Quarterlytics / Healthcare / Biotechnology / Catalyst Pharmaceuticals

Catalyst Pharmaceuticals

cprx · NASDAQ Healthcare
Claim this profile
Ticker cprx
Exchange NASDAQ
Sector Healthcare
Industry Biotechnology
Employees 51-200
← All annual reports
FY2018 Annual Report · Catalyst Pharmaceuticals
Sign in to download
Loading PDF…
2018 ANNUAL REPORT

Dear Stockholders,  

2018 was a transformational year for Catalyst with the approval of Firdapse® (amifampridine phosphate) 
tablets,  the  first  and  only  evidence-based,  FDA  approved  treatment  for  adult  patients  suffering  from 
Lambert-Eaton myasthenic syndrome (LEMS).  This approval means that all LEMS patients (and not just 
a  few)  now  have  affordable  access  to  Firdapse®.  It  also  represents  the  successful  culmination  of  many 
years of hard work and effort by our company.  2018 was further marked by our efforts to prepare for the 
commercial launch of  Firdapse®, as we spent the second half of 2018 building our sales and  marketing 
team, our market access/reimbursement operations, and our patient education and support programs. 

On January 15, 2019, we launched Firdapse® in the U.S., marketing the product through a field force with 
extensive  experience  with  neuromuscular,  central  nervous  system,  or  rare  diseases  products.  Our  team 
includes specialists in patient assistance, insurance navigation support, and payer reimbursement support. 
We  also  have  a  field-based  force  of  medical  science  liaisons  who  are  helping  educate  the  medical 
community and patients about LEMS, the clinical benefits of Firdapse® in treating adult LEMS patients, 
and  about  our  company’s  ongoing  clinical  trial  activities.  Further,  we  work  closely  with  several  rare 
disease  advocacy  organizations (including  Global  Genes,  the  National  Organization  for  Rare  Disorders 
(NORD), and the Myasthenia Gravis Foundation of America) to help increase awareness and the level of 
support for patients living  with  LEMS,  Congenital  Myasthenic  Syndromes  (CMS)  and MuSK  antibody 
positive myasthenia gravis (MuSK-MG).  

In  order  to  help  patients  afford  their  medication,  we,  like  other  pharmaceutical  companies  who  are 
marketing  drugs  for  ultra-orphan  conditions,  have  developed  an  array  of  financial  assistance  programs 
that are available to reduce patient co-pays and deductibles to a nominal affordable amount. For eligible 
patients with commercial insurance coverage, a co-pay assistance program designed to keep out-of-pocket 
costs  to  $10  or  less  per  month  is  available  for  all  LEMS  patients  prescribed  Firdapse®.  We  are  also 
donating, and committing to continue to donate, money to qualified, independent charitable foundations 
dedicated to providing assistance generally to LEMS patients in financial need. Our goal is to ensure that 
no LEMS patient is ever denied access to their medication for financial reasons. 

We are supporting the distribution of Firdapse® through Catalyst Pathways™, our personalized treatment 
support  program.  Catalyst  Pathways™  is  a  single  source  for  personalized  treatment  support,  education, 
and guidance through the challenging dosing and titration regimen to an effective therapeutic dose. It also 
includes  distributing  the  drug  through  a  very  small  group  of  exclusive  specialty  pharmacies  (primarily 
AnovoRx), which is consistent with the way that most pharmaceutical products for ultra-orphan diseases 
are  distributed  and  dispensed  to  patients.  In  addition,  Catalyst  Pathways™  is  the  gateway  for  our  free 
bridge medication for patients during transitioning from investigational product while they are waiting for 
a  coverage  determination  or,  later  on,  for  patients  whose  access  is  threatened  by  the  bureaucratic 
complications arising from a change of insurer. The Catalyst Pathways™ program is also the access point 
for  our  Patient  Assistance  Program,  which  provides  longer-term  free  medication  for  those  who  are 
uninsured  or  functionally  uninsured  with  respect  to  Firdapse®  because  they  may  be  unable  to  obtain 
coverage from their payer despite having health insurance. 

We  are  continuing  to  evaluate  Firdapse®  for  the  treatment  of  other  neurological  conditions  and  we  are 
encouraged  by  the  possibility  that  this  drug  can  help  others  with  rare  diseases.  We  are  currently 
conducting Phase 3 clinical trials evaluating Firdapse® as a treatment for CMS and MuSK-MG, with top-

 
 
 
 
 
line results for both trials expected in the second half of 2019. We are also conducting a proof-of-concept 
study to evaluate Firdapse® as a treatment for Spinal Muscular Atrophy (SMA)  Type 3, and we expect 
top-line results from this study in the first half of 2020. Finally, we are in the early stages of developing a 
Firdapse®  sustained  release  (long-acting)  formulation  that  may  provide  meaningful  patient  benefits  to 
those suffering from rare neuromuscular diseases, including LEMS, CMS and MuSK-MG. 

In  2018,  we  reached  business  development  milestones  as  well.  In  December  2018,  we  entered  into  a 
definitive  agreement  with  Endo  International  for  the  development  and  commercialization  of  generic 
Sabril®  (vigabatrin)  tablets  through  Endo’s  U.S.  generic  pharmaceuticals  segment,  Par  Pharmaceutical.  
Under  this  agreement,  we  received  an  upfront  payment  and  are  entitled  to  milestones  for  regulatory 
approval and profit sharing on commercialization.  

We have had the privilege of working with the LEMS community for several years, and we believe that 
our efforts on behalf of that community have helped advance the visibility of this patient group that has 
been largely unrecognized in the wider medical community and society. We regularly speak with LEMS 
patients  who  reach  out  to  us  to  share  their  patient  journeys.  We  are  carefully  listening  to  all  of  these 
patient stories, and we use those interactions to continuously improve our services to LEMS patients and 
the neurologist and neuromuscular physician communities. 

Thank you for the continued support of Catalyst.  We believe we are well positioned to achieve our vision 
of positively impacting lives of patients living with rare neuromuscular diseases as we continue to build 
our rare disease company. We are excited by the launch of Firdapse® for LEMS thus far and look forward 
to  continued  positive  momentum.    We  would  like  to  also  thank  our  patients,  their  families,  and  their 
caregivers, for their participation in our clinical  trials,  and  our shareholders for their  continued support.  
Lastly,  thank  you  to  our  employees  for  their  commitment  to  our mission  and  strategic  vision. We look 
forward to updating you on the progress to come in 2019.   

Sincerely, 

Patrick J. McEnany 
Chairman and CEO 
April 15, 2019 

2 

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

[Mark One] 

FORM 10-K 

(cid:1800)

(cid:1798)

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

For the Fiscal Year Ended December 31, 2018 

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) 

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

76-0837053 
(IRS Employer 
Identification No.) 

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  (cid:1798)    No  (cid:1800)

Indicate  by  check  mark  if  registrant  is  not  required  to  file  reports  pursuant  to  Rule  13  or  Section  15(d)  of  the 
Act.    Yes  (cid:1798)    No  (cid:1800)

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of 
the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was 
required  to  file  such  reports),  and  (2)  has  been  subject  to  such  filing  requirements  for  the  past  90 
days.    Yes  (cid:1800)    No  (cid:1798)

Indicate by check mark whether the registrant has submitted electronically, every Interactive Data File required to be 
submitted pursuant to rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for 
such shorter period that the registrant was required to submit such files).    Yes  (cid:1800)    No  (cid:1798)

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.  (cid:1798)

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: 

Large accelerated filer 

Non-accelerated filer 

   (cid:1798)

   (cid:1798)

Accelerated filer 

Smaller reporting company 

Emerging Growth Company 

(cid:1800)

(cid:1800)

(cid:1798)

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 (cid:1798)

As of June 30, 2018, 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 $298,397,093. 

Indicate  by  check  mark  whether  the  registrant  is  a  shell  company  (as  defined  in  Rule  12b-2  of  the  Exchange 
Act).    Yes (cid:1798)    No (cid:1800)

Indicate the number of shares outstanding of each of the issuer's classes of common stock, as of the latest practicable 
date: 102,739,257 shares of common stock, $0.001 par value per share, were outstanding as of March 14, 2019. 

Part III incorporates certain information  by reference  from  the registrant's definitive proxy  statement for the 2018 
annual meeting of stockholders. The proxy statement with respect to the 2019 annual meeting of stockholders will be 
filed no later than 120 days after the close of the registrant's fiscal year ended December 31, 2018. 

Table of Contents 

Page

PART I ..........................................................................................................................................................................1

Item 1.

Business .............................................................................................................................................. 3

Item 1A.

Risk Factors ...................................................................................................................................... 29

Item 1B.

Unresolved Staff Comments ............................................................................................................. 48

Item 2.

Item 3.

Item 4.

Properties .......................................................................................................................................... 48

Legal Proceedings ............................................................................................................................. 48

Mine Safety Disclosure ..................................................................................................................... 48

PART II ....................................................................................................................................................................... 49

Item 5.

Item 6.

Item 7.

Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of 
Equity Securities ............................................................................................................................... 49

Selected Financial Data .................................................................................................................... 50

Management's Discussion and Analysis of Financial Condition and Results of Operations ............ 51

Item 7A. Quantitative and Qualitative Disclosures About Market Risk .......................................................... 62

Item 8.

Item 9.

Financial Statements and Supplementary Data ................................................................................. 62

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure ........... 62

Item 9A.

Controls and Procedures ................................................................................................................... 62

Item 9B.

Other Information ............................................................................................................................. 63

PART III ...................................................................................................................................................................... 64

Item 10.

Directors and Executive Officers of the Registrant .......................................................................... 64

Item 11.

Executive Compensation .................................................................................................................. 64

Item 12.

Security Ownership of Certain Beneficial Owners and Management .............................................. 64

Item 13.

Certain Relationships and Related Transactions ............................................................................... 64

Item 14.

Principal Accounting Fees and Services ........................................................................................... 64

PART IV ...................................................................................................................................................................... 65

Item 15.

Exhibits and Financial Statement Schedules .................................................................................... 65

Financial Statements ........................................................................................................................................... F-1 

EXHIBITS FILED WITH FORM 10-K 

Ex. 21.1 
Ex. 23.1 
EX 31.1 
EX 31.2 
EX 32.1 
EX 32.2 

  Subsidiaries of the registrant 
  Consent of Independent Registered Public Accounting Firm 
  Section 302 Certification of CEO 
  Section 302 Certification of CFO 
  Section 906 Certification of CEO 
  Section 906 Certification of CFO 

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, and its wholly-owned subsidiary, Catalyst Pharmaceuticals Ireland, Ltd., a 
corporation organized in the Republic of Ireland. 

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 commercialization of Firdapse® and the development of additional indications for Firdapse® and other 
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  commercializing  and  developing  such 
products, including the uncertainty of: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

our  estimates  regarding  anticipated  capital  requirements  and  our  future  needs  for  additional 
financing; 

the impact on Firdapse® of adverse changes in potential reimbursement and coverage policies from 
government  and  private  payors  such  as  Medicare,  Medicaid,  insurance  companies,  health 
maintenance organizations and other plan administrators, or the impact of pricing pressures enacted 
by industry organizations, the federal government or the government of any state, including as a 
result of increased scrutiny over pharmaceutical pricing or otherwise; 

the impact on our business and results of operations of recent public statements by Senator Bernie 
Sanders and a vocal group of LEMS patients who object to our pricing of Firdapse®; 

whether we will be able to successfully market Firdapse® while maintaining full compliance with 
applicable federal and state laws, rules and regulations; 

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

whether we will be able to locate LEMS patients who are undiagnosed or who are misdiagnosed 
with other diseases; 

whether our efforts to commercialize Firdapse® will be successful and, even if they are successful, 
whether we can become profitable; 

whether payors will reimburse for our product; 

1 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

changes  in  the  healthcare  industry  and  the  effect  of  political  pressure  from  President  Trump, 
Congress and/or medical professionals seeking to reduce prescription drug costs; 

changes  to  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 changes in the healthcare 
industry generally; 

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, and whether our trials and studies 
will be successful; 

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

whether  the  trials  that  we  are  currently  undertaking  to  evaluate  Firdapse®  for  the  treatment  of 
Congenital  Myasthenic  Syndromes  (CMS),  Anti-MuSK  antibody  positive  myasthenia  gravis 
(MuSK-MG) and Spinal Muscular Atrophy (SMA) Type 3, or any other trials that we undertake in 
the future, will be successful; 

whether Firdapse® will ever be approved for the treatment of CMS, MuSK-MG, SMA Type 3, or 
any other neuromuscular disease;  

the result of our currently ongoing arbitration action with Northwestern University regarding our 
license for CPP-115; 

whether our version of generic vigabatrin tablets will ever be approved by the United States Food 
and Drug Administration (FDA); 

even  if  vigabatrin  tablets  are  approved  for  commercialization,  whether  Endo  Ventures/Par 
Pharmaceutical will be successful in marketing the product; 

whether  Catalyst  will  earn  milestone  payments  on  approval  of  an  Abbreviated  New  Drug 
Application  (ANDA)  for  generic  vigabatrin  tablets  and  royalties  on  sales  of  generic  vigabatrin 
tablets; and 

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

Our current plans and objectives are based on assumptions relating to the development of our current drug candidates, 
and particularly the development of additional indications for Firdapse®. 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. 

2 

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 are dedicated to making a meaningful 
impact on the lives of those suffering from rare diseases, and we believe in putting patients first in everything we do. 

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). When we 
acquired the rights to the product, it had already been granted orphan drug designation by the FDA for the treatment 
of  patients  with  Lambert-Eaton  Myasthenic  Syndrome  (LEMS),  a  rare  and  sometimes  fatal  autoimmune  disease 
characterized by muscle weakness. Further, in August 2013, we were granted “breakthrough therapy designation” by 
the United States Food & Drug Administration (FDA), for Firdapse® for the treatment of LEMS. Further, the FDA 
has  granted  Orphan  Drug  Designation  for  Firdapse®  for  the  treatment  of  patients  with  Congenital  Myasthenic 
Syndromes (CMS) and Myasthenia Gravis (MG). 

On November 28, 2018, we received approval from the FDA for Firdapse® 10 mg tablets for the treatment of adults 
with LEMS. Prior to that approval, the chemical entity, amifampridine (3,4-diaminopyridine, or 3,4-DAP), had never 
been approved by the FDA for any indication. Because amifampridine phosphate (Firdapse®) had previously been 
granted Orphan Drug designation for the treatment of LEMS, we have received seven years of marketing exclusivity 
for this indication. Further, since we were the first pharmaceutical company to obtain approval for a product containing 
amifampridine, we have also received five years of marketing exclusivity with respect to the use of this product for 
all indications, running concurrently with the seven years of orphan marketing exclusivity described above.  

In January 2019, we launched Firdapse® in the United States, selling through a field force experienced in neurologic, 
central  nervous  system  or  rare  disease  products  consisting  of  approximately  20  field  personnel,  including  sales 
(Regional  Account  Managers),  patient  assistance  and  insurance  navigation  support  (Patient  Access  Liaisons),  and 
payer reimbursement (National Account Managers) personnel. We also have a field-based force of six medical science 
liaisons who are helping educate the medical communities and patients about LEMS and about our ongoing clinical 
trial  activities  evaluating  Firdapse®  for  other  ultra-orphan,  neuromuscular  diseases.  Finally,  we  are  working  with 
several rare disease advocacy organizations (including Global Genes, the National Organization for Rare Disorders 
(NORD), and  the  Myasthenia Gravis Foundation  of  America)  to help increase awareness and level of  support for 
patients  living  with  LEMS,  CMS  and  MuSK  antibody  positive  myasthenia  gravis,  or  MuSK-MG,  and  to  provide 
education for the physicians who treat these rare diseases and the patients they treat. 

We are supporting the distribution of Firdapse® through "Catalyst Pathways(cid:140)," our personalized treatment support 
program. "Catalyst Pathways" is a single source for personalized treatment support, education and guidance through 
the challenging dosing and titration regimen to an effective therapeutic dose. It also includes distributing the drug 
through a very small group of exclusive specialty pharmacies (primarily AnovoRx), which is consistent with the way 
that most pharmaceutical products for ultra-orphan diseases are distributed and dispensed to patients. We believe that 
by using specialty pharmacies in this way, the difficult task of navigating the health care system is far better for the 
patient needing treatment for their rare disease and the health care community in general. 

In order to help patients afford their medication, we, like other pharmaceutical companies which are marketing drugs 
for  ultra-orphan  conditions,  have  developed  an  array  of  financial  assistance  programs  that  are  available  to  reduce 
patient co-pays and deductibles to a nominal affordable amount. For eligible patients with commercial coverage, a co-
pay assistance program designed to keep out-of-pocket costs to $10 or less per month is available for all LEMS patients 
prescribed Firdapse®. We are also donating, and committing to continue to donate, money to qualified, independent 
charitable foundations dedicated to providing assistance to LEMS patients in financial need. Our goal is to ensure that 
no LEMS patient is ever denied access to Firdapse® for financial reasons. 

We are currently conducting a Phase 3 clinical trial evaluating Firdapse® for the treatment of certain types of CMS. 
This trial, which will include approximately 23 adult and pediatric subjects, is being conducted at trial sites around 

3 

the United States and Canada. Details of this trial are available on www.clinicaltrials.gov (NCT02562066). Based on 
currently available information, we expect to report top-line results from this trial in the second half of 2019.  

We are currently conducting  a Phase 3 clinical trial  evaluating Firdapse® for the treatment of MuSK-MG under a 
Special Protocol Assessment (SPA) with the FDA. The trial is a multi-site, international (United States and Italy), 
double-blind,  placebo-controlled,  clinical  trial  that  is  targeted  to  enroll  approximately  60  subjects  diagnosed 
with MuSK-MG. 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 are currently enrolling subjects. We 
currently expect to report top-line results from this trial in the second half of 2019. Details of this trial are available 
on www.clinicaltrials.gov (NCT03304054). 

Because the FDA has granted Orphan Drug Designation for Firdapse® for the treatment of patients with CMS and 
Myasthenia Gravis (MG), if we are the first to receive approvals in the future for Firdapse® for the treatment of CMS 
or MuSK-MG, we would be eligible to receive seven years of marketing exclusivity for those indications added to our 
Firdapse® label, of which there can be no assurance. 

We are conducting a proof-of-concept clinical study evaluating Firdapse® as a symptomatic treatment for patients with 
Spinal Muscular Atrophy (SMA) Type 3, ambulatory. 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 currently expect to report top-line results from this study in the first half of 2020. 
Details of this trial are available on www.clinicaltrials.gov (NCT03781479). 

There can be no assurance that our currently ongoing trials evaluating Firdapse® for the treatment of CMS, MuSK-
MG or SMA Type 3, or any trials we may undertake in the future to evaluate Firdapse® for the treatment of other rare 
neuromuscular diseases, will be successful. Further, there can be no assurance that we will ever be granted the right 
to commercialize Firdapse® for any of these indications. 

Finally, we intend to take steps to seek approval for Firdapse® in Canada. We also intend as a longer term strategy to 
seek to develop a sustained release formulation for Firdapse®. There can be no assurance that we will be successful in 
these efforts. 

Recent Developments Regarding Pricing for Firdapse® 

The pricing of pharmaceutical products, in general, and of specialty drugs, in particular, has been a topic of concern 
in the United States Congress, where hearings have been held on the topic, and several bills have been introduced 
proposing  a  variety  of  actions  to  restrain  the  prices  of  drugs.    The  President  of  the  United  States  has  frequently 
discussed  his  intention  to  reduce  drug  prices.    The  Administration  has  solicited  public  comment  on  a  variety  of 
regulatory proposals to reduce drug prices, and has also issued several proposed regulations with that objective, such 
as a proposal to conduct a pilot test that involves tying reimbursement of separately paid drugs under Medicare Part 
B to an index of average prices of the drug in certain foreign countries, and a proposal to require drug companies to 
disclose the list price of a drug in direct-to-consumer television advertisements.  It is possible that at least some of 
these legislative proposals will be enacted and some of the proposed regulations will be finalized.  We cannot predict 
how any such laws or regulations, or new laws or regulations that have yet to be proposed, will affect the pricing of 
our product, of orphan drugs generally, or of pharmaceutical products generally. 

We have established pricing for Firdapse® at an annual list price of $375,000 for a typical LEMS patient who remains 
100% persistent and compliant with therapy for an entire year. We believe that the pricing of our product is in line 
with the pricing of other products that provide significant clinical benefits in treating an ultra-orphan disease of similar 
severity and in order to properly compensate companies for the costs associated with developing, manufacturing, and 
marketing an orphan drug in compliance with regulatory requirements. While there can be no assurance, we believe 
that our drug will be widely covered and reimbursed by private and public payors for the indicated small population 
of adult LEMS patients, as part of their mission to assure that rare disease patients receive timely treatment for proven 
medicines. Furthermore, forecasted  rebates,  discounts, patient commercial co-pay support, Medicare coverage gap 
subsidies, statutory Medicaid discounts and other governmental discounts will result in our net sale price being 15-
20% lower than our annual list price for the product. 

4 

In early February 2019, we received a letter from Senator Bernie Sanders asking us to justify our pricing decision for 
Firdapse®. In the letter, Senator Sanders accuses us of "fleecing" Americans and "immoral exploitation" because of 
our decision regarding  the  pricing of  Firdapse®. We  have  responded to Senator Sanders,  who  has issued a  public 
statement in response asking FDA Commissioner Scott Gottlieb to allow pharmacies and manufacturers who were 
previously making this drug to be permitted to resume providing it. 

In our response to Senator Sanders, we noted the following: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

There was a large unmet medical need for an FDA approved therapy to treat LEMS patients. Prior 
to initiating our development program for amifampridine phosphate, only about 200 LEMS patients 
were receiving an unapproved, investigational amifampridine product to treat their disease. Since 
the estimated prevalence of LEMS in the U.S. is about 3,000 patients (of which approximately 1,500 
patients have been diagnosed with LEMS in claims data over the last two years), the vast majority 
of LEMS patients did not have access to an amifampridine-based product. With FDA approval, all 
adult LEMS patients now have affordable access to Firdapse®. 

We have developed an array of financial assistance programs that are available to reduce patient co-
pays  and  deductibles  to  a  nominal  affordable  amount  and,  since  the  approval  of  Firdapse®,  a 
physician can now simply write a prescription and Firdapse® will be delivered to the patient’s door 
within 2-3 days and in most cases the patient’s monthly out-of-pocket expense will be $10 or less. 

While a few patients may have had access to unapproved, investigational amifampridine, Firdapse® 
is not an “old drug” or a repurposed drug. Until Firdapse® was approved, an amifampridine-based 
product had never been approved in the U.S. for any indication, and thus our product has received 
a new chemical entity designation from the FDA. We believe that the orphan drug exclusivity that 
we  received  because  we  were  the  first  amifampridine-based  product  approved  in  the  U.S.  is 
Congress'  way  of  incentivizing  pharmaceutical  companies  like  ours  to  take  the  substantial  risks 
associated with developing and obtaining approval of drugs to treat ultra-rare conditions. 

In order to gain FDA approval of our product, we were required to submit the results of more than 
70  non-clinical  and  clinical  studies,  including  two  Phase  3  trials  evaluating  Firdapse®  for  the 
treatment  of  LEMS,  at  a  cost  of  millions  of  dollars.  Based  on  the  evidence  we  presented,  in 
November  2018  the  FDA  approved  Firdapse®  (amifampridine  phosphate)  for  use  in  adults  with 
LEMS. Now, for the first time, LEMS patients have confidence that their therapy is FDA approved 
and is safe and effective. 

We continue to spend millions of dollars per year evaluating Firdapse® in clinical trials as a potential 
treatment for other rare neuromuscular disorders where there is no current FDA approved drug to 
treat those disorders. While we are hopeful, we have no guarantees that our investment in the clinical 
trials for these other indications will be successful. 

We respectfully question the notion that the use of an experimental product not approved by the 
FDA  is  an  acceptable  standard  of  care  for  LEMS  patients  –  or  indeed  for  any  patients.  The 
distribution of products under compassionate use programs is only intended to allow dispensing of 
unapproved drugs for a limited period of time while companies undertake the  necessary steps to 
obtain FDA review and approval of their product. This means of "distribution" was never intended 
to be a final or even a long term mechanism for making drugs available to patients under the law, 
and such a notion represents a dangerous precedent that runs counter to the entire FDA regulatory 
structure. 

There can be no assurance as to how these matters will affect our business or results of operations. 

We are also aware that the vocal group of neuromuscular physicians and some LEMS patients who have raised these 
issues in the past are continuing to raise concerns with the pricing of our product and with the appropriateness of the 
provisions in the Orphan Drug Act under which we were granted exclusivity for Firdapse®. A few of these patients 
continue to say negative things about us to the media, to the FDA and to politicians. We cannot assess the impact of 
these activities on our business. 

5 

Generic Sabril® 

In September 2015, we announced the initiation of a project to develop generic versions of Sabril® (vigabatrin). Sabril® 
is marketed by Lundbeck Inc. in the United States in two dosage forms (powder sachets and tablets) for the treatment 
of infantile spasms and refractory complex partial seizures. Par Pharmaceutical brought the first generic version of the 
powder sachet to market, and, to date, several generic versions of the powder sachets have been approved. However, 
at this time, there is only one approved generic version of the tablets. 

On  December  18,  2018,  we  announced  that  we  had  signed  a  definitive  agreement  with  Endo  International  PLC's 
subsidiary, Endo Ventures Limited ("Endo"), for the further development and commercialization of generic Sabril® 
tablets  through  Endo's  United  States  Generic  Pharmaceuticals  segment,  Par  Pharmaceutical.  Pursuant  to  the 
agreement, we have received an up-front payment, and we will receive milestone payments based on achievement of 
regulatory  approvals,  and  a  sharing  of  defined  net  profits  upon  commercialization  and  certain  expenses  for 
development. 

There can be no assurance that our collaboration with Endo for the development of generic Sabril® (vigabatrin) tablets 
will be successful and that if an ANDA is approved for vigabatrin tablets in the future, that it will be profitable to us. 

Capital Resources 

At December 31, 2018, we had cash and investments of approximately $58.5 million. Based on our current financial 
condition and forecasts of available cash, we believe that we have sufficient funds to support our operations for at 
least  the  next  12  months.  There  can  be  no  assurance  that  we  will  be  successful  in  commercializing  Firdapse®  or 
become profitable, or as to whether we will require additional funding in the future (and whether any such required 
funding will be available). 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)  neuromuscular  and 
neurological diseases and disorders.  We are dedicated to making a meaningful impact on the lives of those suffering 
from rare diseases, and we believe in putting patients first in everything we do. Specifically, we intend to: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

Commercialize  Firdapse®  for  the  treatment  of  LEMS  and  improve  disease  awareness.  We  are 
currently  commercializing  Firdapse®  in  the  United  States.  A  cornerstone  of  our  strategy  is  our 
development  of  Catalyst  Pathways(cid:140),  our  personalized  treatment  support  program,  and  our 
development of the patient assistance programs that are required to further our goal that no LEMS 
patient be denied access to Firdapse® for financial reasons within existing legal restrictions. 

Pursue  approval  of  Firdapse®  for  CMS,  MuSK-MG,  SMA  Type  3  and  other  neuromuscular 
indications.  We  are  currently  conducting  clinical  trials  evaluating  Firdapse® for  the  treatment  of 
CMS,  MuSK-MG  and  SMA  Type  3.  If  our  clinical  trials  are  successful,  we  hope  to  add  these 
additional indications to our labeling for Firdapse®. We also intend to seek to evaluate Firdapse® as 
a treatment for additional neuromuscular indications. 

Seek to develop a sustained release formulation for Firdapse®. We intend as a longer term strategy 
to seek to develop a Firdapse® sustained release formulation with meaningful patient benefits for 
patients with LEMS, CMS and MuSK-MG. There can be no assurance that we will be successful in 
these efforts. 

Seek approval for Firdapse® in Canada. We intend to take steps to seek approval for Firdapse® in 
Canada. 

Seek to acquire additional products. While our current focus is in evaluating Firdapse® for other 
neuromuscular  indications,  we  may  in  the  future  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 and future product acquisitions would be subject to the availability of funding. 

6 

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  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. 

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 up to 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 (LEMS) 

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. 

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, approximately 1,500 of which are presently diagnosed and identified and approximately 1,500 of which we 
believe are undiagnosed or misdiagnosed.  However, until 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 the number of 
patients actually diagnosed with the disease, the number of patients who are misdiagnosed with other diseases, and 
the  number  of  patients  who  are  simply  undiagnosed.  Additionally,  while  there  is  an  antibody  test  that  positively 
identifies patients with LEMS, the test is not particularly well known or utilized at this time by many neurologists. 

7 

Further, many LEMS patients who have small cell lung cancer (SCLC) are not being treated for LEMS because many 
oncology  medical  professionals  who  treat  SCLC  patients  are  generally  unfamiliar  with  how  to  diagnose  and  treat 
LEMS. All of these factors affect the ultimate number of patients who will benefit from treatment with Firdapse®. 

Firdapse® is the only FDA approved, evidence-based therapy for the treatment of LEMS in adults. 

Congenital Myasthenic Syndromes (CMS) 

Congenital  Myasthenic  Syndromes,  or  CMS,  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. 

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 generally 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. 

CMS is rare, and based on currently available information, we estimate that there are between 1,000 and 1,500 CMS 
patients in the United States. There is currently no drug therapy approved by the FDA for the treatment of CMS. 

Anti-MuSK antibody positive myasthenia gravis (MuSK-MG) 

Myasthenia  Gravis,  or  MG,  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. 

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 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 treated with 
standard MG treatments such as anticholinesterase inhibitors or immunosuppressants, such patients do not generally 
respond adequately to these treatments. 

8 

Based on currently available information, we estimate that there are between 3,000 and 4,800 MuSK-MG patients in 
the United States. There is currently no drug therapy approved by the FDA for the treatment of MuSK-MG. 

Spinal Muscular Atrophy 

Spinal Muscular Atrophy (SMA) 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  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.  

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. 

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, we estimate the prevalence of SMA Type 3 in the United States to be 
between 2,500 and 3,500 patients. 

There  is  presently  one  FDA  approved  treatment  for  SMA  Type  3  (Nusinersen).  We  believe  that  Firdapse®  as  a 
treatment for SMA Type 3 has the potential to slow down the progression of this disease and improve patients’ quality 
of life, although there can be no assurance that any clinical trial we may conduct will show these effects. We also 
believe that Firdapse® may be an effective adjunct therapy with other medications to treat this disease. 

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 European Union (EU). We believe that we remain in compliance with the BioMarin License 
Agreement. 

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

(cid:120)

(cid:120)

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  agreed  to  pay  certain 
milestone payments that BioMarin was 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. As of February 2019, all required milestone payments have been paid. 

9 

(cid:120)

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,  these 
commitments were fully satisfied several years ago. 

Clinical trials supporting our NDA for Firdapse® for LEMS 

Our first Phase 3 clinical trial evaluating Firdapse® for the treatment of LEMS 

As part of the BioMarin License Agreement, 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. 

On September 29, 2014, we reported top-line results from this trial. 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. Further, 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. 
The results of this trial were published in 2016 in Muscle & Nerve (Muscle Nerve, 2016, 53(5):717-725). 

First NDA submission and Refuse-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 a Refuse-to-File (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,  including  the  requirement  that  we  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 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. 

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 (EAP) 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 to be taken in the trial. Details of the LMS-003 trial are available 
on www.clinicaltrials.gov (NCT02970162). Enrollment in this trial, which included 26 subjects, was completed in 
October 2017. 

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), reached statistical significance 
(p=0.0004),  and  the  second,  subject  global  impression  (SGI),  reached  statistical  significance  (p=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=0.0020).  Further,  the  exploratory  endpoints  of  triple  timed  up  and  go  (3TUG, 

10 

p=0.0112) and the evaluation of the QMG-Limb domains endpoint (p=0.0010) were also statistically significant. The 
exploratory endpoint of most bothersome symptom (MBS) (p=0.0572) was not significant, but shows a trend. 

The  results  of  this  trial  were  published  in  March  2019  in  the  Journal  of  Clinical  Neuromuscular  Disease  (J.  Clin 
Neuromusc Dis 2019; 20:111-119).

Approval of Firdapse® for the treatment of LEMS in the United States 

In March 2018, we submitted an NDA seeking approval of Firdapse®  for the treatment of LEMS. Our NDA was 
accepted for filing in May 2018 and, on November 28, 2018, the FDA granted approval of Firdapse® for the treatment 
of LEMS in adult patients.  

Post-Approval Required Studies 

As part of its approval of our NDA for Firdapse® for LEMS, the FDA is requiring us to conduct a clinical trial to 
evaluate the effect of hepatic impairment on the exposure of amifampridine after oral administration of Firdapse® 
relative to that in subjects with normal hepatic function. We expect to submit the final protocol for this trial in the first 
quarter of 2020 and to complete this trial in 2021. The FDA has also asked us to perform a carcinogenicity study of 
amifampridine phosphate in a second species of mice and to establish a pregnancy surveillance program to collect and 
analyze  information  for  a  minimum  of  ten  (10)  years  on  pregnancy  complications  and  birth  outcomes  in  women 
exposed to Firdapse®. 

Expanded access program 

We  currently  operate  an  expanded  access  program  (EAP)  that  makes  Firdapse®  available  to  qualifying  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.  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.  

Prior to the approval of our NDA for Firdapse® for LEMS, adult LEMS patients were also eligible to participate in 
our EAP program, and we are currently in the process of migrating adult LEMS patients who were in our EAP program 
to  our  commercial  product.  We  intend  to  finish  the  migration  of  adult  LEMS  patients  from  our  EAP  to  Catalyst 
Pathways(cid:140) by the second quarter of 2019. 

Sales, Marketing and Distribution 

Launch of Firdapse® in January 2019 

In January 2019, we launched Firdapse® in the United States through a field force of approximately 20 personnel who 
are  experienced  in  neurologic,  central  nervous  system  or  rare  diseases  in  sales,  patient  support  and  payer 
reimbursement.    The sales representatives (Regional Account Managers) who are part of the field force are targeting 
the approximately 1,250 physicians who are either neuromuscular specialists or general neurologists with a known 
adult LEMS patient or specific training in neuromuscular diseases.  We also have as part of the field force Patient 
Access Liaisons who are working with the patients and provider offices to help navigate the insurance landscape, as 
well as National Account Managers who are working directly with the payors to ensure comprehensive coverage for 
Firdapse® across the commercial and governmental plans in the United States. We also have a field-based force of 
six medical science liaisons who are helping educate the medical communities and patients about LEMS and about 
our  company’s  ongoing  clinical  trial  activities.  Further,  we  work  closely  with  several  rare  disease  advocacy 
organizations (including Global Genes, the National Organization for Rare Disorders (NORD), and the Myasthenia 
Gravis Foundation of America) to help increase awareness and the level of support for patients living with LEMS, 
CMS and MuSK antibody positive myasthenia gravis, and to provide education for the physicians who treat these rare 
diseases and the patients they treat. 

We  are  supporting  the  distribution  of  Firdapse®  through  "Catalyst  Pathways,"  our  personalized  treatment  support 
program. "Catalyst Pathways" is a single source for personalized treatment support, education and guidance through 
the challenging dosing and titration regimen to an effective therapeutic dose. It also includes distributing the drug 

11 

through a very small group of exclusive specialty pharmacies (primarily AnovoRx), which is consistent with the way 
that  most  pharmaceutical  products  for  ultra-orphan  diseases  are  distributed  and  dispensed  to  patients.  By  using 
specialty pharmacies in this way, the difficult task of navigating the health care system is far better for the patient 
needing treatment for their rare disease and the health care community in general.  

In addition, "Catalyst Pathways" is the gateway for our free bridge medication for patients during transitioning from 
investigational product while they are waiting for a coverage determination or, later on, for patients whose access is 
threatened by the bureaucratic complications arising from a change of insurer. The "Catalyst Pathways" program is 
also the access point for our Patient Assistance Program, which provides longer-term free medication for those who 
are uninsured or functionally uninsured with respect to Firdapse® because they may be unable to obtain coverage from 
their payer despite having health insurance. 

The cornerstone of our initial sales efforts is to transition patients who have been in our EAP program and patients 
who have been taking investigational or compounded 3,4-DAP to our approved product. The level of effort to generate 
awareness to these patients and their physicians is low, given that they are already aware of 3,4-DAP and Firdapse®.  
We expect the majority of these patients will quickly transition to Firdapse® by the end of the second quarter of 2019.  
At the same time, we are beginning efforts on the longer, slower process to identify patients and their physicians who 
have diagnosed LEMS, but have not had access, awareness or understanding of this treatment for their rare disease.  
These patients often do not see their physician frequently, have many questions about changing treatment(s), and may 
not perceive the need to change to a new therapy.    Further, we expect during the latter part of 2019 and into future 
years to focus our commercial efforts to locate misdiagnosed and undiagnosed LEMS patients and provide educational 
and sales activities to help improve the diagnosis, understanding of the treatment, and information on the prescribing 
process.  We plan to  continue to support  LEMS and rare  disease patient organizational  groups’ efforts to generate 
awareness and educate patients and physicians on the diagnosis of LEMS, the impact of the disease, and the support 
services and treatments available.  

Pricing of and access to Firdapse® 

We have established pricing for Firdapse® at an annual list price of $375,000 for a typical LEMS patient who remains 
100% persistent and compliant with therapy for an entire year. We believe that the pricing of our product is in line 
with the pricing of other products that provide significant clinical benefits in treating an ultra-orphan disease of similar 
severity and in order to properly compensate companies for the costs associated with developing, manufacturing, and 
marketing  an  orphan  drug  in  compliance  with  regulatory  requirements.  We  believe  that  our  drug  will  be  widely 
covered and reimbursed by private and public payors for the indicated small population of adult LEMS patients, as 
part of their mission to assure that rare disease patients receive timely treatment for proven medicines. Furthermore, 
forecasted  rebates,  discounts,  patient  commercial  co-pay  support,  Medicare  coverage  gap  subsidies,  statutory 
Medicaid discounts and other governmental discounts will result in our net sale price being 15-20% lower than our 
annual list price for the product. 

In order to help patients afford their medication, we, like other pharmaceutical companies who are marketing drugs 
for  ultra-orphan  conditions,  have  developed  an  array  of  financial  assistance  programs  that  are  available  to  reduce 
patient co-pays and deductibles to a nominal affordable amount. For eligible patients with commercial coverage, a co-
pay assistance program designed to keep out-of-pocket costs to $10 or less per month is available for all LEMS patients 
prescribed Firdapse®. We are also donating, and committing to continue to donate, money to qualified, independent 
charitable foundations dedicated to providing assistance to LEMS patients in financial need. Our goal is to ensure that 
no LEMS patient is ever denied access to Firdapse® for financial reasons. 

Further,  we  have  taken  steps  to  make  sure  that  we  have  sufficient  supply  of  both  finished  drug  product  and 
amifampridine API to meet all of our patient requirements and the needs for product for our ongoing clinical trials. In 
that regard, based on available information, we currently estimate that we have sufficient finished drug product and 
API on hand to supply all current Firdapse® patients (including those we anticipate for the remainder of 2019) for at 
least 18 months. We have also recently ordered more API to ensure a long-term uninterrupted supply of Firdapse® 
for all patients, including additional new patients. 

12 

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, 
CMS, and MuSK-MG, we anticipate that securing coverage and appropriate reimbursement from third-party payors 
will require targeted education and highly skilled insurance navigation experts that have experience with rare disease 
launches  and  medical  exception  processes  at  insurance  companies  to  provide  patient  coverage  for  important  rare 
disease therapies. To that end, we have engaged a dedicated team of field-based market access account managers and 
reimbursement experts as well as a patient service center staffed with experienced personnel focused on ensuring that 
clinically-qualified patients have access to our product.  

There can be no assurance, however, as to whether payors will agree to cover our product and, if so, what level of 
payment will they make for Firdapse®. In that regard, we have advised payors that we will provide free medication 
to support titration and confirm patient therapeutic benefit. Further, now that we have launched our product, we are 
providing patients with access to therapy at no charge while those patients are awaiting coverage decisions. 

Our efforts to develop Firdapse® as a treatment of additional indications 

We are currently evaluating Firdapse® for the treatment of three additional neuromuscular indications, CMS, MuSK-
MG, and SMA Type 3. The current status of our clinical trials evaluating Firdapse® for these additional indications 
is as follows: 

Ongoing phase 3 clinical trial evaluating Firdapse® for the treatment of CMS 

We are currently conducting a Phase 3 clinical trial evaluating Firdapse® for the treatment of certain types of CMS. 
This trial, which will include approximately 23 adult and pediatric subjects, is being conducted at trial sites around 
the United States and Canada. Details of this trial are available on www.clinicaltrials.gov (NCT02562066). Based on 
currently available information, we expect to report top-line results from this trial in the second half of 2019. There 
can be no assurance that any trial we conduct evaluating 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. 

Previously completed MuSK-MG proof-of-concept study 

In  February  2016,  we  announced  the  initiation  of  an  investigator-sponsored,  randomized,  double-blind,  placebo-
controlled,  crossover  proof-of-concept  clinical  trial  evaluating  the  safety,  tolerability  and  potential  efficacy  of 
Firdapse®  as  a  symptomatic  treatment  for  patients  with  MuSK-MG.  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. 

The  results  of  this  study  were  recently  published  in  SAGE  Open  Medicine  and  can  be  accessed  at 
https://journals.sagepub.com/doi/pdf/10.1177/2050312118819013. 

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

We are currently conducting a Phase 3 clinical trial evaluating Firdapse® for the treatment of MuSK-MG under a SPA 
with  the  FDA.  The  trial  is  a  multi-site,  international  (United  States  and  Italy),  double-blind,  placebo-controlled, 
clinical trial that is targeted to enroll approximately 60 subjects diagnosed with MuSK-MG. The trial will also enroll 
up to 10 generalized myasthenia gravis patients who will be assessed with the same clinical endpoints but achieving 

13 

statistical  significance  in  this  subgroup  of  patients  is  not  required  and  only  summary  statistics  will  be  provided. 
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). 

We  initiated  this  trial  in  January  2018  and  are  currently  enrolling  subjects.  We  currently  expect  to  report top-
line results  from  this  trial  in  the  second  half  of  2019.  Details  of  this  trial  are  available  on www.clinicaltrials.gov
(NCT03304054). 

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

We are currently conducting a proof-of-concept clinical study evaluating Firdapse® as a symptomatic treatment for 
patients  with  SMA  Type  3.  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 currently expect to report top-line results from this study in the first half of 2020. Details of this trial 
are available on www.clinicaltrials.gov (NCT03781479).

Other potential indications 

We are continuing to identify additional neuromuscular diseases for which Firdapse® may be an effective treatment, 
and  we  hope  to  commence  additional  clinical  studies  and  trials  to  evaluate  Firdapse®  for  the  treatment  of  those 
diseases. There can be no assurance that any of these studies or trials will be successful. 

Intellectual property and regulatory exclusivity 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 we are awaiting an office 
action. 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  was  issued  and  the 
application was refiled.  We are awaiting the next office action. We may also pursue other patents in order to seek to 
protect the exclusivity of the drug, dosage forms and methods of administration.  

Until Firdapse® was approved in November 2018, no drug product containing amifampridine for any indication had 
been  approved  by  the  FDA.  Therefore,  our  version  of  amifampridine  has  received  five-year  new  chemical  entity 
exclusivity, which provides a five-year period of marketing exclusivity for all indications. 

We  believe  that  when  Firdapse®  was  approved  for  commercialization,  Jacobus  Pharmaceutical  may  have  had  a 
pending NDA filed with the FDA seeking approval of their version of 3,4-DAP for the treatment of CMS. We do not 
control the FDA's decision on any NDA previously filed by Jacobus, but if the FDA were to approve it, there can be 
no assurance as to the impact that any such approval would have on our business and on our commercialization of 
Firdapse®. 

We are in the early stages of developing a sustained release formulation of Firdapse®. If we are successful, we will 
seek to add additional patent protections for that sustained release product, to the extent available. There can be no 
assurance that we will be successful in those efforts. 

We have licensed the Firdapse® trademark from BioMarin, and the trademark was registered in the United States in 
March 2015. 

Protection of our intellectual property and regulatory exclusivities is a strategic priority for our business. We rely on 
a combination of patent, trademark, copyright and trade secret laws, along with regulatory exclusivity and institutional 
know-how and continuing technological advancement, to develop and maintain our competitive position. Our ability 
to  protect  and  use  our  intellectual  property  rights  and  regulatory  exclusivity  in  the  future  development  and 

14 

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." 

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, 2018. 

On  December  18,  2018,  we  announced  that  we  had  signed  a  definitive  agreement  with  Endo  International  plc's 
subsidiary,  Endo  Ventures  Limited,  for  the  further  development  and  commercialization  of  generic  Sabril®  tablets 
through Endo's United States Generic Pharmaceuticals segment, Par Pharmaceutical. Pursuant to the agreement, we 
have  received  an  up-front  payment,  and  we  will  receive  milestone  payments  based  on  achievement  of  regulatory 
approvals, and a sharing of defined net profits upon commercialization and certain expenses for development. 

Vigabatrin comes in two dosage forms – a powder sachet and a tablet. Par Pharmaceutical brought the first generic 
version of the powder sachet to market, and since then several additional generic versions of this product have been 
approved. However, there is only one approved generic version of the tablets at this time. 

There can be no assurance that our collaboration with Endo/Par for generic Sabril® will be successful.

CPP-115 

For  the  last  few  years,  we  had  been  developing  CPP-115,  a  GABA  aminotransferase  inhibitor.  We  licensed  this 
product  from  Northwestern  University  (Northwestern)  in  2009,  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 included United States patent number 6,794,413 covering the composition 
of matter for CPP-115.  

During 2018, we became aware that certain patents granted to Northwestern in 2018 (which patents have been licensed 
by  Northwestern  to  an  unaffiliated  pharmaceutical  company  for  a  new  GABA  aminotransferase  inhibitor)  were 
derived from CPP-115. As a result, it is our position that Northwestern has violated the license agreement based on 
its failure to transfer these new patent rights to us as part of the existing license agreement. It is also our position that 
Northwestern’s publication of information about the new patents in violation of the license agreement has damaged 
us. On  October  26,  2018,  we  notified  Northwestern  that  we  were  terminating  the  license  agreement  and  seeking 
damages for Northwestern’s breach of the license agreement. Further, on the same date, we filed a claim for damages 
in arbitration against Northwestern for Northwestern’s breaches of the license agreement. 

On November 5, 2018, Northwestern advised us that in its view, Northwestern has a right to terminate the license 
agreement with us because we allegedly breached the license agreement by failing to pay certain milestones and by 
allegedly failing to use commercially reasonable efforts to develop and commercialize any products. Northwestern 
has also advised us that, in its view, we have engaged in wrongful conduct and communications with the unrelated 
pharmaceutical  company  that  licensed  the  new  patents  from  Northwestern,  and  that  such  communications  have 
damaged Northwestern’s relationship with that party. We dispute Northwestern’s allegations and intend to vigorously 
defend ourselves against claims that Northwestern has brought against us in the arbitration proceeding. 

The arbitration is currently pending and there can be no assurance as to the outcome of this matter. See Item 3. Legal 
Proceedings. 

Manufacturing and Supply 

We  are  licensed  in  Florida  as  a  virtual  drug  manufacturer,  which  means  that  we  have  no  in-house  manufacturing 
capacity and we are obligated to rely on contract manufacturers and packagers. We have no plans to build or acquire 
the manufacturing capability needed to manufacture any of our research materials or commercial products, and we 

15 

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. 

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  are  manufacturing 
Firdapse® tablets for us. 

Any significant change that we make for Firdapse® must be approved by the FDA in a supplemental NDA (sNDA). 
If the manufacturing plan and data are insufficient, any sNDA we submit will not be approved. Before an sNDA 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  any  sNDAs  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, our contract manufacturers are required to comply 
with all applicable environmental laws and regulations that affect the manufacturing process. As a result, we do not 
believe that we will have any significant direct exposure to environmental issues. 

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. 

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. 

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 adult LEMS patients in the United States were receiving the drug 
under their program at the time our NDA for Firdapse® was approved. Even though we were the first to obtain an 
FDA  approval  for  this  product  and  its  associated  exclusivity  protections,  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 though we have obtained FDA approval of Firdapse®. Compounded amifampridine 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); (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). 

16 

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 in 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  may  still 
compound near 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. 

Recently,  Senator  Bernie  Sanders  issued  a  public  statement  asking  FDA  Commissioner  Scott  Gottlieb  to  allow 
pharmacies  and  manufacturers  who  were  previously  making  3,4-DAP  to  be  permitted  to  resume  providing  it.  We 
cannot assess the impact of this statement on our business. 

We are taking all available steps to try to enforce our exclusivity rights. However, we cannot determine with certainty 
what impact these factors will have on the market for our product. 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 $229 million in 2017 and $204 million in 2018. 
One  generic  version  of  Sabril®  tablets  has  been  approved  to  date  in  the  United  States,  as  have  numerous  generic 
version of the powder form. We have entered into a definitive agreement with Endo/Par for the further development 
and commercialization of generic Sabril® tablets. 

Factors affecting competition generally 

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

17 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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  our  development  and  commercialization  activities, 
including the availability of funding from the federal government. 

Regulatory Matters 

Government regulation and product approval 

Government authorities in the United States, at the federal, state and local level, and in 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: 

(cid:120)

(cid:120)

(cid:120)

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; 

18 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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  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: 

(cid:120)

(cid:120)

(cid:120)

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. 

19 

(cid:120)

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 
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. 

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 2019 this fee is $2,588,478), 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 2019 is $309,915 per prescription drug product. Beginning in fiscal year 2019, 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 

20 

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. 

Once an NDA is approved, changes to the conditions of approval, including additional indications, are made by the 
submission  of  a  supplement  to  the  NDA.    The  supplemental  NDA,  or  sNDA,  must  contain  all  of  the  information 
necessary to support the change.  In the case of a new indication, that information usually consists of at least one 
clinical trial, and often more.  Like an NDA, FDA determines whether the sNDA is sufficiently complete to permit 
review before it files the sNDA.  FDA then reviews the sNDA.  Like an NDA, FDA can either approve the sNDA or 
issue a complete response letter outlining the deficiencies in the sNDA. 

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. 

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. 

21 

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 are 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. 

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 (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) 

22 

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. 

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. 

23 

There are also user fees for ANDA applicants, sponsors, and manufacturers. For fiscal year 2019, the application fees 
are $178,799 per ANDA application and the facility fees are $211,305 per domestic finished dosage form facility, 
$226,305 per foreign finished dosage form facility, $44,226 per domestic active pharmaceutical ingredient facility, 
and $59,226 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. 

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  United  States  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 
United States healthcare laws and there can be no assurance how changes to those laws may affect our business. 

We anticipate that in the United States, 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: 

(cid:120)

(cid:120)

controls on government-funded reimbursement for drugs; 

controls on healthcare providers; 

24 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

controls on pricing of pharmaceutical products, including the possible reference of the pricing of 
United States drugs to non-United States drug pricing for the same product; 

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 and one U.S. Senator have also  made statements in the press on the potential 
pricing of orphan drugs generally and on the pricing of 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 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 United States 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 

25 

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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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; 

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 

26 

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. 

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 

27 

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. 

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 United States 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 14, 2019 we had 51 employees. We also utilize the services of consultants. None of our employees are 
covered  by  a  collective  bargaining  agreement.  We  believe  our  relationship  with  our  employees  and  consultants  is 
good. 

We previously had a scientific advisory board. However, we disbanded our scientific advisory board during 2018. 

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 

28 

(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. 

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 the commercialization of Firdapse® 

We  depend  substantially  on  the  commercial  success  of Firdapse®,  and  we  may  not  be  able  to  successfully 
commercialize it. 

Until recently, we have focused all of our efforts on obtaining regulatory approval for Firdapse® for the treatment of 
LEMS, on evaluating Firdapse® for the treatment of other neuromuscular diseases including CMS, MuSK-MG and 
SMA Type 3, on raising capital, and on recruiting personnel. On November 28, 2018, the FDA approved our first 
product, Firdapse®, for the treatment of adults with LEMS, which became commercially available in January 2019. 
We have a history of operating losses, with net losses of $34.0 million in fiscal 2018 and $18.4 million in fiscal 2017. 
Although we have received FDA approval and commenced commercialization of Firdapse® for the treatment of adults 
with LEMS in the United States, we may never become profitable.  

Our business may require additional capital. 

We may need to raise additional capital in the future in order to fund our business and generate significant revenue in 
order to achieve and maintain profitability. If necessary, we would likely 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 funding 
will be available, and, even if it is available, whether it will be available on terms that are favorable to us. 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. 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 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. 

Our success depends on our ability to successfully commercialize Firdapse®. We are primarily a single product 
company with little or no commercial sales experience, which makes it difficult to evaluate our current business, 
predict our future prospects and forecast our financial performance and growth. 

We  have  invested  a  significant  portion  of  our  efforts  and  financial  resources  into  the  development  and 
commercialization of our lead product, Firdapse®, which was approved by the FDA as a treatment for adults with 
LEMS on November 28, 2018. Our success depends on our ability to effectively commercialize Firdapse®, and we 
expect  that  the  vast  majority  of  our  product  revenues  in  the  foreseeable  future  will  be  from  sales  of  Firdapse®. 
Successful commercialization of Firdapse® is subject to many risks. We have never launched or commercialized a 
product, and there is no guarantee that we  will be able to do so successfully with Firdapse®. There are numerous 
examples of unsuccessful product launches and failures to meet high expectations of market potential, including by 
pharmaceutical companies with more resources and experience than we have. The commercial success of Firdapse® 
depends on the extent to  which patients and physicians accept and adopt Firdapse®. For example, if the expected 
patient population is smaller than we estimate or if physicians are unwilling to prescribe or patients are unwilling to 
take Firdapse®, the commercial potential of Firdapse® will be limited. Thus, significant uncertainty remains regarding 
the commercial potential of Firdapse®. 

29 

Moreover, our ability to effectively generate product revenue from Firdapse® will depend on our ability to, among 
other things:  

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

achieve  and  maintain  compliance  with  regulatory  requirements,  including  promotion  and 
advertising requirements; 

increase awareness for and achieve market acceptance of Firdapse® through our sales and marketing 
activities and other arrangements established for the promotion of Firdapse®; 

train, deploy and support a qualified field sales and marketing force; 

secure formulary approvals for Firdapse® with a substantial number of targeted payors; 

ensure  that  our  third-party  manufacturers  manufacture  Firdapse®  in  sufficient  quantities,  in 
compliance with requirements of the FDA and at acceptable quality and pricing levels, in order to 
meet commercial demand; 

ensure  that  our  third-party  manufacturers  develop,  validate  and  maintain  commercially  viable 
manufacturing processes that are compliant with current Good Manufacturing Practice, or cGMP, 
regulations; 

implement  and  maintain  agreements  with  wholesalers,  distributors  and  group  purchasing 
organizations on commercially reasonable terms; 

ensure that our entire supply chain efficiently and consistently delivers Firdapse® to our customers; 

provide co-pay assistance to help qualified patients with out-of-pocket costs associated with their 
Firdapse®  prescription,  and/or  other  programs  to  ensure  patient  access  to  our  products,  educate 
physicians  and  patients  about  the  benefits,  administration  and  use  of  Firdapse®,  and  obtain 
acceptance of Firdapse® as safe and effective by patients and the medical community; 

receive adequate levels of coverage and reimbursement for Firdapse® from commercial health plans 
and governmental health programs; 

generate  positive  experience  with  our  Catalyst  Pathways(cid:140)  program  in  helping  patients  obtain 
access to Firdapse® at an acceptable patient out-of-pocket cost; 

the quality of our relationships with patient advocacy groups; 

influence  the  nature  of  publicity  related  to  our  product  relative  to  the  publicity  related  to  our 
competitors’ products; 

obtain regulatory approvals for additional indications for the use of Firdapse® in treating other rare 
neuromuscular diseases; and 

maintain and defend our regulatory exclusivity for Firdapse®. 

Any disruption in our ability to generate product revenue from the sale of Firdapse® will have a material and adverse 
impact on our results of operations. 

We have limited experience as a company in marketing or distributing pharmaceutical products. If we are 
unable to expand our marketing capabilities and effectively commercialize Firdapse®, our business, results of 
operations and financial condition may be materially adversely affected. 

Our strategy is to build our sales, marketing and distribution capabilities to successfully commercialize Firdapse® in 
the  United  States.  While  we  have  established  our  commercial  team  and  launched  our  product,  we  have  limited 
experience commercializing pharmaceutical products as an organization. In order to successfully market Firdapse®, 

30 

we must continue to build our sales, marketing, managerial, compliance, and related capabilities or make arrangements 
with third parties to perform these services. If we are unable to establish adequate sales, marketing, and distribution 
capabilities,  whether  independently  or  with  third  parties,  we  may  not  be  able  to  appropriately  commercialize 
Firdapse® and may not become profitable. 

Included in our strategy in the United States is a direct sales force to commercialize Firdapse®. These efforts will 
continue to be expensive and time-consuming, and we cannot be certain that we will be able to successfully develop 
this  capability.  Firdapse®  is  a  newly  marketed  drug  and,  therefore,  while  many  of  our  sales  force  members  have 
promoted  other  orphan  and/or  neuromuscular  drugs,  none  of  the  members  of  our  sales  force  has  ever  promoted 
Firdapse® prior to its commercial launch. In addition, we must train our sales force to ensure that a consistent and 
appropriate message about Firdapse® is being delivered to our potential customers. If we are unable to effectively 
train our sales force and equip them with effective materials, including medical and sales literature to help them inform 
and educate potential customers about the benefits of Firdapse® and its proper administration, all while maintaining 
compliance  with  regulatory  requirements,  our  efforts  to  successfully  commercialize  Firdapse®  could  be  harmed, 
which would negatively impact our ability to generate product revenue. Additionally, we will need to maintain and 
further develop our sales force to achieve commercial success, and we will be competing with other pharmaceutical 
and biotechnology companies to recruit, hire, train and retain marketing and sales personnel. In the event we are unable 
to  continue  to  develop  and  effectively  maintain  our  commercial  team,  our  ability  to  successfully  commercialize 
Firdapse® would be limited, and we would not be able to generate product revenue successfully. 

There  are  risks  involved  both  with  establishing  our  own  sales  and  marketing  capabilities,  and  with  entering  into 
arrangements  with  third  parties  to  perform  these  services.  For  example,  any  efforts  to  develop  a  direct  sales  and 
marketing organization are subject to numerous risks, including: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

the expense and time required to recruit, retain, and motivate members of the sales force; 

our inability to recruit, retain or motivate adequate numbers of effective marketing personnel and 
partner marketing agencies; 

the inability to provide adequate training to sales and marketing personnel; 

the expense and time required to monitor regulatory compliance;  

the  inability  of  sales  personnel  to  obtain  access  to  physicians  or  convince  adequate  numbers  of 
physicians to prescribe any product; and 

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

Similarly, if we enter into arrangements with third parties to perform sales, marketing and distribution services, our 
product revenue or the profitability associated with any product revenue may be lower than if we were to market and 
sell any products that we develop ourselves. In addition, we may not be successful in entering into arrangements with 
third parties to sell and market our products or may be unable to do so on terms that are favorable to us. We may have 
little control over such third parties, and any of them may fail to devote the necessary resources and attention to sell 
and market our products effectively. Moreover, we may be negatively impacted by other factors outside of our control 
relating to such third parties, including, but not limited to, their inability to comply with regulatory requirements. If 
we do not establish sales, marketing and distribution capabilities successfully, either on our own or in collaboration 
with third parties, we will not be successful in commercializing our products. 

Finally, because we are using a very small group of exclusive specialty pharmacies to distribute our product, if the 
organizations that we work with to deliver our drug do not perform in a lawful manner or have issues unrelated to our 
business, our business could be adversely affected. 

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 

31 

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 us. In addition, we compete against biotechnology companies, universities, government agencies, and 
other research institutions in the development of pharmaceutical products. 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,  we  may  also  compete  with  respect  to 
manufacturing efficiency and marketing capabilities. 

For example, amifampridine, the active ingredient in Firdapse®, despite not being previously 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®. Even with 
the FDA approval of 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.  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 treatment of LEMS. 

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 that we believe to be adequate. 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 key employees and on our Board of Directors. 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,  we  have  no  employment  or  retention  agreements  with  any  of  our  other  officers  or  key 
employees. If we lose the services of any of our existing officers or key employees, 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. 

32 

We have relationships 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. As a result, conflicts may arise from the work in which our collaborators are involved. 

Risks Related to the Development of Additional Indications for Firdapse® 

Our efforts may fail. 

Development of additional indications for Firdapse® is subject to risks of failure. For example: 

(cid:120)

(cid:120)

(cid:120)

Firdapse® may be found to be ineffective or unsafe for the additional indications, or fail to receive 
necessary regulatory approvals; 

Firdapse®  may  not  be  economical  to  market  or  take  substantially  longer  to  obtain  necessary 
regulatory approvals for additional indications 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 Firdapse®. 

As a result, our drug development activities may not result in any safe, effective and commercially viable additional 
indications, 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.  

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 Firdapse® for additional indications 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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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; 

33 

(cid:120)

(cid:120)

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 additional indications. 

We do not currently have the ability to independently conduct pre-clinical studies or clinical studies and trials, 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 for us. 
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 Firdapse® for additional indications 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 any additional indications if 
these requirements are not met. 

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

We are licensed in Florida as a virtual drug manufacturer, which means we have no in-house manufacturing capacity 
and we will be obligated to rely on contract manufacturers and packagers. We cannot be sure that we will successfully 
manufacture  any  product,  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 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  drugs,  it  could  have  a  material  adverse  effect  on  our  ability  to 
successfully commercialize our drug candidates. 

34 

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. 

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

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. 

We have recently hired employees for the commercialization of Firdapse®. 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 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 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 

35 

limiting coverage and the amount of reimbursement for particular medications, which could affect our ability to sell 
our  product  candidates  profitably.  These  payors  may  not  view  our  products  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 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 of specialty drugs, in particular, has been a topic of concern 
in the United States Congress, where hearings have been held on the topic, and several bills have been introduced 
proposing  a  variety  of  actions  to  restrain  the  prices  of  drugs.    The  President  of  the  United  States  has  frequently 
discussed  his  intention  to  reduce  drug  prices.    The  Administration  has  solicited  public  comment  on  a  variety  of 
regulatory proposals to reduce drug prices, and has also issued several proposed regulations with that objective, such 
as a proposal to conduct a pilot test that involves tying reimbursement of separately paid drugs under Medicare Part 
B to an index of average prices of the drug in certain foreign countries, and a proposal to require drug companies to 
disclose the list price of a drug in direct-to-consumer television advertisements.  It is possible that at least some of 
these legislative proposals will be enacted and some of the proposed regulations will be finalized.  We cannot predict 
how any such laws or regulations, or new laws or regulations that have yet to be proposed, will affect the pricing of 
our product, of orphan drugs generally, or of pharmaceutical products generally. 

We cannot assess the impact on our business of the public concerns expressed by a U.S. Senator and a vocal group 
of neuromuscular physicians and patients with LEMS about our pricing of our drug product. 

In early February 2019, we received a letter from Senator Bernie Sanders asking us to justify our pricing decision for 
Firdapse®. In the letter, Senator Sanders accuses us of "fleecing" Americans and "immoral exploitation" because of 
our decision regarding  the  pricing of  Firdapse®. We  have  responded to Senator Sanders,  who  has issued a  public 
statement in response asking FDA Commissioner Scott Gottlieb to allow pharmacies and manufacturers who were 
previously making this drug to be permitted to resume providing it, regardless of the fact that such a decision would 
violate the exclusivity provisions in the Orphan Drug Act of 1983, since we were the first pharmaceutical company 
who received an approval for an amifampridine product. 

There can be no assurance as to how these matters will affect our business or results of operations. 

We are also aware that the vocal group of neuromuscular physicians and some LEMS patients who have raised these 
issues in the past are continuing to raise concerns with the pricing of our product and with the appropriateness of the 
provisions in the Orphan Drug Act that grant us exclusivity for Firdapse®. A few of these patients continue to say 
negative things about us to the media, to the FDA and to politicians. We cannot assess the impact of these activities 
on our business. 

36 

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® targets 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,  and  high  per  patient  prices  could  drive  physicians  to  seek  out 
compounding  pharmacies  to  provide  compounded  amifampridine  to  fill  their  prescriptions  rather  than  Firdapse®, 
thereby lowering the Firdapse® market share or penetration in the market. 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®,  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  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.

37 

Risks Related to Government Regulation 

The  regulatory  approval  process  is  lengthy,  and  we  may  not  be  able  to  obtain  all  of  the  regulatory  approvals 
required to manufacture and commercialize Firdapse® for additional indications. 

We  will  not  be  able  to  commercialize  our  products  in  other  countries  or  for  additional  indications  until  we  have 
obtained the requisite regulatory approvals from applicable governmental authorities. To obtain regulatory approval 
of a drug candidate for an indication, we must demonstrate to the satisfaction of the applicable regulatory agency that 
such  drug  candidate  is  safe  and  effective  for  that  indication.  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 United States 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  candidate  is  safe  and  effective  in  specific 
indications, in which event we would not receive the regulatory approval required to market it. 

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. 

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 future regulatory approval for the sale of our drug candidate for an indication, 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. 

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 candidate may not be found to be safe and effective 
in  particular  indications  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®, 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, 

38 

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, including Firdapse®. 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. 

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 United 
States. 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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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  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 products 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. 

Firdapse® is subject to ongoing regulatory review. If we fail to comply with continuing United States and applicable 
foreign regulations, we could lose those approvals, and our business would be severely harmed. 

We are and will continue to be subject to continuing regulatory review for our approved products, 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, 

39 

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. 

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. 

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 United States, 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  United  States. The  Health  Care  Reform  Law  also  expanded  the  340B  drug  discount 

40 

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 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 United States 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 United States, 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. 

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 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. 

41 

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. 

Even though our MuSK-MG trial is being 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 
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. 

Further, there can be no assurance that the FDA will not require an additional adequate and well controlled clinical 
trial  to  approve  Firdapse®  for  CMS  or  MuSK-MG,  even  if  the  clinical  trials  we  are  currently  undertaking  are 
successful. 

Our operations and relationships with healthcare providers, healthcare organizations, customers and third-party 
payors are subject to applicable anti-bribery, anti-kickback, fraud and abuse, transparency and other healthcare 
laws and regulations, which could expose us to, among other things, enforcement actions, criminal sanctions, civil 
penalties,  contractual  damages,  reputational  harm,  administrative  burdens  and  diminished  profits  and  future 
earnings.  

Our  current  and  future  arrangements  with  healthcare  providers,  healthcare  organizations,  third-party  payors, 
customers, and patients expose us to broadly applicable anti-bribery, fraud and abuse and other healthcare laws and 
regulations that may constrain the business or financial arrangements and relationships through which we research, 
market, sell and distribute our product candidates. In addition, we may be subject to patient data privacy and security 
regulation  by  the  U.S.  federal  government  and  the  states  and  the  foreign  governments  in  which  we  conduct  our 
business. Restrictions under applicable federal and state anti-bribery and healthcare laws and regulations include the 
following:  

(cid:120)

(cid:120)

the  Federal  health  care  program  Anti-Kickback  Statute,  which  prohibits  individuals  and  entities 
from,  among  other  things,  knowingly  and  willfully  soliciting,  offering,  receiving  or  providing 
remuneration, directly or indirectly, in cash or in kind, to induce or reward, or in return for, either 
the referral of an individual for, or the purchase, order or recommendation of, any good or service, 
for which payment may be made under a federal and state healthcare program such as Medicare and 
Medicaid. A person or entity does not need to have actual knowledge of the statute or specific intent 
to violate it in order to have committed a violation;  

the federal criminal and civil false claims and civil monetary penalties laws, including the federal 
False  Claims  Act,  which  can  be  imposed  through  civil  whistleblower  or  qui  tam  actions  against 
individuals  or  entities,  prohibits,  among  other  things,  knowingly  presenting,  or  causing  to  be 
presented, to the federal government, claims for payment that are  false or fraudulent,  knowingly 
making,  using  or  causing  to  be  made  or  used,  a  false  record  or  statement  material  to  a  false  or 
fraudulent  claim,  or  from  knowingly  making  a  false  statement  to  avoid,  decrease  or  conceal  an 
obligation  to  pay  money  to  the  federal  government.  In  addition,  certain  marketing  practices, 

42 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

including off-label promotion, may also violate false claims laws. Moreover, the government may 
assert  that  a  claim  including  items  and  services  resulting  from  a  violation  of  the  federal  Anti-
Kickback Statute constitutes a false or fraudulent claim for purposes of the federal False Claims 
Act;  

HIPAA, which imposes criminal and civil liability, prohibits, among other things, knowingly and 
willfully executing, or attempting to execute a scheme to defraud any healthcare benefit program, 
or  knowingly  and  willfully  falsifying,  concealing  or  covering  up  a  material  fact  or  making  any 
materially  false  statement  in  connection  with  the  delivery  of  or payment  for  healthcare  benefits, 
items or services; similar to the federal Anti-Kickback Statute, a person or entity does not need to 
have actual  knowledge of the statute or specific  intent to violate it in order to have committed a 
violation;  

HIPAA, as amended by HITECH, which impose obligations on certain healthcare providers, health 
plans, and healthcare clearinghouses, known as covered entities, as well as their business associates 
that  perform  certain  services  involving  the  storage,  use  or  disclosure  of  individually  identifiable 
health information, including mandatory contractual terms, with respect to safeguarding the privacy, 
security, and transmission of individually identifiable health information, and require notification to 
affected  individuals  and  regulatory  authorities  of  certain  breaches  of  security  of  individually 
identifiable health information;  

the federal legislation commonly referred to as the Physician Payments Sunshine Act, enacted as 
part of the ACA, and its implementing regulations, which requires certain manufacturers of covered 
drugs, devices, biologics and medical supplies that are reimbursable under Medicare, Medicaid, or 
the  Children’s  Health  Insurance  Program,  with  certain  exceptions,  to  report  annually  to  CMS 
information related to certain payments and other transfers of value to physicians (defined to include 
doctors,  dentists,  optometrists,  podiatrists  and  chiropractors)  and  teaching  hospitals,  as  well  as 
ownership  and  investment  interests  held  by  the  physicians  described  above  and  their  immediate 
family members, with the information made publicly available on a searchable website; effective 
January  1,  2022,  transfers  of  value  to  physician  assistants,  nurse  practitioners  or  clinical  nurse 
specialists,  certified  registered  nurse  anesthetists,  and  certified  nurse-midwives  must  also  be 
reported;  

the U.S. Foreign Corrupt Practices Act of 1977, as amended, which prohibits, among other things, 
U.S. companies and their employees and agents from authorizing, promising, offering, or providing, 
directly or indirectly, corrupt or improper payments or anything else of value to foreign government 
officials,  employees  of  public  international  organizations  and  foreign  government  owned  or 
affiliated  entities,  candidates  for  foreign  political  office,  and  foreign  political  parties  or  officials 
thereof;  

analogous state and foreign laws and regulations, such as state anti-kickback and false claims laws, 
that may apply to sales or marketing arrangements and claims involving healthcare items or services 
reimbursed by non-governmental third-party payors, including private insurers; and  

certain  state  laws  that  require  pharmaceutical  companies  to  comply  with  the  pharmaceutical 
industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by 
the  federal  government  in  addition  to  requiring  drug  and  therapeutic  biologics  manufacturers  to 
report information related to payments to physicians and other healthcare providers or marketing 
expenditures  and  pricing  information,  state  and  local  laws  that  require  the  registration  of 
pharmaceutical sales representatives, and state laws governing the privacy and security of health 
information in certain circumstances, many of which differ from each other in significant ways and 
often are not preempted by HIPAA, thus complicating compliance efforts.  

If we or our collaborators, manufacturers or service providers fail to comply with applicable federal, state or foreign 
laws or regulations, we could be subject to enforcement actions, which could affect our ability to develop, market and 
sell our products successfully and could harm our reputation and lead to reduced acceptance of our products by the 

43 

market. These enforcement actions include, not only civil and criminal penalties, but also exclusion from participation 
in government-funded healthcare programs, and exclusion from eligibility for the award of government contracts for 
our products.  

Efforts to ensure that our current and future business arrangements with third parties comply with applicable healthcare 
laws and regulations could involve substantial costs. It is possible that governmental authorities will conclude that our 
business practices do not comply with current or future statutes, regulations, agency guidance or case law involving 
applicable fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of 
any  such  requirements,  we  may  be  subject  to  significant  penalties,  including  civil,  criminal  and  administrative 
penalties,  damages,  fines,  disgorgement,  imprisonment,  the  curtailment  or  restructuring  of  our  operations,  loss  of 
eligibility  to  obtain  approvals  from  the  FDA,  exclusion  from  participation  in  government  contracting,  healthcare 
reimbursement or other government programs, including Medicare and Medicaid, integrity oversight and reporting 
obligations,  or  reputational  harm,  any  of  which  could  adversely  affect  our  financial  results.  Although  effective 
compliance programs can mitigate the risk of investigation and prosecution for violations of these laws, these risks 
cannot  be  entirely  eliminated.  Any  action  against  us  for  an  alleged  or  suspected  violation  could  cause  us  to  incur 
significant legal expenses and could divert our management’s attention from the operation of our business, even if our 
defense is successful. In addition, achieving and sustaining compliance with applicable laws and regulations may be 
costly to us in terms of money, time and resources.  

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. 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 we are awaiting an office action. 
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  was  issued  and  the 
application was refiled.  We are awaiting the next office action. We may also pursue other patents in order to seek to 
protect the exclusivity of the drug, dosage forms and methods of administration.  

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. 

Our commercial success will depend in large part on our ability to use patents and regulatory exclusivity 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. 

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

44 

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  United  States,  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: 

(cid:120)

(cid:120)

(cid:120)

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. 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 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. 

45 

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  United  States  Patent 
Office or in other proceedings outside the United States, 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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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

status of regulatory requirements for approval of our drug candidates; 

adverse publicity regarding the pricing of Firdapse®; 

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 license from BioMarin), research contracts, 
or other collaboration agreements; 

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

intellectual property, product liability or other litigation against us; 

changes in the market valuations of similar companies; 

changes in pharmaceutical company regulations or reimbursements for pharmaceutical products 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 

46 

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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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 2018 annual meeting of stockholders, the stockholders 
approved the Rights Plan. 

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. 

47 

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 14, 2019, we had 102,739,257 shares of our common stock outstanding, of which 7,084,164 shares were 
held by our officers and directors. We also had outstanding: (i) stock options to purchase an aggregate of 10,649,500 
shares at exercise prices ranging from $0.79 to $4.64 per share (5,334,163 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. 

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 
7,800 square feet of space for which we pay annual rent of approximately $330,000. 

Item 3.  Legal Proceedings 

In 2018, we became aware that certain patents granted to Northwestern in 2018 (which patents have been licensed by 
Northwestern to a third-party) for a new GABA aminotransferase inhibitor were derived from CPP-115. As a result, 
it is our position that Northwestern has violated the license agreement based on its failure to transfer these new patent 
rights  to  us  as  part  of  the  existing  license  agreement.  It  is  also  our  position  that  Northwestern’s  publication  of 
information about the new patents in violation of the license agreement has damaged us. On October 26, 2018, we 
notified  Northwestern  that  we  were  terminating  the  license  agreement  for  CPP-115  and  seeking  damages  for 
Northwestern’s breach of the license agreement. Further, on the same date, we filed a claim for damages in arbitration 
against Northwestern for Northwestern’s breaches of the license agreement. 

On November 5, 2018, Northwestern advised us that in its view, Northwestern has a right to terminate the license 
agreement with us because we allegedly breached the license agreement by failing to pay certain milestones and by 
allegedly failing to use commercially reasonable efforts to develop and commercialize any products. Northwestern 
has also advised us that, in its view, we have engaged in wrongful conduct and communications with the unrelated 
pharmaceutical  company  that  licensed  the  new  patents  from  Northwestern,  and  that  such  communications  have 
damaged Northwestern’s relationship with that party. We dispute Northwestern’s allegations and intend to vigorously 
defend ourselves against claims that Northwestern has brought against us in the arbitration proceedings. 

The arbitration is currently pending and there can be no assurance as to the outcome of this matter. 

Additionally,  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. 

48 

PART II 

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

Market Information 

Our common stock trades on the Nasdaq Capital Market under the symbol "CPRX.” 

The closing sale price for the common stock on March 14, 2019 was $2.99. As of March 14, 2019, there were 39 
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 11,500 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. 

Performance Graph 

Not applicable. 

49 

Item 6. 

Selected Financial Data 

The selected statement of operations data for the years ended December 31, 2018 and 2017, and the balance sheet data 
as of December 31, 2018 and 2017, 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, 2016, 2015 
and 2014 and the selected balance sheet data at December 31, 2016, 2015 and 2014 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. 

Statement of Operations Data: 
Revenues from collaborative arrangement

2018 

Year Ended December 31, 
2016 

2017 

2015 

2014 

$

500,000

$

-

$

-

$

- $

-

Operating costs and expenses: 
Research and development 
General and administrative 

19,919,204
15,875,961

11,375,237
7,304,399

11,369,941
7,910,260

11,801,342
8,597,010

10,117,774
4,473,654

Total operating cost and expenses 

35,795,165

18,679,636

19,280,201

20,398,352

14,591,428

Loss from operations 

(35,295,165)

(18,679,636)

(19,280,201)

(20,398,352)

(14,591,428)

Other income, net 
Change in fair value of warrants liability   

1,291,651
-

454,163
(186,904)

321,612
886,137

100,389
65,005

76,233
(993,866)

Loss before income taxes 
Provision for income taxes 

(34,003,514)
-

(18,412,377)
-

(18,072,452)
-

(20,232,958)
-

(15,509,061)
-

Net loss

$ (34,003,514)

$ (18,412,377) $ (18,072,452)

$ (20,232,958) $ (15,509,061)

Net loss per share -basic and diluted 

$

(0.33)

$

(0.21) $

(0.22)

$

(0.25) $

(0.24)

Weighted average shares outstanding -

basic and diluted 

102,633,884

85,802,487

82,875,281

80,858,393

64,142,534

Balance Sheet Data: 
Cash and cash equivalents, certificates of 

2018 

2017 

As of December 31, 
2016 

2015 

2014 

$ 40,405,817   $ 58,396,395 $ 39,275,123
37,972,795
43,908,086
2,794,891
8,665,756
35,242,330

39,359,226
41,706,853
122,226
2,397,923
39,308,930

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

deposit and investments 

Working capital 
Total assets 
Warrants liability, at fair value 
Total liabilities 
Stockholders' equity 

  $ 58,489,856    $ 84,013,413
80,920,995
85,387,430
-
4,423,618
80,963,812

45,676,052
60,449,962
-
9,666,153
50,783,809

50 

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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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 2018 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  the  two 
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 are dedicated to making a meaningful 
impact on the lives of those suffering from rare diseases, and we believe in putting patients first in everything we do. 

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). When we 
acquired the rights to the product, it had already been granted orphan drug designation by the FDA for the treatment 
of  patients  with  Lambert-Eaton  Myasthenic  Syndrome  (LEMS),  a  rare  and  sometimes  fatal  autoimmune  disease 
characterized by muscle weakness. Further, in August 2013, we were granted “breakthrough therapy designation” by 
the United States Food & Drug Administration (FDA), for Firdapse® for the treatment of LEMS. Finally, the FDA 
has  granted  Orphan  Drug  Designation  for  Firdapse®  for  the  treatment  of  patients  with  Congenital  Myasthenic 
Syndromes (CMS) and Myasthenia Gravis (MG). 

51 

On November 28, 2018, we received approval from the FDA for Firdapse® 10 mg tablets for the treatment of adults 
with LEMS. Prior to that approval, the chemical entity, amifampridine (3,4-diaminopyridine, or 3,4-DAP), had never 
been approved by the FDA for any indication. Because amifampridine phosphate (Firdapse®) had previously been 
granted Orphan Drug designation for the treatment of LEMS, we have received seven years of marketing exclusivity 
for this indication. Further, since we were the first pharmaceutical company to obtain approval for a product containing 
amifampridine, we have also received five years of marketing exclusivity with respect to the use of this product for 
all indications, running concurrently with the seven years of orphan marketing exclusivity described above.  

In January 2019, we launched Firdapse® in the United States, selling through a field force experienced in neurologic, 
central  nervous  system  or  rare  disease  products  consisting  of  approximately  20  field  personnel,  including  sales 
(Regional  Account  Managers),  patient  assistance  and  insurance  navigation  support  (Patient  Access  Liaisons),  and 
payer reimbursement (National Account Managers) personnel. We also have a field-based force of six medical science 
liaisons who are helping educate the medical communities and patients about LEMS and about our ongoing clinical 
trial  activities  evaluating  Firdapse®  for  other  ultra-orphan,  neuromuscular  diseases.  Finally,  we  are  working  with 
several rare disease advocacy organizations (including Global Genes, the National Organization for Rare Disorders 
(NORD), and  the  Myasthenia Gravis Foundation  of  America)  to help increase awareness and level of  support for 
patients  living  with  LEMS,  CMS  and  MuSK  antibody  positive  myasthenia  gravis,  or  MuSK-MG,  and  to  provide 
education for the physicians who treat these rare diseases and the patients they treat. 

We are supporting the distribution of Firdapse® through "Catalyst Pathways(cid:140)," our personalized treatment support 
program. "Catalyst Pathways" is a single source for personalized treatment support, education and guidance through 
the challenging dosing and titration regimen to an effective therapeutic dose. It also includes distributing the drug 
through a very small group of exclusive specialty pharmacies (primarily AnovoRx), which is consistent with the way 
that most pharmaceutical products for ultra-orphan diseases are distributed and dispensed to patients. We believe that 
by using specialty pharmacies in this way, the difficult task of navigating the health care system is far better for the 
patient needing treatment for their rare disease and the health care community in general. 

In order to help patients afford their medication, we, like other pharmaceutical companies which are marketing drugs 
for  ultra-orphan  conditions,  have  developed  an  array  of  financial  assistance  programs  that  are  available  to  reduce 
patient co-pays and deductibles to a nominal affordable amount. For eligible patients with commercial coverage, a co-
pay assistance program designed to keep out-of-pocket costs to $10 or less per month is available for all LEMS patients 
prescribed Firdapse®. We are also donating, and committing to continue to donate, money to qualified, independent 
charitable foundations dedicated to providing assistance to LEMS patients in financial need. Our goal is to ensure that 
no LEMS patient is ever denied access to Firdapse® for financial reasons. 

We are currently conducting a Phase 3 clinical trial evaluating Firdapse® for the treatment of certain types of CMS. 
This trial, which will include approximately 23 adult and pediatric subjects, is being conducted at trial sites around 
the United States and Canada. Details of this trial are available on www.clinicaltrials.gov (NCT02562066). Based on 
currently available information, we expect to report top-line results from this trial in the second half of 2019.  

We are currently conducting  a Phase 3 clinical trial  evaluating Firdapse® for the treatment of MuSK-MG under a 
Special Protocol Assessment (SPA) with the FDA. The trial is a multi-site, international (United States and Italy), 
double-blind,  placebo-controlled,  clinical  trial  that  is  targeted  to  enroll  approximately  60  subjects  diagnosed 
with MuSK-MG. 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 are currently enrolling subjects. We 
currently expect to report top-line results from this trial in the second half of 2019. Details of this trial are available 
on www.clinicaltrials.gov (NCT03304054). 

Because the FDA has granted Orphan Drug Designation for Firdapse® for the treatment of patients with CMS and 
MG, if we are the first to receive approvals in the future for Firdapse® for the treatment of CMS or MuSK-MG, we 
would be eligible to receive seven years of marketing exclusivity for those indications added to our Firdapse® label, 
of which there can be no assurance. 

We are conducting a proof-of-concept clinical study evaluating Firdapse® as a symptomatic treatment for patients with 
Spinal Muscular Atrophy (SMA) Type 3, ambulatory. 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 

52 

efficacy  of  amifampridine  in  ambulatory  patients  diagnosed  with  SMA  Type  3.  The  study  is  planned  to  include 
approximately 12 patients, and we currently expect to report top-line results from this study in the first half of 2020. 
Details of this trial are available on www.clinicaltrials.gov (NCT03781479). 

There can be no assurance that our currently ongoing trials evaluating Firdapse® for the treatment of CMS, MuSK-
MG or SMA Type 3, or any trials we may undertake in the future to evaluate Firdapse® for the treatment of other rare 
neuromuscular diseases, will be successful. Further, there can be no assurance that we will ever be granted the right 
to commercialize Firdapse® for any of these indications. 

Finally, we intend to take steps to seek approval for Firdapse® in Canada. We also intend as a longer term strategy to 
seek to develop a sustained release formulation for Firdapse®. There can be no assurance that we will be successful in 
these efforts. 

Generic Sabril® 

In September 2015, we announced the initiation of a project to develop generic versions of Sabril® (vigabatrin). Sabril® 
is marketed by Lundbeck Inc. in the United States in two dosage forms (powder sachets and tablets) for the treatment 
of infantile spasms and refractory complex partial seizures. Par Pharmaceutical brought the first generic version of the 
powder sachet to market, and, to date, several generic versions of the powder sachets have been approved. However, 
at this time, there is only one approved generic version of the tablets. 

On  December  18,  2018,  we  announced  that  we  had  signed  a  definitive  agreement  with  Endo  International  PLC's 
subsidiary, Endo Ventures Limited ("Endo"), for the further development and commercialization of generic Sabril® 
tablets  through  Endo's  United  States  Generic  Pharmaceuticals  segment,  Par  Pharmaceutical.  Pursuant  to  the 
agreement, we have received an up-front payment, and we will receive milestone payments based on achievement of 
regulatory  approvals,  and  a  sharing  of  defined  net  profits  upon  commercialization  and  certain  expenses  for 
development. 

There can be no assurance that our collaboration with Endo for the development of generic Sabril® (vigabatrin) tablets 
will be successful and that if an Abbreviated New Drug Application (ANDA) is approved for vigabatrin tablets in the 
future, that it will be profitable to us. 

Basis of Presentation 

Revenues 

In 2018 we were a development stage company, as we had no revenues from product sales. We expect to have product 
sales in 2019 as we commercialize Firdapse®. In 2018, we generated revenues of $500,000 from up-front license fees 
received under a collaborative agreement with Endo. We expect these revenues to fluctuate in future periods based on 
our collaborators’ abilities to meet various regulatory milestones set forth in such agreements.  

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 formerly CPP-115, and we expect that our future 
development costs will be attributable principally to the continued development of Firdapse®. 

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 

53 

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. 

Selling and Marketing Expenses 

We had no selling expenses in 2018. During the fourth quarter of 2018, as Firdapse® was approved by the FDA as a 
treatment  for  adults  with  LEMS,  we  actively  committed  funds  to  developing  our  commercialization  program  for 
Firdapse® so that  we  would  be in a  position to launch  the product  in  early 2019. 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,  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 
consolidated balance sheet 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. 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, 2018 and 2017, we had net operating loss 
carryforwards of approximately $78,956,000 and $62,584,000, respectively. Our net deferred tax asset has a 100% 
valuation allowance as of December 31, 2018 and 2017, 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. 

54 

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 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. 

55 

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, 2018 and 2017, the assumptions used were an estimated annual volatility of 82% 
and 104%,  expected  holding  periods of zero to seven  years and four  to seven  years,  and  risk-free  interest rates of 
2.09% to 2.88% and 1.66% to 2.25%, respectively. 

Results of Operations 

Years Ended December 31, 2018 and 2017 

Revenues 

We had no revenues from product sales for the years ended December 31, 2018 or 2017. We had revenues in 2018 in 
the amount of $500,000 relating to the up-front payment from Endo in connection with the collaboration for vigabatrin 
tablets. 

Research and Development Expenses 

Year 
2018 
2017   

Amount 
$ 19,919,204
$ 11,375,237

Change from 
Prior Year 
75.1% 
0.0% 

Percentage of Total Operating
Costs and Expenses 

55.6% 
61.0% 

Our expenses, including stock-based compensation, for research and development for the year ended December 31, 
2018 increased compared to amounts expended during the 2017 fiscal year. Research and development expenses, in 
the  aggregate,  represented  approximately  55.6%  of  total  operating  costs  and  expenses  for  the  2018  fiscal  year, 
compared to 61.0% for the 2017 fiscal year, respectively. The stock-based compensation is non-cash and relates to 
the expense of stock options awards to certain employees. 

Research and development expenses in the 2018 fiscal year primarily included consulting expenses as we prepared to 
submit our NDA for Firdapse® during the first quarter of 2018, milestone expenses relating to the acceptance and 
approval of our NDA submission, expenses from our medical affairs program, compensation and related personnel 
costs as we expanded our headcount to support our ongoing trials evaluating Firdapse® for the treatment of CMS, 
MuSK-MG  and  SMA  Type  3,  costs  of  operating  our  Expanded  Access  Program,  and  costs  incurred  to  build  up 
inventory to launch Firdapse® in early 2019. 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®.  

We expect that research and development costs will continue to be substantial in 2019 as we continue our clinical 
trials  evaluating  Firdapse®  for  the  treatment  of  CMS  and  MuSK-MG,  continue  our  Expanded  Access  Programs, 
conduct our proof-of-concept trial evaluating Firdapse® for the treatment of SMA Type 3, take steps to develop a 
sustained release formulation of Firdapse®, and potentially prepare an NDA for Firdapse® for the treatment of CMS 
and/or MuSK-MG. 

Our research and development expenses for 2018 and 2017, 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 
2018 and 2017 relating to our research and development activities was $1,079,230 and $785,899, respectively. The 

56 

 
weighted-average  grant-date  fair  value  of  the  stock  options  granted  in  2018  and  2017  was  $1.99  and  $0.84, 
respectively. 

Selling and Marketing Expenses 

We had no selling expenses during 2018 and 2017. As we moved closer to the approval of Firdapse® for the treatment 
of LEMS, we actively committed funds to building a commercial team and developing our commercialization program 
for  Firdapse®  so  that  we  would  be  in  a  position  to  launch  the  product  in  early  2019,  including  our  marketing 
efforts. Pre-commercialization costs are included in general and administrative expenses. 

General and Administrative Expenses 

Year 
2018 
2017 

Amount 
$ 15,875,961
7,304,399
$

Change from 
Prior Year 

117.3 % 
(7.7 )% 

Percentage of Total Operating 
Costs and Expenses 
44.4% 
39.0% 

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 2018 and 2017 
was (i) stock-based compensation of $2,471,414 and $1,622,062, respectively, and (ii) pre-commercialization costs of 
$6,897,483 and $809,584, respectively. 

The 117.3% increase in general and administrative expenses for the year ended December 31, 2018 when compared 
to the same period in 2017 was primarily due to our efforts to expand our operations and headcount in order to prepare 
for  the  commercialization  of  Firdapse®.  We  expect  that  general  and  administrative  costs,  excluding  pre-
commercialization costs (which, going forward, will be included in sales and marketing expenses), will increase in 
2019 compared with the general and administrative costs incurred in 2018, as we expand our operations and headcount 
to support the commercialization of Firdapse®. 

Stock-Based Compensation 

We issued stock options and other share-based payments to several of our employees, directors, and consultants in 
2018  and  2017.  Total  stock-based  compensation  expense  for  the  years  ended  December 31,  2018  and  2017  was 
$3,550,644 and $2,407,961, respectively. We regularly grant non-cash stock-based compensation to employees and 
directors as part of their compensation packages. The 2018 increase in expense from the prior year is primarily due to 
the expense of options granted to employees and directors during the first quarter of 2018 in connection with 2017 
year-end grants and the effect of grants to new employees as we increase our headcount to build up our infrastructure 
and commercial programs to support the launch of Firdapse® in 2019.  

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. As of May 2, 2017, all of the 2011 warrants were either exercised or had 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.  

No gain or loss was recognized for the year ended December 31, 2018, as all 2011 warrants that were not exercised 
expired on May 2, 2017. For the year ended December 31, 2017, we recognized a loss of $186,904 in connection with 
the change in the fair value of the warrants liability. The loss during 2017 was principally a result of fluctuations in 
our common stock price and the warrants liability expiration date on May 2, 2017.  

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 

57 

 
 
 
trading  securities  and  realized  gain  (loss)  on  available-for-sale  securities,  if  any.  The  $837,488  increase  in  other 
income, net for the year ended December 31, 2018 as compared to the year ended December 31, 2017 was principally 
due to higher yields on investment balances from the proceeds of our offerings. These proceeds were used to fund our 
drug  development  activities  and  our  operations.  Substantially  all  such  funds  were  invested  in  short-term  interest-
bearing obligations, a short-term bond fund and U.S. Treasuries. 

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 $34,003,514 in the year ended December 31, 2018 ($0.33 per basic and diluted share) as compared 
to $18,412,377 in the year ended December 31, 2017 ($0.21 per basic and diluted share). 

Non-GAAP Net Loss 

Our non-GAAP net loss for the year ended December 31, 2018 was the same as our GAAP net loss, as there were no 
non-GAAP adjustments. 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 was $18,225,473 ($0.21 per basic and diluted share).  

Liquidity and Capital Resources 

Since our inception, we have financed our operations primarily with the net proceeds of public and private offerings 
of our securities. At December 31, 2018, we had cash and investments aggregating $58.5 million and working capital 
of  $45.7  million  as  compared  to  cash  and  investments  of  $84.0  million  and  working  capital  of  $80.9  million  at 
December 31, 2017. At December 31, 2018, substantially all of our cash and cash equivalents were deposited with 
one financial institution, and such balances were in excess of federally insured limits. 

We have to date incurred operating losses, and we may never become profitable. Further, we expect to continue to 
spend substantial dollars on our current and future drug development programs. 

Based on forecasts of available cash, we believe that we have sufficient resources to support our currently anticipated 
operations for at least the next 12 months. There can be no assurance that we will ever become profitable or that we 
will obtain any additional funding that we may require in the future. 

We may also require additional working capital to support our operations beyond that time, depending on our success 
in launching 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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

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 level of revenues that we report from sales of Firdapse®; 

58 

(cid:120)

(cid:120)

(cid:120)

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 that we may require in the future, through public or private equity offerings, debt 
financings,  corporate  collaborations  or  other  means.  We  also  may  seek  governmental  grants  for  a  portion  of  the 
required  funding  for  our  clinical  trials  and  preclinical  trials.  We  may  also  seek  to  raise  capital  to  fund  additional 
product development efforts or product acquisitions, 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 million 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, raising net proceeds of approximately $53.8 million from the sale of 16,428,572 shares of our 
common stock on November 28, 2017. 

On December 23, 2016, we filed a shelf registration statement with the SEC to sell up to $33.8 million 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 $92.5 million of our 
2017 Shelf Registration Statement remains available for future sales.  

Contractual Obligations and Arrangements 

We have entered into the following contractual arrangements: 

(cid:120)

Payments to BioMarin and others under our license agreement with BioMarin. We have agreed to pay certain 
payments under our license agreement with BioMarin: 

(cid:120)

(cid:120)

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. 

Milestone  Payments:  Under  our  license  agreement  with  BioMarin,  we  agreed  to  pay  certain 
milestone payments that BioMarin was 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.  In  full  satisfaction  of  these  obligations,  we  have  paid  (i)  $3,150,000  in  milestone 
payments to the third party licensor of the rights that have been sublicensed to us ($150,000 of which 
was paid in 2018 and $3.0 million of which was paid in February 2019), and (ii) $2.0 million in 
milestone payments to the former Huxley Stockholders (all of which was paid in 2018). 

59 

(cid:120)

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 we fulfilled 
our commitment to BioMarin in that regard several years ago. 

Employment agreements. We have entered into an employment agreement with our Chief Executive Officer 
that requires us to make base salary payments of approximately $546,000 in 2019. The agreement expires in 
November 2020. 

Lease for office space. We operate our business in leased office space in Coral Gables, Florida. We currently 
lease  approximately  7,800  square  feet  of  office  space  for  which  we  pay  annual  rent  of  approximately 
$330,000. 

(cid:120)

(cid:120)

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  $25,704,406  and  $13,742,572,  respectively,  for  the  years  ended 
December 31, 2018 and 2017. 

During the year ended December 31, 2018, net cash used in operating activities was primarily attributable to our net 
loss of $34,003,514 and increases of $476,037 in prepaid expenses and other current assets and deposits and $56,012 
in  inventory,  which  was  partially  offset  by  increases  of  $391,792  in  accounts  payable  and  $4,850,743  in  accrued 
expenses. The loss included an additional $3,588,622 of non-cash expenses, consisting of stock-based compensation 
expense and depreciation. 

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. 

Net cash used in investing activities was $15,526,011 and  $3,958, respectively, for 2018 and 2017.  During 2018, net 
cash  used  in  investing  activities  was  primarily  attributable  to  purchases  of  investments  of  $36,802,418.  This  was 
partially  offset  by  $21,368,425  proceeds  from  maturities  of  investments.  During  2017,  net  cash  used  in  investing 
activities consisted of purchases of investments. 

Net cash provided by financing activities was $293,115 and $57,350,168, respectively, for 2018 and 2017. During 
2018, net cash from financing activities consisted primarily of proceeds from the exercise of stock options. During 
2017, net cash from financing activities consisted 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. Such funds are being used to fund our research and development costs, our general and 
administrative costs, and our commercialization costs associated with the launch of Firdapse®. 

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-

60 

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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

our  estimates  regarding  anticipated  capital  requirements  and  our  future  needs  for  additional 
financing; 

the impact on Firdapse® of adverse changes in potential reimbursement and coverage policies from 
government  and  private  payors  such  as  Medicare,  Medicaid,  insurance  companies,  health 
maintenance organizations and other plan administrators, or the impact of pricing pressures enacted 
by industry organizations, the federal government or the government of any state, including as a 
result of increased scrutiny over pharmaceutical pricing or otherwise; 

the impact on our business and results of operations of recent public statements by Senator Bernie 
Sanders and a vocal group of LEMS patients who object to our pricing of Firdapse®; 

whether we will be able to successfully market Firdapse® while maintaining full compliance with 
applicable federal and state laws, rules and regulations; 

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

whether we will be able to locate LEMS patients who are undiagnosed or are misdiagnosed with 
other diseases; 

whether our efforts to commercialize Firdapse® will be successful and, even if they are successful, 
whether we can become profitable; 

whether payors will reimburse for our product; 

changes  in  the  healthcare  industry  and  the  effect  of  political  pressure  from  President  Trump, 
Congress and/or medical professionals seeking to reduce prescription drug costs; 

changes  to  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 changes in the healthcare 
industry generally; 

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, and whether our trials and studies 
will be successful; 

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

whether  the  trials  that  we  are  currently  undertaking  to  evaluate  Firdapse®  for  the  treatment  of 
Congenital  Myasthenic  Syndromes  (CMS),  Anti-MuSK  antibody  positive  myasthenia  gravis 
(MuSK-MG) and Spinal Muscular Atrophy (SMA) Type 3, or any other trials that we undertake in 
the future, will be successful; 

whether Firdapse® will ever be approved for the treatment of CMS, MuSK-MG, SMA Type 3, or 
any other neuromuscular disease;  

the result of our currently ongoing arbitration action with Northwestern University regarding our 
license for CPP-115; 

61 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

whether our version of generic vigabatrin tablets will ever be approved by the United States Food 
and Drug Administration (FDA); 

even  if  vigabatrin  tablets  are  approved  for  commercialization,  whether  Endo  Ventures/Par 
Pharmaceutical will be successful in marketing the product; 

whether  Catalyst  will  earn  milestone  payments  on  approval  of  an  Abbreviated  New  Drug 
Application  (ANDA)  for  generic  vigabatrin  tablets  and  royalties  on  sales  of  generic  vigabatrin 
tablets; and 

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

Our current plans and objectives are based on assumptions relating to the development of our current drug candidates, 
and particularly the development of additional indications for Firdapse®. 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.   

Item 7A.  Quantitative and Qualitative Disclosures About Market Risk 

Not applicable. 

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 

None. 

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, 2018, 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. 

62 

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. 

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, 2018 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, 2018. 

During the fourth quarter of 2018, 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. 

63 

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 2019 Annual Meeting of Stockholders. Our Proxy Statement for the 2019 
Annual Meeting of Stockholders is expected to be filed not later than 120 days after the end of our fiscal year ended 
December 31, 2018 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. 

64 

Item 15.  Exhibits and Financial Statement Schedules 

(a) 

Documents filed as part of this report. 

PART IV 

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: 

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

(cid:120)

Reports of Grant Thornton LLP, Independent Registered Public Accounting Firm 

Consolidated Balance Sheets as of December 31, 2018 and 2017 

Consolidated Statements of Operations for the years ended December 31, 2018 and 2017 

Consolidated Statements of Changes in Stockholders' Equity for the years ended December 31, 2018 
and 2017. 

Consolidated Statements of Cash Flows for the years ended December 31, 2018 and 2017 

Notes to Consolidated Financial Statements 

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. 

(b) 

Exhibits. 

Exhibit
No. 
2.1 

3.1 
3.2 
3.3 
3.4 
3.5 
4.1 
4.2 
4.3 

Description of Exhibit 
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 

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

10.1 +  Employment Agreement between the Company and Patrick J. McEnany 
10.2 + 
10.3 + 
10.4 +  Third Amendment to Employment Agreement between the Company and Patrick J. McEnany 
Fourth Amendment to Employment Agreement between the Company and Patrick J. McEnany 
10.5+ 
Fifth Amendment to Employment Agreement between the Company and Patrick J. McEnany 
10.6+ 
Sixth Amendment to Employment Agreement between the Company and Patrick J. McEnany 
10.7+ 
2014 Stock Incentive Plan 
10.8+ 
10.9+ 
Amendment No. 1 to 2014 Stock Incentive Plan
10.10+  Amendment No. 2 to 2014 Stock Incentive Plan
10.11+  2018 Stock Incentive Plan

65 

Exhibit
No. 
10.12 
10.13 
10.14 
10.15 

10.16 

10.17 

10.18 

10.19 

10.20 

10.21 

10.22 

10.23 

21.1 
23.1 
31.1 
31.2 
32.1 
32.2 

Description of Exhibit 
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 
Fourth Amendment to Lease, dated effective as of August 13, 2018 among the Company and PRII 355 
Alhambra Circle, LLC 
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. 
Settlement Agreement, dated effective as of July 26, 2018, by and among (i) Aceras BioMedical LLC, in 
its capacity as Stockholder Representative for the former stockholders of Huxley Pharmaceuticals, Inc., 
(ii) BioMarin Pharmaceutical, Inc., and (iii) the Company 
Development, License and Commercialization Agreement, dated effective as of December 18, 2018, by 
and between Endo Ventures Limited and the Company 
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 

+ 
* 

Management contract or compensatory plan 
Filed herewith 

66 

Pursuant to the requirements of Section 13 and 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 18th 
day of March, 2019. 

SIGNATURES 

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 18, 2019 

March 18, 2019 

Director  

March 18, 2019 

Director  

March 18, 2019 

Director  

March 18, 2019 

Director  

March 18, 2019 

Director  

March 18, 2019 

67 

Years ended December 31, 2018 and 2017  

INDEX TO FINANCIAL STATEMENTS  

Reports of independent registered public accounting firm ........................................................................................ F-2

Consolidated balance sheets ...................................................................................................................................... F-4

Consolidated statements of operations and comprehensive loss................................................................................ F-5

Consolidated statements of changes in stockholders’ equity ..................................................................................... F-6

Consolidated statements of cash flows ...................................................................................................................... F-7

Notes to consolidated financial statements ................................................................................................................ F-8

F-1 

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

Board of Directors and Shareholders 
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,  2018,  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,  2018,  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, 
2018, and our report dated March 18, 2019 expressed an unqualified opinion on those financial statements. 

Basis for opinion 
The Company’s management is responsible for maintaining effective internal control over financial reporting and for 
its  assessment  of  the  effectiveness  of  internal  control  over  financial  reporting,  included  in  the  accompanying 
Management’s Annual 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. 

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 18, 2019 

F-2 

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

Board of Directors and Shareholders 
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, 2018 and 2017, the related consolidated statements 
of operations and comprehensive loss, changes in stockholders’ equity, and cash flows for the two years in the period 
ended December 31, 2018, and the related notes (collectively referred to as the “financial statements”). In our opinion, 
the financial statements present fairly, in all material respects, the financial position of the Company as of December 
31, 2018 and 2017, and the results of its operations and its cash flows for each of the two years in the period ended 
December 31, 2018, 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,  2018,  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 18, 2019 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 18, 2019

F-3 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED BALANCE SHEETS 

December 31, 
2018 

December 31, 
2017 

ASSETS
Current Assets: 

Cash and cash equivalents 
Short-term investments 
Inventory 
Prepaid expenses and other current assets 

Total current assets 

Investments 
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 

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, 2018 and 2017 
Common stock, $0.001 par value, 150,000,000 shares  
    authorized; 102,739,257 shares and 102,549,498 shares  
    issued and outstanding at December 31, 2018 and 2017, 
    respectively 
Additional paid-in capital 
Accumulated deficit 
Accumulated other comprehensive loss 
Total stockholders’ equity 
Total liabilities and stockholders’ equity 

$

$

$

$

16,559,400
36,922,213
56,012
1,649,781
55,187,406
5,008,243
245,425
8,888
60,449,962

2,337,367
7,173,987
9,511,354

154,799
9,666,153

$

$

$

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

—

—

102,739
211,265,279
(160,563,961 ) 
(20,248 ) 

50,783,809
60,449,962

102,549
207,421,710
(126,560,447 ) 

—
80,963,812
85,387,430

$

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

F-4 

 
CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS 

Revenues from collaborative arrangement 

$

500,000 

$

—

Year Ended December 31, 

2018 

2017 

Operating costs and expenses: 

Research and development 
General and administrative 

Total operating costs and expenses 

        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 

Net loss 
Other comprehensive loss: 

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

Comprehensive loss 

19,919,204
15,875,961
35,795,165
(35,295,165 )

1,291,651
-
(34,003,514 )
—
(34,003,514 )
(0.33 )
102,633,884

(34,003,514 )

(20,248 )
(34,023,762 )

$
$

$

$

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

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

(18,412,377 )

—
(18,412,377 )

$
$

$

$

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

F-5 

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’ EQUITY 
For the years ended December 31, 2018 and 2017 

Preferred
Stock 

$

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 

Balance at December 31, 2017

Issuance of common stock, net 
Issuance of stock options for services 
Exercise of stock options for common stock 
Other comprehensive loss 
Net loss 

Balance at December 31, 2018

$

-
-
-
-
-
-
-

-

-
-
-
-
-

-

$

$

Common
Stock 
82,972
16,455
-
-
2,258
864
-

Additional
Paid-in 
Capital 
147,374,028 
53,756,105 
2,342,625 
65,336 
3,516,295 
367,321 
- 

$

$

Accumulated
Deficit 
(108,148,070 )
-
-
-
-
-
(18,412,377 )

102,549

207,421,710 

(126,560,447 )

Accumulated 
Other 
Comprehensive
Loss 

$

-
 -
-
-
-
-
-

 -

3
-
187
-
-

10,546 
3,535,647 
297,376 
- 
- 

 -
-
-
-
(34,003,514 )

 -
-
-
(20,248 )
-

Total 
39,308,930
53,772,560
2,342,625
65,336
3,518,553
368,185
(18,412,377 )

80,963,812

10,549
3,535,647
297,563
(20,248 )
(34,003,514 )

$

102,739   $

211,265,279 

$

(160,563,961 )

$

(20,248 )   $

50,783,809

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

F-6 

 
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: 
   Inventory 
   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: 
Purchases of property and equipment 
Purchases of investments 
Proceeds from maturities of investments 
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 stock options 
Net cash provided by (used in) financing activities
Net increase (decrease) in cash and cash equivalents
Cash and cash equivalents –  beginning of period 
Cash and cash equivalents –  end of period 

Non-cash investing and financing activities: 
Unrealized gain (loss) on available-for-sale securities 
Exercise of liability classified warrants for common stock 

$

$
$

  Year Ended December 31, 
2017 
2018 

$

(34,003,514)

$

(18,412,377) 

37,978
3,550,644
—

(56,012)
 (476,037)

45,689
2,407,961
186,904

—

(125,800) 

391,792
4,850,743
(25,704,406))

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

(92,018)
(36,802,418)
21,368,425
(15,526,011)

—
(4,448)
—
297,563
293,115
(40,937,302)
57,496,702
16,559,400

—

(3,958) 

—

(3,958) 

53,772,560
—
3,209,423
368,185
57,350,168
43,603,638
13,893,064
57,496,702

$

(20,248) 
— 

$
$

—
309,130 

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

F-7 

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), and MuSK antibody positive myasthenia gravis (MuSK-MG). 
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.  

On November 28, 2018, the U.S. Food and Drug Administration, or FDA, granted approval of Firdapse® for 

the treatment of adults with LEMS.  

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, 2018. The Company has been able to 
fund its cash needs to date primarily through public and private offerings of its securities. 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 from the issuance date of 
this Form 10-K. 

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. 

b. 

c. 

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 2017. 

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. 

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. 

F-8 

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

d. 

INVESTMENTS. The Company invests in high credit-quality funds in order to obtain higher yields 
on its cash and investments pending the use of those funds in its business. At December 31, 2018, 
investments  consisted  of  a  short-term  bond  fund  and  U.S.  Treasuries.  At  December  31,  2017, 
investments consisted of a short-term bond fund. Such investments are not insured by the Federal 
Deposit Insurance Corporation. 

Short-term bond fund 
The short-term bond fund is classified 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. At December 31, 
2018 and 2017, the only investment classified as trading securities was the short-term bond fund. 
Unrealized gain (loss) on trading securities was ($29,430) and $29,430, respectively, for the years 
ended  December  31,  2018,  and  2017  and  is  included  in  other  income,  net  in  the  accompanying 
consolidated statements of operations.  

U.S. Treasuries 
U.S. Treasuries are classified as available-for-sale securities. The Company classifies available-for-
sale securities with stated maturities of greater than three months and less than one year from the 
date  of  purchase  as  short-term  investments.  Available-for-sale  securities  with  stated  maturities 
greater than one year are classified as non-current investments in the accompanying consolidated 
balance sheets. The Company records available-for-sale securities at fair value with unrealized gains 
and  losses  in  accumulated  other  comprehensive  income  (loss)  in  stockholders’  equity.  Realized 
gains and losses are included in other income, net in the consolidated statements of operations and 
are  derived  using  the  specific  identification  method  for  determining  the  cost  of  securities  sold. 
Interest income is recognized when earned and is included in other income, net in the consolidated 
statements  of  operations.  The  Company  recognizes  a  charge  when  the  declines  in  the  fair  value 
below  the  amortized  cost  basis  of  its  available-for-sale  securities  are  judged  to  be  other-than-
temporary. The Company considers various factors in determining whether to recognize an other-
than-temporary charge, including whether the Company intends to sell the security or whether it is 
more likely than not that the Company would be required to sell the security before recovery of the 
amortized cost basis. The Company has not recorded any other-than-temporary impairment charges 
on its available-for-sale securities. See Note 3. 

INVENTORY.  Inventories  are  stated  at  the  lower  of  cost  or  net  realizable  value  with  cost 
determined under the first-in-first-out (FIFO) cost method. Inventories consist of raw materials and 
supplies, work in process and finished goods. Costs to be capitalized as inventories include third 
party manufacturing costs, associated compensation related costs of personnel indirectly involved 
in the  manufacturing process and other overhead  costs such as ancillary supplies. The Company 
began capitalizing inventories post FDA approval of Firdapse® on November 28, 2018 as the related 
costs were expected to be recoverable through the commercialization of the product. Costs incurred 
prior to the FDA approval of Firdapse® have been recorded as research and development expenses 
in  the  consolidated  statements of operations. If  information becomes available  that  suggests  that 
inventories may not be realizable, the Company may be required to expense a portion or all of the 
previously  capitalized  inventories. The  costs  of  inventories  during  the  year  ended  December  31, 
2018 consists mainly of packaging and labeling costs, indirect costs including compensation cost of 
personnel  and  supplies.  As  of  December  31, 2018,  inventory  was  approximately  $56,000.  As  of 
December 31, 2017, the Company did not have any inventory. 

Products that have been approved by the FDA or other regulatory authorities, such as Firdapse®, 
are  also  used  in  clinical  programs  to  assess  the  safety  and  efficacy  of  the  products  for  usage  in 
treating diseases that have not been approved by the FDA or other regulatory authorities. The form 
of Firdapse® utilized for both commercial and clinical programs is identical and, as a result, the 
inventory has an “alternative future use” as defined in authoritative guidance. Raw materials and 
purchased drug product  associated with  clinical development programs are  included in  inventory  

F-9 

e. 

2. 

Basis of Presentation and Significant Accounting Policies (continued).  

f. 

g. 

h. 

i. 

j. 

and  charged  to  research  and  development  expense  when  the  product  enters  the  research  and 
development process and no longer can be used for commercial purposes and, therefore, does not 
have an “alternative future use”.  

The  Company  evaluates  for  potential  excess  inventory  by  analyzing  current  and  future  product 
demand  relative  to  the  remaining  product  shelf  life.  The  Company  builds  demand  forecasts  by 
considering  factors  such  as,  but  not  limited  to,  overall  market  potential,  market  share,  market 
acceptance, and patient usage. 

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. 

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 to five years for computer equipment to five years 
for furniture and equipment, and from four to seven years for leasehold improvements. Expenditures 
for repairs and maintenance are charged to expenses as incurred. 

OPERATING LEASES. The Company recognizes lease expense on a straight-line basis over the 
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, 2018, and 
2017, the Company had $188,207 and $181,467, respectively, of deferred rent and lease incentive 
in accrued expenses and other liabilities in the consolidated balance sheet. 

FAIR VALUE OF FINANCIAL INSTRUMENTS. The Company’s financial instruments consist 
of  cash  and  cash  equivalents,  investments,  accounts  payable,  and  accrued  expenses  and  other 
liabilities. At December 31, 2018 and 2017, the fair value of these instruments approximated their 
carrying value. 

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 

F-10 

2. 

Basis of Presentation and Significant Accounting Policies (continued).

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, 
2018 

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

Significant 
Other 
Observable 
Inputs  
(Level 2) 

Significant 
Unobservable 
Inputs 
 (Level 3) 

14,462,087 

$ 

14,462,087 

$ 

— 

26,541,349 
10,380,864

$ 
$ 

26,541,349 

$ 
— $ 

— 
10,380,864

5,008,243

$ 

— $ 

5,008,243

$

$
$

$

—

—
—

—

Balances as of 
December 31, 
2017 

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

Significant 
Other 
Observable 
Inputs 
(Level 2) 

Significant 
Unobservable 
Inputs 
 (Level 3) 

56,820,688

$ 

56,820,688

$ 

26,516,711

$ 

26,516,711

$ 

— $ 

— $ 

—

—

$ 

$ 
$ 

$ 

$ 

$ 

Cash and cash equivalents:
Money market funds 
Short-term investments:
Short-term bond fund 
U.S. Treasuries  
Investments:
U.S. Treasuries  

Cash and cash equivalents: 
Money market funds 
Short-term investments: 
Short-term bond fund 

k. 

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. During the period that the 2011 warrants were outstanding, 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, occurred. 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. All 
unexercised 2011 warrants expired on May 2, 2017.  

F-11 

 
 
 
 
2. 

Basis of Presentation and Significant Accounting Policies (continued).  

The following table rolls forward the fair value of the Company’s warrants liability activity for the 
year ended December 31, 2017. On May 2, 2017, all outstanding and unexercised 2011 warrants 
expired. 

Fair value, beginning of period 
Issuance of warrants 
Exercise of warrants 
Change in fair value  
Fair value, end of period 

2017
122,226  
—
(309,130) 
186,904  
—

$

$

l. 

m. 

n. 

o. 

p. 

During the year ended December 31, 2017, 613,913 of the 2011 warrants were exercised, with 
proceeds of $798,087 to the Company. 

REVENUES FROM COLLABORATIVE ARRANGEMENT. The Company has entered into a 
collaboration  agreement  for  the  further  development  and  commercialization  of  generic  Sabril® 
(vigabatrin) tablets. Pursuant to the terms of this agreement, collaborators could be required to make 
various  payments  to  the  Company,  including  upfront  license  fees,  milestone  payments  based  on 
achievement of regulatory approvals, and royalties on sales of products resulting from collaborative 
agreement.  

Nonrefundable  upfront  license  fees  are  recognized  upon  receipt  as  persuasive  evidence  of  an 
arrangement  exists,  the  price  to  the  collaborator  is  fixed  or  determinable  and  collectability  is 
reasonably  assured.  An  upfront  license  fee  of  $500,000  was  recognized  in  the  year  ended 
December 31,  2018  when  it  was  paid  following  execution  of  the  collaborative  arrangement  for 
vigabatrin tablets. 

Refer to Note 7, Collaborative Arrangement, for further discussion on the Company's collaborative 
arrangement. 

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. 

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 five years. Forfeitures are recognized as a reduction of stock-based compensation expense as 
they occur.  

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 
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. 

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 the financial reporting and tax basis of assets and liabilities and are measured using enacted  

F-12 

2. 

Basis of Presentation and Significant Accounting Policies (continued).  

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 2015. 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. 

COMPREHENSIVE  INCOME  (LOSS).  U.S.  GAAP  requires  that  all  components  of 
comprehensive income (loss) be reported in the 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. The Company’s comprehensive  loss is shown on  the 
Consolidated Statements of Operations and Comprehensive Loss for the year ended December 31, 
2018 and is comprised of net unrealized losses on the Company’s available-for-sale securities. For 
December 31, 2017 and all prior periods, the Company’s net loss equaled comprehensive loss, since 
the Company had no items which were considered other comprehensive income (loss). 

NET LOSS PER SHARE. Basic net 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, are as follows: 

Options to purchase common stock 
Potential equivalent common stock excluded

2018

10,532,500  
10,532,500  

2017

5,191,666  
5,191,666  

q. 

r. 

Potentially dilutive stock options to purchase common stock as of December 31, 2018, had exercise 
prices ranging from $0.79 to $4.64. Potentially dilutive stock options to purchase common stock as 
of  December 31, 2017 had exercise prices ranging from $0.47 to $4.64.  

s. 

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

F-13 

 
 
2. 

Basis of Presentation and Significant Accounting Policies (continued).  

t.

u. 

RECLASSIFICATIONS. Certain prior year amounts in the consolidated financial statements have 
been reclassified to conform to the current year presentation.  

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 
adopted  the  standard  as  of  January  1,  2019,  the  beginning  of  fiscal  2019,  using  the  modified 
retrospective approach in which prior comparative periods are not adjusted. The Company elected 
the package of practical expedients permitted under the transition guidance within the new standard, 
which among other things, allows the Company to carry forward historical lease classification. The 
Company has operating leases for its office facilities, which expire on November 30, 2022. As of 
January 1, 2019, the Company will recognize an additional asset and corresponding liability related 
to  its  facility  lease  on  the  consolidated  balance  sheet  of  approximately  $1.0M  to  $1.5M.  The 
difference between the additional lease assets and lease liabilities, net of the deferred tax impact, 
was recorded as an adjustment to accumulated deficit. The standard did not materially impact the 
Company's consolidated statement of operations and had no impact on cash flows. 

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 adopted this standard in the first quarter of 2018. The adoption of this standard did not 
have a material impact on the Company’s consolidated financial statements.  

In  June  2018,  the  FASB  issued  ASU  No.  2018-07,  Compensation  -  Stock  Compensation  (Topic 
718):  Improvements  to  Nonemployee  Share-Based  Payment  Accounting  that  largely  aligns  the 
accounting  for  share-based  payment  awards  issued  to  employees  and  nonemployees.  Under  this 
ASU,  most  of  the  guidance  on  such  payments  to  nonemployees  would  be  aligned  with  the 
requirements  for  share-based  payments  granted  to  employees.  ASU  2018-07  is  effective  for  all 
entities for annual reporting periods beginning after December 15, 2018, including interim reporting 
periods  within  each  annual  reporting  period,  with  early  adoption  permitted.  The  Company  has 
adopted  this  standard  in  the  first  quarter  of  2019.  The  adoption  of  this  standard  will  not  have  a 
material impact on the Company’s consolidated financial statements. 

In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments — Credit Losses (Topic 
326), Measurement of Credit Losses on Financial Instruments. The standard amends the impairment 
model by requiring entities to use a forward-looking approach based on expected losses to estimate 
credit losses for most financial assets and certain other instruments that aren’t measured at fair value 
through net income. For available-for-sale debt securities, entities will be required to recognize an 
allowance for credit losses rather than a reduction in carrying value of the asset. Entities  will no 
longer be permitted to consider the length of time that fair value has been less than amortized cost 
when evaluating when credit losses should be recognized.  The Company plans  to adopt the new 
guidance on January 1, 2020. The Company does not anticipate the adoption will have a material 
impact on its consolidated financial position or results of operations. 

F-14 

3. 

Investments. 

Available-for-sale investments by security type were as follows: 

Amortized cost

Gross 
Unrealized 
Gains 

Gross 
Unrealized 
Losses 

Estimated Fair 
Value 

At December 31, 2018: 
U.S. Treasuries - ST 
U.S. Treasuries - LT 
Total 

$ 

$ 

10,382,699 $
5,026,656
15,409,355 $

— $
—
— $

(1,835)  $ 
(18,413)    
(20,248)  $ 

10,380,864
5,008,243
15,389,107

At December 31, 2017, the Company did not have any available-for-sale securities. 

In accordance with FASB ASC Topic 320, “Investments – Debt and Equity Securities”, or ASC 320, the 
Company has classified its U.S. Treasuries as available-for-sale securities with secondary or resale markets, and, as 
such, they are reported at fair value with unrealized gains and losses included in comprehensive loss in stockholders’ 
equity and realized gain and losses, included in other income, net. There were no realized gains or losses from sales 
of available-for-sale securities for the years ended December 31, 2018 or 2017. 

Certain U.S. Treasuries at December 31, 2018 had fair values less than their amortized costs and, therefore, 
contained unrealized losses.  Given that the Company has no intent to sell the U.S. Treasuries until a recovery of the 
fair  value,  which  may  be  at  maturity,  and  there  are  no  current  requirements  to  sell  any  of  these  securities,  as  of 
December  31,  2018,  the  Company  did  not  consider  these  investments  to  be  other-than-temporarily  impaired.  The 
Company anticipates full recovery of amortized costs with respect to these investments at maturity.  The duration of 
time the U.S. Treasuries have been in a continuous unrealized loss position as of December 31, 2018 was less than 12 
months. 

The estimated fair values of available-for-sale securities at December 31, 2018, by contractual maturity, are 

summarized as follows: 

Due in one year or less 
Due after one year but within two years 

2018
10,380,864 
5,008,243 
15,389,107 

$ 

$ 

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 

$ 

2018 

2017 

$ 

358,209 
800,261
 17,030 
170,552
31,561 
272,168

388,977
638,139
65,000
23,347
—
58,281

Total prepaid expenses and other current assets 

$ 

1,649,781

$ 

1,173,744

F-15 

 
 
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 

2018 

2017 

$ 

$ 

$ 

52,704
212,451
177,417
442,572
(197,147)

245,425

$ 

27,915
169,931
152,708
350,554
(159,169)

191,385

Depreciation expense was $37,978 and $45,689, respectively, for the years ended December 31, 2018 and 

2017. 

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 

$ 

2018 

2017 

821,633
1,311,061
1,941,449
3,000,000
33,408
66,436
7,173,987
154,799
154,799
7,328,786

$ 

$ 

970,649
227,457
821,935
252,500
24,011
24,035
2,320,587
157,456
157,456
2,478,043

7. 

Collaborative Arrangement. 

In December 2018, the Company entered into a collaboration and license agreement with Endo International 
plsc’s  subsidiary,  Endo  Ventures  Limited  (EVL),  for  the  further  development  and  commercialization  of  generic 
Sabril®  (vigabatrin)  tablets  through  Endo’s  U.S.  Generic  Pharmaceuticals  segment,  doing  business  as  Par 
Pharmaceutical.  

EVL  assumes  all  development,  manufacturing,  clinical,  regulatory,  sales  and  marketing  costs  under  the 
collaboration, while the Company is responsible for exercising commercially reasonable efforts to develop, or cause 
the development of, a final finished, stable dosage form of generic Sabril® tablets. 

Under  the  terms  of  the  Collaboration,  the  Company  has  received  an  up-front  payment,  and  will  receive 
milestone  payments  based  on  achievement  of  regulatory  approvals,  and  a  sharing  of  defined  net  profits  upon 
commercialization  from  EVL  consisting  of  a  mid-double  digit  percent  of  net  sales  of  generic  Sabril®.  Unless 
terminated earlier in accordance with its terms, the collaboration continues in effect until the date that is ten years 
following the commercial launch. As of December 31, 2018, a $500,000 upfront license fee was recognized. 

F-16 

 
 
 
8. 

Commitments and Contingencies. 

The  Company  has  contracted  with  drug  manufacturers  and  other  vendors,  including  clinical  research 
organizations (CRO) overseeing one or more of 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. 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 operating lease agreements  for its corporate office. The  leases have  free and 
escalating rent payment provisions. The Company recognizes rent expense under such leases on a straight-line basis 
over  the  term  of  the  lease.  As  of  December 31,  2018,  future  minimum  lease  payments  under  the  operating  lease 
agreements are as follows:  

2019 
2020 
2021 
2022 

$ 

329,725
339,612
349,792
329,662
$  1,348,791

In August 2018, the Company entered into a fourth amendment to the lease to its corporate offices to obtain 
additional  space  for  its  operations.  The  Company  now  leases  approximately  7,800  square  feet  and  the  lease  term 
expires in November 2022. In connection with the expansion, approximately $13,000 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 $242,155 and $204,170 respectively, for the years ended December 31, 2018 and 2017.  

There are no obligations under capital leases. 

On  August  27,  2009,  the  Company  entered  into  a  license  agreement  with  Northwestern  University 
(Northwestern), under which it acquired worldwide rights to CPP-115. As of December 31, 2018, the Company had 
paid $424,885 in connection with the license and had accrued license fees of $0 in the accompanying December 31, 
2018 consolidated balance sheet for expenses, maintenance fees and milestones. 

In 2018, the Company became aware that certain patents granted to Northwestern in 2018 (which patents 
have been licensed by Northwestern to a third-party) for a new GABA aminotransferase inhibitor were derived from 
CPP-115.  As  a  result,  the  Company  terminated  the  license  agreement,  based  on  the  Company’s  position  that 
Northwestern  has  violated  the  license  agreement  because  of  its  failure  to  transfer  these  new  patent  rights  to  the 
Company as part of the existing license agreement. It is also the Company's position that Northwestern's publication 
of information about the new patents in violation of the license agreement has damaged the Company.  On October 
26, 2018, the Company filed a claim for damages in arbitration against Northwestern for Northwestern’s breaches of 
the license agreement.  

On  November  5,  2018,  Northwestern  advised  the  Company  that  in  its  view,  Northwestern  has  a  right  to 
terminate the license agreement with the Company because the Company has allegedly breached the license agreement 
by failing to pay certain milestones and by allegedly failing to use commercially reasonable efforts to develop and 
commercialize any products. Northwestern has also advised the Company that, in its view, the Company has engaged 
in wrongful conduct and communications with the third party that licensed the new patents from Northwestern, and 
that such communications  have  damaged Northwestern's relationship  with that  third party. The Company disputes 
Northwestern's allegations and is vigorously defending itself against claims that Northwestern has brought against it 
in the arbitration proceeding.  

F-17 

 
 
 
8. 

Commitments and Contingencies (continued). 

There can be no assurance as to the outcome of this matter.  

The Company has an employment agreement with its Chief Executive Officer. Under this agreement, the 
CEO received an annual base salary of approximately $525,000 in 2018. This agreement expires in November 2020. 

9. 

Agreements.  

a. 

LICENSE  AGREEMENT  WITH  BIOMARIN  (FIRDAPSE®).  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  agreed  to  pay  certain 
milestone payments that BioMarin was 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.  

In full satisfaction of the milestone obligations, the Company has paid (i) $3,150,000 in milestone 
payments to the third party licensor of the rights that have been sublicensed to the Company ($3.0 
million of which was paid in February 2019 and the balance of which was paid in 2018), and (ii) 
$2.0 million in milestone payments to the former Huxley Stockholders (all of which was paid in 
2018). 

In  the  BioMarin  License  Agreement,  the  Company  agreed  to  share  in  the  cost  of  certain  post-
marketing studies of Firdapse® that were being conducted by BioMarin, and the Company fulfilled 
its commitment to BioMarin regarding all such payments several years ago.  

b. 

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, 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. 

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. 

F-18 

10. 

Income Taxes (continued).  

The reconciliation of income tax expense (benefit) computed at the statutory federal income tax rate of 21% 

to amounts included in the statements of operations is as follows: 

Statutory rate 
State tax 
Valuation allowance 
Federal rate change 
Tax credit 
Other 

2018 

2017 

21.0% 
4.2% 
(25.9)% 
0.0% 
1.4% 
(0.7)% 
0.0% 

34.0%
3.5%
26.5%
(73.2)%
6.8%
2.4%
0.0%

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, 2018 and 2017 are  as follows: 

Net operating loss 
Start-up cost 
Tax credits 
Deferred compensation  
Other 
Gross deferred tax asset  
Valuation allowance 
Net deferred tax assets

$ 

2018 

19,867,591 
13,861,147 
12,625,275 
1,919,434 
109,779 
48,383,226 
(48,383,226) 

2017 

$  15,718,570 
10,508,487 
11,582,134 
1,326,189 
72,395 
39,207,775 
(39,207,775) 

$ 

—

$ 

—

The Company's deferred tax assets have been fully offset by a valuation allowance at December 31, 2018 
and 2017 because the Company believes that it is more likely than not that the deferred tax asset will not be realized. 
The  increase and decrease  in  the  valuation  allowance  on  the  deferred  tax  assets was $9,175,451 and $3,388,951 
for the years ended December 31, 2018 and 2017, respectively. 

At  December  31,  2018  and  2017,  respectively,  the  Company  had  net  operating  loss  carryforwards  of 
approximately $79.0 million and $62.6 million available to reduce future taxable income, if any. The net operating 
loss carryforwards will expire at various dates beginning in 2023 and ending in 2037, the amount of net operating loss 
generated in 2018 will have an infinite life, but will be limited to utilization per year of 80% of taxable income. 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 21% 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, 2018. 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  2015.  The  Company  is  not  currently  under  income  tax 
examinations by any tax authorities. 

F-19 

 
 
 
 
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, 

2018 and 2017. No shares of preferred stock were outstanding at December 31, 2018 and 2017.  

Common Stock  

The  Company  has  150,000,000  shares  of  authorized  common  stock,  par  value  $0.001  per  share.  At 
December 31, 2018 and 2017, 102,739,257 and 102,549,498 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.  

On November 28, 2017, the Company filed a prospectus supplement and offered for sale 16,428,572 shares 
of its common stock at a price of $3.50 per share in an underwritten public offering under the 2017 Shelf Registration. 
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. 

At December 31, 2018, there is approximately $92.5 million available for future sale under the 2017 Shelf 

Registration Statement. 

Warrant Exercises 

All  unexercised  warrants  expired  in  2017.  For  the  year  ended  December  31,  2017,  the  Company  issued 
2,257,663 shares 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.  

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.  

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  

F-20 

11. 

Stockholders’ Equity (continued). 

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  Stockholders  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. 

12. 

Stock Compensation Plans. 

For the years ended December 31, 2018 and 2017, the Company recorded stock-based compensation 

expense as follows:  

Research and development     
General and administrative 
Total stock-based compensation 

$ 

$ 

2018 
1,079,230 
2,471,414 
3,550,644 

$ 

$ 

2017

785,899 
1,622,062 
2,407,961 

The Company may issue stock options, restricted stock, stock appreciation rights and restricted stock units 
(collectively, the “Awards”) to employees, directors, and consultants of the Company under the 2014 and 2018 Stock 
Incentive Plans (the 2014 Plan and the 2018 Plan or collectively, the Plans). At December 31, 2018, no shares remain 
available for future issuance under the 2014 Plan. Under the 2018 Plan, 7,500,000 shares were reserved for issuance 
and as of December 31, 2018, 3,620,603 shares remain available for future issuance.  

Stock Options  

The  Company  has  granted  stock  options  to  employees,  officers,  directors,  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  5  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, 2018 and 2017, options to purchase 186,665 and 780,000 shares of the 
Company’s  common  stock  were  exercised  with  gross  proceeds  to  the  Company  of  $297,563  and  $368,185, 
respectively.  Further,  during the year ended  December 31, 2018, no  options to purchase  shares of the  Company’s 

F-21 

12. 

Stock Compensation Plans (continued). 

common stock were exercised on a “cashless” basis. During the year ended December 31, 2017, options to purchase 
100,000 shares of the Company’s common stock were exercised on a “cashless” basis, resulting in the issuance of an 
aggregate of 84,280 shares of the Company’s common stock, respectively.  

During  the  years  ended  December 31,  2018  and  2017  the  Company  recorded  non-cash  stock-based 

compensation expense related to stock options totaling $3,535,647 and $2,342,625, respectively.  

During the years ended December 31, 2018 and 2017, the Company granted seven-year options to purchase 
an  aggregate  of  5,822,500  and  1,550,000  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, 2018 is summarized as 

follows:  

Outstanding at beginning of year 
  Granted 
  Exercised or released 
  Forfeited or cancelled 
  Expired  
Outstanding at end of year 
Exercisable at end of year 

Number of 
Options 

5,191,666 
5,822,500 
(186,665) 
(270,001) 
(25,000)  
  10,532,500 
4,349,996 

Weighted 
Average 
Exercise 
Price 

$ 

$ 
$ 

1.96 
3.04 
1.59 
2.94 
0.47 
2.54 
2.16 

Weighted 
Average 
Remaining 
Contractual 
Term (in 
years) 

Aggregate 
Intrinsic 
Value 

5.39 
4.00 

$ 
$ 

2,239,500 
1,679,297 

Other information pertaining to stock option activity during the years ended December 31, 2018 and 2017 

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  

2018 

1.93 
2,193,294 
274,864 

$ 
$ 
$ 

2017 

0.91 
2,016,992 
2,296,100 

$ 
$ 
$ 

The following table summarizes information about the Company’s options outstanding at December 31, 

2018:  

Range of 
Exercise 
Prices       
$0.79 to $1.13 
$1.14 to $2.28 
$2.29 to $3.07 
$3.08 to $3.75 
$3.76 to $4.64 

Number 
Outstanding 
2,385,000 
2,440,000 
1,765,000 
2,005,000 
1,937,500 
10,532,500 

Options Outstanding 
Weighted 
Average 
Remaining 
Contractual 
Life (Years) 
4.78 
6.87 
4.84 
4.59 
5.62 
5.39 

Weighted 
Average 
Exercise 
Price 

$0.99 
$2.22 
$2.60 
$3.30 
$4.03 
$2.54 

Options Exercisable 
Weighted 
Average 
Remaining 
Contractual 
Life (Years) 
4.69 
6.22 
3.72 
2.71 
3.92 
4.00 

Weighted 
Average 
Exercise 
Price 

$0.93 
$2.07 
$2.53 
$3.14 
$4.11 
$2.16 

Number 
Exercisable 
1,686,664 
209,999 
1,098,333 
995,000 
360,000 
4,349,996 

F-22 

 
 
 
 
 
12. 

Stock Compensation Plans (continued). 

As  of  December 31,  2018,  there  was  approximately  $8.8  million  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 2.58 years. 

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. Forfeitures are recognized as a reduction of stock-based compensation expense as they occur.   

Assumptions used during the years were as follows:  

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

Restricted Stock Units 

December 31, 2018 

December 31, 2017 

2.09% to 2.88% 
0 to 7 years 
82% 
—% 
—% 

1.66% to 2.25% 
4 to 7 years 
104% 
—% 
—% 

Under  the  2018  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 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. No restricted stock units were granted during 2018. Restricted stock unit activity during 2017 
was as follows: 

Nonvested balance at beginning of year 

  Granted 
  Vested 
  Forfeited  
Nonvested balance at end of year 

2017 

Number of Restricted 
Stock Units 

Weighted Average 
Grant Date Fair Value 

26,667  
—  
(26,667) 
—  
—  

$ 

$ 

2.83 
—  
2.83 
—  
— 

No stock-based compensation related to restricted stocks was recorded during 2018. During the year ended 
December 31, 2017, the Company recorded non-cash stock-based compensation expense related to restricted stock 
units totaling $65,336. All restricted stock units were vested as of December 31, 2017. 

F-23 

 
 
 
12. 

Stock Compensation Plans (continued). 

Common Stock 

During the year ended December 31, 2018, the Company granted 3,094 net shares of common stock to an 
employee as compensation. The Company recorded stock-based compensation related to common stock issued to an 
employee totaling approximately $15,000, during the year ended December 31, 2018. No shares of common stock 
were granted during the year ended December 31, 2017.  

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, 2018 and 2017, 
the Company’s matching contributions were approximately $123,000 and $84,000, respectively. 

14. 

Quarterly Financial Information (unaudited). 

The  following  table  presents  unaudited  supplemental  quarterly  financial  information  for  the  years  ended 

December 31, 2018 and 2017:  

Revenues  
Loss from operations 
Net loss 
Net loss per share —basic and 
diluted 

Revenues  
Loss from operations 
Change in fair value of warrants   
liability 
Net loss 
Net loss per share —basic and 
diluted 

Quarter Ended 

March 31, 
2018 

— 
(5,933,440) 
(5,699,892) 

June 30, 
2018 

$ 
— 
$  (6,335,855) 
$  (5,965,140) 

(0.06) 

$ 

(0.06) 

September 30, 
2018 

December 31, 
2018 

$ 
$ 
$ 

$ 

— 
(8,182,603) 
(7,838,873) 

(0.08) 

$ 
$ 
$ 

$ 

500,000 
(14,843,267) 
(14,499,609) 

(0.14) 

Quarter Ended 

March 31, 
2017 

June 30, 
2017 

September 30, 
2017 

December 31, 
2017 

— 
(4,679,871) 

— 
$ 
$  (4,181,271) 

(397,235) 
(4,967,129) 

$ 
210,331 
$  (3,879,901) 

(0.06) 

$ 

(0.05) 

$ 
$ 

$ 
$ 

$ 

— 
(4,306,708) 

— 
(4,177,649) 

(0.05) 

$ 
$ 

$ 
$ 

$ 

— 
(5,511,786) 

— 
(5,387,698) 

(0.06) 

$ 
$ 
$ 

$ 

$ 
$ 

$ 
$ 

$ 

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. 

On  January  15,  2019,  the  Company  launched  its  first  product,  Firdapse®,  in  the  United  States  for  the 

treatment of adults with LEMS. 

F-24 

Corporate Directory 

BOARD OF DIRECTORS 

EXECUTIVE OFFICERS 

ANNUAL MEETING 

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. 

Richard J. Daly 
Chief Operating Officer 
BeyondSpring Pharma 

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 
President and Chief Executive Officer 
BiopharmX, Inc. 

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 23, 2019 at 
9:00 a.m., local time, at the Hyatt 
Regency Coral Gables, located at:  

Steven R. Miller, PhD 
Chief Operating Officer 
and Chief Scientific Officer 

Alicia Grande, CPA, CMA 
Vice President, Treasurer and Chief 
Financial Officer  

Gary Ingenito, M.D., Ph.D. 
Chief Medical Officer and Head of 
Regulatory Affairs 

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: 

Daniel J. Brennan 
Chief Commercial Officer 

Brian Elsbernd, J.D.
Chief Compliance Officer and Chief 
Legal Officer 

Catalyst Pharmaceuticals, Inc. 
355 Alhambra Circle, Suite 1250 
Coral Gables, FL  33134 
(305) 420-3200 
(305) 569-0233 fax 
Email:info@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