not be sufficient to allow our products, if 
any, to be marketed on a competitive basis. Cost-control initiatives could cause us to decrease the price we 
might establish for products, which could result in lower than anticipated product revenues. If the prices 
for our products, if any, decrease or if governmental and other third-party payors do not provide adequate 
coverage or reimbursement, our prospects for revenue and profitability will suffer.   

There may also be delays in obtaining coverage and reimbursement for newly approved drugs, and coverage 
may be more limited than the indications for which the drug is approved by the FDA. Moreover, eligibility 
for reimbursement does not imply that any drug will be paid for in all cases or at a rate that covers our costs, 
including research, development, manufacture, sale and distribution. Reimbursement rates may vary, by 
way of example, according to the use of the drug and the clinical setting in which it is used. Reimbursement 
rates may also be based on reimbursement levels already set for lower cost drugs or may be incorporated 
into existing payments for other services.   

In  addition,  increasingly,  third-party  payors  are  requiring  higher  levels  of  evidence  of  the  benefits  and 
clinical  outcomes  of  new  technologies  and  are  challenging  the  prices  charged.  We  cannot  be  sure  that 
coverage  will  be  available  for  any  product  candidate  that  we  commercialize  and,  if  available,  that  the 
reimbursement rates will be adequate. Further, the net reimbursement for drug products may be subject to 
additional reductions if there are changes to laws that presently restrict imports of drugs from countries 
where they may be sold at lower prices than in the United States. An inability to promptly obtain coverage 
and  adequate  payment  rates  from  both  government  funded  and  private  payors  for  any  of  our  product 
candidates for which we obtain marketing approval could have a material adverse effect on our operating 
results, our ability to raise capital needed to commercialize products and our overall financial condition.  

The pricing of pharmaceutical products, in general, and specialty drugs, in particular, has been a topic of 
concern in the U.S. Congress, where hearings on the topic have been held. It has also been a topic raised 
by President Trump, most recently in a meeting with pharmaceutical industry participants. There can be no 
assurance as to how this scrutiny on pricing of pharmaceutical products will impact future pricing of orphan 
drugs or pharmaceutical products generally or our products in particular.  

We  cannot  assess  the  impact  on  our  business  of  the  public  concerns  expressed  by  a  vocal  group  of
neuromuscular physicians and some patients with LEMS. 

There is a vocal group of neuromuscular physicians who have raised public concerns in a letter to the editor 
of  a  medical  journal  and  some  LEMS  patients  and  neuromuscular  physicians  who  have  raised  public 
concerns in interviews quoted in articles published in the press. Their overarching concern appears to be 
that LEMS patients may not be able to get amifampridine treatment because of the concern that it would be 

48 

priced too high as an orphan drug if we are the first pharmaceutical company to receive an FDA approval 
for an amifampridine product, thereby giving us the seven-year orphan drug exclusivity and the five-year 
new  chemical  entity  exclusivity  for  our  product.  Articles  about  their  concerns  have  been  published  in 
several national publications and some in the press have sought to tie their expectations about the anticipated 
pricing  of  Firdapse®  to  stories  about  perceived  abusive  price  increases  of  drug  products  by  other 
pharmaceutical companies. This vocal group has also questioned the appropriateness of the provisions of 
the  Orphan  Drug  Act  that would  grant  us  exclusivity  if  our  product  were  to  be  the first amifampridine 
product approved by the FDA, and whether this exclusivity should be eliminated from the law. We have 
responded to their concerns in a letter to the editor to the same medical journal. However, there can be no 
assurance as to the ultimate impact of the activities of this vocal group on us or our products. 

Because the target patient populations for Firdapse® and our other drug candidates are small, we must 
achieve significant market share and obtain relatively high per-patient prices for our products to achieve 
meaningful gross margins. 

Firdapse®  and  our  other  orphan  drug  candidates  target  diseases  with  small  patient  populations. A  key 
component  of  the  successful  commercialization  of  a  drug  product  for  these  indications  includes 
identification  of  patients  and  a  targeted  prescriber  base  for  the  drug  product. Due  to  small  patient 
populations, we believe that we would need to have significant market penetration to achieve meaningful 
revenues and identifying patients and targeting the prescriber base are key to achieving significant market 
penetration. Typically, drugs for conditions with small prevalence have higher prices in order to generate a 
return on investment, and as a result, the per-patient prices at which we anticipate we may sell Firdapse®
will need to be relatively high in order for us to generate an appropriate return for the investment in these 
product development programs and achieve meaningful gross margins. There can be no assurance that we 
will be successful in achieving a sufficient degree of market penetration and/or obtaining or maintaining 
high per-patient prices for Firdapse® for diseases with small patient populations. Further, even if we obtain 
significant market share for Firdapse®, if approved, because the potential target populations are very small, 
we may never achieve profitability despite obtaining such significant market share. Additionally, patients 
who discontinue therapy or do not fill prescriptions are not easily replaced by new patients, given the limited 
patient population.  

Our internal computer systems, or those of our contract research organizations and other key vendors 
or consultants, may fail or suffer security breaches, which could result in a material disruption of our 
product development programs. 

Our internal computer systems and those of our contract research organizations and other key vendors and 
consultants  are  vulnerable  to  damage  from  computer  viruses,  unauthorized  access,  natural  disasters, 
terrorism,  war  and  telecommunication  and  electrical  failures.  If  such  an  event  were  to  occur  and  cause 
interruptions in our operations, it could result in a material disruption of our programs. For example, the 
loss of clinical trial data from completed or ongoing clinical trials could result in delays in our regulatory 
approval efforts and significantly increase our costs to recover or reproduce the data. To the extent that any 
disruption or security breach results in a loss of or damage to our data or applications, or inappropriate 
disclosure of confidential or proprietary information, we could incur liability and the further development 
of our drug candidates could be delayed.  

Our  employees  and  consultants  may  engage  in  misconduct  or  other  improper  activities,  including 
noncompliance with regulatory standards and requirements.

We  are  exposed  to  the  risk  of  employee  or  consultant  fraud  or  other  misconduct.  Misconduct  by  our 
employees  or  consultants  could  include  intentional  failures  to  comply  with  FDA  regulations,  provide 
accurate  information  to  the  FDA,  comply  with  manufacturing  standards,  comply  with  federal  and  state 

49 

healthcare fraud and abuse laws and regulations, report financial information or data accurately or disclose 
unauthorized activities to us. In particular, sales, marketing and business arrangements in the healthcare 
industry are subject to extensive laws and regulations intended to prevent fraud, kickbacks, self-dealing, 
and other abusive practices. These laws and regulations may restrict or prohibit a wide range of pricing, 
discounting, marketing and promotion, sales commission, customer incentive programs, and other business 
arrangements. Employee and consultant misconduct could also involve the improper use of information 
obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to our 
reputation. It is not always possible to identify and deter such misconduct, and the precautions we take to 
detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses 
or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure 
to be in compliance with such laws or regulations. If any such actions are instituted against us, and we are 
not successful in defending ourselves or asserting our rights, those actions could have a significant impact 
on our business, including the imposition of significant fines or other sanctions.  

Risks Related to Government Regulation 

We  have  not  received  regulatory  approval  in  the  United  States  or  any  foreign  jurisdiction  for  the 
commercial sale of any of our drug candidates. The regulatory approval process is lengthy, and we may 
not be able to obtain all of the regulatory approvals required to manufacture and commercialize our 
drug candidates.  

We do not currently have any products that have been approved for commercialization. We will not be able 
to commercialize our products until we have obtained the requisite regulatory approvals from applicable 
governmental authorities. To obtain regulatory approval of a drug candidate, we must demonstrate to the 
satisfaction of the applicable regulatory agency that such drug candidate is safe and effective for its intended 
uses. The type and magnitude of the testing required for regulatory approval varies depending on the drug 
candidate and the disease or condition for which it is being developed. In addition, in the U.S. we must 
show that the facilities used to manufacture our drug candidate are in compliance with cGMP requirements. 
We will also have to meet similar regulations in any foreign country where we may seek to commercialize 
our drug candidates. In general, these requirements mandate that manufacturers follow elaborate design, 
testing, control, documentation, and other quality assurance procedures throughout the entire manufacturing 
process.  The  process  of  obtaining  regulatory  approvals  typically  takes  several  years  and  requires  the 
expenditure of substantial capital and other resources. Despite the time, expense and resources invested by 
us  in  the  approval  process,  we  may  not  be  able  to  demonstrate  that  our  drug  candidates  are  safe  and 
effective, in which event we would not receive the regulatory approvals required to market them.  

The FDA and other regulatory authorities generally approve products for particular indications. Our drug 
candidates may not be approved for any or all of the indications that we request, which would limit the 
indications for which we can promote it and adversely impact our ability to generate revenues. We may 
also be required to conduct costly, post-marketing follow-up studies if FDA requests additional information.  

The FDA and other regulatory bodies must approve trade names for products. The FDA typically conducts 
a thorough review of a proposed trade name, including an evaluation of potential confusion with other trade 
names.  We  have  previously  submitted  a  request  for  FDA  approval  of  the trade  name  Firdapse®,  which 
request was conditionally approved in 2014; however, the approval of other drugs since that time may affect 
the applicability of that conditional approval.  

50 

If our pre-clinical studies or our clinical studies and trials are unsuccessful or significantly delayed, our 
ability to commercialize our products will be impaired.  

Before we can obtain regulatory approval for the sale of our drug candidates, we may have to conduct, at 
our own expense, pre-clinical tests in animals in order to support the safety of our drug candidates. Pre-
clinical testing is expensive, difficult to design and implement, can take several years to complete and is 
uncertain as to outcome. Our pre-clinical tests may produce negative or inconclusive results, and on the 
basis of such results, we may decide, or regulators may require us, to halt ongoing clinical trials or conduct 
additional pre-clinical testing.  

In September 2014, we announced positive results from our first Phase 3 clinical trial for Firdapse®. In 
October 2016, we announced that we had reached an agreement with the FDA under a SPA for the protocol 
design,  clinical  endpoints,  and  statistical  analysis  approach  to  be  taken  in  our  second  Phase  3  study 
evaluating Firdapse® for the symptomatic treatment of LEMS. In November 2017, we announced positive 
top-line results for our second Phase 3 trial of Firdapse®. Even after our successful second Phase 3 trial of 
Firdapse®, we may nevertheless fail to meet the safety and efficacy standards required by the FDA to accept 
our NDA for filing or to obtain regulatory approval. In addition, while we believe our single proposed Phase 
3  registration  trial  for  Firdapse®  in  MuSK-MG,  if  successful,  along  with  the  completed  Phase  2/3 
investigator-sponsored trial, will be sufficient to support an NDA for this indication, there is no guaranty 
that the FDA will find these trials sufficient for filing or approval of this indication. 

Additionally, future clinical trials for our drug candidates may not be successfully completed or may take 
longer than anticipated because of any number of factors, including potential delays in the start of the trial, 
an  inability  to  recruit  clinical  trial  participants  at  the  expected  rate,  failure  to  demonstrate  safety  and 
efficacy,  unforeseen  safety  issues,  or  unforeseen  governmental  or  regulatory  delays.  Further,  our  drug 
candidates may not be found to be safe and effective, and may not be approved by regulatory authorities 
for the proposed indication. Further, regulatory authorities and IRBs that must approve and monitor the 
safety of each clinical study may suspend a clinical study at any time if the patients participating in such 
study are deemed to be exposed to any unacceptable health risk. We may also choose to suspend human 
clinical studies and trials if we become aware of any such risks. We might encounter problems in our clinical 
trials, including our expanded access program, such as seizures, weakness or other side effects that will 
cause  us,  regulatory  authorities,  or  IRBs  to  delay  or  suspend  such  trial  or  study.  Moreover,  FDA  will 
consider  the  data,  including  safety  data,  from  patients  enrolled  in  our  expanded  access  program  in  the 
evaluation of any NDA we may submit for Firdapse®. 

In other countries where Firdapse®, CPP-115 or any other product we develop or license may be marketed, 
we will also be subject to regulatory requirements governing human clinical studies, trials and marketing 
approval for drugs. The requirements governing the conduct of clinical studies, trials, product licensing, 
pricing and reimbursement varies widely from country to country.  

We may face significant delays in our clinical studies and trials due to an inability to recruit patients for 
our clinical studies and trials or to retain patients in the clinical studies and trials we may perform.  

We  may  encounter  difficulties  in  our  current  and  future  clinical  studies  and  trials  recruiting  patients, 
particularly since the conditions we are studying are rare, orphan conditions. We compete for study and 
trial  subjects  with  others  conducting  clinical  trials  testing  other  treatments  for  the  indications  we  are 
studying  for  our  drug  candidates.  Further,  unrelated  third  parties  and  investigators  in  the  academic 
community have in the past and we expect will continue in the future to test our drug candidates. If these 
third-party tests are unsuccessful, or if they show significant health risk to the test subjects, our development 
efforts may also be adversely affected.  

51 

Clinical trials in orphan diseases are often difficult to enroll given the small number of patients with these 
diseases. Completion of orphan clinical trials may take considerable more time than other trials, sometimes 
years, depending on factors such as type, complexity, novelty and intended use of a product candidate. As 
a result of the uncertainties described above, there can be no assurance that we will meet timelines that we 
establish for any of our clinical trials. 

If  our  third-party  suppliers  or  contract  manufacturers  do  not  maintain  appropriate  standards  of 
manufacturing in accordance with cGMP and other manufacturing regulations, our development and 
commercialization activities could suffer significant interruptions or delays.  

We rely, and intend to continue to rely, on third-party suppliers and contract manufacturers to provide us 
with materials for our clinical trials and commercial-scale production of our products. These suppliers and 
manufacturers must continuously adhere to cGMP as well as any applicable corresponding manufacturing 
regulations outside of the U.S. In complying with these regulations, we and our third-party suppliers and 
contract  manufacturers  must  expend  significant  time,  money  and  effort  in  the  areas  of  design  and 
development,  testing,  production,  record-keeping,  and  quality  control  to  assure  that  our  products  meet 
applicable  specifications  and  other  regulatory  requirements.  Failure  to  comply  with  these  requirements 
could  result  in  an  enforcement  action  against  us,  including  warning  letters,  the  seizure  of  products, 
suspension  or  withdrawal  of  approvals,  shutting  down  of  production,  and  criminal  prosecution.  Any  of 
these third-party suppliers or contract manufacturers will also be subject to inspections by the FDA and 
other regulatory agencies. If any of our third-party suppliers or contract manufacturers fail to comply with 
cGMP or other applicable manufacturing regulations, our ability to develop and commercialize our products 
could suffer significant interruptions and delays.  

Reliance on third-party manufacturers entails risks to which we would not be subject if we manufactured 
the product ourselves, including:  

•

•

•

•

•

•

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

reliance on the continued financial viability of the third parties; 

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

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

the possible breach of the manufacturing agreement by the third party because of factors beyond 
our control; and 

the  possible  termination  or  nonrenewal  of  the  agreement  by  the  third  party,  based  on  its  own 
business priorities, at a time that is costly or inconvenient for us. 

If  any  of  our  contract  manufacturers  fail  to  achieve  and  maintain  appropriate  manufacturing  standards, 
patients using our drug candidates could be injured or die, resulting in product liability claims. Even absent 
patient injury, we may be subject to product recalls, product seizures or withdrawals, delays or failures in 
testing or delivery, cost overruns, or other problems that could seriously harm our business or profitability.  

52 

Even if we obtain regulatory approvals, our drug candidates will be subject to ongoing regulatory review. 
If  we  fail  to  comply  with  continuing  U.S.  and  applicable  foreign  regulations,  we  could  lose  those 
approvals, and our business would be severely harmed. 

Even if we receive regulatory approval of any drugs we are developing or may develop, we will be subject 
to continuing regulatory review, including the review of clinical results which are reported after our drug 
candidates  become  commercially  available  approved  drugs.  As  greater  numbers  of  patients  use  a  drug 
following its approval, side effects and other problems may be observed after approval that were not seen 
or  anticipated  during  preapproval  clinical  studies  and  trials.  In  addition,  the  manufacturer,  and  the 
manufacturing facilities we use to make any approved drugs, will also be subject to periodic review and 
inspection  by  the  FDA.  The  subsequent  discovery  of  previously  unknown  problems  with  the  drug, 
manufacturer  or  facility  may  result  in  restrictions  on  the  drug,  manufacturer  or  facility,  including 
withdrawal  of  the  drug  from  the  market.  If  we  fail  to  comply  with  applicable  continuing  regulatory 
requirements, we may be subject to fines, suspension or withdrawal of regulatory approval, product recalls 
and seizures, operating restrictions, and criminal prosecutions.  

As  a  condition  of  approval  for  some  of  our  products,  the  FDA  might  require  a  Risk  Evaluation  and 
Mitigation Strategy (REMS) to help ensure that the benefits of the drug outweigh the potential risks. REMS 
can include medication guides, communication plans for healthcare professionals, and other Elements To 
Assure Safe Use (ETASU). ETASU can include, but are not limited to, special training or certification for 
prescribing or dispensing, dispensing only under certain circumstances, special monitoring, and the use of 
patient registries. For example, approved versions of vigabatrin, the active moiety in our CPP-109 product 
(which operates by the same mechanism of action as our CPP-115 product) were approved with an FDA-
mandated REMS program due to the risks of visual field damage and are only available through a special 
restricted distribution program approved by the FDA. Accordingly, our abbreviated new drug application 
(ANDA) for vigabatrin, if approved, will be subject to either the same REMS, or a comparable REMS that 
will need to be reviewed and approved by the FDA. If any of our products were to be approved with a 
REMS, the potential market and profitability of the drug could be materially affected.  

Our product promotion and advertising is also subject to regulatory requirements and continuing regulatory 
review. In particular, the marketing claims we will be permitted to make in labeling or advertising regarding 
our  marketed  products  will  be  limited  by  the  terms  and  conditions  of  the  FDA-approved  labeling  and 
available scientific data. We must submit copies of our advertisements and promotional labeling to the FDA 
at the time of initial publication or dissemination. If the FDA believes these materials or statements promote 
our products for unapproved indications, or with unsubstantiated claims, or if we fail to provide appropriate 
safety related information, the FDA could allege that our promotional activities misbrand our products. 
Specifically, the FDA could issue an untitled letter or warning letter, which may demand, among other 
things, that we cease such promotional activities and issue corrective advertisements and labeling to all 
recipients of the misbranded materials. The FDA also could take enforcement action including seizure of 
allegedly misbranded product, injunction or criminal prosecution against us and our officers or employees. 
If we repeatedly or deliberately fail to submit such advertisements and labeling to the agency, the FDA 
could  withdraw  our  approvals.  Moreover,  the  Department  of  Justice  can  bring  civil  or  criminal  actions 
against companies and executives that promote drugs or biologics for unapproved uses, based on the Federal 
Food, Drug, and Cosmetic Act, the False Claims Act, and other federal laws governing the marketing and 
reimbursement  for  such  products  under  federally  supported  healthcare  programs  such  as  Medicare  and 
Medicaid. Monetary penalties in such cases have often been substantial, and civil penalties can include 
costly  mandatory  compliance  programs  and  potential  exclusion  of  a  company’s  products  from  federal 
healthcare programs.  

53 

Enacted  and  future  legislation  or  judicial  action  may  increase  the  difficulty  and  cost  for  us  to 
commercialize Firdapse® or any other drug candidate we develop and affect the prices we may obtain.

In the U.S., there have been a number of court cases, legislative and regulatory changes and other potential 
changes relating to the healthcare system that restrict or regulate post-approval activities, which may affect 
our ability to profitably sell Firdapse® or any other drug candidate for which we obtain marketing approval.  

The Medicare Prescription Drug Improvement and Modernization Act of 2003, or MMA, changed the way 
Medicare covers and pays for pharmaceutical products. The legislation expanded Medicare coverage for 
outpatient  drug  purchases  by  those  covered  by  Medicare  under  a  new  Part  D  and  introduced  a 
reimbursement  methodology  based  on  average  sales  prices  for  Medicare  Part  B  physician-administered 
drugs. In addition, this legislation authorized Medicare Part D prescription drug plans to use formularies 
whereby they can limit the number of drugs that will be covered in any therapeutic class. As a result of this 
legislation and the expansion of federal coverage of drug products, there is additional pressure to contain 
and reduce costs. While the MMA applies only to drug benefits for Medicare beneficiaries, private payors 
often follow Medicare coverage policy and payment limitations in setting their own reimbursement rates, 
and  any  reduction  in  reimbursement  that  results  from  the  MMA  may  result  in  a  similar  reduction  in 
payments  from  private  payors. These cost  reduction  initiatives  and  other provisions  of the  MMA  could 
decrease the coverage and reimbursement that we receive for any approved products, and could seriously 
harm our business. Manufacturers’ contributions to this area, including donut hole coverage (as described 
below) or potential excise taxes, are increasing and are subject to additional changes in the future.  

In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, as amended by 
the Health Care and Education Reconciliation Act of 2010 (together, the “Health Care Reform Law”), a 
sweeping law intended to broaden access to health insurance, reduce or constrain the growth of healthcare 
spending, enhance remedies against fraud and abuse, add new transparency requirements for healthcare and 
health insurance industries, impose new taxes and fees on the health industry, and impose additional health 
policy  reforms. The  Health  Care  Reform  Law,  among  other  things,  revised  the  definition  of  Average 
Manufacturer  Price  used  by  the  Medicaid  Drug  Rebate  Program  for  reporting  purposes,  which  could 
increase the amount of Medicaid drug rebates to states and extended the rebate program to beneficiaries 
enrolled in Medicaid managed care organizations. The Health Care Reform Law also imposed a significant 
annual fee on companies that manufacture or import branded prescription drug products and established an 
annual  non-deductible  fee  on  entities  that  sell  branded  prescription  drugs  or  biologics  to  specified 
government  programs  in  the  U.S. The  Health  Care Reform  Law  also  expanded  the  340B  drug  discount 
program (excluding orphan drugs), including the creation of new penalties for non-compliance and included 
a  50%  discount  on  brand  name  drugs  for  Medicare  Part  D  participants  in  the  coverage  gap,  or  “donut 
hole.” The Health Care Reform Law increased the Medicaid rebates for line extensions or reformulated 
drugs, which could substantially increase our Medicaid rebate rate (in effect limiting reimbursement for 
these patients).  

Both  President  Trump  and  the  Republican  leadership  in  Congress  have  expressed  their  intention  to 
eliminate the Health Care Reform Law and replace it with a still unknown new law. While proposals have 
been introduced in Congress, and efforts made to repeal the Health Care Reform Law, it is still unknown 
what form any such modifications or any law passed to replace the Health Care Reform Law would take, 
and how or any such new law may affect our business in the future. 

Additionally, in response to controversies regarding pricing of pharmaceutical products, there has been a 
recent push to propose legislation, both on state and federal levels, that would require greater disclosure as 
to the reasoning behind drug prices and, in some cases, could give state or federal-level commissions the 
right to impose cost controls on certain drugs. These and other new provisions are likely to continue the 
pressure  on  pharmaceutical  pricing,  may  require  us  to  modify  our  business  practices  with  healthcare 
practitioners, and may also increase our regulatory burdens and operating costs. In that regard, President 

54 

Trump and members of Congress in both parties have expressed concerns about high drug prices. However, 
whether and to what extent any such positions will result in changes of the law, and how any such changes 
could impact our business, cannot be determined at this time. 

Legislative and regulatory proposals also have been made to expand post-approval requirements and restrict 
sales and promotional activities for pharmaceutical products. In addition, increased scrutiny by the U.S. 
Congress  of  the  FDA’s  approval  process  may  subject  us  to  more  stringent  product  labeling  and  post-
marketing  testing  and  other  requirements. Delays  in  feedback  from  the  FDA  may  affect  our  ability  to 
quickly update or adjust our label in the interest of patient adherence and tolerability. We cannot predict 
whether other legislative changes will be adopted or how such changes would affect the pharmaceutical 
industry generally and specifically the commercialization of Firdapse®.  

If  we  fail  to  obtain  or  subsequently  maintain  orphan  drug  exclusivity  or  regulatory  exclusivity  for 
Firdapse® and our other orphan drug candidates, our competitors may sell products to treat the same 
conditions at greatly reduced prices, and our revenues would be significantly adversely affected. 

In the U.S., orphan drug designation entitles a party to financial incentives such as opportunities for grant 
funding towards clinical trial costs, tax advantages, and user-fee waivers. The company that first obtains 
FDA approval for a designated orphan drug for a given rare disease receives marketing exclusivity for use 
of that drug for the stated condition for a period of seven years, with an additional six months of exclusivity 
if the product also qualifies for pediatric exclusivity. Orphan drug exclusive marketing rights may be lost 
if the FDA later determines that the request for designation was materially defective, a subsequent product 
is deemed clinically superior, or if the manufacturer is unable to deliver sufficient quantity of the drug.  

In  the  EU,  the  EMA’s  Committee  for  Orphan  Medicinal  Products,  or  COMP,  grants  orphan  drug 
designation  to  promote  the  development  of  products  that  are  intended  for  the  diagnosis,  prevention  or 
treatment  of  life-threatening  or  chronically  debilitating  conditions  affecting  not  more  than  five  in 
10,000 persons in the EU Community and for which no satisfactory method of diagnosis, prevention, or 
treatment has been authorized (or the product would be a significant benefit to those affected). Additionally, 
designation is granted for products intended for the diagnosis, prevention, or treatment of a life-threatening, 
seriously debilitating or serious and chronic condition and when, without incentives, it is unlikely that sales 
of the drug in the EU would be sufficient to justify the necessary investment in developing the medicinal 
product. An EU orphan drug designation entitles a party to financial incentives such as reduction of fees or 
fee waivers and 10 years of market exclusivity is granted following medicinal product approval. This period 
may be reduced to six years if the orphan drug designation criteria are no longer met, including where it is 
shown that the product is sufficiently profitable not to justify maintenance of market exclusivity. Orphan 
drug designation must be requested before submitting an application for marketing approval. Orphan drug 
designation does not convey any advantage in, or shorten the duration of, the regulatory review and approval 
process.  

Because the extent and scope of patent protection for some of our drug products may be particularly limited, 
orphan  drug  designation  is  especially  important  for  our  products  that  are  eligible  for  orphan  drug 
designation. For eligible drugs, we plan to rely on the orphan exclusivity period to maintain a competitive 
position. However,  if  we  do  not  obtain  orphan  drug  exclusivity  for  our  drug  candidates  or  we  cannot 
maintain orphan exclusivity for our drug candidates, our competitors may then sell the same drug to treat 
the same condition and our revenues will be reduced. Also, without strong patent protection, competitors 
may sell a generic version upon the expiration of orphan exclusivity if our patent position is not upheld.  

Even if we obtain orphan drug designation for our future drug candidates, we may not fulfill the criteria for 
exclusivity or we may not be the first to obtain marketing approval for any orphan indication. Further, even 
if we obtain orphan drug exclusivity for a particular product, that exclusivity may not effectively protect 

55 

the product from competition because different drugs can be approved for the same condition. Even after 
an orphan drug is approved, the FDA can subsequently approve a drug for the same condition if the FDA 
concludes that the later drug is safer, more effective or makes a major contribution to patient care. The FDA 
can discontinue orphan drug exclusivity after it has been granted if the orphan drug cannot be manufactured 
in sufficient quantities to meet demand.  

Finally, there can be no assurance that the exclusivity provisions currently in the law may not be changed 
in the future and the impact of any such changes (if made) on us.  The orphan drug exclusivity contained 
in the Orphan Drug Act has been the subject of recent scrutiny from the press, from some  members of 
Congress and from some in the medical community. There can be no assurance that the exclusivity granted 
in the Orphan Drug Act to orphan drugs approved by the FDA will not be modified in the future, and as to 
how any such change might affect our products, if approved. 

Breakthrough Therapy Designation may not actually lead to a faster review process. 

Under the Prescription Drug User Fee Act, the FDA has a goal of responding to NDAs for new molecular 
entities within 10 months of the date that the FDA files the NDA for standard review, but this timeframe is 
also often extended.  We have in the past and we may in the future, seek approval of our drug candidates 
under programs designed to accelerate the FDA's review and approval of NDAs.  For example, there is a 
category of drugs referred to as "breakthrough therapies," which are defined as drugs intended, alone or in 
combination with one or more other drugs, to treat a serious or life-threatening disease or condition, and 
preliminary  clinical  evidence  indicates  that  the  drug  may  demonstrate  substantial  improvement  over 
existing  therapies  on  one  or  more  clinically  significant  endpoints,  such  as  substantial  treatment  effects 
observed early  in  clinical development.   In  our  case,  Firdapse® has  been  granted  "breakthrough  therapy 
designation" for the treatment of LEMS. In the future, we may request breakthrough designation or fast 
track designation from the FDA for our other drug candidates or for treatment of other diseases, but we 
cannot assure that we will obtain such designations.  Moreover, even if we obtain breakthrough designation, 
under the Prescription Drug User Fee Act, the FDA has a goal of responding to NDAs for new molecular 
entities within 10 months of the date that the FDA files the NDA for standard review, but this timeframe is 
also often extended.  Further, even if we obtain breakthrough designation or fast track designation from the 
FDA, the designations do not guarantee FDA approval of our NDA, that the development program or review 
timeline will ultimately be shorter than if we had not obtained the designations, or that the FDA will not 
request additional information, including requesting additional clinical studies (although potentially a post-
marketing requirement), during its review.  Any request for additional information or clinical data could 
delay the FDA's timely review of our NDA. 

Even though our second Phase 3 study of Firdapse® for the treatment of LEMS was conducted under a 
Special Protocol Assessment (SPA) agreed to with the FDA, we cannot guarantee that the design of, or 
data collected from, that trial or any of our clinical trials will be sufficient to support filing or approval 
of an NDA. 

In the context of a Phase 3 clinical trial, the purpose of a SPA is to reach agreement with the FDA on the 
protocol design and analysis that will form the primary basis of an efficacy claim: in other words, if the 
agreed-upon  clinical  trial  protocol  is  followed,  the  clinical  trial  endpoints  are  achieved,  and  there  is  a 
favorable risk-benefit profile, the data may serve as the primary basis for an efficacy claim in support of an 
NDA.  However, FDA may rescind a SPA if the director of the FDA reviewing division determines that a 
substantial scientific issue essential to determining the safety or efficacy of the drug was identified after the 
trial began.  Thus, a SPA is not binding on the FDA if, for example, the Agency identifies a safety concern 
related  to  the  product  or  its  pharmacological  class,  if  FDA  or  the  scientific  community  recognizes  a 
paradigm shift in disease diagnosis or management, if the relevant data or assumptions provided by the 
sponsor  in  the  SPA  submission  are  found  to  be  false  or  misstated,  or  if  the  sponsor  fails  to  follow  the 

56 

protocol that was agreed upon with FDA.  In addition, a SPA may be modified with the written agreement 
of the FDA and the trial sponsor.  The FDA retains significant latitude and discretion in interpreting the 
terms of a SPA agreement and the data and results from the applicable clinical trial.  Moreover, even if a 
clinical trial is conducted pursuant to a SPA, that does not mean that the NDA will meet the standard for 
approval.   

Risks Related to Our Intellectual Property  

We  are  dependent  on  our  relationships  and  license  agreements,  and  we  rely  upon  the  patent  rights 
granted to us pursuant to the license agreements.  

All of our patent rights for Firdapse® are derived from our license agreement with BioMarin. Pursuant to 
this  license  agreement,  we  have  licensed  rights  under  BioMarin’s  Firdapse®  patent  applications  in  the 
United  States,  which  expire  in  2022  and  2034.  We  may  lose  our  rights  to  these  patents  and  patent 
applications if we breach our obligations under the license agreement, including, without limitation, our 
financial  obligations  to  BioMarin.  If  we  violate  or  fail  to  perform  any  term  or  covenant  of  the  license 
agreement,  BioMarin  may  terminate  the  license  agreement  upon  satisfaction  of  any  applicable  notice 
requirements and expiration of any applicable cure periods. Additionally, any termination of the license 
agreement, whether by us or by BioMarin, will not relieve us of our obligation to pay any license fees owing 
at the time of such termination. If we fail to retain our rights under the license agreement, we would not be 
able to commercialize Firdapse®, and our business, results of operations, financial condition and prospects 
would be materially adversely affected.  

Most  of  our  patent  rights  for  CPP-115  are  derived  from  our  license  agreement  with  Northwestern 
University. Pursuant to this license agreement, we have exclusive worldwide rights to two patents in the 
United States. These were filed and obtained by Northwestern relating to compositions of matter for a class 
of molecules, including CPP-115. Both patents expire in 2023. Additionally, we have licensed rights from 
Northwestern to know how for derivatives of vigabatrin that are unrelated to CPP-115. These rights are 
subject to the right of Northwestern, under limited circumstances, to practice the covered inventions for or 
on its own behalf for research. We may lose our rights to these patents and patent applications if we breach 
our  obligations  under  the  license  agreement,  including,  without  limitation,  our  financial  obligations, 
including milestone payments, to Northwestern. If we violate or fail to perform any term or covenant of the 
license agreement, Northwestern may terminate the license agreement upon satisfaction of any applicable 
notice requirements  and expiration  of  any  applicable cure  periods.  Additionally,  any  termination  of  the 
license agreement, whether by us or by Northwestern, will not relieve us of our obligation to pay any license 
fees owing at the time of such termination. If we fail to retain our rights under the license agreement, we 
would not be able to commercialize CPP-115, and our business, results of operations, financial condition 
and prospects would be materially adversely affected.  

If we obtain approval to market Firdapse® or CPP-115, our commercial success will depend in large part 
on our ability to use patents, especially those licensed to us by BioMarin and Northwestern, respectively, 
to  exclude  others  from  competing  with  our  products.  The  patent  position  of  emerging  pharmaceutical 
companies like us can be highly uncertain and involve complex legal and technical issues. Until our licensed 
patents are interpreted by a court, either because we have sought to enforce them against a competitor or 
because a competitor has preemptively challenged them, we will not know the breadth of protection that 
they will afford us. Our patents may not contain claims sufficiently broad to prevent others from practicing 
our technologies or marketing competing products. Third parties may intentionally attempt to design around 
our patents or design around our patents so as to compete with us without infringing our patents. Moreover, 
the issuance of a patent is not conclusive  as to its validity or enforceability,  and so our patents may be 
invalidated or rendered unenforceable if challenged by others.  

57 

As a result of the foregoing factors, we cannot be certain how much protection from competition patent 
rights will provide us.  

Our success will depend significantly on our ability to operate without infringing the patents and other 
proprietary rights of third parties.  

While  we  are  not  currently  aware  of  any  third-party  patents  which  we  may  infringe,  there  can  be  no 
assurance that we do not or will not infringe on patents held by third parties or that third parties will not 
claim that we have infringed on their patents. In the event that our technologies infringe or violate the patent 
or  other  proprietary  rights  of  third  parties,  we  may  be  prevented  from  pursuing  product  development, 
manufacturing or commercialization of our products that utilize such technologies. There may be patents 
held by others of which we are unaware that contain claims that our products or operations infringe. In 
addition, given the complexities and uncertainties of patent laws, there may be patents of which we are 
aware that we may ultimately be held to infringe, particularly if the claims of the patent are determined to 
be broader than we believe them to be. Adding to this uncertainty, in the U.S., patent applications filed in 
recent years are confidential for 18 months, while older applications are not publicly available until the 
patent issues. As a result, avoiding patent infringement may be difficult.  

If a third-party claims that we infringe its patents, any of the following may occur:  

• we may be required to pay substantial financial damages if a court decides that our technologies 
infringe a competitor’s patent, which can be tripled if the infringement is deemed willful, or be 
required to discontinue or significantly delay development, marketing, selling and licensing of the 
affected products and intellectual property rights;  

•

a  court  may  prohibit  us  from  selling  or  licensing  our  product  without a license  from  the  patent 
holder,  which  may  not  be  available  on  commercially  acceptable  terms  or  at  all,  or  which  may 
require us to pay substantial royalties or grant cross-licenses to our patents; and  

• we may have to redesign our product so that it does not infringe others’ patent rights, which may 

not be possible or could require substantial funds or time and require additional studies.  

In addition, employees, consultants, contractors and others may use the proprietary information of others 
in their work for us or disclose our proprietary information to others. As an example, we do not currently 
have  written  agreements  regarding  confidentiality  with  several  principal  members  of  our  Scientific 
Advisory Board. If our employees, consultants, contractors or others disclose our data to others or use data 
belonging  to  others  in  connection  with  our  business,  it  could  lead  to  disputes  over  the  ownership  of 
inventions derived from that information or expose us to potential damages or other penalties.  

The  occurrence  of  any  of  these  events  could  have  a  material  adverse  effect  on  our  business,  financial 
condition, results of operations or prospects.  

We may incur substantial costs as a result of litigation or other proceedings relating to patent and other 
intellectual property rights.  

There is substantial history of litigation and other proceedings regarding patent and intellectual property 
rights in the pharmaceutical industry. We may be forced to defend claims of infringement brought by our 
competitors and others, and we may institute litigation against others who we believe are infringing our 
intellectual  property  rights.  The  outcome  of  intellectual  property  litigation  is  subject  to  substantial 
uncertainties and may, for example, turn on the interpretation of claim language by the court, which may 

58 

not  be  to  our  advantage,  or  on  the  testimony  of  experts  as  to  technical  facts  upon  which  experts  may 
reasonably disagree.  

Under our license agreements, we have the right to bring legal action against any alleged infringers of the 
patents we license. However, we are responsible for all costs relating to such potential litigation. We have 
the  right  to  any  proceeds  received  as  a  result  of  such  litigation,  but,  even  if  we  are  successful  in  such 
litigation, there is no assurance we would be awarded any monetary damages.  

Our involvement in intellectual property litigation could result in significant expense to us. Some of our 
competitors have considerable resources available to them and a strong economic incentive to undertake 
substantial efforts to stop or delay us from commercializing products. Moreover, regardless of the outcome, 
intellectual  property  litigation  against  or  by  us  could  significantly  disrupt  our  development  and 
commercialization efforts, divert our management’s attention and quickly consume our financial resources.  

In addition, if third parties file patent applications or issue patents claiming technology that is also claimed 
by us in pending applications, we may be required to participate in interference proceedings with the U.S. 
Patent  Office  or  in  other  proceedings  outside  the  U.S.,  including  oppositions,  to  determine  priority  of 
invention or patentability. Even if we are successful in these proceedings, we may incur substantial costs, 
and  the  time  and  attention  of  our  management  and  scientific  personnel  will  be  diverted  from  product 
development or other more productive matters. 

Risks Related to Our Common Stock  

The trading price of the shares of our common stock has been and could in the future be highly volatile.  

The market price of our common stock has fluctuated in the past and is likely to fluctuate in the future. 
Market prices for biopharmaceutical companies have historically been particularly volatile. Some of the 
factors that may cause the market price of our common stock to fluctuate include:  

•

•

•

•

•

•

•

•

•

•

developments concerning our clinical studies and trials and our pre-clinical studies; 

status of regulatory requirements for approval of our drug candidates; 

announcements of product development successes and failures by us or our competitors; 

new products introduced or announced by us or our competitors; 

adverse changes in the abilities of our third-party manufacturers to provide drug or product in a 
timely manner or to meet FDA requirements; 

changes in reimbursement levels; 

changes in financial estimates by securities analysts; 

actual or unanticipated variations in operating results; 

expiration or termination of licenses (particularly our licenses from BioMarin and Northwestern), 
research contracts, or other collaboration agreements; 

conditions or trends in the regulatory climate and the biotechnology and pharmaceutical industries; 

59 

•

•

•

•

•

intellectual property, product liability or other litigation against us; 

changes in the market valuations of similar companies;  

changes in pharmaceutical company regulations or reimbursements as a result of healthcare reform 
or other legislation; 

changes in economic conditions; and 

sales of shares of our common stock, particularly sales by our officers, directors and significant 
stockholders, or the perception that such sales may occur.  

In  addition,  equity  markets  in  general,  and  the  market  for  emerging  pharmaceutical  and  life  sciences 
companies in particular, have experienced substantial price and volume fluctuations that have often been 
unrelated or disproportionate to the operating performance of companies traded in those markets. Further, 
changes in economic conditions in the United States, Europe or globally could impact our ability to grow 
profitably. Adverse economic changes are outside our control and may result in material adverse impacts 
on  our  business  or  financial  results.  These  broad  market  and  industry  factors  may  materially  affect  the 
market  price of  our  shares,  regardless of  our  own  development and  operating  performance.  In  the  past, 
following periods of volatility in the market price of a company’s securities, securities class-action litigation 
has often been instituted against that company. Any such litigation that we become involved in could cause 
us  to  incur  substantial  costs  and  divert  our  management’s  attention  and  resources,  which  could  have  a 
material adverse effect on our business, financial condition, and results of operations.  

Delaware law and our certificate of incorporation and by-laws contain provisions that could delay and 
discourage takeover attempts that stockholders may consider favorable.  

Certain provisions of our certificate of incorporation and by-laws, and applicable provisions of Delaware 
corporate  law,  may  make  it  more  difficult  for  or  prevent  a  third  party  from  acquiring  control  of  us  or 
changing our Board of Directors and management. These provisions include:  

•

•

•

•

•

the  ability  of  our  Board  of  Directors  to  issue  preferred  stock  with  voting  or  other  rights  or 
preferences; 

limitations on the ability of stockholders to amend our charter documents, including stockholder 
supermajority voting requirements; 

the inability of stockholders to act by written consent or to call special meetings; 

requirements  that  special  meetings  of  our  stockholders  may  only  be  called  by  the  Board  of 
Directors; and 

advance notice procedures our stockholders must comply with in order to nominate candidates for 
election  to  our  Board  of  Directors  or  to  place  stockholders’  proposals  on  the  agenda  for 
consideration at meetings of stockholders.  

On September 20, 2011, the board of directors approved the adoption of a stockholder rights plan (“Rights 
Plan”), which was amended on September 19, 2016. Further, at the 2017 annual meeting of stockholders, 
the stockholders approved the Rights Plan.  

60 

The  Rights  Plan  was  implemented  through  our  entry  into  a  rights  agreement  with  Continental  Stock 
Transfer & Trust Company, as rights agent, and the declaration of a non-taxable dividend distribution of 
one preferred stock purchase right (each, a Right) for each outstanding share of our common stock. The 
dividend was paid on October 7, 2011 to holders of record as of that date. Each right is attached to and 
trades  with the associated share  of common  stock.  The  rights  will  become  exercisable  only  if  a  person 
acquires beneficial ownership of 17.5% or more of our common stock (or, in the case of a person who 
beneficially owned 17.5% or more of our common stock on the date the rights plan was adopted, such 
person acquires beneficial ownership of any additional shares of our common stock) or after the date of the 
Rights Agreement, commences a tender offer that, if consummated, would result in beneficial ownership 
by a person of 17.5% or more of our common stock. The rights will expire on September 20, 2019, unless 
the rights are earlier redeemed or exchanged.  

The intent of the Rights Plan is to protect our stockholders’ interests by encouraging anyone seeking control 
of our company to negotiate with our Board of Directors. However, our Rights Plan could make it more 
difficult for a third party to acquire us without the consent of our Board of Directors, even if doing so may 
be beneficial to our stockholders. This plan may discourage, delay or prevent a tender offer or takeover 
attempt, including offers or attempts that could result in a premium over the market price of our common 
stock. This plan could reduce the price that stockholders might be willing to pay for shares of our common 
stock in the future. Furthermore, the anti-takeover provisions of our Rights Plan may entrench management 
and make it more difficult to replace management even if the stockholders consider it beneficial to do so.  

In addition, Section 203 of the Delaware General Corporation Law generally prohibits us from engaging in 
a business combination with any person who owns 15% or more of our common stock for a period of three 
years  from  the  date  such  person  acquired such  common  stock,  unless  Board  or stockholder  approval is 
obtained. These provisions could make it difficult for a third party to acquire us, or for members of our 
Board of Directors to be replaced, even if doing so would be beneficial to our stockholders.  

Any  delay  or  prevention  of  a  change  of  control  transaction  or  changes  in  our  Board  of  Directors  or 
management  could  deter  potential  acquirers  or  prevent  the  completion  of  a  transaction  in  which  our 
stockholders could receive a substantial premium over the then current market price for their shares.  

Future sales of our common stock may cause our stock price to decline. 

As of March 9, 2018, we had 102,556,164 shares of our common stock outstanding, of which 6,886,070 
shares were held by our officers and directors. We also had outstanding: (i) stock options to purchase an 
aggregate of 6,932,500 shares at exercise prices ranging from $0.79 to $4.64 per share (3,526,662 of which 
are currently exercisable). Sales of restricted shares or shares underlying stock options, or the perception in 
the market that the holders of a large number of shares intend to sell shares, could reduce the market price 
of our common stock.  

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

We  have  never  declared  or  paid  any  cash  dividends  on  our  common  stock  or  other  securities,  and  we 
currently  do  not  anticipate  paying  any  cash  dividends  in  the  foreseeable  future.  Accordingly,  investors 
should not invest in our common stock if they require dividend income. Our stockholders will not realize a 
return on their investment unless the trading price of our common stock appreciates, which is uncertain and 
unpredictable.  

61 

Item 1B.          Unresolved Staff Comments

None. 

Item 2. 

Properties 

We  currently  operate  our  business  in  leased  office  space  in  Coral  Gables,  Florida.    We  currently  lease 
approximately 5,200 square feet of space for which we pay annual rent of approximately $200,000.  

Item 3. 

Legal Proceedings 

From time to time we may become involved in legal proceedings arising in the ordinary course of business. 
We believe that there is no litigation pending at this time that could have, individually or in the aggregate, 
a material adverse effect on our results of operations, financial condition or cash flows. 

Item 4. 

Mine Safety Disclosure

Not applicable. 

62 

PART II

Item 5. 
Purchases of Equity Securities 

Market  for  Registrant's  Common  Equity,  Related  Stockholder  Matters  and  Issuer 

Market Information 

Our common stock trades on the Nasdaq Capital Market under the symbol "CPRX."  The following table 
sets forth the high and low closing sales prices per share of our common stock as reported on the Nasdaq 
Capital Market for the periods indicated. 

Year Ended December 31, 2016 
First Quarter 
Second Quarter 
Third Quarter 
Fourth Quarter 

Year Ended December 31, 2017 
First Quarter 
Second Quarter 
Third Quarter 
Fourth Quarter 

Year ending December 31, 2018 
First Quarter (through March 9, 2018) 

High 

$2.36 
$1.25 
$1.25 
$1.46 

$2.01 
$2.84 
$3.14 
$4.40 

$4.01 

Low 

$1.01 
$0.56 
$0.72 
$0.96 

$1.09 
$1.64 
$2.40 
$2.51 

$3.15 

The closing sale price for the common stock on March 9, 2018 was $3.23.  As of March 9, 2018, there were 
40 holders of record of our common stock, which includes custodians who hold our securities for the benefit 
of others. We estimate that there are approximately 9,000 beneficial holders of our common stock. 

Dividend Policy 

We have never declared or paid any cash dividends on our capital stock.  We currently intend to retain all 
available funds and any future earnings to support operations and finance the growth and development of 
our business and do not intend to pay cash dividends on our common stock for the foreseeable future.  Any 
future determination related to our dividend policy will be made at the discretion of our Board of Directors. 

63 

Performance Graph  

The graph below matches Catalyst Pharmaceuticals, Inc.'s cumulative 5-Year total shareholder return on 
common stock with the cumulative total returns of the NASDAQ Composite index, the Russell MicroCap 
index, and the NASDAQ Biotechnology index. The graph tracks the performance of a $100 investment in 
our  common  stock  and  in  each  index  (with  the  reinvestment  of  all  dividends)  from  12/31/2012  to 
12/31/2017. 

$1,000

$900

$800

$700

$600

$500

$400

$300

$200

$100

$0

1 2 / 1 2

1 2 / 1 3

1 2 / 1 4

1 2 / 1 5

1 2 / 1 6

1 2 / 1 7

Catalyst Pharmaceuticals, Inc.

NASDAQ Composite

Russell MicroCap

NASDAQ Biotechnology

*$100 invested on 12/31/12 in stock or index, including reinvestment of dividends.
Fiscal year ending December 31.

Copyright© 2018 Russell Investment Group. All rights reserved.

Catalyst Pharmaceuticals, Inc. 
NASDAQ Composite 
Russell MicroCap 
NASDAQ Biotechnology 

12/12
100.00
100.00
100.00
100.00

12/13
448.28
141.63
145.62
174.05

12/14
682.76
162.09
150.93
230.33

12/15
563.22
173.33
143.15
244.29

12/16
241.38
187.19
172.30
194.95

12/17
898.85
242.29
194.99
228.29

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

64 

Item 6. Selected Financial Data 

The selected statement of operations data for the years ended December 31, 2017, 2016, 2015, and the 
balance sheet data as of December 31, 2017 and 2016, have been derived from our audited consolidated 
financial statements included elsewhere in this Form 10-K.  The selected statement of operations data for 
the years ended December 31, 2014 and 2013 and the selected balance sheet data at December 31, 2015, 
2014  and  2013  have  been  derived  from  financial  statements  that  are  not  included  in  this  Form  10-K.  
Historical results are not necessarily indicative of future results.  This selected financial data should be read 
in  conjunction  with  "Management's  Discussion  and  Analysis  of  Financial  Condition  and  Results  of 
Operations" and our consolidated financial statements and related notes included elsewhere in this Form 
10-K. 

Year Ended December 31, 

Statement of Operations Data:

2017 

2016 

2015 

2014 

2013 

Revenues – government grant 

  $ 

-- 

  $ 

-- 

  $ 

-- 

  $ 

-- 

  $ 

-- 

Operating costs and expenses: 
Research and development 
General and administrative 

      11,375,237 
        7,304,399 

11,369,941   
7,910,260   

11,801,342   
8,597,010   

10,117,774   
4,473,654   

8,096,774 
2,214,884 

Total operating cost and expenses  

      18,679,636 

19,280,201   

20,398,352   

14,591,428   

10,311,658 

Loss from operations 

     (18,679,636)   

(19,280,201)  

(20,398,352)

(14,591,428)  

(10,311,658) 

Other income, net 
Change in fair value of   
     warrants liability 

454,163 

321,612   

100,389   

76,233   

47,421 

(186,904) 

886,137 

65,005 

(993,866)

(1,890,359) 

Loss before income taxes 
Provision for income taxes 

(18,412,377)   

-- 

(18,072,452)  
--   

(20,232,958)

--   

(15,509,061)  
--   

  (12,154,596) 

-- 

Net loss

  $   (18,412,377)    $  (18,072,452)    $  (20,232,958)   $  (15,509,061)   $ (12,154,596) 

Net loss per share —basic  
     and diluted 

Weighted average shares 
     outstanding —basic and diluted

$              (0.21) 

$             (0.22) 

$             (0.25)

$             (0.24)

$ 

  (0.27) 

85,802,487 

82,875,281   

80,858,393   

64,142,534   

    45,452,447 

Balance Sheet Data:

2017 

2016 

2015 

2014 

2013 

As of December 31, 

Cash and cash equivalents, certificates of 
     deposit and short-term investments 
Working capital 
Total assets 
Warrants liability, at fair value 
Total liabilities 
Stockholders' equity 

$84,013,413 
80,920,995 
85,387,430 
-- 
4,423,618 
80,963,812 

$40,405,817
39,359,226
41,706,853
122,226
2,397,923
39,308,930

$58,396,395
56,460,530
60,101,570
1,008,363
4,625,259
55,476,311

$39,275,123
37,972,795
43,908,086
2,794,891
8,665,756
35,242,330

$23,710,596 
23,180,429 
25,369,554 
1,819,562 
3,978,302 
21,391,252 

65 

 
 
 
 
 
 
 
 
 
 
Item 7. 

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

The following discussion and analysis of our financial condition and results of operations should be read 
in conjunction with "Selected Financial Data" and our consolidated financial statements and related notes 
appearing elsewhere in this Form 10-K.  In addition to historical information, this discussion and analysis 
contains forward-looking statements that involve risks, uncertainties, and assumptions.  Our actual results 
may  differ  materially  from  those  anticipated  in  these  forward-looking  statements  as  a  result  of  certain 
factors, including but not limited to those set forth under the caption "Risk Factors" in Item 1A of this Form 
10-K.

Introduction

Management's  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations  (MD&A)  is 
intended to provide an understanding of our financial condition, changes in financial condition and results 
of operations. The discussion and analysis is organized as follows:  

• Overview. This section provides a general description of our business and information about our 
business  that  we  believe  is  important  in  understanding  our  financial  condition  and  results  of 
operations. 

• Basis  of  Presentation.  This  section  provides  information  about  key  accounting  estimates  and 
policies  that  we  followed  in  preparing  our  consolidated  financial  statements  for  the  2017  fiscal 
year. 

• Critical Accounting Policies and Estimates.  This section discusses those accounting policies that 
are  both  considered  important  to  our  financial  condition  and  results  of  operations,  and  require 
significant  judgment  and  estimates  on  the  part  of  management  in  their  application.  All  of  our 
significant accounting policies, including the critical accounting policies, are also summarized in 
the notes to our accompanying consolidated financial statements. 

• Results of Operations.  This section provides an analysis of our results of operations for all three 

fiscal years presented in the accompanying consolidated statements of operations. 

•

Liquidity  and  Capital  Resources.    This  section  provides  an  analysis  of  our  cash  flows,  capital 
resources, off-balance sheet arrangements and our outstanding commitments, if any. 

• Caution Concerning Forward-Looking Statements.  This section discusses how certain forward-
looking statements made throughout this MD&A and in other sections of this report are based on 
management's present expectations about future events and are inherently susceptible to uncertainty 
and changes in circumstance. 

Overview 

We are a biopharmaceutical company focused on developing and commercializing innovative therapies for 
people with rare, debilitating, chronic neuromuscular and neurological diseases. We currently have three 
drug candidates in development. 

66 

Firdapse® 

In October 2012, we licensed the North American rights to Firdapse®, a proprietary form of amifampridine 
phosphate,  or  chemically  known  as 3,4-diaminopyridine phosphate,  from  BioMarin  Pharmaceutical  Inc. 
(BioMarin). In August 2013, we were granted “breakthrough therapy designation” by the U.S. Food and 
Drug Administration (FDA) for Firdapse® for the treatment of patients with Lambert-Eaton Myasthenic 
Syndrome, or LEMS, a rare and sometimes fatal autoimmune disease characterized by muscle weakness. 
Further,  the  FDA  has  previously  granted  Orphan  Drug  Designation  for  Firdapse® for  the  treatment  of 
patients with LEMS, Congenital Myasthenic Syndromes, or CMS, and Myasthenia Gravis (MG). 

The chemical entity, amifampridine (3,4-diaminopyridine, or 3,4-DAP), has never been approved by the 
FDA  for  any  indication.  Because  amifampridine  phosphate (Firdapse®)  has  been  granted three  separate 
Orphan Drug designations for the treatment of LEMS, CMS and MG by the FDA, the product is also eligible 
to receive  seven  years  of marketing  exclusivity  upon  approval  of amifampridine  for any  or  all  of  these 
indications.  Further,  if  we  are  the  first  pharmaceutical  company  to  obtain  approval  for  marketing  an 
amifampridine product, of which there can be no assurance, we will be eligible to receive five years of 
marketing exclusivity with respect to the use of this product for any indication, running concurrently with 
the seven years of orphan marketing exclusivity described above (if both exclusivities are granted). 

We  previously  sponsored  a  multi-center,  randomized,  placebo-controlled  Phase  3  trial  evaluating 
Firdapse® for the treatment of LEMS. This Phase 3 trial, which involved 38 subjects, was designed as a 
randomized “withdrawal” trial in which all patients were treated with Firdapse® during a 7 to 91-day run-
in-period followed by treatment with either Firdapse® or placebo over a two-week randomization period. 
The co-primary endpoints for this Phase 3 trial were the comparison of changes in patients randomized to 
continue  Firdapse® versus  those  who  transitioned  to  placebo  that  occurred  in  both  the  Quantitative 
Myasthenia Gravis Score (QMG), which measures muscle strength, and subject global impression score 
(SGI), on which the subjects rate their global impression of the effects of a study treatment during the two-
week randomization period. In September 2014, we reported positive top-line results from this Phase 3 trial, 
and the successful results of this study were published in 2016 in Muscle & Nerve (Muscle Nerve, 2016, 
53(5):717-725). 

During  2014,  we  established  an  expanded  access  program  (EAP)  to  make  Firdapse® available  to  any 
patients diagnosed with LEMS, CMS, or Downbeat Nystagmus in the United States, who meet the inclusion 
and exclusion criteria, with Firdapse® being provided to patients for free until sometime after new drug 
application (NDA) approval, should we receive such approval (of which there can be no assurance). We 
continue to inform neuromuscular physicians on the availability of the Firdapse® EAP and also to work 
with various rare disease advocacy organizations to inform patients and other physicians about the program. 

On  December 17,  2015,  we  announced  completion  of  the  submission  of  an  NDA  for  Firdapse® for  the 
treatment  of  LEMS  and  CMS.  However,  on  February 17,  2016,  we  announced  that  we  had  received  a 
“refusal-to-file” (RTF) letter from the FDA regarding our NDA submission. In early April 2016, we met 
with  the  FDA  to  obtain  greater  clarity  regarding  what  would  be  required  by  the  FDA  to  accept  the 
Firdapse® NDA for filing. Following the receipt of the formal minutes of that meeting, on April 26, 2016, 
we  issued  a  press  release  reporting  that  the  FDA  had  advised  us  that  in  addition  to  the  results  of  our 
previously submitted multi-center, randomized, placebo-controlled Phase 3 trial, we would need to submit 
positive results from a second adequate and well-controlled study in patients with LEMS. Additionally, 
there was a requirement for us to perform three abuse liability studies for Firdapse®. 

67 

In October 2016, we announced that we had reached an agreement with the FDA under a Special Protocol 
Assessment (SPA) for the protocol design, clinical endpoints, and statistical analysis approach to be taken 
in our second Phase 3 study evaluating Firdapse® for the symptomatic treatment of LEMS. A SPA is a 
process by which sponsors ask the FDA to evaluate the protocol of a proposed clinical trial to determine 
whether it adequately addresses scientific and regulatory requirements for the purpose identified by the 
sponsor.  A  SPA  agreement  indicates  FDA  concurrence  with  the  adequacy  and  acceptability  of  specific 
critical elements of protocol design, endpoints and analysis. Additionally, it provides a binding agreement 
with FDA’s review division that critical design elements of a pivotal trial adequately address the scientific 
and  regulatory  objectives  in  support  of  a  regulatory  submission  for  drug  approval.  However,  even  if  a 
clinical trial is conducted pursuant to a SPA, it does not mean that the NDA will meet the standard for 
approval.  Moreover, the FDA may rescind a SPA agreement when the division director determines that a 
substantial scientific issue essential to determining the safety or efficacy of the product has been identified 
after the trial has begun. 

Our second Phase 3 trial evaluating Firdapse® for the treatment of LEMS (designated as LMS-003) was 
conducted at sites in Miami, Florida and Los Angeles, California. This double-blind, placebo-controlled 
withdrawal trial had the same co-primary endpoints as our first Phase 3 trial evaluating Firdapse® for the 
treatment of LEMS. Further, the FDA allowed us to enroll patients from our expanded access program as 
study subjects in this second trial. Enrollment in this trial, which included 26 subjects, was completed in 
October 2017. Details of the Phase 3 clinical trial are available on www.clinicaltrials.gov (NCT02970162).  

On November 27, 2017, we reported positive top-line results from the LMS-003 trial. This trial had two 
prospectively  defined  co-primary  endpoints.  The  first  of  these,  quantitative  myasthenia  gravis  score 
(QMG), achieved a statistically significant p-value of 0.0004, and the second, subject global impression 
(SGI),  achieved  a  statistically  significant  p-value  of  0.0003.  More  importantly,  a  clinically  significant 
difference of 6.4 points was observed between the Firdapse® and placebo groups for the QMG endpoint. 
Firdapse® was well tolerated and showed a similar safety profile to that seen in earlier studies. All p-values 
reported are based on the entire intent to treat (ITT) population of patients that enrolled in this trial.  

The prospectively defined secondary endpoint for the physician's clinical global impression of improvement 
(CGI-I) achieved statistical significance (p-value 0.0020).  Further, the exploratory endpoints of triple timed 
up and go (3TUG, p-value 0.0112) and the evaluation of the QMG-Limb domains endpoint (p-value 0.0010) 
were also statistically significant.  The exploratory endpoint of most bothersome symptom (MBS) (p-value 
0.0572) was not significant, but showed a trend. 

We  were  also  required  to  conduct  three pre-clinical abuse  liability  studies  under  the  FDA  guidance  for 
“Assessment  of  Abuse  Potential  of  Drugs”  that  was  finalized  in  January  2017  (Self-Administration, 
Physical Dependence and Drug Discrimination). All three studies have now been completed, and results 
indicate that amifampridine phosphate does not exhibit abuse potential in these assessment models. 

On February 12, 2018, after receipt of the minutes of our recently held Type C meeting with the FDA, we 
issued a press release reporting on the results of the meeting. Prior to the meeting, we had provided the 
FDA with our preliminary data package for our proposed NDA resubmission, including the positive top-
line results from our LMS-003 trial, as well as the FDA-required abuse liability studies that we recently 
completed demonstrating that Firdapse® does not have abuse liability potential. The minutes of the meeting 
reflect the FDA's advice to us that our proposed filing package will be sufficient for resubmission of an 
NDA for Firdapse®, and we currently anticipate resubmitting our NDA for Firdapse® for LEMS to the FDA 
by the end of the first quarter of 2018. Notwithstanding, there can be no assurance that any NDA that we 
submit for Firdapse® for LEMS will be accepted for filing or approved. 

68 

Our original NDA submission for Firdapse® included data and information (including data from a currently 
ongoing investigator treatment IND) providing evidence supporting the benefits of Firdapse® for treating 
certain types of CMS, and requested that CMS be included in our initial label for Firdapse®. To provide 
additional support for our submission of an NDA for Firdapse® for the treatment of CMS, in October 2015 
we initiated a small blinded clinical trial at four academic centers of up to 10 subjects in the pediatric CMS 
population,  ages  2  to  17.  However,  after  considering  comments  from  the  FDA  about  this  study,  we 
determined to enroll both adult and pediatric subjects with CMS in this trial and to expand the number of 
subjects  to  be  evaluated  in  the  trial  to  an  aggregate  of  approximately  20  subjects.  We  are  currently 
conducting this study at five sites around the United States, and we are currently working on adding several 
additional 
available  on 
sites  outside 
www.clinicaltrials.gov (NCT02562066). 

the  United  States.  Details  of 

trial 

this 

are 

Based on currently available information, we expect to complete enrollment in this trial before the end of 
2018 and to report top-line results from this trial in the first quarter of 2019. If the results of the trial are 
successful, we hope to add the CMS indication to our labeling for Firdapse®. There can be no assurance 
that any trial we perform for Firdapse® for the treatment of CMS will be successful or whether any NDA 
or NDA supplement that we may submit for Firdapse® for the treatment of CMS in the future will be filed 
by the FDA for review and approved. 

In  February  2016,  we  announced  the  initiation  of  an  investigator-sponsored,  randomized,  double-blind, 
placebo-controlled,  crossover  Phase  2/3  clinical  trial  evaluating  the  safety,  tolerability  and  potential 
efficacy  of  Firdapse® as  a  symptomatic  treatment  for  patients  with  anti-MuSK  antibody  positive 
Myasthenia Gravis (MuSK-MG). MuSK-MG is a particularly severe form of myasthenia gravis that affects 
about 3,000 to 4,800 patients in the U.S., for which there are no approved effective therapies (and therefore 
it is an unmet medical need). Seven patients participated in this proof-of-concept trial. We provided study 
drug, placebo, and financial support for this study. 

On March 15, 2017, we reported top-line results from this trial. Both of the co-primary efficacy endpoints 
of change from baseline (CFB) in total Quantitative Myasthenia Gravis (QMG) score (p=0.0003) and CFB 
in total Myasthenia Gravis Activities of Daily Living (MG-ADL) score (p=0.0006) were statistically and 
clinically significant in this trial. Several secondary efficacy measures also achieved statistical significance. 
Amifampridine phosphate was well tolerated in this population of patients. 

On August 30, 2017, we announced that we had reached an agreement with the FDA on a SPA for the 
protocol design, clinical endpoints, and statistical analysis approach to be taken in our proposed Phase 3 
registration trial evaluating the safety and efficacy of amifampridine phosphate treatment in patients with 
MuSK-MG. The  protocol  that  the  FDA  has  reviewed  is  for  a  multi-site,  international  (U.S.  and  Italy), 
double-blind, placebo-controlled, clinical trial that is targeted to enroll approximately 60 subjects diagnosed 
with MuSK-MG. The trial  will  employ  a  primary  endpoint  of  Myasthenia  Gravis  Activities  of  Daily 
Living (MG-ADL) and  a  secondary  endpoint  of  Quantitative  Myasthenia  Gravis  Score  (QMG). At  the 
FDA’s request, the trial will also enroll up to 10 generalized myasthenia gravis patients who will be assessed 
with the same clinical endpoints, but achieving statistical significance in this subgroup of patients is not 
required and only summary statistics will be provided.  

We initiated this trial in January 2018 and expect to begin enrolling subjects in this trial during the first half 
of 2018. We anticipate that it will take about 12 months to complete the enrollment for the trial and we 
expect to report top-line results from this trial in the first half of 2019. Details of this trial are available 
on www.clinicaltrials.gov (NCT03304054). 

On November 21, 2017, we announced the initiation of a company-sponsored, proof-of-concept clinical 
trial evaluating safety, tolerability and efficacy of Firdapse® as a symptomatic treatment for patients with 

69 

Spinal Muscular Atrophy (SMA) Type 3. The study is being conducted by a team of researchers led by 
Lorenzo Maggi, MD, and Giovanni Baranello, MD, of the Fondazione Istituto Neurologico Carlo Besta in 
Milan, Italy, a major referral center for SMA patients. The study is designed as a randomized (1:1), double-
blind, 2-period, 2-treatment, crossover, outpatient proof-of-concept study to evaluate the safety, tolerability 
and potential efficacy of amifampridine in ambulatory patients diagnosed with SMA Type 3. The study is 
planned to include approximately 12 patients, and we anticipate reporting top-line results from the study in 
the second half of 2019. 

There can be no assurance that any trial that we initiate to evaluate Firdapse® for MuSK-MG or SMA Type 
3 will be successful. Further, there can also be no assurance that the FDA will ever approve Firdapse® for 
these indications. 

Finally, we may seek to evaluate Firdapse® for the treatment of other treatment-refractory types of MG or 
other rare, similar neuromuscular diseases, although we have not yet begun to develop clinical programs 
for these other indications, and all such programs are subject to the availability of funding. There can be no 
assurance that Firdapse® will be an effective treatment for other treatment-refractory types of MG or for 
any other rare, similar neuromuscular diseases. 

Prior to the receipt of the RTF letter, we had actively been taking steps to prepare for the commercialization 
of Firdapse® in the United States. However, in light of the receipt of the RTF letter, in the first quarter of 
2016 we put most of our commercialization activities on hold in order to conserve cash. During the fourth 
quarter of 2017, we restarted the development of our commercialization plans for Firdapse®. We are also 
continuing to work with several rare disease advocacy organizations to help increase awareness of LEMS, 
CMS and MuSK-MG, and to provide awareness and outreach support for the physicians who treat these 
rare diseases and the patients they treat. 

CPP-115 

We are developing CPP-115, a GABA aminotransferase inhibitor that, based on our preclinical studies to 
date, we believe is a more potent form of vigabatrin, and may have fewer side effects (e.g., visual field 
defects)  than  those  associated  with  vigabatrin.  We  are  hoping  to  develop CPP-115 for  the  treatment  of 
refractory  infantile  spasms. CPP-115 has  been  granted  Orphan  Drug  Designation  by  the  FDA  for  the 
treatment of infantile spasms and Orphan Medicinal Product Designation in the European Union, or EU, 
for West syndrome (a form of infantile spasms). 

We are currently refining our development plans for this product. We are also working with one or more 
potential investigators who have expressed an interest in evaluating our product for particular indications 
(particularly infantile spasms). 

Finally,  we  are  continuing  our  efforts  to  seek  a  partner  to  work  with  us  in  furthering  the  development 
of CPP-115. However, no agreements have been entered into to date. 

There can be no assurance that we will ever successfully commercialize CPP-115. 

Generic Sabril® 

In  September  2015,  we  announced  the  initiation  of  a  project  to  develop  generic  versions  of 
Sabril® (vigabatrin) in two dosage forms: tablets and powder sachets. Sabril® is marketed by Lundbeck Inc. 
in  the  United  States in  both  dosage  forms  for  the  treatment  of  infantile spasms  and refractory  complex 
partial seizures. There can be no assurance that we will be successful in these efforts or that any abbreviated 
new drug applications (ANDAs) that we submit for vigabatrin will be accepted for review or approved. 

70 

We are also continuing our efforts to seek a partner to work with us in furthering the development of 
generic Sabril®. However, no agreements have been entered into to date. 

There can be no assurance that we will ever successfully commercialize a generic version of Sabril®. 

Capital Resources 

At December 31, 2017, we had cash and investments of approximately $84.0 million. Based on our current 
financial condition and forecasts of available cash, we believe that we have sufficient funds to support our 
operations through 2019 (without considering revenues and cash receipts that may be received in 2019 if 
we are successful in obtaining an approval of Firdapse® and launching the product in 2019, of which there 
can be no assurance). There can be no assurance that we will ever be in a position to commercialize any of 
our  drug  candidates  or  that  we  will  obtain  any  additional  funding  that  we  require  in  the  future.  See 
"Liquidity and Capital Resources" below for further information on our liquidity and cash flow. 

Basis of presentation 

Revenues

We are a development stage company and have had no revenues from product sales to date. We will not 
have  revenues  from  product  sales  until  such  time  as  we  receive  approval  of  our  drug  candidates, 
successfully  commercialize  our  products  or  enter  into  a  licensing  agreement  which  may  include up-
front licensing fees, of which there can be no assurance. 

Research and development expenses

Our  research  and  development  expenses  consist  of  costs  incurred  for  company-sponsored  research  and 
development  activities,  as  well  as  support  for  selected  investigator-sponsored  research.  The  major 
components of research and development costs include preclinical study costs, clinical manufacturing costs, 
clinical study and trial expenses, insurance coverage for clinical trials, consulting, scientific advisors and 
other third-party costs, salaries and employee benefits, stock-based compensation expense, supplies and 
materials and allocations of various overhead costs related to our product development efforts. To date, all 
of  our  research  and  development  resources  have  been  devoted  to  the  development  of Firdapse®,  CPP-
109 (our version of vigabatrin), and CPP-115, and we expect this to continue for the foreseeable future. 

Our cost accruals for clinical studies and trials are based on estimates of the services received and efforts 
expended  pursuant  to  contracts  with  numerous  clinical  study  and  trial  sites  and  clinical  research 
organizations (CROs). In the normal course of our business we contract with third parties to perform various 
clinical study and trial activities in the on-going development of potential products. The financial terms of 
these agreements are subject to negotiation and vary from contract to contract and may result in uneven 
payment flows. Payments under the contracts depend on factors such as the achievement of certain events 
or milestones, the successful enrollment of patients, the allocation of responsibilities among the parties to 
the  agreement,  and  the  completion  of  portions  of  the  clinical  study  or  trial  or  similar  conditions.  The 
objective of our accrual policy is to match the recording of expenses in our consolidated financial statements 
to the actual services received and efforts expended. As such, expense accruals related to preclinical and 
clinical studies or trials are recognized based on our estimate of the degree of completion of the event or 
events specified in the specific study or trial contract. We monitor service provider activities to the extent 
possible; however, if we underestimate activity levels associated with various studies or trials at a given 
point in time, we could be required to record significant additional research and development expenses in 
future periods. Preclinical and clinical study and trial activities require significant up-front expenditures. 
We  anticipate  paying  significant  portions  of  a  study  or  trial’s  cost  before  such  begins,  and  incurring 
additional expenditures as the study or trial progresses and reaches certain milestones. 

71 

Selling and marketing expenses 

We do not currently have any selling or marketing expenses. We had been incurring costs tied to our future 
sales and marketing efforts for Firdapse®. However, during the first quarter of 2016, following the receipt 
of the RTF letter, we put most of these activities on hold in order to conserve cash. In the fourth quarter of 
2017, we recommenced the development of our commercialization plans for Firdapse® as we move closer 
to  the  submission  of  an  NDA  for  Firdapse®. Pre-commercialization costs  are  included  in  general  and 
administrative expenses. 

General and administrative expenses 

Our  general  and  administrative  expenses  consist  primarily  of  salaries  and  personnel  expenses  for 
accounting, corporate, compliance and administrative functions. Other costs include administrative facility 
costs, regulatory fees, insurance, pre-commercialization costs, and professional fees for legal, information 
technology, accounting and consulting services. 

Stock-based compensation

We  recognize  expense  for  the  fair  value  of  all  stock-based  awards  to  employees,  directors,  scientific 
advisors  and  consultants  in  accordance  with  U.S.  GAAP.  For  stock  options,  we  use  the  Black-Scholes 
option valuation model in calculating the fair value of the awards. 

Warrants Liability

We  issued  warrants  to  purchase  shares  of  our  common  stock  as  part  of  an  equity  financing  that  we 
completed in October 2011. In accordance with U.S. GAAP, we recorded the fair value of those warrants 
as a liability in the accompanying consolidated balance sheet at December 31, 2016 using a Black-Scholes 
option-pricing model. We re-measured the fair value of this warrants liability at each reporting date until 
the warrants were exercised or until the unexercised warrants expired on May 2, 2017. During all periods 
in  which  the  2011  warrants  were  outstanding,  changes  in  the  fair  value  of  the  warrants  liability  were 
reported in the consolidated statements of operations as income or expense. The fair value of the warrants 
liability was subject to significant fluctuation based on changes in the inputs to the Black-Scholes option-
pricing model, including our common stock price, expected volatility, expected term, the risk-free interest 
rate and dividend yield. 

Income taxes

We  have  incurred  operating  losses  since  inception.  As  of  December  31,  2017  and  2016,  we  had  net 
operating loss carryforwards of approximately $62,584,000 and $56,255,000, respectively. Our net deferred 
tax asset has a 100% valuation allowance as of December 31, 2017 and 2016, as we believe it is more likely 
than not that the deferred tax asset will not be realized. The net operating loss carry-forwards will expire at 
various dates beginning 2023 through 2037. If an ownership change, as defined under Internal Revenue 
Code 382, occurs, the use of these carry-forwards may be subject to limitations. 

As required by ASC 740, Income Taxes, we recognize the financial statement benefit of a tax position only 
after determining that the relevant tax authority would more likely than not sustain the position following 
an  audit.  For  tax  positions  meeting  the  more-likely-than-not  threshold,  the  amount  recognized  in  the 
financial statements is the largest benefit that has a greater than 50 percent likelihood of being realized upon 
ultimate settlement with the relevant tax authority.  

72 

Recently Issued Accounting Standards 

For  discussion  of  recently  issued  accounting  standards,  please  see  Note  2,  “Basis  of  Presentation  and 
Significant Accounting Policies,” in the consolidated financial statements included in this report. 

Non-GAAP Financial Measures 

We  prepare  our  consolidated  financial  statements  and  notes  thereto  which  accompany  this  report  in 
accordance with U.S. GAAP. To supplement our financial results presented on a U.S. GAAP basis, we may 
use non-GAAP financial measures in our reports filed with the Commission and/or our communications 
with investors. Non-GAAP measures are provided as additional information and not as an alternative to our 
consolidated financial statements presented in accordance with GAAP. Our non-GAAP financial measures 
are intended to enhance an overall understanding of our current financial performance.  We believe that the 
non-GAAP financial measures we present provide investors and prospective investors with an alternative 
method for assessing our operating results in a manner that we believe is focused on the performance of 
ongoing operations and provide a more consistent basis for comparison between periods.  

The non-GAAP financial measures that we typically present exclude from the calculation of net loss the 
expense (or the income) associated with the change in fair value of the liability-classified warrants.  Further, 
we often report non-GAAP net loss per share, which is calculated by dividing non-GAAP net loss by the 
weighted average common shares outstanding.  

Any non-GAAP financial measures that we report should not be considered in isolation or as a substitute 
for comparable U.S. GAAP accounting, and investors should read them in conjunction with our financial 
statements and notes thereto prepared in accordance with U.S. GAAP.  Finally, the non-GAAP measures 
of net loss we may use may be different from, and not directly comparable to, similarly titled measures used 
by other companies. 

Critical Accounting Policies and Estimates  

Our  discussion  and  analysis  of  our  financial  condition  and  results  of  operations  are  based  on  our 
consolidated  financial  statements,  which  have  been  prepared  in  accordance  with  U.S.  GAAP.  The 
preparation  of  these  consolidated  financial  statements  requires  us  to  make  judgments,  estimates,  and 
assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets 
and  liabilities  at  the  date  of  the  consolidated  financial  statements,  as  well  as  the  reported  revenue  and 
expenses during the reporting periods. We continually evaluate our judgments, estimates and assumptions. 
We  base  our  estimates  on  the  terms  of  underlying  agreements,  our  expected  course  of  development, 
historical experience and other factors we believe are reasonable based on the circumstances, the results of 
which form our management’s basis for making judgments about the carrying value of assets and liabilities 
that are not readily apparent from other sources. Actual results may differ from these estimates.  

The accounting policies described below are not intended to be a comprehensive list of all of our accounting 
policies.  In  many  cases,  the  accounting  treatment  of  a  particular  transaction  is  specifically  dictated  by 
GAAP. There are also areas in which our management’s judgment in selecting any available alternative 
would not produce a materially different result. Our consolidated financial statements and the notes thereto 
included elsewhere in this report contain accounting policies and other disclosures as required by GAAP.  

Preclinical study and clinical trial expenses

Research  and  development  expenditures  are  charged  to  operations  as  incurred.  Our  expenses  related  to 

73 

preclinical and clinical trials are based on actual and estimated costs of the services received and efforts 
expended pursuant to contracts with multiple research institutions and any CRO that conducts and manages 
our clinical trials. The financial terms of these agreements are subject to negotiation and will vary from 
contract to contract and may result in uneven payment flows. Generally, these agreements will set forth the 
scope of the work to be performed at a fixed fee or unit price. Payments under these contracts will depend 
on  factors  such  as  the  successful  enrollment  of  patients  or  the  completion  of  clinical  trial  milestones. 
Expenses related to clinical trials generally are accrued based on contracted amounts applied to the level of 
patient enrollment and activity according to the protocol. If timelines or contracts are modified based upon 
changes in the clinical trial protocol or scope of work to be performed, we would be required to modify 
estimates accordingly on a prospective basis.  

Warrants Liability

We  previously  issued  warrants to  purchase  our  common  stock  that  might  have  required  us  to  purchase 
unexercised warrants for a cash amount equal to their fair value following the announcement of specified 
events defined as Fundamental Transactions (Fundamental Transactions)  involving our company, which 
was deemed to occur if we were acquired in an all cash transaction or by a company that was not listed on 
a national securities exchange, or when the common stock was no longer listed on a national securities 
exchange. The cash settlement provisions required use of the Black-Scholes model in calculating the cash 
payment  value  in  the  event  of  a  Fundamental  Transaction.  As  a  consequence  of  these  provisions,  the 
warrants,  which  expired in  May  2017,  were  classified  as  a  liability  on  our consolidated  balance sheets. 
Changes in the fair value of the common stock warrants liability were recognized as income or loss for 
periods before the warrants expired in the changes in fair value of warrants liability line in the consolidated 
statement of operations. 

Stock-based compensation

We recognize stock-based compensation for the fair value of all share-based payments, including grants of 
stock options and restricted stock units. For stock options, we use the Black-Scholes option valuation model 
to determine the fair value of stock options on the date of grant. This model derives the fair value of stock 
options based on certain assumptions related to expected stock price volatility, expected option life, risk-
free interest rate and dividend yield. Expected volatility is based on reviews of historical volatility of our 
common stock.  The estimated expected option life is based upon the simplified method. Under this method, 
the  expected  option  life  is  presumed  to  be  the  mid-point  between  the  vesting  date  and  the  end  of  the 
contractual term. We will continue to use the simplified method until we have sufficient historical exercise 
data to estimate the expected life of the options. The risk-free interest rate assumption is based upon the 
U.S. Treasury yield curve appropriate for the expected life of our stock options awards. For the years ended 
December 31, 2017, 2016 and 2015, the assumptions used were an estimated annual volatility of 104%, 
100%, and 102%, expected holding periods of four to seven years, two to six years, and three to seven years 
and risk-free interest rates of 1.66% to 2.25%, 0.76% to 2.15%, and 1% to 2.13%, respectively.  

Results of Operations 

Years Ended December 31, 2017 and 2016 

Revenues

We had no revenues for the year ended December 31, 2017 or 2016.  

74 

Research and Development Expenses

Year 

2017 
2016 

Amount 

Change from Prior     

$11,375,237 
$11,369,941 

Year 

0.0% 
(3.7)% 

Percentage of Total Operating 
Costs and Expenses 

61.0% 
59.0% 

Our  expenses,  including  stock-based  compensation,  for  research  and  development  for  the  year  ended 
December  31,  2017  were  consistent  with  amounts  expended  during  the  2016  fiscal  year.  Research  and 
development  expenses,  in  the  aggregate,  represented  approximately  61%  of  total  operating  costs  and 
expenses for the 2017 fiscal year, compared to 59% for the 2016 fiscal year, respectively. The stock-based 
compensation  is non-cash and  relates  to  the  expense  of  stock  options  awards  to  certain  employees  and 
consultants. 

Research and development expenses in the 2017 fiscal year primarily included, among other items, costs 
associated  with  our  ongoing  second  Phase  3  trial  evaluating  Firdapse® for  the  treatment  of  LEMS,  our 
ongoing clinical trial evaluating Firdapse® for the treatment of CMS, and our Expanded Access Program 
for  Firdapse®.  Research  and  development  expenses  in  2016  primarily  included,  among  other  items, 
(i) regulatory affairs and legal costs associated with the receipt of the refusal-to-file letter in February 2016, 
(ii) costs relating to the close-out of our first Phase 3 trial evaluating Firdapse® for the treatment of LEMS, 
and (iii) costs incurred to build up inventory to launch Firdapse® in the summer of 2016 (which did not 
occur as anticipated).  

We expect that research and development costs will continue to be substantial in 2018 as we complete our 
clinical  trial  evaluating  Firdapse® for  the  treatment  of  CMS,  continue  our  Expanded  Access  Program, 
conduct  our  clinical  trial  evaluating  Firdapse® for  the  treatment  of MuSK-MG,  conduct  our  proof-of-
concept  trial  evaluating  Firdapse® for  the  treatment  SMA  Type  3,  prepare  the  NDA  submission  for 
Firdapse® and manufacture Firdapse® launch supplies. 

Our research and development expenses for 2017 and 2016, include stock-based compensation relating to 
the  value  of  stock  options  granted  to  certain  employees  and  consultants.  The  amount  of  stock-based 
compensation recorded in 2017 and 2016 relating to our research and development activities was $785,899 
and $590,857, respectively. The weighted-average grant-date fair value of the stock options granted in 2017 
and 2016 was $0.84 and $0.62, respectively.  

Selling and Marketing Expenses

We had no selling and marketing expenses during 2017 and 2016. In 2017 and  2016, we incurred pre-
commercialization costs, tied to our preparation for future sales and marketing efforts, as we moved closer 
to the potential commercialization of Firdapse®. However, during the first quarter of 2016, following the 
receipt of the RTF letter, we put most of these activities on hold in order to conserve cash. During the fourth 
quarter  of  2017,  we  restarted  the  development  of  our  commercialization  plans  for  Firdapse®.  Pre-
commercialization costs are included in general and administrative expenses. 

General and Administrative Expenses

Year 

2017 
2016 

Amount 

$7,304,399 
$7,910,260 

Change from Prior 
Year 

Percentage of Total Operating 
Costs and Expenses 

(7.7)% 
(8.0)% 

75 

39.0% 
41.0% 

General and administrative expenses include, among other expenses, corporate and office expenses, legal, 
accounting  and  consulting  fees,  pre-commercialization  costs  and  travel  expenses  for  our  administrative 
employees,  consultants and  members  of  our  Board  of  Directors.  Included in  general and administrative 
expenses  in  the  years  2017  and  2016,  was  stock-based  compensation  of  $1,622,062  and  $1,245,228, 
respectively.  As  discussed  above,  pre-commercialization  costs  are  also  included  in  general  and 
administrative expenses, and amounted to $809,584 and $2,471,461 in 2017 and 2016, respectively.  

The 7.7% decrease in general and administrative expenses for the year ended December 31, 2017 when 
compared to the same period in 2016 was primarily due to our efforts to conserve cash after the receipt of 
the refusal to file letter. We expect that general and administrative costs, excluding pre-commercialization 
costs, will increase slightly in 2018 compared with the general and administrative costs incurred in 2017, 
as we expand our operations and headcount to build up our infrastructure in preparation for the potential 
future commercialization of Firdapse®. We also expect that pre-commercialization costs will significantly 
increase in 2018 as we prepare for the potential launch of Firdapse® in 2019. 

Stock-Based Compensation

We  issued  stock  options  and  other  share-based  payments  to  several  of  our  employees,  directors,  and 
consultants in 2017 and 2016. Total stock-based compensation expense for the years ended December 31, 
2017  and  2016  was  $2,407,961  and  $1,836,085,  respectively.  We  regularly  grant  non-cash  stock-based 
compensation to employees and directors as part of their compensation packages. The 2017 increase in 
expense from the prior year is primarily due to additional headcount and expense related to incentive grants 
to employees and directors. 

Change in fair value of warrants liability  

In  connection  with  the  October  2011  equity  offering,  we  issued  warrants  to  purchase  an  aggregate  of 
1,523,370 shares of common stock. The fair value of the warrants is recorded in the liability section of the 
consolidated balance sheet and was estimated at $122,000 at December 31, 2016. During the year ended 
December 31, 2017, all of the remaining 2011 warrants were either exercised or expired. During the period 
that the 2011 warrants were outstanding, the fair value of the warrants liability was determined at the end 
of each reporting period with the resulting gains or losses recorded as the change in fair value of warrants 
liability in the consolidated statements of operations.  

For the years ended December 31, 2017 and 2016, we recognized a loss of $186,904 and a gain of $886,137, 
respectively, in connection with the change in the fair value of the warrants liability. The loss and gain 
during 2017 and 2016, respectively, were principally a result of fluctuations in our common stock price. 
The associated warrants expired on May 2, 2017 and as a result we will no longer recognize any gain or 
loss with respect to these warrants. 

Other Income, net

We reported other income, net in all periods relating to our investment of funds received from offerings of 
our securities. Other income, net consists of interest income, dividend income and unrealized and realized 
gain (loss) on trading securities.  The $132,551 increase in other income, net for the year ended December 
31,  2017  as  compared  to  the  year  ended  December  31,  2016  was  principally  due  to  higher  yields  on 
investment balances from the proceeds of our offerings. These proceeds were used to fund our product-
development activities and our operations. Substantially all such funds were invested in short-term interest-
bearing obligations and short-term bond funds.  

76 

Income taxes

We have incurred net operating losses since inception. Consequently, we have applied a 100% valuation 
allowance against our deferred tax asset as we believe that it is more likely than not that the deferred tax 
asset will not be realized.  

Net Loss 

Our net loss was $18,412,377 in the year ended December 31, 2017 ($0.21 per basic and diluted share) as 
compared to $18,072,452 in the year ended December 31, 2016 ($0.22 per basic and diluted share).  

Non-GAAP Net Loss

Our non-GAAP net loss, which excludes for 2017 a $186,904 loss associated with the change in the fair 
value of liability classified warrants and excludes for 2016 a $886,137 gain associated with the change in 
the  fair  value  of  liability-classified  warrants,  was  $18,225,473  ($0.21  per  basic  and  diluted  share)  as 
compared to $18,958,589 ($0.23 per basic and diluted share) for 2016. 

Results of Operations 

Years Ended December 31, 2016 and 2015 

Revenues

We had no revenues for the year ended December 31, 2016 or 2015.  

Research and Development Expenses

Year 

2016 
2015 

Amount 

Change from Prior     

$11,369,941 
$11,801,342 

Year 

(3.7)% 
16.6% 

Percentage of Total Operating 
Costs and Expenses 

59.0% 
57.9% 

Our  expenses,  including  stock-based  compensation,  for  research  and  development  for  the  year  ended 
December 31, 2016 decreased 3.7% compared to amounts expended during the 2015 fiscal year. Research 
and  development  expenses  in  2016  and  2015  consisted  mainly  of  costs  related  to  our  Phase  3  trials  of 
Firdapse®, our CMS trial, our Phase 1b trial of CPP-115, costs relating to other preclinical and clinical 
testing  for  Firdapse®,  costs  related  to  the  operation  of  the  Firdapse®  Expanded  Access  Program,  costs 
associated  with  the  submission  of  our  NDA  filing  for  Firdapse®, costs relating  to  the  manufacturing  of 
Firdapse®, our share of the costs of the joint studies being conducted with BioMarin, and costs relating to 
our generic Sabril® program.   

Our research and development expenses for 2016 and 2015, include stock-based compensation relating to 
the value of stock options granted to certain employees. The amount of stock-based compensation recorded 
in  2016  and  2015  relating  to  our  research  and  development  activities  was  $590,857  and  $378,548, 
respectively. The weighted-average grant-date fair value of the stock options granted in 2016 and 2015 was 
$0.62 and $2.28, respectively.  

77 

Selling and Marketing Expenses

We had no selling and marketing expenses during 2016 and 2015. In 2015 and  2016, we incurred pre-
commercialization costs, tied to our preparation for future sales and marketing efforts, as we moved closer 
to the potential commercialization of Firdapse®. In the first quarter of 2016, following receipt of the “refusal 
to  file"  letter,  these  costs  were  substantially  reduced,  in  order  to  conserve  cash.  These  costs  were  for 
personnel, and their related activities, to develop both a sales force and a patient advocacy and assistance 
program so that we would be in a position to commence our selling efforts had we been successful in filing 
our NDA for Firdapse® and obtaining an approval. There can be no assurance that we will ever obtain an 
NDA approval for Firdapse®. Pre-commercialization costs have been included in general and administrative 
expenses. 

General and Administrative Expenses

Year 

2016 
2015 

Amount 

$7,910,260 
$8,597,010 

Change from Prior 
Year 

Percentage of Total Operating 
Costs and Expenses 

(8.0)% 
92.2% 

41.0% 
42.1% 

General and administrative expenses include, among other expenses, corporate and office expenses, legal, 
accounting  and  consulting  fees,  pre-commercialization  costs  and  travel  expenses  for  our  administrative 
employees,  consultants and  members  of  our  Board  of  Directors.  Included in  general and administrative 
expenses  in  the  years  2016  and  2015,  was  stock-based  compensation  of  $1,245,228  and  $1,206,910, 
respectively.  As  discussed  above,  pre-commercialization  costs  are  also  included  in  general  and 
administrative expenses, and amounted to $2,471,461 and $3,833,855 in 2016 and 2015, respectively.  

The 8.0% decrease in general and administrative expenses for the year ended December 31, 2016 when 
compared to the same period in 2015 was primarily due to our efforts to conserve cash after the receipt of 
the refusal to file letter, partly offset by increases in pre-commercialization expenses, payroll and benefits, 
during the first half of 2016, including approximately $600,000 in severance costs related to the reduction-
in-force that occurred in May 2016.  

Stock-Based Compensation

We  issued  stock  options  and  other  share-based  payments  to  several  of  our  employees,  directors,  and 
consultants in 2016 and 2015. Total stock-based compensation expense for the years ended December 31, 
2016  and  2015  was  $1,836,085  and  $1,585,458,  respectively.  We  regularly  grant  non-cash  stock-based 
compensation to employees and directors as part of their compensation packages. The 2016 increase in 
expense from the prior year is primarily due to additional headcount and expense related to incentive grants 
to employees and directors. 

Change in fair value of warrants liability  

In  connection  with  the  October  2011  equity  offering,  we  issued  warrants  to  purchase  an  aggregate  of 
1,523,370 shares of common stock. The fair value of the warrants is recorded in the liability section of the 
balance sheet and was estimated at $122,000 and $1.0 million at December 31, 2016 and 2015, respectively.  

For  the  years  ended  December  31,  2016  and  2015,  we  recognized  gains  of  $886,137  and  $65,005, 
respectively, in connection with the change in the fair value of the warrants liability. The gains during 2016 
and 2015 were principally a result of fluctuations in our common stock price.  

78 

Other Income, net

We reported other income, net in all periods relating to our investment of funds received from offerings of 
our securities. Other income, net consists of interest income, dividend income and unrealized and realized 
gain (loss) on trading securities.  The $221,000 increase in other income, net for the year ended December 
31,  2016  as  compared  to  the  year  ended  December  31,  2015  was  principally  due  to  higher  yields  on 
investment balances from the proceeds of our offerings. These proceeds were used to fund our product-
development activities and our operations. Substantially all such funds were invested in short-term interest 
bearing obligations and short-term bond funds.  

Income taxes

We have incurred net operating losses since inception. Consequently, we have applied a 100% valuation 
allowance against our deferred tax asset as we believe that it is more likely than not that the deferred tax 
asset will not be realized.  

Net Loss 

Our net loss was $18,072,452 in the year ended December 31, 2016 ($0.22 per basic and diluted share) as 
compared to $20,232,958 in the year ended December 31, 2015 ($0.25 per basic and diluted share).  

Non-GAAP Net Loss

Our non-GAAP net loss, which excludes for 2016 a $886,137 gain associated with the change in the fair 
value of liability-classified warrants and excludes for 2015 a $65,005 gain associated with the change in 
the  fair  value  of  liability-classified  warrants,  was  $18,958,589  ($0.23  per  basic  and  diluted  share),  as 
compared to $20,297,963 ($0.25 per basic and diluted share) for 2015. 

Liquidity and Capital Resources 

Since  our  inception,  we  have  financed  our  operations  primarily  with  the  net  proceeds  of  three  private 
placements,  an initial  public  offering  (IPO),  an  investment  by  a  strategic purchaser,  a secondary  public 
offering and ten registered direct public offerings under our shelf registration statements. At December 31, 
2017, we had cash and cash equivalents and short-term investments aggregating $84,013,413 and working 
capital of $80,920,995 as compared to cash and cash equivalents and short-term investments aggregating 
$40,405,817  and  working  capital  of  $39,359,226  at  December  31,  2016.  At  December  31,  2017, 
substantially all of our cash and cash equivalents were deposited with one financial institution and our short-
term investments were invested in a high-quality short-term bond fund. Throughout 2017, we had cash 
balances at certain financial institutions in excess of federally insured limits.  

We have to date incurred operating losses, and we expect these losses to increase substantially in the future 
as  we  expand  our  drug  development  programs  and  prepare  for  the  commercialization  of  our  drug 
candidates. We anticipate using current cash on hand to finance these activities. It will likely be some time 
before  we  obtain  the  necessary  regulatory  approvals  to  commercialize  one  or  more  of  our  product 
candidates in the United States.  

Based on our current financial condition and forecasts of available cash, we believe that we have sufficient 
funds to support our operations through 2019 (without considering revenues and cash receipts that may be 
received in 2019 if we are successful in obtaining an approval of Firdapse® and launching the product in 
2019, of which there can be no assurance). There can be no assurance that we will ever be in a position to 

79 

commercialize any of our drug candidates or that we will obtain any additional funding that we require in 
the future. 

At the present time, we will require additional funding for future studies or trials, other than those described 
as being on-going in this report. We may also require additional working capital to support our operations 
beyond that time, depending on when and if we are able to launch Firdapse® and whether the results are 
cash flow positive. There can be no assurance as to the amount of any such funding that will be required 
for these purposes or whether any such funding will be available to us when it is required. 

In that regard, our future funding requirements will depend on many factors, including: 

•

•

•

•

•

•

•

•

•

the scope, rate of progress and cost of our clinical trials and other product development activities; 

future clinical trial results; 

the terms and timing of any collaborative, licensing and other arrangements that we may establish; 

the cost and timing of regulatory approvals; 

the  cost  and  delays  in  product  development  as  a  result  of  any  changes  in  regulatory  oversight 
applicable to our products; 

the cost and timing of establishing sales, marketing and distribution capabilities; 

the effect of competition and market developments; 

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

the extent to which we acquire or invest in other products. 

We  plan  to  raise  additional  funds  to  support  our  product  development  activities  and  working  capital 
requirements through public or private equity offerings, debt financings, corporate collaborations or other 
means.  We may also seek governmental grants to support our clinical trials and preclinical trials.  We may 
also seek to raise capital to fund additional product development efforts even if we have sufficient funds 
for our planned operations.  Any sale by us of additional equity or convertible debt securities could result 
in dilution to our stockholders. There can be no assurance that any such required additional funding will be 
available to us at all or available on terms acceptable to us.  Further, to the extent that we raise additional 
funds through collaborative arrangements, it may be necessary to relinquish some rights to our technologies 
or grant sublicenses on terms that are not favorable to us.  If we are not able to secure additional funding 
when needed, we may have to delay, reduce the scope of or eliminate one or more research and development 
programs, which could have an adverse effect on our business. 

On July 12, 2017, we filed a shelf registration statement with the SEC to sell up to $150,000,000 of common 
stock, preferred stock, warrants to purchase common stock, debt securities and units consisting of one or 
more of such securities (the “2017 Shelf Registration Statement”). The 2017 Shelf Registration Statement 
(file no. 333-219259) was declared effective by the SEC on July 26, 2017. We have completed one offering 
under the 2017 Shelf Registration Statement: 

• On November 28, 2017, we raised net proceeds of approximately $53.8 million from the sale of 

16,428,572 shares of our common stock. 

80 

On December 23, 2016, we filed a shelf registration statement with the SEC to sell up to $33,842,512 of 
common stock (the "2016 Shelf Registration Statement"). This shelf registration statement was declared 
effective  by  the  SEC  on  January  9,  2017.  We  have  made  no  sales  under  the  2016  Shelf  Registration 
Statement.  

As of the date of this Form 10-K, the full amount of our 2016 Shelf Registration Statement and $92,499,998 
of our 2017 Shelf Registration Statement remains available for future sales.  However, if our public float 
(the market value of our common stock held by non-affiliate stockholders) were to fall below $75 million, 
we would be subject to a further limitation under which we could sell no more than one-third (1/3) of our 
public float during any 12-month period.  Further, the number of shares that we can sell at any one time 
may  be  limited  under  certain  circumstances to  20%  of  the  outstanding  common  stock  under  applicable 
NASDAQ marketplace rules. 

Contractual obligations and arrangements 

As of December 31, 2017, we had the following contractual obligations. Further, we may owe in the future 
certain milestone or royalty payment obligations (as described below). Since we are not currently able to 
determine when or if these milestones will be achieved, or when or if the events triggering payment of the 
obligations will occur, they are not included in the following table. 

Operating lease obligations 
License obligations 

Payments Due by Period 

Total 

  $   1,113,829
        300,000

Less than
1 year 
$    213,644
300,000

1-3 years 
$    446,708
--

4-5 years
$  453,477
--

After 5 
years 
$             --
--

Total 

  $   1,413,829  $    513,644  $    446,708  $  453,477  

$            --

We have entered into the following contractual arrangements: 

• Payments to BioMarin and others under our license agreement with BioMarin. We have agreed to 

pay certain payments under to our license agreement with BioMarin. 

o Royalties: We have agreed to pay (i) royalties to BioMarin for seven years from the first 
commercial sale of Firdapse® equal to 7% of net sales (as defined in the license agreement) 
in North America for any calendar year for sales up to $100 million, and 10% of net sales 
in North America in any calendar year in excess of $100 million; and (ii) royalties to the 
third-party licensor of the rights sublicensed to us for seven years from the first commercial 
sale of Firdapse® equal to 7% of net sales (as defined in the license agreement between 
BioMarin and the third-party licensor) in any calendar year. 

o Milestone Payments. Under our license agreement with BioMarin, we have agreed to pay 
certain milestone payments that BioMarin is obligated to pay to both a third-party licensor 
of the rights that have been sublicensed to us and to the former stockholders of Huxley 
Pharmaceuticals (“Huxley”) under an earlier stock purchase agreement between BioMarin 
and the former Huxley stockholders. These milestones aggregate (i) approximately $2.6 
million  due  upon  acceptance  by  the  FDA  of  a  filing  of  an  NDA  for  Firdapse®  for  the 
treatment of LEMS or CMS (approximately $150,000 of which will be due to the third 
party licensor and approximately $2,425,000 of which will be due to the former Huxley 
stockholders), and (ii) approximately $7.2 million due upon the unconditional approval by 
the FDA of an NDA for Firdapse® for the treatment of LEMS (approximately $3.0 million 
of which will be due to the third party licensor and approximately $4.2 million of which 
will be due to the former Huxley stockholders). However, under BioMarin’s agreement 
with the former Huxley stockholders (and under our license agreement with BioMarin), 
BioMarin’s  obligation  to  pay  the  milestone  payments  due  to  the  former  Huxley 

81 

stockholders (and our corresponding obligation to pay such milestone payments) expressly 
expires if these milestones have not been not satisfied by April 20, 2018. 

BioMarin  has  recently  advised  us  that  the  former  Huxley  stockholders  may  take  legal 
action seeking payment of the milestone payments due to them from BioMarin if these 
milestones are achieved after April 20, 2018, notwithstanding the express termination date 
in the agreements. BioMarin has also advised us that we could become involved in any 
such legal action. While it is too early to determine how this matter will affect us, based on 
currently  available  information  we  do  not  believe  that  this  matter  will  have  a  material 
adverse effect on our financial position or results of operations. 

o Cost  Sharing  Payments. We  have  agreed  to  share  in  the  cost  of  certain  post-marketing 
studies  conducted  by  BioMarin,  and,  as  of  December  31,  2017,  we  had  paid  BioMarin 
$3.8 million related to expenses in connection with Firdapse® studies and trials. 

• Payments to Northwestern University under our license agreement. Under our license agreement 
with Northwestern, we have paid to date $424,885, had accrued liabilities of $252,500, at December 
31, 2017 in the accompanying consolidated balance sheet, and owe certain milestone payments in 
future years if we do not cancel the license agreement. The next milestone payment of $300,000 is 
due  on  the  earlier  of  successful  completion  of  the  first  Phase  3  clinical  trial  of CPP-115  or 
August 27, 2018. 

•

Lease for office space. We operate our business in leased office space in Coral Gables, Florida. We 
currently lease approximately 5,200 square feet of office space for which we pay annual rent of 
approximately $200,000. 

• Employment agreement. We have entered into an employment agreement with our Chief Executive 
Officer that requires us to make base salary payments of approximately $525,000 in 2018. The 
agreement expires in November 2018. 

Off-Balance Sheet Arrangements 

We currently have no debt or capital leases. We have operating leases for our office facilities.  We do not 
have any off-balance sheet arrangements as such term is defined in rules promulgated by the SEC.

Cash Flows 

Net cash used in operating activities was $13,742,572 and $17,963,503, respectively, for the years ended 
December 31, 2017 and 2016.  

During the year ended December 31, 2017, net cash used in operating activities was primarily attributable 
to our net loss of $18,412,377 and an increase of $125,800 in prepaid expenses and other current assets and 
deposits,  which  was  partially  offset  by  increases  of  $1,012,399  in  accounts  payable  and  $1,142,652  in 
accrued expenses, and a loss of $186,904 of non-cash change in fair value of warrants liability. The loss 
included an additional $2,453,650 of non-cash expenses, consisting of stock-based compensation expense 
and depreciation. 

During the year ended December 31, 2016, net cash used in operating activities was primarily attributable 
to our net loss of $18,072,452, decreases of $860,951 in accounts payable and $480,248 in accrued expenses 
and other liabilities, and a gain of $886,137 of non-cash change in fair value of warrants liability, which 
were partially offset by a decrease of $456,794 in prepaid expenses and other current assets and deposits. 
The loss included an additional $1,879,491 of non-cash expenses, consisting of stock-based compensation 
expense and depreciation. 

82 

Net cash (used in) provided by investing activities was $(3,958) and $3,552,565, respectively, for 2017 and 
2016. During 2017, funds were used primarily for purchases of short term investments. During 2016, funds 
were primarily from redemption of certificates of deposit offset by capital expenditures.  

Net cash provided by financing activities was $57,350,168 and $68,986, respectively, for 2017 and 2016. 
During 2017, net cash from financing activities consisted mostly of the net proceeds from the sale of shares 
of common stock in an underwritten direct public offering under the 2017 Shelf Registration Statement, as 
well  as  proceeds  from  exercise  of  stock  options  and  warrants.  During  2016,  net  cash  from  financing 
activities consisted mostly of proceeds from exercise of stock options. Such funds are being used to fund 
our research and development costs and our general and administrative costs.  

Caution Concerning Forward-Looking Statements

Some of the statements in this Form 10-K are “forward-looking statements”, as that term is defined in the 
Private  Securities  Litigation  Reform  Act  of  1995. These include  statements regarding  our expectations, 
beliefs, plans or objectives for future operations and anticipated results of operations. For this purpose, any 
statements contained herein that are not statements of historical fact may be deemed to be forward-looking 
statements.  Without  limiting  the  foregoing,  “believes”,  “anticipates”,  “proposes”,  “plans”,  “expects”, 
“intends”, “may”, and other similar expressions are intended to identify forward-looking statements. Such 
statements involve known and unknown risks, uncertainties and other factors that may cause our actual 
results,  performance or  achievements  to  be  materially  different from  any  future  results,  performance  or 
achievements expressed or implied by such forward-looking statements. The forward-looking statements 
made in this Form 10-K are based on current expectations that involve numerous risks and uncertainties.  

The successful development of our product candidates is highly uncertain. We cannot reasonably estimate 
or know the nature, timing, or estimated expenses of the efforts necessary to complete the development of, 
or the period in which material net cash inflows are expected to commence due to the numerous risks and 
uncertainties associated with developing such products, including the uncertainty of: 

•

•

•

•

•

•

•

our estimates regarding anticipated capital requirements and our need for additional funding; 

the risk that another pharmaceutical company (Jacobus Pharmaceuticals) will receive an approval 
for  its  formulation  of  3,4-diaminopyridine  (3,4-DAP)  for  the  treatment  of  Lambert-Eaton 
Myasthenic  Syndrome  (LEMS),  Congenital  Myasthenic  Syndromes  (CMS),  or  any  other 
indication, before we do; 

whether the clinical studies or trials that are required to be completed before the FDA will accept 
an NDA submission for Firdapse® for the treatment of either LEMS or CMS will be acceptable 
to the FDA; 

what additional supporting information, including any additional clinical studies or trials, will be 
required  before  the  FDA  will accept our  NDA  submission  for  Firdapse®  for the treatment  of 
either LEMS or CMS (or any other condition or disease);  

whether any NDA that we may submit for Firdapse® will be accepted for filing by the FDA, and 
if accepted, whether it will be granted a priority review; 

whether,  even  if  the  FDA  accepts  an  NDA  submission  for  Firdapse®,  such  product  will  be 
determined to be safe and effective and approved for commercialization for any of the submitted 
indications; 

whether the receipt of breakthrough therapy designation for Firdapse® for LEMS will result in 
an expedited review of Firdapse® by the FDA or affect the likelihood that the product will be 
found to be safe and effective; 

83 

•

•

•

•

•

•

•

•

•

•

•

•

•

whether, assuming Firdapse® is approved for commercialization, we will be able to develop or 
contract with a sales and marketing organization that can successfully market Firdapse® while 
maintaining full compliance with applicable federal and state laws, rules and regulations; 

whether any future trial that we undertake evaluating Firdapse® for the treatment of anti-MuSK 
antibody positive Myasthenia Gravis (MuSK-MG) or Spinal Muscular Atrophy (SMA) Type 3 
will be successful and whether we can obtain the funding required to conduct such trials; 

whether as part of the FDA review of any NDA that we may submit for filing for Firdapse®, the 
tradename  Firdapse®,  which  is  the  tradename  used  for  the  same  product  in  Europe,  will  be 
approved for use for the product in the United States; 

whether CPP-115 will be determined to be safe for humans; 

whether CPP-115 will be determined to be effective for the treatment of infantile spasms; 

whether any bioequivalence study of our version of vigabatrin (CPP-109) compared to Sabril®
that we submit as part of an Abbreviated New Drug Application (ANDA) for this product will be 
acceptable to the FDA; 

whether any ANDA that we submit for a generic version of Sabril® will be accepted by the FDA 
for review and approved (and the timing of any such approval); 

the scope, rate of progress and expense of our clinical trials and studies, pre-clinical studies, proof-
of-concept studies, and our other drug development activities; 

our ability to complete our trials and studies on a timely basis and within the budgets we establish 
for such trials and studies and whether our trials and studies will be successful; 

the ability of our third-party suppliers and contract manufacturers to maintain compliance with 
current Good Manufacturing Practices (cGMP); 

whether our estimates of the size of the market for our drug candidates will turn out to be accurate; 

the  pricing  of  our  products  that  we  may  be  able  to  achieve  if  we  are  granted  the  ability  to 
commercialize our drug candidates; and 

changes  in  the  healthcare  industry  occasioned  by  any  future  repeal  and  replacement  of  the 
Affordable Care Act, in laws relating to the pricing of drug products, or in the healthcare industry 
generally.    

Our current plans and objectives are based on assumptions relating to the development of our current drug 
candidates. Although we believe that our assumptions are reasonable, any of our assumptions could prove 
inaccurate. The significant uncertainties inherent in the forward-looking statements we have made herein, 
which reflect our views only as of the date of this report, suggest that you should not place undue reliance 
upon  such  statements.  We  undertake  no  obligation  to  update  or  revise  publicly  any  forward-looking 
statements, whether as a result of new information, future events or otherwise. 

Item 7A. 

Quantitative and Qualitative Disclosures About Market Risk 

Market  risk  represents  the  risk  of  changes  in  the  value  of  market  risk-sensitive  instruments  caused  by 
fluctuations in interest rates, foreign exchange rates and commodity prices.  Changes in these factors could 
cause fluctuations in our results of operations and cash flows. 

Our exposure to interest rate risk is currently confined to our cash and short-term investments that are from 
time to time invested in highly liquid money market funds, short-term certificates of deposit and short-term, 

84 

high-quality bond funds.  The primary objective of our investment activities is to preserve our capital to 
fund operations.  We also seek to maximize income from our investments without assuming significant 
risk.  We do not use derivative financial instruments in our investment portfolio.  Our cash and investments 
policy emphasizes liquidity and preservation of principal over other portfolio considerations. 

Item 8. 

Financial Statements and Supplementary Data 

See the list of financial statements filed with this report under Item 15 below. 

Item 9. 

Changes  in  and  Disagreements  with  Accountants  on  Accounting  and  Financial 
Disclosure 

Not applicable. 

Item 9A. 

Controls and Procedures 

Disclosure Controls and Procedures 

We have carried out an evaluation, under the supervision and with the participation of our management, 
including our principal executive officer and principal financial officer, of the effectiveness of the design 
and operation of our disclosure controls and procedures. The term “disclosure controls and procedures”, as 
defined in  Rules  13a-15(e)  and 15(d)-15(e)  under  the  Securities  Exchange  Act of  1934  (the  "Exchange 
Act"),  means  controls  and  other  procedures  of  a  company  that  are  designed  to  ensure  that  information 
required to be disclosed by a company in the reports that it files or submits under the Exchange Act is 
processed,  summarized  and  reported,  within  the  time  periods  specified  in  the  Securities  and  Exchange 
Commission’s rules and forms. Disclosure controls and procedures include, without limitation, controls and 
procedures designed to ensure that information required to be disclosed by a company in the reports that it 
files or submits under the Exchange Act is accumulated and communicated to the company’s management, 
including its principal executive and principal financial officers, as appropriate to allow timely decisions 
regarding required disclosure. 

Based on such evaluation, our principal executive officer and principal financial officer have concluded 
that  as  of  December 31,  2017,  our  disclosure  controls  and  procedures  were  effective  to  ensure  that  the 
information  required  to  be  disclosed  by  us  in  the  reports  filed  or  submitted  by  us  under  the  Securities 
Exchange  Act  of  1934,  as  amended,  was  recorded,  processed,  summarized  or  reported  within  the  time 
periods specified in the rules and regulations of the SEC, and include controls and procedures designed to 
ensure that information required to be disclosed by us in such reports was accumulated and communicated 
to management, including our principal executive officer and principal financial officer, as appropriate to 
allow timely decisions regarding required disclosures. 

Management’s Annual Assessment of Internal Control Over Financial Reporting 

Management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  financial 
reporting,  as  such  term  is  defined  in  Exchange  Act  Rule  13a-15(f).  Our  internal  control  over  financial 
reporting  includes  those  policies  and  procedures  that  (i) pertain  to  the  maintenance  of  records  that,  in 
reasonable detail, accurately and fairly reflect the transactions and dispositions of our assets; (ii) provide 
reasonable  assurance  that  transactions  are  recorded  as  necessary  to  permit  preparation  of  financial 
statements  in  accordance  with  generally  accepted  accounting  principles,  and  that  our  receipts  and 
expenditures are being made only in accordance with authorizations of our management and directors; and 
(iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, 
or disposition of our assets that could have a material effect on our consolidated financial statements. 

85 

Internal control over financial reporting is designed to provide reasonable assurance regarding the reliability 
of  financial  reporting  and  the  preparation  of  financial  statements  prepared  for  external  purposes  in 
accordance  with  generally  accepted  accounting  principles.  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. 

Under  the  supervision  and  with  the  participation  of  our  principal  executive  officer  and  our  principal 
financial  officer,  management  conducted  an evaluation  of  the effectiveness  of  our  internal control  over 
financial reporting as of December 31, 2017 based on the 2013 framework in Internal Control — Integrated 
Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission and in 
accordance  with  the  interpretive  guidance  issued  by  the  SEC  in  Release  No. 34-55929.  Based  on  that 
evaluation, management concluded that our internal control over financial reporting was effective as of 
December 31, 2017. 

During the fourth quarter of 2017, there were no changes in our internal control over financial reporting, as 
defined in Rule 13a-15(f) under the Securities and Exchange Act of 1934 that have materially affected, or 
are reasonably likely to materially affect, our internal control over financial reporting. 

Our independent registered public accounting firm, Grant Thornton LLP, has issued a report on our internal 
control over financial reporting, which is included in Item 15 of this Annual Report on Form 10-K. 

Item 9B. 

Other Information 

Not applicable.

86 

Item 10. 

Directors and Executive Officers of the Registrant 

PART III 

The information required by this item will be contained in our definitive proxy statement, or Proxy 
Statement, to be filed with the SEC in connection with our 2018 Annual Meeting of Stockholders.  Our 
Proxy Statement for the 2018 Annual Meeting of Stockholders is expected to be filed not later than 120 
days after the end of our fiscal year ended December 31, 2017 and is incorporated into this report by this 
reference. 

We have adopted a code of ethics that applies to our chief executive officer, chief financial officer, 
and to all of our other officers, directors, employees and agents.  The code of ethics is available on our 
website at www.catalystpharma.com.  We intend to disclose future amendments to, or waivers from, certain 
provisions of our code of ethics on the above website within five business days following the date of such 
amendment or waiver. 

Item 11. 

Executive Compensation 

The information required by this item will be set forth in the Proxy Statement and is incorporated 

into this report by this reference. 

Item 12. 

Security Ownership of Certain Beneficial Owners and Management 

The information required by this item will be set forth in the Proxy Statement and is incorporated 

into this report by this reference. 

Item 13. 

Certain Relationships and Related Transactions 

The information required by this item will be set forth in the Proxy Statement and is incorporated 

into this report by this reference. 

Item 14. 

 Principal Accounting Fees and Services 

The information required by this item will be set forth in the Proxy Statement and is incorporated 

into this report by this reference. 

87 

PART IV 

Item 15. 

Exhibits and Financial Statement Schedules 

(a) 

Documents filed as part of this report. 

1. 

The following financial statements of Catalyst Pharmaceuticals, Inc. and Reports of Grant 

Thornton LLP, independent registered public accounting firm, are included in this report: 

•

•

•

•

•

•

Reports of Grant Thornton LLP, Independent Registered Public Accounting Firm 

Consolidated Balance Sheets as of December 31, 2017 and 2016 

Consolidated Statements of Operations for the years ended December 31, 2017, 2016 and 
2015  

Consolidated Statement of Stockholders' Equity for the period December 31, 2014 until 
December 31, 2017 

Consolidated Statements of Cash Flows for the years ended December 31, 2017, 2016 and 
2015 

Notes to Consolidated Financial Statements 

2. 

List  of  financial  statement  schedules.    All  schedules  are  omitted  because  they  are  not 

applicable or the required information is shown in the financial statements or notes thereto. 

3. 

List of exhibits required by Item 601 of Regulation S-K.  See part (b) below. 

88 

(b) 

Exhibits. 

Exhibit No.

Description of Exhibit

2.1 

3.1 

3.2 

3.3 

3.4 

3.5 

4.1 

4.2 

4.3 

10.1 + 

10.2 + 

10.3 + 

10.4 + 

10.5+ 

10.6+ 

10.7+ 

10.8+ 

10.9+ 

10.10 

10.11 

10.12 

10.13 

10.14 

Agreement  and  Plan  of  Merger,  dated  August  14,  2006,  between  the  Company  and  Catalyst 
Pharmaceutical Partners, Inc., a Florida corporation

Certificate of Incorporation

Amendment to Certificate of Incorporation

Amendment to Certificate of Incorporation

Amendment to Certificate of Incorporation

By-laws

Specimen stock certificate for common stock

Rights Agreement between the Company and Continental Stock Transfer and Trust Company

Amendment to  Rights  Agreement between  the  Company and Continental  Stock Transfer and 
Trust Company

Employment Agreement between the Company and Patrick J. McEnany

First Amendment to Employment Agreement between the Company and Patrick J. McEnany

Second Amendment to Employment Agreement between the Company and Patrick J. McEnany

Third Amendment to Employment Agreement between the Company and Patrick J. McEnany

Fourth Amendment to Employment Agreement between the Company and Patrick J. McEnany

Fifth Amendment to Employment Agreement between the Company and Patrick J. McEnany

2014 Stock Incentive Plan

Amendment No. 1 to 2014 Stock Incentive Plan

Amendment No. 2 to 2014 Stock Incentive Plan

License Agreement between the Company and Northwestern University

Lease Agreement between the Company and 355 Alhambra Plaza, Ltd.

First Amendment to Lease Agreement between the Company and 355 Alhambra Plaza, Ltd.

Second  Amendment  to  Lease,  dated  as  of  February  4,  2014,  between  the  Company  and  355 
Alhambra Circle LLC

Third Amendment to Lease, dated effective as of March 16, 2015, between the Company and 
355 Alhambra Circle LLC

89 

Exhibit No.

Description of Exhibit

10.15 

10.16 

10.17 

10.18 

10.19 

21.1 

23.1 

31.1 

31.2 

32.1 

32.2 

License Agreement among the Company, New York University, and The Feinstein Institute for 
Medical Research

Convertible  Promissory  Note  and  Note  Purchase  Agreement,  dated  as  of  October  26,  2012, 
between the Company and BioMarin Pharmaceutical, Inc.

License  Agreement,  dated  as  of  October  26,  2012,  between  the  Company  and  BioMarin 
Pharmaceutical, Inc.

Amendment  No,  1  to  License  Agreement,  dated  April  8,  2014,  between  the  Company  and 
BioMarin Pharmaceutical, Inc.

Termination  Agreement,  dated  effective  October  1,  2013,  between  the  Company  and 
Brookhaven Science Associates, LLC

Subsidiaries of the registrant* 

Consent of Independent Registered Public Accounting Firm* 

Section 302 CEO Certification* 

Section 302 CFO Certification* 

Section 906 CEO Certification* 

Section 906 CFO Certification* 

101.INS 

XBRL Instance Document 

101.SCH 

XBRL Taxonomy Extension Schema 

101.CAL 

XBRL Taxonomy Extension Calculation Linkbase 

101.DEF 

XBRL Taxonomy Extension Definition Linkbase 

101.LAB 

XBRL Taxonomy Extension Label Linkbase 

101.PRE 

XBRL Taxonomy Extension Presentation Linkbase 

* 

Filed Herewith 

90 

SIGNATURES 

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the 
Registrant has caused this Annual Report on Form 10-K to be signed by the undersigned, thereunto duly 
authorized, this 14th day of March, 2018. 

CATALYST PHARMACEUTICALS, INC. 

By: 

/s/ Patrick J. McEnany 
Patrick J. McEnany, Chairman, 
President and CEO 

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed 

by the following persons, in the capacities and on the dates indicated. 

Signature 

Title

Date

/s/ Patrick J. McEnany_________
Patrick J. McEnany 

/s/ Alicia Grande_____________ 
Alicia Grande 

/s/ Charles B. O’Keeffe________ 
Charles B. O’Keeffe 

/s/ Philip H. Coelho___________ 
Philip H. Coelho 

/s/ David S. Tierney, M.D.______
David S. Tierney, M.D. 

/s/ Donald A. Denkhaus________
Donald A. Denkhaus 

/s/ Richard Daly______________
Richard Daly 

Chairman of the Board of 
Directors, President and Chief 
Executive Officer (Principal 
Executive Officer)  

Vice President, Treasurer, Chief 
Financial Officer (Principal 
Financial Officer and Principal 
Accounting Officer) 

March 14, 2018 

March 14, 2018 

Director  

March 14, 2018 

Director  

March 14, 2018 

Director  

March 14, 2018 

Director  

March 14, 2018 

Director  

March 14, 2018 

91 

[This page intentionally left blank] 

92 

INDEX TO FINANCIAL STATEMENTS 

Years ended December 31, 2017, 2016, and 2015 

Reports of independent registered public accounting firm

Consolidated balance sheets

Consolidated statements of operations

Consolidated statement of stockholders’ equity

Consolidated statements of cash flows

Notes to consolidated financial statements

  F-2 

  F-5

  F-6 

  F-7 

  F-8 

  F-9 

F-1 

REPORT OF INDEPENDENT REGISTERED
PUBLIC ACCOUNTING FIRM 

Board of Directors and Stockholders  
Catalyst Pharmaceuticals, Inc.  

Opinion on internal control over financial reporting 

We have audited the internal control over financial reporting of Catalyst Pharmaceuticals, Inc. (a Delaware 
corporation) and subsidiary (the “Company”) as of December 31, 2017, based on criteria established in the 
2013 Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the 
Treadway Commission (COSO). In our opinion, the Company maintained, in all material respects, effective 
internal control over financial reporting as of December 31, 2017, based on criteria established in the 2013 
Internal Control—Integrated Framework issued by COSO. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board 
(United States) (“PCAOB”), the consolidated financial statements of the Company as of and for the year 
ended December 31, 2017, and our report dated March 14, 2018 expressed an unqualified opinion on those 
financial statements. 

Basis for opinion 

The  Company’s  management  is  responsible  for  maintaining  effective  internal  control  over  financial 
reporting and for its assessment of the effectiveness of internal control over financial reporting, included in 
the accompanying Management’s Annual Assessment of Internal Control Over Financial Reporting. Our 
responsibility is to express an opinion on the Company’s internal control over financial reporting based on 
our audit. 

We are a public accounting firm registered with the PCAOB and are required to be independent with respect 
to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations 
of the Securities and Exchange Commission and the PCAOB.  

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we 
plan  and perform the audit to obtain reasonable assurance about whether effective internal control over 
financial reporting was maintained in all material respects. Our audit included obtaining an understanding 
of internal control over financial reporting, assessing the risk that a material weakness exists, testing and 
evaluating  the  design  and  operating  effectiveness  of  internal  control  based  on  the  assessed  risk,  and 
performing such other procedures as we considered necessary in the circumstances. We believe that our 
audit provides a reasonable basis for our opinion. 

Definition and limitations of internal control over financial reporting 

A company’s internal control over financial reporting is a process designed to provide reasonable assurance 
regarding  the  reliability  of  financial  reporting  and  the  preparation  of  financial  statements  for  external 
purposes in accordance with generally accepted accounting principles. A company’s internal control over 
financial reporting includes those policies and procedures that (1) pertain to the maintenance of records 
that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the 
company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation 
of financial statements in accordance with generally accepted accounting principles, and that receipts and 
expenditures of the company are being made only in accordance with authorizations of management and 
directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of 
unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on 
the financial statements. 

F-2 

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/ GRANT THORNTON LLP 

Miami, Florida 
March 14, 2018 

F-3 

REPORT OF INDEPENDENT REGISTERED
PUBLIC ACCOUNTING FIRM 

Board of Directors and Stockholders  
Catalyst Pharmaceuticals, Inc.  

Opinion on the financial statements  

We  have  audited  the  accompanying  consolidated  balance  sheets  of  Catalyst  Pharmaceuticals,  Inc.  (a 
Delaware corporation) and subsidiary (the  “Company”) as of December 31, 2017 and 2016, the related 
consolidated statements of operations, stockholders’ equity, and cash flows for each of the three years in 
the  period  ended  December  31,  2017,  and  the  related  notes  (collectively  referred  to  as  the  “financial 
statements”). In our opinion, the financial statements present fairly, in all material respects, the financial 
position of the Company as of December 31, 2017 and 2016, and the results of its operations and its cash 
flows for each of the three years in the period ended December 31, 2017, in conformity with accounting 
principles generally accepted in the United States of America.  

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, 
2017,  based  on  criteria  established  in  the  2013  Internal  Control—Integrated  Framework  issued  by  the 
Committee of Sponsoring Organizations of the Treadway Commission (“COSO”), and our report dated 
March 14, 2018 expressed an unqualified opinion. 

Basis for opinion  

These financial statements are the responsibility of the Company’s management. Our responsibility is to 
express an opinion on the Company’s financial statements based on our audits. We are a public accounting 
firm  registered  with  the  PCAOB  and  are  required  to  be  independent  with  respect  to  the  Company  in 
accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities 
and Exchange Commission and the PCAOB.  

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

/s/ GRANT THORNTON LLP 

We have served as the Company’s auditor since 2006.  

Miami, Florida 
March 14, 2018 

F-4 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED BALANCE SHEETS 

ASSETS

Current Assets: 
     Cash and cash equivalents 
     Short-term investments 
     Prepaid expenses and other current assets 

Total current assets 
     Property and equipment, net 
     Deposits 

Total assets 

LIABILITIES AND STOCKHOLDERS’ EQUITY

Current Liabilities: 
     Accounts payable 
     Accrued expenses and other liabilities 

Total current liabilities 

Accrued expenses and other liabilities, non-current 
Warrants liability, at fair value 

Total liabilities 

Commitments and contingencies 

Stockholders’ equity: 
Preferred stock, $0.001 par value, 5,000,000 shares 
    authorized: none issued and outstanding at December 31, 
    2017 and 2016
Common stock, $0.001 par value, 150,000,000 shares 
     authorized; 102,549,498 shares and 82,972,316 shares 
     issued and outstanding at December 31, 2017 and 2016, 
     respectively
Additional paid-in capital 
Accumulated deficit 

Total stockholders’ equity 
Total liabilities and stockholders’ equity 

December 31, 
2017 

December 31, 
2016 

$

$

$

57,496,702
26,516,711
1,173,744
85,187,157
191,385
8,888
85,387,430

1,945,575
2,320,587
4,266,162

157,456
—
4,423,618

$

$

$

13,893,064
26,512,753
1,047,944
41,453,761
244,204
8,888
41,706,853

933,176
   1,161,359
        2,094,535

           181,162
122,226
2,397,923

—

—

102,549
207,421,710
(126,560,447)
80,963,812
85,387,430

$

82,972
147,374,028
(108,148,070)
39,308,930
41,706,853

$

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

F-5 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF OPERATIONS 

Revenues  
Operating costs and expenses: 
    Research and development 
    General and administrative 
Total operating costs and expenses 

2017 
$                — 

Year Ended December 31, 
2016 
$                —

2015 
$                — 

11,375,237  
7,304,399  
18,679,636  

 11,369,941
7,910,260
19,280,201

 11,801,342 
8,597,010 
20,398,352 

Loss from operations 
Other income, net 
Change in fair value of warrants liability 
Loss before income taxes 
Provision for income taxes 
Net loss 
Net loss per share - basic and diluted  
Weighted average shares outstanding – basic and diluted 

(18,679,636) 
454,163  
(186,904) 
(18,412,377) 
 — 
$ (18,412,377) 
$             (0.21) 
     85,802,487 

(19,280,201)
321,612 
        886,137
(18,072,452)
—  
$ (18,072,452)
$            (0.22)
    82,875,281 

(20,398,352) 
   100,389  
          65,005 
(20,232,958) 
—   
$ (20,232,958)
$           (0.25) 
   80,858,393  

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

F-6 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENT OF STOCKHOLDERS’ EQUITY 
for the years ended December 31, 2017, 2016 and 2015 

Balance at December 31, 2014
Issuance of common stock, net 
Issuance of stock options for services 
Amortization of restricted stock for services
Exercise of warrants for common stock 
Exercise of stock options for 
    common stock 
Net loss

Preferred 
Stock 

Common 
Stock 

$                — $         69,119
11,527
—
—
1,178

—
—
—
—

Additional 
Paid-In 
Capital
$      105,015,871
34,862,342
1,510,018
75,440
3,616,083

—
—

1,027
—

389,324
—

Balance at December 31, 2015

                —          82,851

 145,469,078

Accumulated 
Deficit 
$    (69,842,660)
—
—
—
—

—
(20,232,958)

(90,075,618)

—
—
—

Total 
$         35,242,330
34,873,869
1,510,018
75,440
3,617,261

390,351
(20,232,958)

55,476,311

—
1,760,591
75,494

Issuance of common stock, net 
Issuance of stock options for services 
Amortization of restricted stock for services
Exercise of stock options for  
     common stock 

Net loss

Balance at December 31, 2016
Issuance of common stock, net 
Issuance of stock options for services 
Amortization of restricted stock for services
Exercise of warrants for  
     common stock 
Exercise of stock options for  
     common stock 
Net loss

    (27)
1,760,591
75,494

—
—
—

—
—

27
—
—

94
—

68,892
—

—
(18,072,452)

68,986
(18,072,452)

                —          82,972

 147,374,028

(108,148,070)

       39,308,930

—
—
—

—

—
—

16,455
  —
  —

53,756,105
2,342,625
65,336

2,258

3,516,295

 —
—
 —

—

53,772,560
2,342,625
65,336

3,518,553

864
—

367,321
—

 —
(18,412,377)

368,185
(18,412,377)

Balance at December 31, 2017

$                — $       102,549

$      207,421,710

$  (126,560,447)

$         80,963,812

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

F-7 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF CASH FLOWS 

Operating Activities: 
Net loss 
Adjustments to reconcile net loss to net 
   cash used in operating activities: 
Depreciation  
Stock-based compensation 
Change in fair value of warrants liability 
(Increase) decrease in: 
   Prepaid expenses and other current assets and deposits 
Increase (decrease) in: 
   Accounts payable 
   Accrued expenses and other liabilities 
Net cash used in operating activities 

Investing Activities: 
Capital expenditures 
Proceeds (purchase) of short-term investments 
Proceeds (purchase) of certificates of deposit 
Net cash provided by (used in) investing activities 

Financing Activities:
Proceeds from issuance of common 
   stock, net 
Payment of employee withholding tax related to stock- 
   based compensation 
Proceeds from exercise of warrants 
Proceeds from exercise of options 
Net cash provided by financing activities 
Net increase (decrease) in cash and cash equivalents 
Cash and cash equivalents –  beginning of period 
Cash and cash equivalents –  end of period 

2017 

Year Ended December 31, 
2016 

2015 

$      (18,412,377) 

$    (18,072,452) 

$    (20,232,958) 

                45,689 
      2,407,961 
186,904 

43,406 
      1,836,085 
(886,137) 

34,468 
1,585,458 
(65,005) 

         (125,800) 

         456,794 

(452,040) 

1,012,399 
1,142,652 
(13,742,572) 

(860,951) 
(480,248) 
(17,963,503) 

(20,083) 
1,134,939 
(18,015,221) 

— 
(3,958) 
— 
(3,958) 

 (96,061) 
(68,603) 
   3,717,229 
3,552,565 

(23,465) 
            18,812 
  (1,846) 
(6,499) 

53,772,560 

— 

34,873,869 

 — 
3,209,423 
              368,185 
57,350,168 
43,603,638 
13,893,064 
$       57,496,702             

(11,265) 
      — 
      80,251 
68,986 
(14,341,952) 
28,235,016 
$       13,893,064 

                 — 
     1,895,738 
390,351 
37,159,958 
19,138,238 
9,096,778 
$       28,235,016 

Non-cash investing and financing activities: 
Exercise of liability classified warrants for common stock  
Non-cash incentive received from lessor 

$            309,130 
$                     — 

$                     — 
$                     — 

 $        1,721,523 
 $           131,175 

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

F-8 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CATALYST PHARMACEUTICALS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS 

1.  Organization and Description of Business

Catalyst Pharmaceuticals, Inc. and subsidiary (collectively, the Company), is a development-stage 
biopharmaceutical company focused on developing and commercializing innovating therapies for people 
with  rare  debilitating,  chronic  neuromuscular  and  neurological  diseases,  including  Lambert-Eaton 
Myasthenic  Syndrome  (LEMS),  Congenital  Myasthenic  Syndromes  (CMS),  MuSK  antibody  positive 
myasthenia gravis, and infantile spasms. The Company (f/k/a Catalyst Pharmaceutical Partners, Inc.) was 
incorporated in Delaware in July 2006. It is the successor by merger to Catalyst Pharmaceutical Partners, 
Inc., a Florida corporation, which commenced operations in January 2002. 

Since  inception,  the  Company  has  devoted  substantially  all  of  its  efforts  to  business  planning, 
research  and  development,  recruiting  management  and  technical  staff,  acquiring  operating  assets  and 
raising capital. The Company’s primary focus is on the development and commercialization of its drug 
candidates. The Company has incurred operating losses in each period from inception through December 
31, 2017. The Company has been able to fund its cash needs to date through several public and private 
offerings of its common stock and warrants, through government grants, and through an investment by a 
strategic purchaser. See Note 11. 

Capital Resources  

While there can be no assurance, based on currently available information, the Company estimates 

that it currently has sufficient resources to support its operations for at least the next 12 months.  

The Company may raise required funds in the future through public or private equity offerings, debt 
financings, corporate collaborations, governmental research grants or other means. The Company may also 
seek to raise new capital to fund additional product development efforts, even if it has sufficient funds for 
its planned operations. Any sale by the Company of additional equity or convertible debt securities could 
result in dilution to the Company’s current stockholders. There can be no assurance that any such required 
additional funding will be available to the Company at all or available on terms acceptable to the Company. 
Further, to the extent that the Company raises additional funds through collaborative arrangements, it may 
be necessary to relinquish some rights to the Company’s drug candidates or grant sublicenses on terms that 
are not favorable to the Company. If the Company is not able to secure additional funding when needed, 
the Company may have to delay, reduce the scope of, or eliminate one or more research and development 
programs, which could have an adverse effect on the Company’s business.  

2. 

Basis of Presentation and Significant Accounting Policies

a. PRINCIPLES  OF  CONSOLIDATION.  The  consolidated  financial  statements  include  the 
Company’s accounts and those of its wholly-owned subsidiary Catalyst Pharmaceuticals Ireland, 
Ltd.  (“Catalyst  Ireland”).  All  intercompany  accounts  and  transactions  have  been  eliminated  in 
consolidation. Catalyst Ireland was organized in August 2017. 

b. USE OF ESTIMATES. The preparation of financial statements in conformity with U.S. generally 
accepted  accounting  principles  (U.S.  GAAP)  requires  management  to  make  estimates  and 
assumptions  that  affect  the  amounts  reported  in  the  consolidated  financial  statements  and 
accompanying notes. Actual results could differ from those estimates. 

F-9 

2. 

Basis of Presentation and Significant Accounting Policies (continued) 

c. CASH  AND  CASH  EQUIVALENTS.  The  Company  considers  all  highly  liquid  instruments, 
purchased with an original maturity of three months or less to be cash equivalents. Cash equivalents 
consist  mainly  of  money  market  funds. The  Company  has substantially  all  of its  cash  and  cash 
equivalents deposited with one financial institution. These amounts at times may exceed federally 
insured limits. 

d. SHORT-TERM  INVESTMENTS.  The  Company  invests  in  short-term  investments  in  high 
credit-quality funds in order to obtain higher yields on its cash available for investments. As of 
December 31, 2017, and 2016, short-term investments consisted of a short-term bond fund. Such 
investments are not insured by the Federal Deposit Insurance Corporation. Short-term investments 
at December 31, 2017 and 2016 were accounted for as trading securities. Trading securities are 
recorded at fair value based on the closing market price of the security. For trading securities, the 
Company  recognizes  realized  gains  and  losses  and  unrealized  gains  and  losses  to  earnings. 
Unrealized gain (loss) on trading securities for the years ended December 31, 2017, 2016 and 2015 
were $29,430, $58,861, and ($29,430), respectively, and are included in other income, net in the 
accompanying consolidated statements of operations.

e. PREPAID EXPENSES AND OTHER CURRENT ASSETS. Prepaid expenses and other current 
assets consist primarily of prepaid research fees, prepaid insurance, prepaid pre-commercialization 
fees and prepaid subscription fees. Prepaid research fees consist of advances for the Company’s 
product  development  activities,  including  drug  manufacturing,  contracts  for  preclinical  studies, 
clinical trials and studies, regulatory affairs and consulting. Such advances are recorded as expense 
as the related goods are received or the related services are performed. 

f. PROPERTY AND EQUIPMENT. Property and equipment are recorded at cost. Depreciation is 
calculated to amortize the depreciable assets over their useful lives using the straight-line method 
and commences when the asset is placed in service. Leasehold improvements are amortized on a 
straight-line basis over the term of the lease or the estimated life of the improvement, whichever is 
shorter. Useful lives generally range from three years for computer equipment to three to six years 
for  furniture  and  equipment,  and  from  five  to  seven  years  for  leasehold  improvements. 
Expenditures for repairs and maintenance are charged to expenses as incurred. 

g. OPERATING LEASES. The Company recognizes lease expense on a straight-line basis over the 
initial lease term. For leases that contain rent holidays, escalation clauses or tenant improvement 
allowances, the Company recognizes rent expense on a straight-line basis and records the difference 
between the rent expense and rental amount payable as deferred rent. As of December 31, 2017, 
and  2016,  the  Company  had  $181,467  and  $199,256,  respectively,  of  deferred  rent  and  lease 
incentive in accrued expenses and other liabilities. 

h. FAIR  VALUE  OF  FINANCIAL  INSTRUMENTS.  The  Company’s  financial  instruments 
consist  of  cash  and  cash  equivalents,  short-term  investments,  accounts  payable  and  accrued 
expenses and other liabilities, and warrants liability. At December 31, 2017 and 2016, the fair value 
of these instruments approximated their carrying value. 

F-10 

2. 

Basis of Presentation and Significant Accounting Policies (continued) 

i. FAIR VALUE MEASUREMENTS. Current Financial Accounting Standards Board (FASB) fair 
value guidance emphasizes that fair value is a market-based measurement, not an entity-specific 
measurement. Therefore, a fair value measurement should be determined based on the assumptions 
that market participants would use in pricing the asset or liability. As a basis for considering market 
participant assumptions in fair value measurements, current FASB guidance establishes a fair value 
hierarchy that distinguishes between market participant assumptions based on market data obtained 
from sources independent of the reporting entity (observable inputs that are classified within Levels 
1  and  2  of  the  hierarchy)  and  the  reporting  entity’s  own  assumptions  that  it  believes  market 
participants would use in pricing assets or liabilities (unobservable inputs classified within Level 3 
of the hierarchy). 

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities 
that the Company has the ability to access at the measurement date. Level 2 inputs are inputs other 
than quoted prices included in Level 1 that are observable for the asset or liability, either directly 
or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active 
markets, as well as inputs that are observable for the asset or liability (other than quoted prices), 
such as interest rates, foreign exchange rates, and yield curves that are observable at commonly 
quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically 
based on an entity’s own assumptions, as there is little, if any, related market activity. In instances 
where the determination of the fair value measurement is based on inputs from different levels of 
the  fair  value  hierarchy,  the  level  in  the  fair  value  hierarchy  within  which  the  entire  fair  value 
measurement falls is based on the lowest level input that is significant to the fair value measurement 
in its entirety. The Company’s assessment of the significance of a particular input to the fair value 
measurement in its entirety requires judgment and considers factors specific to the asset or liability.  

Fair Value Measurements at Reporting Date Using 

Balances as of 
December 31, 
2017 
56,820,688 
26,516,711 

  $
  $

Quoted Prices in 
Active Markets 
for Identical 
Assets/Liabilities 
(Level 1)
56,820,688 
26,516,711 

Significant 
Other 
Observable 
Inputs 
(Level 2)

  $
  $

—   $
—   $

Significant 
Unobservable 
Inputs 
(Level 3)

—

—

Fair Value Measurements at Reporting Date Using 

Balances as of 
December 31, 
2016 
13,395,759 
26,512,753 
122,226 

  $
  $
  $

Quoted Prices in 
Active Markets 
for Identical 
Assets/Liabilities 
(Level 1)
13,395,759 
26,512,753 

  $
  $
—   $

Significant 
Other 
Observable 
Inputs 
(Level 2)

—   $
—   $
 —   $

Significant 
Unobservable 
Inputs 
(Level 3)

—

—
122,226 

$
$

$
$
$

Money market funds 
Short-term investments 

Money market funds 
Short-term investments 
Warrants liability  

F-11 

2. 

Basis of Presentation and Significant Accounting Policies (continued) 

j. WARRANTS LIABILITY. In October 2011, the Company issued 1,523,370 warrants (the 2011 
warrants) to purchase shares of the Company’s common stock in connection with a registered direct 
offering. The Company accounted for these warrants as a liability measured at fair value due to a 
provision included in the warrants agreement that provided the warrants holders with an option to 
require the Company (or its successor) to purchase their warrants for cash in an amount equal to 
their  Black-Scholes  Option  Pricing  Model  (the  Black-Scholes  Model)  value,  in  the  event  that 
certain  fundamental  transactions,  as  defined,  were  to  occur  while  the  2011  warrants  were 
outstanding. During periods that the 2011 warrants were outstanding, the fair value of the warrants 
liability was estimated using the Black-Scholes Model which required inputs such as the expected 
term  of  the  warrants,  share  price  volatility  and  risk-free  interest  rate.  These  assumptions  were 
reviewed on a quarterly basis and changes in the estimated fair value of the outstanding warrants 
were recognized each reporting period in the “Change in fair value of warrants liability” line in the 
consolidated  statements  of  operations.  The  2011  warrants  expired  on  May  2,  2017.  At 
December 31,  2017  and  2016,  respectively,  none  and  763,913  of  the  2011  warrants  remained 
outstanding.  

k. RESEARCH  AND  DEVELOPMENT.  Costs  incurred  in  connection  with  research  and 
development activities are expensed as incurred. These costs consist of direct and indirect costs 
associated with specific projects as well as fees paid to various entities that perform research related 
services for the Company.  

l. STOCK-BASED  COMPENSATION.  The  Company  recognizes  expense  in  the  consolidated 
statements  of  operations  for  the  fair  value  of  all  stock-based  payments  to employees,  directors, 
scientific advisors and consultants, including grants of stock options and other share-based awards. 
For stock options, the Company uses the Black-Scholes option valuation model, the single-option 
award approach and the straight-line attribution method. Using this approach, compensation cost 
is  amortized  on  a  straight-line  basis  over  the  vesting  period  of  each  respective  stock  option, 
generally one to three years. Forfeitures are recognized as a reduction of share-based compensation 
expense as they occur.  

For  the  years  ended  December 31,  2017,  2016  and  2015,  the  Company  recorded  stock-based 
compensation expense as follows:  

Research and development 
General and administrative 
Total stock-based compensation 

2017 

2016

2015

$              785,899 $          590,857 $          378,548
1,206,910
      1,245,228
$          2,407,961 $       1,836,085 $       1,585,458

      1,622,062

m. CONCENTRATION OF CREDIT RISK. The financial instruments that potentially subject the 
Company to concentration of credit risk are cash equivalents (i.e. money market funds) and short-
term  investments.  The  Company  places  its  cash  equivalents  with  high-credit  quality  financial 
institutions. These amounts at times may exceed federally insured limits. The Company has not 
experienced any credit losses in these accounts.  

F-12 

2. 

Basis of Presentation and Significant Accounting Policies (continued) 

n.

INCOME TAXES. The Company utilizes the asset and liability method of accounting for income 
taxes. Under this method, deferred tax assets and liabilities are determined based on differences 
between financial reporting and tax bases of assets and liabilities and are measured using enacted 
tax rates and laws that will be in effect when the differences are expected to reverse. A valuation 
allowance is provided when it is more likely than not that some portion or all of a deferred tax asset 
will not be realized.  

The Company recognizes the financial statement benefit of a tax position only after determining 
that the relevant tax authority would more likely than not sustain the position following an audit. 
For  tax  positions  meeting  the  more-likely-than-not  threshold,  the  amount  recognized  in  the 
financial statements is the largest  benefit that  has  a  greater than  50  percent likelihood  of  being 
realized upon ultimate settlement with the relevant tax authority. The Company is subject to income 
taxes in the U.S. federal jurisdiction and various state jurisdictions. Tax regulations within each 
jurisdiction  are  subject  to  the  interpretation  of  the  related  tax  laws  and  regulations  and  require 
significant  judgment  to  apply.  The  Company  is  not  subject  to  U.S.  federal,  state  and  local  tax 
examinations by tax authorities for years before 2014. If the Company were to subsequently record 
an unrecognized tax benefit, associated penalties and tax related interest expense would be reported 
as a component of income tax expense.  

On  December 22, 2017,  the  U.S.  government  enacted  comprehensive tax  legislation  commonly 
referred to as the Tax Cuts and Jobs Act (the “Tax Act”). The Tax Act 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 from 35 to 21 percent; (2) requiring companies to pay a one-time transition tax on certain 
repatriated earnings of foreign subsidiaries; (3) generally eliminating U.S. federal income taxes on 
dividends from foreign subsidiaries; (4) requiring a current inclusion in U.S. federal taxable income 
earnings of controlled foreign corporations; (5) eliminating the corporate alternative minimum tax 
(AMT) and changing how existing AMT credits can be realized; (6) creating the base erosion anti-
abuse  tax  (BEAT),  a  new  minimum  tax;  (7)  creating  a  new  limitation  on  deductible  interest 
expense, and (8) changing rules related to uses and limitations of net operating loss carryforwards 
created in tax years beginning after December 31, 2017. 

o. COMPREHENSIVE  INCOME  (LOSS).  U.S.  GAAP  require  that  all  components  of 
comprehensive income (loss) be reported in the consolidated financial statements in the period in 
which they are recognized. Comprehensive income (loss) is net income (loss), plus certain other 
items that are recorded directly into stockholders’ equity. For all periods presented, the Company’s 
net loss equals comprehensive loss, since the Company has no items which are considered other 
comprehensive income (loss). 

p. NET INCOME (LOSS) PER SHARE. Basic loss per share is computed by dividing net loss for 
the period by the weighted average number of common shares outstanding during the period. The 
calculation of basic and diluted net loss per share is the same for all periods presented, as the effect 
of potential common stock equivalents is anti-dilutive due to the Company’s net loss position for 
all periods presented. The potential shares, which are excluded from the determination of basic and 
diluted net loss per share as their effect is anti-dilutive, for the years ended December 31, 2017, 
2016 and 2015, are as follows:  

Stock options to purchase common stock 
Warrants to purchase common stock 
Unvested restricted stock 
Potential equivalent common stock excluded 

2017 
5,191,666 
—
—
5,191,666 

2016 
4,660,000 
   2,407,663
        26,667
   7,094,330

2015 
4,250,000
2,407,663
53,334
6,710,997

F-13 

2. 

Basis of Presentation and Significant Accounting Policies (continued) 

Potentially dilutive stock options to purchase common stock as of December 31, 2017, 2016 and 
2015 have exercise prices ranging from $0.47 to $4.64. Potentially dilutive warrants to purchase 
common stock as of December 31, 2016 and 2015 had exercise prices ranging from $1.04 to $2.08 
and expired in periods between May 2017 and August 2017.  

q. SEGMENT INFORMATION. Management has determined that the Company operates in one 
reportable segment, which is the development and commercialization of pharmaceutical products.  

r. RECLASSIFICATIONS.  Certain  prior  year  amounts  in  the  consolidated  financial  statements 

have been reclassified to conform to the current year presentation.  

s. RECENTLY ISSUED ACCOUNTING STANDARDS.    In February 2016, the FASB issued 
ASU No. 2016-02, Leases (Topic 842), which requires an entity to recognize assets and liabilities 
arising  from  a  lease  for  both  financing  and  operating  leases.  The  ASU  will  also  require  new 
qualitative and quantitative disclosures to help investors and other financial statement users better 
understand the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is 
effective for fiscal years beginning after December 15, 2018, with early adoption permitted. The 
Company is currently evaluating the impact this accounting standard will have on its consolidated 
financial statements. 

On  March 30,  2016,  the  FASB  issued  ASU  No. 2016-09,  Compensation—Stock  Compensation
(Topic  718):  Improvements  to  Employee  Share-Based  Payment  Accounting,  which  simplifies 
several aspects of the accounting for employee share-based payment transactions for both public 
and  nonpublic  entities, including  the accounting  for income  taxes, forfeitures,  and  statutory  tax 
withholding  requirements,  as  well  as  classification  in  the  statement  of  cash  flows.  For  public 
companies, the  changes  are  effective  for  reporting  periods  (annual  and interim)  beginning  after 
December 15, 2016. The Company adopted this standard in the first quarter of 2017. The adoption 
of this standard did not have a material impact on the Company’s consolidated financial statements. 

In May 2017, the FASB issued ASU No. 2017-09, Compensation – Stock Compensation (Topic 
718): Scope of Modification Accounting to clarify when to account for a change to the terms or 
conditions  of  a  share-based  payment  award  as  a  modification.  Under  this  new  guidance, 
modification  accounting  is  required  if  the  fair  value, vesting  conditions, or  classification  of the 
award changes as a result of the change in terms or conditions. ASU 2017-09 is effective for all 
entities  for  annual  reporting  periods  beginning  after  December 15,  2017,  including  interim 
reporting  periods  within  each  annual  reporting  period,  applied  prospectively  on  or  after  the 
effective date. The Company is currently evaluating the impact this accounting standard will have 
on its consolidated financial statements; however, the Company does not expect that the adoption 
of this standard will have a material impact on the Company’s consolidated financial statements. 

3.  Warrants Liability, at Fair Value

The Company allocated approximately $1.3 million of proceeds from its October 2011 registered 
direct offering to the fair value of common stock purchase warrants issued in connection with the offering 
that  were  classified  as  a  liability  (the  2011  warrants).  The  2011  warrants  were  classified  as  a  liability 
because of provisions in such warrants that allowed for the net cash settlement of such warrants in the event 
of certain fundamental transactions (as defined in the warrant agreement).  

F-14 

3.  Warrants Liability, at Fair Value (continued)

During  periods  that  the  2011  warrants  were  outstanding,  the  valuation  of  the  2011  warrants  was 
determined using the Black-Scholes Model. This model uses inputs such as the underlying price of the 
shares  issued  when  the  warrant  is  exercised,  volatility,  risk  free  interest  rate  and  expected  life  of  the 
instrument. The Company has determined that the 2011 warrants liability should be classified within Level 
3 of the fair value hierarchy by evaluating each input for the Black-Scholes Model against the fair value 
hierarchy criteria and using the lowest level of input as the basis for the fair value classification. There are 
six inputs: closing price of the Company’s common stock on the day of evaluation; the exercise price of the 
warrants; the remaining term of the warrants; the volatility of the Company’s common stock; annual rate 
of dividends; and the risk-free rate of return. Of those inputs, the exercise price of the warrants and the 
remaining term are readily observable in the warrants agreement. The annual rate of dividends is based on 
the Company’s historical practice of not granting dividends. The closing price of the Company’s common 
stock would fall under Level 1 of the fair value hierarchy as it is a quoted price in an active market. The 
risk-free rate of return is a Level 2 input, while the historical volatility is a Level 3 input in accordance with 
the fair value accounting guidance. Since the lowest level input is a Level 3, the Company determined the 
2011 warrants liability was most appropriately classified within Level 3 of the fair value hierarchy. This 
liability was subject to a fair value mark-to-market adjustment each reporting period.  

The calculated value of the 2011 warrants liability was determined using the Black-Scholes option-

pricing model with the following assumptions:  

Risk free interest rate 
Expected term 
Expected volatility 
Expected dividend yield 
Expected forfeiture rate 

December 31, 2016

0.85% 
0.33 years 
100% 
0% 
0% 

The following table rolls forward the fair value of the Company’s warrants liability activity for the 

years ended December 31, 2017, 2016 and 2015:  

Fair value, beginning of period 
Issuance of warrants 
Exercise of warrants 
Change in fair value 
Fair value, end of period 

2016 
2017 
$      1,008,363
  $         122,226
—
—
—
          (309,130)
             186,904
(886,137)
  $                  — $        122,226

2015 
$       2,794,891
—
(1,721,523)
(65,005)
$      1,008,363

During  2017,  613,913  of  the  2011  warrants  were  exercised,  with  proceeds  of  $798,087  to  the 
Company. On May 2, 2017, the outstanding and unexercised 2011 warrants expired. During 2016, none of 
the  2011  warrants  were  exercised.  During  2015,  478,261  of  the  2011  warrants  were  exercised,  with 
proceeds  to  the  Company  of  $621,739.  During  periods  that  the  2011  warrants  were  outstanding,  the 
Company recognized the change in the fair value of the warrants liability as a non-operating income or loss 
in the consolidated statements of operations.   

F-15 

4. 

Prepaid Expenses and Other Current Assets 

           Prepaid expenses and other current assets consist of the following as of December 31:  

Prepaid research fees 
Prepaid insurance 
Prepaid pre-commercialization fees 
Prepaid subscriptions fees 
Prepaid rent 
Other 
Total prepaid expenses and other current assets 

          2017
$     388,977 
638,139 
65,000 
23,347 
— 
58,281 
$  1,173,744 

           2016
$     334,565 
598,909 
35,500  
22,770 
19,756 
36,444 
$  1,047,944 

5. 

Property and Equipment, net 

Property and equipment, net consists of the following as of December 31:  

Computer equipment 
Furniture and equipment 
Leasehold improvements 

Less: Accumulated depreciation 

Total property and equipment, net 

2017 

2016 

  $                27,915 
              169,931 
    152,708 
350,554 
(159,169)

  $               27,915
               177,061
               152,708
               357,684
             (113,480)

$              191,385 

$             244,204          

Depreciation  expense  was  $45,689,  $43,406,  and  $34,468,  respectively,  for  the  years  ended 

December 31, 2017, 2016 and 2015.  

6. 

Accrued Expenses and Other Liabilities 

Accrued expenses and other liabilities consist of the following as of December 31:  

Accrued preclinical and clinical trial expenses 
Accrued professional fees 
Accrued compensation and benefits 
Accrued license fees 
Deferred rent and lease incentive 
Other 

Current accrued expenses and other liabilities 

Deferred rent and lease incentive—non-current 

Non-current accrued expenses and other liabilities 

Total accrued expenses and other liabilities 

2017
$           970,649 
227,457 
821,935 
252,500 
24,011 
24,035 
2,320,587 
157,456 
157,456 
$        2,478,043 

2016
$            623,855 
102,673 
264,237 
152,500 
18,094 
—
1,161,359 
181,162 
181,162 
$      1,342,521 

F-16 

 
 
 
7. 

Commitments and Contingencies 

The Company has contracted with drug manufacturers and other vendors, including clinical research 
organizations  (CRO)  overseeing  the  clinical  trials  of  the  Company’s  drug  candidates,  to  assist  in  the 
execution  of  the  Company’s  preclinical  and  clinical  trials,  analysis,  and  the  preparation  of  material 
necessary  for  the  submission  of  new  drug  applications  (NDAs)  and  abbreviated  new  drug  applications 
(ANDAs) with the U.S. Food and Drug Administration (FDA). The contracts are cancelable at any time, 
but obligate the Company to reimburse the providers for any time or costs incurred through the date of 
termination.  

The Company has executed a non-cancellable operating lease agreement for its corporate office. The 
lease has free and escalating rent payment provisions. The Company recognizes rent expense under such 
lease on a straight-line basis over the term of the lease. As of December 31, 2017, future minimum lease 
payments under the operating lease agreement are as follows:  

2018 
2019 
2020 
2021 
2022 

$ 

213,644 
220,053 
226,655 
233,454 
220,023 
$  1,113,829 

In March 2015, the Company amended the lease to its corporate offices to obtain additional space for 
its operations. The Company now leases approximately 5,200 square feet and the lease term now expires 
in 2022. In connection with the expansion, approximately $131,000 of tenant build-out costs were funded 
and paid by the landlord through lease incentives. The lease incentives are being amortized over the term 
of the lease as a reduction of rent expense. The lease provides for fixed increases in minimum annual rent 
payments, as well as rent free periods. The total amount of rental payments due over the lease term is being 
charged to rent expense on the straight-line method over the term of the lease. The differences between rent 
expense recorded and the amount paid is credited or charged to accrued expenses and other liabilities in the 
accompanying  consolidated  balance  sheets.  Rent  expense  was  $204,170,  $201,920,  and  $129,727 
respectively, for the years ended December 31, 2017, 2016 and 2015.  

There are no obligations under capital leases. 

For commitments related to the Company’s license agreements with BioMarin (defined below) and 

Northwestern (defined below), see Note 8.  

8. 

Agreements

a.  LICENSE AGREEMENT WITH NORTHWESTERN UNIVERSITY. On August 27, 2009, 
the Company entered into a license agreement with Northwestern University (Northwestern), 
under  which  it  acquired  worldwide  rights  to  commercialize  new  GABA  aminotransferase 
inhibitors and derivatives of vigabatrin that have been discovered by Northwestern. Under the 
terms  of  the  license  agreement,  Northwestern  granted  the  Company  an  exclusive  worldwide 
license to certain composition of matter patents related to the new class of inhibitors and a patent 
application relating to derivatives of vigabatrin. The Company has identified and designated the 
lead compound under this license as CPP-115. 

F-17 

8. 

Agreements (continued) 

Under  the  license  agreement  with  Northwestern,  the  Company  is  responsible  for  continued 
research and development of any resulting product candidates. As of December 31, 2017, the 
Company  has  paid  $424,885  in  connection  with  the  license  and  has  accrued  license  fees  of 
$252,500 and $152,500 as of December 31, 2017, and 2016, respectively, in the accompanying 
consolidated  balance  sheets  for  expenses,  maintenance  fees  and  milestones.  In  addition,  the 
Company  is  obligated  to  pay  certain  milestone  payments  in  future  years  relating  to  clinical 
development activities with respect to CPP-115, and royalties on any products resulting from 
the  license  agreement.  The  next  milestone  payment  of  $300,000  is  due  on  the  earlier  of 
successful completion of the first Phase 3 clinical trial for CPP-115 or August 27, 2018.

b.  LICENSE  AGREEMENT  WITH  NEW  YORK  UNIVERSITY  AND  THE  FEINSTEIN 
INSTITUTE FOR MEDICAL RESEARCH. On December 13, 2011, the Company entered 
into  a  license  agreement  with  New  York  University  (NYU)  and  the  Feinstein  Institute  for 
Medical Research (FIMR) under which it acquired worldwide rights to commercialize GABA 
aminotransferase inhibitors in the treatment for Tourette syndrome. The Company is obligated 
to pay certain milestone payments in future years relating to clinical development activities and 
royalties on any products resulting from the license agreement.

c.  LICENSE AGREEMENT WITH BIOMARIN.  On October 26, 2012, the Company entered 
into a license agreement with BioMarin Pharmaceutical, Inc. (BioMarin) for the North American 
rights to Firdapse®. 

Under the License Agreement, the Company has agreed to pay: (i) royalties to BioMarin for 
seven years from the first commercial sale of Firdapse® equal to 7% of net sales (as defined in 
the license agreement) in North America for any calendar year for sales up to $100 million, and 
10%  of  net  sales  in  North  America  in  any  calendar  year  in  excess  of  $100 million;  and 
(ii) royalties to the third-party licensor of the rights sublicensed to the Company for seven years 
from the first commercial sale of Firdapse® equal to 7% of net sales (as defined in the license 
agreement between BioMarin and the third-party licensor) in any calendar year. 

Under the Company’s license agreement with BioMarin, the Company has agreed to pay certain 
milestone payments that BioMarin is obligated to pay to both a third-party licensor of the rights 
that  have  been  sublicensed  to  the  Company  and  to  the  former  stockholders  of  Huxley 
Pharmaceuticals (“Huxley”) under an earlier stock purchase agreement between BioMarin and 
the former Huxley stockholders. These milestones aggregate (i) approximately $2.6 million due 
upon acceptance by the FDA of a filing of an NDA for Firdapse® for the treatment of LEMS or 
CMS  (approximately  $150,000  of  which  will  be  due  to  the  third  party  licensor  and 
approximately  $2,425,000 of  which  will  be  due  to  the  former  Huxley  stockholders),  and  (ii) 
approximately $7.2 million due upon the unconditional approval by the FDA of an NDA for 
Firdapse® for the treatment of LEMS (approximately $3.0 million of which will be due to the 
third party licensor and approximately $4.2 million of which will be due to the former Huxley 
stockholders). However, under BioMarin’s agreement with the former Huxley stockholders (and 
under  the  Company’s  license  agreement  with  BioMarin),  BioMarin’s  obligation  to  pay  the 
milestone payments due to the former Huxley stockholders (and the Company’s corresponding 
obligation to pay such milestone payments) expressly expires if these milestones have not been 
not satisfied by April 20, 2018.  

BioMarin has recently advised the Company that the former Huxley stockholders may take legal 
action  seeking  payment  of  the  milestone  payments  due  to  them  from  BioMarin  if  these 
milestones are achieved after April 20, 2018, notwithstanding the express termination date in 
the  agreements.  BioMarin  has  also  advised  the  Company  that  the  Company  could  become 
involved in any such legal action.  While it is too early to determine how this matter will affect 

F-18 

8. 

Agreements (continued) 

the Company, based on currently available information the Company does not believe that this 
matter  will  have  a  material  adverse  effect  on  the  Company’s  financial  position  or  results  of 
operations. 

The Company also agreed to share in the cost of certain post-marketing studies conducted by 
BioMarin, and, as of both December 31, 2017, and 2016, the Company had paid BioMarin $3.8 
million in the aggregate, related to expenses in connection with Firdapse® studies and trials. 

d.  AGREEMENTS  FOR  DRUG  DEVELOPMENT,  PRECLINICAL  AND  CLINICAL 
STUDIES.  The  Company  has  entered  into  agreements  with  contract  manufacturers  for  the 
manufacture of drug and study placebo for the Company’s trials and studies, and for commercial 
requirements  if  any  product  is  approved  for  commercialization,  with  contract  research 
organizations (CRO) to conduct and monitor the Company’s trials and studies and with various 
entities  for  laboratories  and  other  testing  related  to  the  Company’s  trials  and  studies.  The 
contractual terms of the agreements vary, but most require certain advances as well as payments 
based on the achievement of milestones. Further, these agreements are cancellable at any time, 
but obligate the Company to reimburse the providers for any time or costs incurred through the 
date of termination. 

9. 

Related Party Transactions

During each of the years ended December 31, 2017, 2016 and 2015, the Company paid approximately 

$10,000, in consulting fees to members of the Company’s Scientific Advisory Board. 

During 2015, the Company entered into a consulting agreement with one of its directors to serve as 
interim chief commercial officer during a period that the Company was seeking to fill that position. The 
consulting arrangement ended in September 2015 and the director received a total of $45,000 in consulting 
fees for those services. 

The Company has an employment agreement with its Chief Executive Officer. Under this agreement, 
the CEO will receive an annual base salary of approximately $525,000 in 2018. This agreement expires in 
November 2018.   

10. 

Income Taxes

Due to the ongoing operating losses and the inability to recognize any income tax benefit, there is no 
provision  for  income  taxes  in  any  period  presented  in  these  financial  statements.  Since  inception,  the 
Company has only generated pretax losses. 

The reconciliation of income tax expense (benefit) computed at the statutory federal income tax rate 

of 34% to amounts included in the consolidated statements of operations is as follows: 

        Statutory rate 
        State tax 
        Valuation allowance 
        Federal rate change 
        Tax credit 
        Other 

2017 

34.0%
3.5%
26.5%
(73.2)%
6.8%
2.4%
0.0%

2016 
34.0%
3.4%
(44.7)%
0.0%
6.2%
1.1%
0.0%

2015 

34.0%
3.6%
(37.7)%
0.0%
0.0%
0.1%
0.0%

F-19 

10.  Income Taxes (continued) 

Deferred tax assets and liabilities reflect the net tax effects of net operating loss and tax credit 

carryovers and the temporary differences between the carrying  amounts of assets and liabilities for 
financial reporting and the amounts used for income tax purposes. Significant components of the 
Company’s deferred  tax  assets as of December 31, 2017 and 2016 are as follows: 

        Net operating loss  
        Start-up cost 
        Tax credits 
        Deferred compensation  
        Other 
        Gross deferred tax asset  
        Valuation allowance 

Net deferred tax assets 

2017 
$    15,718,570
10,508,487
11,582,134
1,326,189
72,395
39,207,775
  (39,207,775)
$                  0

2016 
$     21,050,217
12,823,113
6,960,838
1,555,425
207,133
42,596,726
    (42,596,726)
$                     0

The Company's deferred tax assets have been fully offset by a valuation allowance at December 
31, 2017  and  2016 because the Company believes that it is more likely than not that the deferred tax 
asset will not be realized.  The  decrease and  increase  in  the  valuation  allowance  on  the  deferred  tax 
assets was $3,388,951 and $8,287,962 for the years ended December 31, 2017 and 2016, respectively. 

Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable 
income in years in which those temporary differences are expected to be recovered or settled. As changes 
in tax laws or rates are enacted, deferred tax assets and liabilities are adjusted through income tax expense. 
As a result of the reduction in the U.S. corporate tax rate from 35% to 21% under the Tax Act enacted in 
December 2017, the Company recorded a reduction of approximately $13.5 million in the fourth quarter of 
2017 related to the revaluation of its deferred tax assets. There was no impact to tax expense as a result of 
the revaluation as the Company’s deferred tax assets have a full valuation allowance. 

At December 31, 2017 and 2016, respectively, the Company had net operating loss carryforwards of 
approximately $62.6 million and $56.3 million available to reduce future taxable income, if any. The net 
operating  loss  carryforwards  will  expire  at  various  dates  beginning  in  2024  and  ending  in  2037.  If  an 
ownership change, as defined under Internal Revenue Code Section 382, occurs, the use of these carry-
forwards may be subject to limitation. The effective tax rate of 0% in all periods presented differs from the 
statutory rate of 34% due to the valuation allowance and because the Company had no taxable income. 

Beginning  in  2010,  the  Company  has  received  several  orphan  drug  designations  by  the  FDA  for 
products currently under development. The orphan drug designations allow the Company to claim increased 
federal tax credits for certain research and development activities.  

No  interest  or  penalties  were  accrued  through  December  31,  2017.  The  Company’s  policy  is  to 
recognize any related interest or penalties in income tax expense. The Company is not subject to U.S federal, 
state and local tax examinations by tax authorities for any years before 2014. The Company is not currently 
under income tax examinations by any tax authorities. 

11.  Stockholders’ Equity

Preferred Stock 

The  Company  has  5,000,000  shares  of  authorized  preferred  stock,  $0.001  par  value  per  share  at 
December 31, 2017 and 2016. No shares of preferred stock were outstanding at December 31, 2017 and 
2016.  

F-20 

11.  Stockholders’ Equity (continued) 

Common Stock 

During  2015,  the  Company’s  stockholders  approved  an  increase  in  the  Company’s  authorized 
common  stock  par  value  $0.001  per  share,  from  100,000,000  shares  to  150,000,000  shares.  At 
December 31, 2017 and 2016, 102,549,498 and 82,972,316 shares, respectively, of common stock were 
issued and outstanding. Each holder of common stock is entitled to one vote of each share of common stock 
held of record on all matters on which stockholders generally are entitled to vote.  

2016 Shelf Registration Statement 

On December 23, 2016, the Company filed a shelf Registration Statement on Form S-3 (the 2016 Shelf 
Registration Statement) with the SEC to sell up to approximately $33.8 million of common stock. The 2016 
Shelf Registration Statement (file No. 333-215315) was declared effective by the SEC on January 9, 2017. 
No sales have been conducted to date under the 2016 Shelf Registration Statement. 

2017 Shelf Registration Statement 

On July 12, 2017, the Company filed a universal shelf Registration Statement on Form S-3 (the 2017 
Shelf Registration Statement) with the SEC to sell up to $150 million of common stock, preferred stock, 
warrants to purchase common stock, or debt securities (including debt securities that may be convertible or 
exchangeable for common stock or other securities), which securities may be offered separately or together 
in  units  or  multiple  series.  The  2017  Shelf  Registration  Statement  (file  No. 333-219259)  was  declared 
effective  by  the  SEC  on  July 26,  2017.  The  Company  has  to  date  conducted  the  following  sales  of  its 
securities under the 2017 Shelf Registration Statement: 

(a) On  November  28,  2017,  the  Company  filed  a  prospectus  supplement  and  offered  for  sale 
16,428,572  shares if its  common  stock  at  a  price of $3.50  per  share in  an  underwritten  public 
offering.  The  Company  received  gross  proceeds in  the  public  offering  of  approximately  $57.5 
million before underwriting commission and incurred expenses of approximately $3.7 million. 

As of December 31, 2017, there is approximately $92.5 million available for future sale under the 

2017 Shelf Registration Statement. 

Warrant Exercises 

For the year ended December 31, 2017, the Company issued 2,257,663 of its authorized but unissued 
common stock upon the exercise of previously issued common stock purchase warrants, with net proceeds 
to the Company of $3,209,423. No warrants were exercised during the year ended December 31, 2016. For 
the year ended December 31, 2015, the Company issued an aggregate of 1,178,261 shares of its authorized 
but  unissued  common  stock  upon  the  exercise  of  previously  issued  common  stock  purchase  warrants, 
raising net proceeds of $1,895,738.  

Stockholder Rights Plan  

On September 20, 2011, the Board of Directors approved the Company’s adoption of a Stockholder 
Rights Plan. Under the Plan, a dividend of one preferred share purchase right (a Right) was declared for 
each share of common stock of the Company that was outstanding on October 7, 2011. Each Right entitles 
the holder to purchase from the Company one one-hundredth of a share of Series A Junior Preferred Stock 
at a purchase price of $7.80, subject to adjustment.  

F-21 

11.  Stockholders’ Equity (continued) 

The Rights trade automatically with the common stock and will not be exercisable until a person or 
group  has  become  an  “acquiring  person”  by  acquiring  17.5%  or  more  of  the  Company’s  outstanding 
common stock, or a person or group commences, or publicly announces a tender offer that will result in 
such  a  person  or  group  owning  17.5%  or  more  of  the  Company’s  outstanding  common  stock.  Upon 
announcement  that  any  person  or  group  has  become  an  acquiring  person,  each  Right  will  entitle  all 
rightholders (other  than the  acquiring  person) to  purchase,  for the  exercise  price  of  $7.80,  a number  of 
shares  of  the  Company’s  common  stock  having  a  market  value  equal  to  twice  the  exercise  price. 
Rightholders would also be entitled to purchase common stock of the acquiring person having a value of 
twice the exercise price if, after a person had become an acquiring person, the Company were to enter into 
certain mergers or other transactions. If any person becomes an acquiring person, the Board of Directors 
may, at its option and subject to certain limitations, exchange one share of common stock for each Right.  

The Rights have certain anti-takeover effects, in that they would cause substantial dilution to a person 
or group that attempts to acquire a significant interest in the Company on terms not approved by the Board 
of Directors. In the event that the Board of Directors determines a transaction to be in the best interests of 
the Company and its stockholders, the Board of Directors may redeem the Rights for $0.001 per share at 
any time prior to a person or group becoming an acquiring person.  

On September 19, 2016, the Board of Directors unanimously approved, and on the same date the 
Company entered into Amendment No. 1 to the Stockholder Rights Plan (the “Amendment”). Under the 
terms of the Amendment, the outside expiration date of the rights plan has been extended from September 
20, 2016 to September 20, 2019. Additionally, as part of the Amendment, the Board adopted a Certificate 
of Designation, Preferences and Rights of Series A Junior Participating Preferred Stock of the Company to 
increase the number of shares of Series A Junior Participating Preferred Stock of the Company available 
for issuance under the Rights Plan from 500,000 shares to 1.5 million shares. 

At the Company’s 2017 annual meeting of stockholders, the Company’s stockholders approved the 

stockholder rights plan, as amended. 

12. 

Stock Compensation Plans

Stock Options 

The Company may issue stock options, restricted stock, stock appreciation rights and restricted stock 
units  (collectively,  the  “Awards”)  to  employees,  directors,  consultants  and  scientific  advisors  of  the 
Company under the 2006 and 2014 Stock Incentive Plans (the 2006 Plan and the 2014 Plan or collectively, 
the  Plans).  At  December 31,  2017, no  shares remain available for  future issuance  under the  2006  Plan.  
Under the 2014 Plan, 9,000,000 shares were reserved for issuance and as of December 31, 2017, 3,646,668 
shares remain available for future issuance. 

The  Company  has  granted  stock  options  to  employees,  officers,  directors,  scientific  advisors  and 
consultants generally at exercise prices equal to the market price of the common stock at grant date. Option 
awards generally vest over a period of 1 to 3 years of continuous service and have contractual terms from 
5 to 7 years. Certain awards provide for accelerated vesting if there is a change in control. The Company 
issues new shares as shares are required to be delivered upon exercise of outstanding stock options.  

During the years ended December 31, 2017, 2016, and 2015, options to purchase 780,000, 75,000, 
and 265,000 shares of the Company’s common stock were exercised with gross proceeds to the Company 
of  $368,185,  $80,251, and  $390,351,  respectively.  Further,  during  the  years  ended  December 31,  2017, 
2016, and 2015, options to purchase 100,000, 50,000, and 984,608 shares of the Company’s common stock 
were  exercised  on  a  “cashless”  basis,  resulting  in  the  issuance  of  an  aggregate  of  84,280,  20,030,  and 
761,600 shares of the Company’s common stock, respectively.  

F-22 

12. 

Stock Compensation Plans (continued)

During the years ended December 31, 2017, 2016 and 2015 the Company recorded non-cash stock-
based  compensation  expense  related  to  stock  options  totaling  $2,342,625,  $1,760,591,  and  $1,510,018, 
respectively.  

During the years ended December 31, 2017, 2016 and 2015, the Company granted seven-year options 
to purchase an aggregate of 1,550,000, 1,285,000 and 1,760,000 shares, respectively, of the Company’s 
common stock to certain of the Company’s officers, employees, directors, and consultants.  

Stock  option  activity  under  the  Company’s  Plans  for  the  year  ended  December  31,  2017  is 

summarized as follows: 

Outstanding at beginning of year 
  Granted 
  Exercised 
  Forfeited or cancelled 
  Expired  

Outstanding at end of year 
Exercisable at end of year 

Number of 
Options 

4,660,000 
1,550,000 
(880,000) 
(138,334) 
— 
5,191,666 
2,908,330 

Weighted 
Average 
Exercise 
Price 
$      1.94 
1.17 
0.47 
1.94 
0.00 

$      1.96 
$      2.44 

Weighted 
Average 
Remaining 
Contractual 
Term (in years) 

Aggregate 
Intrinsic 
Value 

4.94 
4.40 

$10,178,881 
$  4,334,327 

Other  information  pertaining  to  stock  option  activity  during  the  years  ended  December 31,  2017, 

2016 and 2015 was as follows:  

Weighted–average fair value of granted stock options  
Total fair value of vested stock options  
Total intrinsic value of exercised stock options  

2017 
$         0.91 
$2,016,992 
$2,296,100 

2016 
$         0.62 
  $1,634,562   
$     42,000 

2015 
$         2.13 
  $1,307,895   
$3,311,599 

The following table summarizes information about the Company’s options outstanding at 

December 31, 2017:  

Range of 
Exercise 
Prices 
$0.47 to $0.85 
$0.86 to $1.14 
$1.15 to $2.80 
$2.81 to $3.23 
$3.24 to $4.64 

Number 
Outstanding 
1,085,000 
1,516,666 
1,195,000 
1,020,000 
375,000 
5,191,666 

Options Outstanding 

Options Exercisable 

  Weighted 
Average 
Remaining 
Contractual 
Life (Years) 
5.15 
6.00 
4.75 
3.67 
4.06 
4.94 

Weighted 
Average 
Exercise 
Price 

$0.78 
$1.13 
$2.48 
$3.12 
$3.93 
$1.96 

  Weighted 
Average 
Remaining 
Contractual 
Life (Years) 
5.09 
5.99 
4.65 
3.67 
3.81 
4.40 

Number 
Exercisable 
550,000 
199,999 
866,665 
1,020,000 
271,666 
2,908,330 

Weighted 
Average 
Exercise 
Price 

$0.79 
$1.13 
$2.51 
$3.12 
$3.94 
$2.44 

As  of  December 31,  2017,  there  was  approximately  $1,367,155  of  unrecognized  compensation 
expense related to non-vested stock option awards granted under the Plans. That cost is expected to be 
recognized over a weighted average period of approximately 1.39 years. 

F-23 

 
 
 
 
 
 
 
 
12. 

Stock Compensation Plans (continued)

The Company utilizes the Black-Scholes option-pricing model to determine the fair value of stock 
options on the date of grant. This model derives the fair value of stock options based on certain assumptions 
related to the expected stock price volatility, expected option life, risk-free interest rate and dividend yield. 
Expected  volatility  is  based  on  reviews  of  historical  volatility  of  the  Company’s  common  stock.  The 
estimated expected option life is based upon estimated employee exercise patterns and considers whether 
and the extent to which the options are in-the-money. The Company estimates the expected option life for 
options  granted  to  employees  and  directors  based  upon  the  simplified  method.  Under  this  method,  the 
expected life is presumed to be the mid-point between the vesting date and the end of the contractual term. 
The Company will continue to use the simplified method until it has sufficient historical exercise data to 
estimate  the  expected  life  of  the  options.  The  risk-free  interest  rate  assumption  is  based  upon  the  U.S. 
Treasury yield curve appropriate for the estimated life of the stock options awards. The expected dividend 
rate is zero. Stock–based compensation expense also includes an estimate, which the Company makes at 
grant date, of the number of awards that are expected to be forfeited. The Company revises this estimate in 
subsequent periods if actual forfeitures differ from those estimates.  

Assumptions used during the years were as follows:  

2017 
1.66% to 2.25% 
       4 to 7 years 
104% 
—% 
—% 

Year ended December 31, 
2016 
0.76% to 2.15% 
        2 to 6 years 
100% 
—% 
—% 

2015 
1.00% to 2.13% 
3 to 7 years 
102% 
—% 
—% 

Risk free interest rate 
Expected term 
Expected volatility 
Expected dividend yield 
Expected forfeiture rate 

Restricted Stock Units 

Under the 2014 Plan, participants may be granted restricted stock units, each of which represents a 
conditional right to receive shares of common stock in the future.  The restricted stock units granted under 
this plan generally vest ratably over a three to four-year period.  Upon vesting, the restricted stock units 
will convert into an equivalent number of shares of common stock.  The amount of expense relating to the 
restricted stock units is based on the closing market price of the Company's common stock on the date of 
grant and is amortized on a straight-line basis over the requisite service period. Restricted stock unit activity 
during 2017, 2016, and 2015 was as follows: 

2017 

2016 

2015 

Number of 
Restricted 
Stock 
Units 

   26,667  
          —  
 (26,667) 
          —  

  Weighted 
Average 
Grant 
Date Fair 
Value 

$     2.83 
—  
2.83 
—  

Number of 
Restricted 
Stock Units 

       53,334  
              —  
     (26,667) 
              —  

Weighted 
Average 
Grant 
Date Fair 
Value 

$     2.83 
—  
2.83 
—  

Number of 
Restricted 
Stock Units 

   80,000  
         —  
  (26,666) 
—  

Weighted 
Average 
Grant Date 
Fair Value 

$      2.83 
—  
2.83 
—  

$       —  

$       —  

      26,667  

$     2.83 

    53,334  

$      2.83 

Nonvested balance at  
beginning of year 
Granted 
        Vested 

Forfeited  
Nonvested balance at 
end of year 

F-24 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
12. 

Stock Compensation Plans (continued)

During the years ended December 31, 2017, 2016 and 2015, the Company recorded non-cash stock-
based  compensation  expense  related  to  restricted  stock  units  totaling  $65,336,  $75,494,  and  $75,440, 
respectively. 

13.  Benefit Plan

The  Company  maintains  an  employee  savings  plan  pursuant  to  Section 401(k)  of  the  Internal 
Revenue Code covering all eligible employees. Subject to certain dollar limits, eligible employees may 
contribute up to 15% of their pre-tax annual compensation to the plan. The Company has elected to make 
discretionary matching contributions of employee contributions up to 4% of an employee’s gross salary. 
For  the  years  ended  December 31,  2017,  2016  and  2015,  the  Company’s  matching  contributions  were 
approximately $84,000, $59,000 and $69,000, respectively.  

14. 

Quarterly Financial Information (unaudited)  

The following table presents unaudited supplemental quarterly financial information for the years 

ended December 31, 2017 and 2016:  

Revenues  
Loss from operations 
Change in fair value of 
warrants   liability 

Net loss 
Net loss per share —basic 
and diluted 

Quarter Ended 

March 31,  
2017 
$               —  
(4,679,871) 

June 30,  
2017 
$                —  
(4,181,271) 

September 30, 
2017 
$                 —  
(4,306,708) 

December 31, 
2017 
$                —  
(5,511,786) 

(397,235) 
$  (4,967,129) 

210,331  
$  (3,879,901) 

—  
$   (4,177,649) 

—  
$  (5,387,698) 

$           (0.06) 

$           (0.05) 

$            (0.05) 

$           (0.06)

Revenues  
Loss from operations 
Change in fair value of warrants   

liability 

Net loss 
Net loss per share —basic and 
diluted 

Quarter Ended

March 31,  
2016 
$              —  
 (6,237,536) 

June 30,  
2016 
$              —  
(4,814,452) 

September 30, 
2016 

$               —  
 (3,914,014) 

December 
31, 2016 
$             —  
 (4,314,199) 

733,356  
$ (5,386,237) 

152,783  
$(4,568,914) 

(106,948) 
$ (3,953,981) 

106,946  
$(4,163,320) 

$          (0.07) 

$         (0.06) 

$          (0.05) 

$         (0.05)

Quarterly basic and diluted net loss per common share were computed independently for each quarter 

and do not necessarily total to the full year basic and diluted net loss per common share.  

15.  Subsequent Events 

Subsequent  to  year-end,  the  Company  granted  seven-year  options  to  purchase  an  aggregate  of 
1,772,500  shares  of  the  Company’s  common  stock  to  certain  of  the  Company’s  officers,  employees, 
directors, and consultants. 

F-25 

 
 
 
 
 
 
 
 
 
 
[This page intentionally left blank] 

Corporate Directory 

BOARD OF DIRECTORS 

MANAGEMENT TEAM 

ANNUAL MEETING 

Patrick J. McEnany 
Chairman of the Board, President, 
Chief Executive Officer and 
Co-Founder 

The annual meeting of stockholders will 
be held on Thursday, May 24, 2018 at 
9:00 a.m., local time, at the Hyatt 
Regency Coral Gables, located at:  

Patrick J. McEnany 
Chairman of the Board, President, 
Chief Executive Officer and 
Co-Founder 
Catalyst Pharmaceuticals, Inc. 

Philip H. Coelho 
Chair, Nominating and Corporate 
Governance Committee  
Chief Technology Officer 
ThermoGenesis Corp. 

Steven R. Miller, PhD 
Chief Operating Officer 
and Chief Scientific Officer 

Alicia Grande, CPA, CMA 
Chief Financial Officer  

Richard Daly 
President and Chief Executive Officer 
Neuralstem Inc. 

Gary Ingenito, M.D., Ph.D. 
Chief Medical Officer and Head of 
Regulatory Affairs 

David J. Caponera 
Vice President, Patient Engagement 
and Access Support 

Brian Elsbernd, J.D. 
Sr. Vice President, Legal and 
Compliance 

Donald A. Denkhaus 
Chair, Audit Committee 
Chairman and Chief Financial Officer 
The Kitchen, LLC 

Charles B. O'Keeffe 
Lead Independent Director 
Professor, Pharmacology, 
Epidemiology and Community Health 
Virginia Commonwealth University 

David S. Tierney, MD 
Chair, Compensation Committee 
Chief Executive Officer 
Icon Bioscience, Inc. 

50 Alhambra Plaza 
Coral Gables, Florida 33134 

INVESTOR INFORMATION 

Recent press releases and other 
Catalyst Pharmaceuticals information 
are available without charge on 
Catalyst’s website at 
www.catalystpharma.com 
or by written request to: 

Catalyst Pharmaceuticals, Inc. 
355 Alhambra Circle, Suite 1250 
Coral Gables, FL  33134 
(305) 420-3200 
(305) 569-0233 fax 
Email:agrande@catalystpharma.com 

INDEPENDENT REGISTERED 
PUBLIC ACCOUNTING FIRM 

STOCK LISTING 

Grant Thornton LLP  
Miami, Florida 

Catalyst’s common stock trades on the 
Nasdaq Capital Market under the 
symbol CPRX. 

CORPORATE COUNSEL 

TRANSFER AGENT 

Akerman LLP 
Miami, Florida 

Continental Stock Transfer 
One State Street Plaza, 30th Floor 
New York, NY 10004 
(212) 509-4000 

 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
355 Alhambra Circle 
Suite 1250
Coral Gables, FL 33134
(305) 420-3200
(305) 569-0233 fax

www.catalystpharma.com