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Catalyst Pharmaceuticals

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FY2020 Annual Report · Catalyst Pharmaceuticals
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UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION 
Washington, D.C. 20549 

FORM 10-K 

[Mark One] 
☒  ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the Fiscal Year Ended December 31, 2020 
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 801
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. 

Title of Each Class

Ticker
Symbol

Common Stock, par value $0.001 per share

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

Name of Exchange
on Which Registered

NASDAQ Capital Market

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

Indicate by check mark if registrant is not required to file reports pursuant to Rule 13 or Section 15(d) of the Act.    Yes  ☐    No  ☒
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the 
preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 
days.    Yes  ☒    No  ☐
Indicate by check mark whether the registrant has submitted electronically, every Interactive Data File required to be submitted pursuant to rule 405 of Regulation S-T 
(§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  ☒    No  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging 
growth company. See the definitions of “large accelerated filer”, “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act:  

Large accelerated filer ☐

Non-accelerated filer ☐

Accelerated filer

Smaller reporting company

☒

☐

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

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control 
over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued 
its audit  
report ☒

As of June 30, 2020, 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 $444,887,344.  

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  ☒
Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date: 103,824,973 shares of common stock, 
$0.001 par value per share, were outstanding as of March 11, 2021.  
Part III incorporates certain information by reference from the registrant’s definitive proxy statement for the 2021 annual meeting of stockholders. The proxy statement 
with respect to the 2021 annual meeting of stockholders will be filed no later than 120 days after the close of the registrant’s fiscal year ended December 31, 2020.  

Table of Contents 

PART I 

Item 1.        Business
Item 1A.  Risk Factors
Item 1B.  Unresolved Staff Comments
Item 2.        Properties
Item 3. 
Item 4. 

Legal Proceedings
Mine Safety Disclosure

PART II 

Item 5. 

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 
Securities
Selected Financial Data
Management’s Discussion and Analysis of Financial Condition and Results of Operations

Item 6. 
Item 7. 
Item 7A.  Quantitative and Qualitative Disclosures About Market Risk
Financial Statements and Supplementary Data
Item 8. 
Item 9. 
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Item 9A.  Controls and Procedures
Item 9B.  Other Information

PART III 

Item 10.  Directors and Executive Officers of the Registrant
Item 11. 
Item 12. 
Item 13.  Certain Relationships and Related Transactions
Item 14. 

Executive Compensation
Security Ownership of Certain Beneficial Owners and Management

Principal Accounting Fees and Services

PART IV 

Item 15. 

Exhibits and Financial Statement Schedules 

EXHIBITS FILED WITH FORM 10-K

EX 4.5
EX 23.1
EX 31.1
EX 31.2
EX 32.1
EX 32.2

Description of the Company’s Capital Stock
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

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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 continued successful commercialization of Firdapse® and the development of additional indications for Firdapse® is highly 
uncertain. Factors that will affect our success include the uncertainty of:  

• 

The impact of the COVID-19 pandemic on our business or on the economy generally;  

•  Whether we will be able to continue 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 Firdapse® for the treatment of Lambert-Eaton Myasthenic Syndrome 

(“LEMS”) 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 patients will discontinue from the use of our drug at rates that are higher than historically experienced or are 

higher than we project;  

•  Whether the daily dose taken by patients changes over time and affects our results of operations;  

•  Whether Firdapse® patients can be successfully titrated to stable therapy;  

•  Whether we can continue to market Firdapse® on a profitable and cash flow positive basis;  

•  Whether any revenue guidance that we provide to the public market will turn out to be accurate;  

•  Whether payors will reimburse for our product at the price that we charge for the product;  

• 

• 

• 

• 

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

The ability of our distributor and the specialty pharmacies that distribute our product to maintain compliance with 
applicable law;  

Our ability to maintain compliance with applicable rules relating to our patient assistance programs and our 
contributions to 501(c)(3) organizations that support LEMS patients;  

The scope of our intellectual property and the outcome of any future challenges or opposition to our intellectual 
property, and, conversely, whether any third-party intellectual property presents unanticipated obstacles for Firdapse®;  

•  Whether our lawsuits against Jacobus and the specialty pharmacy distributing its product for patent infringement will be 

successful;  

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• 

The effect on our business and future results of operations arising from the approval by the FDA of Ruzurgi® for the 
treatment of pediatric LEMS patients (ages 6 to under 17);  

•  Whether our appeal of the District Court’s decision in our suit against the United States FDA seeking to vacate the 

FDA’s approval of Ruzurgi® will be successful;  

•  Whether we can continue to compete successfully if the approval of Ruzurgi® is not overturned and Ruzurgi® continues 

to be prescribed for off-label use by adult LEMS patients;  

•  Whether, because of the lower price of Ruzurgi®, payors will require that patients try off-label Ruzurgi® first before they 

approve Firdapse® as a treatment for adult LEMS patients;  

• 

• 

• 

• 

• 

• 

• 

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 organization, 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 public statements by politicians and a vocal group of LEMS 
patients and doctors who object to our pricing of Firdapse®;  

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

The state of the economy generally and its impact on our business;  

Changes to the healthcare industry occasioned by any future changes 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 any clinical trials and studies that we may undertake on a timely basis and within the budgets we 
establish for such trials and studies;  

•  Whether COVID-19 will further affect the timing and costs of our currently ongoing and contemplated clinical trials;  

•  Whether Firdapse® will ever be approved for the treatment of any neuromuscular disease other than LEMS;  

•  Whether we can successfully commercialize Firdapse® in Canada on a profitable basis;  

•  Whether our suit to overturn the approval of Ruzurgi® in Canada will be successful;  

• 

The impact on sales of Firdapse® in the United States if an amifampridine product is purchased in Canada for use in the 
United States;  

•  Whether we will be able to successfully complete the clinical trial in Japan that will be required to seek approval to 

commercialize Firdapse® in Japan;  

•  Whether we will be able to obtain approval to commercialize Firdapse® in Japan;  

•  Whether we can successfully develop, obtain approval of and successfully market a long-acting version of amifapridine;  

•  Whether our efforts to grow our business beyond Firdapse® through acquisitions of companies or in-licensing of product 

opportunities will be successful;  

•  Whether we will have sufficient capital to finance any such acquisitions;  

•  Whether our version of generic vigabatrin tablets will ever be approved by the FDA;  

• 

Even if our version of vigabatrin tablets is approved for commercialization, whether Endo Ventures/Par Pharmaceutical 
(our collaborator in this venture) will be successful in marketing the product; and  

•  Whether we will earn milestone payments on the first commercial sale of vigabatrin tablets and royalties on sales of 

generic vigabatrin tablets.  

Our current plans and objectives are based on assumptions relating to the continued commercialization of Firdapse® and 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.  

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Item 1. 

Business 

Overview 

We are a biopharmaceutical company focused on developing and commercializing innovative therapies for people with rare, 
debilitating, chronic diseases. We are currently focusing our efforts on products that treat diseases in the neuromuscular and 
neurological space, but we recently decided to expand our strategic focus to include acquiring or in-licensing innovative technology 
platforms and earlier stage programs in other rare disease therapeutic categories outside of these spaces. 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.  

Impact of the COVID-19 pandemic on our business 

The COVID-19 pandemic has resulted, and is expected to continue to result, in significant economic disruption, and has adversely 
affected and will likely continue to adversely affect our business. We are actively monitoring the situation and are taking those actions 
that may be required by federal, state or local authorities or that we determine are in the best interests of our patients, investigators, 
employees and stockholders.  

In March 2020, in light of worsening conditions as a result of the pandemic, we implemented a number of safety related initiatives 
among our employees, including a travel ban and a work from home policy for all employees. This included our customer-facing 
employees, who began working remotely and utilizing telephone and web-based technologies to provide support to patients and their 
healthcare providers. We believe that because many healthcare providers have delayed seeing new patients because of the pandemic, 
there has been a delay in the diagnosis of new LEMS patients and their initiating therapy, which has slowed our efforts to locate new 
patients who could benefit from our therapy. However, we believe that as more healthcare providers resume seeing new patients on a 
regular basis, that this aspect of the COVID-19 pandemic on our business will lessen.  

Our Firdapse® supply chain remains robust and thus far we have observed no disruptions in the production of Firdapse®. We reiterate 
that we are committed to providing patients with the ability to obtain an uninterrupted supply of Firdapse®, and we believe that we 
have an adequate supply of Firdapse® to address patients’ needs for the foreseeable future. Further, we are advised by our U.S. 
manufacturing partners that they have implemented contingency plans to remain in operation. We are committed to meeting our 
patients’ needs for Firdapse® and believe that our supply chain will continue to remain solid and uninterrupted through the COVID-19 
outbreak and beyond.  

Until such time as the COVID-19 pandemic is over, it will likely adversely impact the timetable of our ongoing and contemplated 
clinical trials and studies, and increase the costs of such trials and studies, consistent with the impact that the COVID-19 pandemic has 
had on many biopharmaceutical companies.  

Strategic Plan for 2021 and Beyond 

Our Board of Directors recently approved an expansion in our company’s strategic focus to include acquiring or in-licensing 
innovative technology platforms and earlier stage programs in other therapeutic categories outside of neuromuscular diseases. To 
accomplish these new priorities, we are prepared to invest more heavily in research and development, including acquiring earlier stage 
opportunities and innovative technology. We believe that this strategic expansion will better position our company to build out a 
broader more diversified portfolio of drug candidates that we believe will add greater value to our company over the near and long-
term. However, there can be no assurance that whatever product candidates or technology platforms we acquire, if any, will be 
successfully developed.  

To spearhead this investment, we have commenced a national search for a key executive to manage this more progressive strategy. 
This person will likely be an M.D. or Ph.D. with at least 15-20 years of relevant pharmaceutical experience and experience in 
developing innovative drug technology. This person will be responsible for portfolio expansion planning and developing medicines 
from discovery through marketing authorizations, as well as strategic leadership across all R&D activities including, direct oversight 
of science and clinical research.  

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

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On November 28, 2018, we received approval from the FDA for Firdapse® 10 mg tablets for the treatment of adult LEMS patients 
(ages 17 and 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 at the time of approximately 20 field personnel, including sales 
(Regional Account Managers), patient assistance and insurance navigation support (Patient Access Liaisons), and payor 
reimbursement (National Account Managers). 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, Anti-MuSK antibody positive myasthenia gravis, or MuSK-
MG, and other neurological diseases, and to provide education for the physicians who treat these rare diseases and the patients they 
treat.  

In early 2020, we expanded our field sales group by almost one hundred percent and contracted with an experienced inside sales 
agency generating leads through telemarketing to targeted physicians. We made these changes to expand our sales efforts beyond the 
neuromuscular specialists who regularly treat LEMS patients to reach the roughly 9,000 neurology and neuromuscular healthcare 
providers that may be treating an adult LEMS patient who can benefit from Firdapse®. We also continue to make available at no-cost a 
LEMS voltage gated calcium channel (VGCC) antibody testing program for use by physicians who suspect that one of their patients 
may have LEMS and wish to reach a definitive diagnosis. Further, we are continuing to expand our digital and social media activities 
in order to introduce our product and services to potential patients and their healthcare providers.  

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. 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 adult LEMS 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 not more than $10.00 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 any U.S. LEMS patients in financial need. Subject to compliance with regulatory requirements, our goal is that no LEMS 
patient is ever denied access to their medication for financial reasons.  

In May 2019, the FDA approved a New Drug Application (NDA) for Ruzurgi®, another version of amifampridine (3,4-DAP), for the 
treatment of pediatric LEMS patients (ages 6 to under 17). While the NDA for Ruzurgi® only covers pediatric patients, we believe that 
Ruzurgi® is regularly being prescribed off label to adult LEMS patients. We believe that under applicable law, Jacobus is not 
permitted to market its amifampridine product to adult LEMS patients in the United States, and we are continuing to aggressively take 
all steps available to us to protect Firdapse’s® exclusivity under the Orphan Drug Act. There can be no assurance, however, that we 
will be able to stop the off-label prescribing of Ruzurgi® to adult LEMS patients. If Jacobus is able to successfully sell Ruzurgi® off-
label to additional adult LEMS patients, it could have a material adverse effect on our business, financial condition and results of 
operations.  

We also believe that the FDA’s approval of Ruzurgi® violated our statutory rights and was in multiple other respects arbitrary, 
capricious and contrary to law. As a result, in June 2019 we filed suit against the FDA and several related parties challenging this 
approval and related drug labeling. Our complaint, which was filed in the federal district court for the Southern District of Florida, 
alleged that the FDA’s approval of Ruzurgi® violated multiple provisions of FDA regulations regarding labeling, resulting in 
misbranding in violation of the Federal Food, Drug, and Cosmetic Act (FDCA); violated our statutory rights to Orphan Drug 
Exclusivity and New Chemical Entity Exclusivity under the FDCA; and was in multiple other respects arbitrary, capricious, and 
contrary to law, in violation of the Administrative Procedure Act. Among other remedies, the suit sought an order setting aside the 
FDA’s approval of Ruzurgi®.  

On July 30, 2020, the Magistrate Judge considering our lawsuit against the FDA filed a Report and Recommendation in which she 
recommended to the District Judge handling the case that she grant the FDA’s and Jacobus’ motions for summary judgment and deny 
our motion for summary judgment. On September 29, 2020, the District Judge adopted the Report and Recommendation of the 
Magistrate Judge, granted the FDA’s and Jacobus’ motions for summary judgment, and dismissed our case.  

We believe that the District Judge’s decision is incorrect as a matter of law and contrary to the plain language of the Orphan Drug Act. 
We believe that if the District Judge’s decision to grant summary judgment is correct on the law, it means that the FDA has the 

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authority to effectively eliminate the benefits of exclusivity under the Orphan Drug Act, which we believe will chill the incentive for 
drug companies to spend the millions of dollars necessary to develop an orphan drug. As a result, we have appealed the decision to the 
Eleventh Circuit Court of Appeals. There can be no assurance of the result of such proceeding.  

We are currently developing a long-acting formulation of amifampridine phosphate. A number of candidate formulations have been 
prepared, and three of the most promising formulations were evaluated in a pharmacokinetic (PK) study completed during the fourth 
quarter of 2020. The results of this first PK study will be used to inform the design and refinement of future product formulations and 
additional PK work to be conducted in 2021. We have also completed a number of advisory board meetings with both patients and 
doctors in order to establish the optimum target characteristics of the long-acting formulation of amifampridine phosphate that are 
desired by the LEMS patient community and treating physicians. There can be no assurance that we will be able to successfully 
develop a long-acting formulation of amifampridine phosphate, that any such formulation will be approved by the FDA for marketing, 
or that any such formulation will be commercially viable.  

On August 10, 2020, we announced the top-line results from our Phase 3 clinical trial (MSK-002) evaluating Firdapse® for the 
treatment of adults with MuSK-MG. Our trial was a multi-site, international (United States, Italy and Serbia), double-blind, placebo-
controlled, clinical trial being conducted under a Special Protocol Assessment (SPA) with the FDA. Unfortunately, the MSK-002 trial 
did not achieve statistical significance on its primary endpoint or its secondary endpoint. However, we have recently concluded a 
detailed analysis of the data from this trial in an effort to understand why the MuSK-MG Phase 3 trial did not meet statistical 
significance on its endpoints, even though clinical improvement was observed by patients and investigators during the initial dose-
titration period of the trial and in our previous proof-of-concept trial. We found in our analysis that there was a large degree of 
symptom variability during the double-blind withdrawal period. We believe that sources of such variability can be addressed in a 
redesigned study that may better demonstrate the efficacy of our drug for the treatment of MuSK-MG.  

We plan to present our hypotheses and a revised protocol to the FDA with respect to the MuSK-MG indication for discussion during 
the first half of 2021. However, there can be no assurance that the FDA will either grant a meeting, agree with our protocol design or, 
even if the study is successful, accept the results of a single study of a different trial design as sufficient evidence for approval of the 
MuSK-MG indication. While we prepare for the meeting with FDA, we also plan to evaluate new clinical trial sites and discuss the 
new trial design with investigators. After meeting with the FDA, we will determine whether or not to proceed with a new trial that 
incorporates the new trial design.  

Our exploratory study, SMA-001 (A Randomized Placebo Controlled Crossover Study to Evaluate the Safety and Efficacy of 
Amifampridine Phosphate in Ambulatory Patients with Spinal Muscular Atrophy (SMA) Type 3, met the primary endpoint of a 
statistically significant difference for the Hammersmith Functional Motor Scale Expanded (HFMSE). Clinically, however, the effect 
was modest. The secondary endpoints were not statistically significant, although several individual quality of life measures 
demonstrated a nominally positive statistically significant change. Key opinion leaders with whom we have spoken believed that 
Firdapse® needed to show a large clinically significant change if there was the possibility to affect disease progression through 
retrograde signaling from enhanced neuromuscular junction function. After considering all of these factors, we have concluded that 
the modest results exhibited in this study are unlikely to result in a sufficient modification of disease progression, and, particularly in 
light of the fact that there are now three approved disease modifying medications for SMA Type 3, we have decided not to pursue the 
SMA Type 3 indication further.  

We intend to conduct a proof-of-concept study evaluating Firdapse® as a treatment for Hereditary Neuropathy with Liability to 
Pressure Palsies (HNPP). The scientific basis for considering this indication is that leakage of neuron potassium channels is observed 
in HNPP. Since Firdapse® is a potassium channel blocker, it may mitigate the pathological effects of the potassium channel leakage in 
HNPP patients. There can be no assurance that this proof-of-concept study will be successful.  

There can be no assurance that clinical trials of Firdapse® that we undertake in the future will be successful. Further, there can be no 
assurance that we will ever be granted the right to commercialize Firdapse® for any additional indications.  

Our NDS filing for Firdapse® for the symptomatic treatment of LEMS was approved by Health Canada on July 31, 2020. In August 
2020, we entered into a license agreement with KYE Pharmaceuticals (KYE), pursuant to which we licensed the Canadian rights for 
Firdapse® for the treatment of LEMS to KYE. Pursuant to the license agreement, KYE is obligated to pay us an up-front payment 
based on approval and product supply, data protection milestones based on achievements of sales and regulatory milestones, and a 
sharing of defined net sales upon commercialization.  

On August 10, 2020, Health Canada issued a Notice of Compliance (NOC) to Medunik for Ruzurgi® for the treatment of LEMS. We 
have since initiated a legal proceeding in Canada seeking judicial review of Health Canada’s decision to issue the NOC for Ruzurgi®
as incorrect and unreasonable under Canadian law. Data protection, per Health Canada regulations, is supposed to prevent Health 
Canada from issuing a NOC to a drug that directly or indirectly references an innovative drug’s data, for eight years from the date of 
the innovative drug’s approval. The Ruzurgi® Product Monograph clearly references pivotal nonclinical carcinogenicity and 

5

reproductive toxicity data for amifampridine phosphate developed by us. As such, we believe that our data was relied upon to establish 
the nonclinical safety profile of Ruzurgi® needed to meet the standards of the Canadian Food and Drugs Act. There can be no 
assurance of the results of this proceeding.  

In May 2019, we entered into an amendment to our license agreement for Firdapse®. Under the amendment, we have expanded our 
commercial territory for Firdapse®, which originally was comprised of North America, to include Japan. Additionally, we have an 
option to further expand our territory under the license agreement to include most of Asia, as well as Central and South America, upon 
the achievement of certain milestones in Japan. Under the amendment, we will pay royalties on net sales in Japan of a similar 
percentage to the royalties that we are currently paying under our original license agreement for North America.  

We have met with Japanese regulatory authorities and believe that we have reached an agreement with them as to the scope of the 
clinical trial that we will be required to undertake in Japan before we will be permitted to submit an application to the Japanese 
regulatory authorities to seek to commercialize Firdapse® for the treatment of LEMS in Japan. We also have applied for orphan drug 
designation in Japan for the symptomatic treatment of LEMS. There can be no assurance that we will successfully obtain the right to 
commercialize Firdapse® in Japan or obtain orphan drug designation.  

All of our patent rights for Firdapse® are derived from our license agreement. In August 2020, the United States Patent and Trademark 
Office (USPTO) allowed Patent No. 10,798,893 (the ’893 patent) to our licensor and thereby to us, and the patent issued on October 6, 
2020. The patent is directed to the use of suitable doses of amifampridine to treat patients, regardless of the therapeutic indication, that 
are slow metabolizers of amifampridine. Any drug product containing amifampridine with a label that states the patented dosing 
regimens and doses in the Dosing and Administration section prior to April 7, 2034, the expiration date of the patent, could possibly 
infringe this patent. Generic drug product labels would necessarily have to do this, and we intend to take all appropriate actions to 
protect our intellectual property.  

In that regard, in October 2020, we filed a lawsuit in the U.S. District Court for New Jersey against Jacobus and a lawsuit in the U.S. 
District Court for the Western District of Pennsylvania against the specialty pharmacy marketing Ruzurgi®, PantherRx Rare LLC 
(PantherRx), for infringement of the ‘893 Patent. The suits have since been combined in the U.S. District Court for New Jersey. The 
lawsuit arises from Jacobus’ and PantherRx’s sales and marketing of Ruzurgi® (amifampridine, 10 mg). The lawsuit alleges that the 
Ruzurgi® product infringes the ‘893 patent when administered in accordance with its product labeling. The lawsuit seeks damages and 
injunctive relief to prevent further marketing of Ruzurgi® in violation of our patent rights.  

We are also pursuing additional patent applications for Firdapse® in an effort to further protect our drug product. There can be no 
assurance that any additional patents will be issued which provide additional intellectual property protection for our drug product.  

There can be no assurance that we do not or will not infringe on patents held by third parties or that third parties in the future will not 
claim that we have infringed on their patents. In the event that our products or technologies infringe or violate the patent or other 
proprietary rights of third parties, there is a possibility we may be prevented from pursuing product development, manufacturing or 
commercialization of our products that utilize such technologies until the underlying patent dispute is resolved. For example, there 
may be patents or patent applications held by others that contain claims that our products or operations might be determined to 
infringe or that may be broader than we believe them to be. Given the complexities and uncertainties of patent laws, there can be no 
assurance as to the impact that future patent claims against us may have on our business, financial condition, results of operations, or 
prospects.  

Generic Sabril®

In December 2018, we entered into 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, in December 2018, we received an up-front payment of $500,000. We will 
be entitled to receive a milestone payment of $2.0 million on the commercial launch of the product. Further, we will receive a sharing 
of defined net profits upon commercialization and we are obligated to share the costs of certain development expenses.  

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.  

Capital Resources 

At December 31, 2020, we had cash and investments of approximately $140.3 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 continue to be successful in commercializing Firdapse® or will continue to be profitable. Further, 

6

there can be no assurance that if we need additional funding in the future, whether such funding will be available to us. 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:  

•  Commercialize Firdapse® for the treatment of LEMS and other potential neuromuscular diseases and improve disease 

awareness. We are currently commercializing Firdapse® in the United States and Canada. A cornerstone of our strategy 
is our continuing development of Catalyst Pathways™, 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. We also hope to develop Firdapse® for the treatment of 
other neuromuscular diseases.  

• 

• 

Seek to develop a long-acting formulation for Firdapse®. We are currently developing a Firdapse® long-acting 
formulation that we hope will provide meaningful patient benefits for patients with LEMS and other neuromuscular 
indications.  

Seek to acquire additional products. While we continue to focus on evaluating Firdapse® for the treatment of other 
neuromuscular indications, we have expanded our strategic focus to include acquiring or in-licensing innovative 
technology platforms and earlier stage programs in other therapeutic categories outside of neuromuscular diseases. To 
accomplish these new priorities, we are prepared to invest more heavily in research and development, including 
acquiring earlier stage opportunities and innovative technology. We believe that this strategic expansion will better 
position us to build out a broader more diversified portfolio of drug candidates that we expect will add greater value to 
the company over the near and long-term. However, no products have been acquired to date.  

• 

Seek approval for Firdapse® in Japan. We are currently taking steps to seek approval for Firdapse® in Japan.  

Firdapse® Product Overview 

Firdapse® is Catalyst’s registered trade name in the United States 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 

7

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. 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.  

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.  

Hereditary Neuropathy with Liability to Pressure Palsies 

Hereditary Neuropathy with liability to Pressure Palsies (HNPP) is a disorder that affects peripheral nerves. These nerves connect the 
brain and spinal cord to muscles and sensory cells that detect touch, pain, and temperature. In people with this disorder, the peripheral 
nerves are unusually sensitive to pressure, such as the pressure that occurs when carrying heavy grocery bags, leaning on an elbow, or 
sitting without changing position, particularly with crossed legs. These activities would not normally cause sensation problems in 
people without the disorder.  

Hereditary neuropathy with liability to pressure palsies is characterized by recurrent episodes of numbness, tingling, and loss of 
muscle function (palsy) in the region associated with the affected nerve, usually an arm, hand, leg, or foot. An episode can last from 
several minutes to several months, but recovery is usually complete. Repeated incidents, however, can cause permanent muscle 
weakness or loss of sensation. This disorder is also associated with pain in the limbs, especially the hands.  

A pressure palsy episode results from pressure on a single nerve, and any peripheral nerve can be affected. Although episodes often 
recur, they can affect different nerves. The most common problem sites involve nerves in the wrists, elbows, and knees. The fingers, 
shoulders, hands, feet, and scalp can also be affected. Many people with this disorder experience carpal tunnel syndrome, which 
occurs when a nerve in the wrist (the median nerve) is involved. Carpal tunnel syndrome is characterized by numbness, tingling, and 
weakness in the hand and fingers. An episode in the hand may affect fine motor activities such as writing, opening jars, and fastening 
buttons. An episode of nerve compression in the knee can lead to a condition called foot drop, which makes walking, climbing stairs, 
or driving difficult or impossible.  

The symptoms of HNPP usually begin during adolescence or early adulthood but may develop anytime from childhood to late 
adulthood. Symptoms vary in severity; many people never realize they have the disorder, while some people experience prolonged 
disability. HNPP does not affect life expectancy. Based on currently available data, we estimate the prevalence of HNPP in the United 
States to be between 2,300 and 5,200 patients.  

There is currently no standard medical treatment for HNPP. Management generally involves strategies to avoid or modify positions 
(such as leaning on the elbows) and activities that cause symptoms, and using splints or pads on the wrists or arms to avoid pressure 
on the nerves. An ankle-foot orthosis may be needed permanently for those with a residual foot drop. Management of pain may 
include over-the-counter pain medicines and/or prescription drugs used for peripheral neuropathy.  

License Agreement for Firdapse®

On October 26, 2012, we licensed the exclusive North American rights to Firdapse® pursuant to a License Agreement (the “License 
Agreement”) between us and BioMarin Pharmaceutical Inc. (‘BioMarin”). Under the License Agreement, we make the following 
royalty payments on our net sales of Firdapse®:  

•  Royalties to the licensor 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  

•  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 for the duration of any pending or issued patents or regulatory exclusivity within a territory and 
3.5% for territories in any calendar year in territories without pending or issued patents or regulatory exclusivity.  

On May 29, 2019, we entered into an amendment to our License Agreement. Under the amendment, we expanded our commercial 
territory for Firdapse®, which originally was comprised of North America, to include Japan. Additionally, we have an option to further 
expand our territory under the License Agreement to include most of Asia, as well as Central and South America, upon the 
achievement of certain milestones in Japan. Under the amendment, we will pay royalties on net sales in Japan of a similar percentage 
to the royalties that we are currently paying under our original License Agreement for North America.  

In January 2020, we were advised that BioMarin had sold certain rights under the License Agreement to SERB SA.  

We believe that we remain in compliance with our obligations under the License Agreement.  

9

Clinical trials supporting our NDA for Firdapse® for LEMS and approval of our NDA 

We conducted two successful Phase 3 double-blind, placebo controlled clinical trials evaluating Firdapse® for the treatment of LEMS. 
The results of the first trial published in 2016 in Muscle & Nerve (Muscle Nerve, 2016, 53(5):717-725). The results of the second trial 
were published in March 2019 in the Journal of Clinical Neuromuscular Disease (J. Clin Neuromusc Dis 2019; 20:111-119).  

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.  

Required Post-Approval Studies 

As part of the 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 have submitted the final protocol and begun screening patients for this trial. We have also established a 
pregnancy surveillance program to collect and analyze information for a minimum of ten (10) years on pregnancy complications and 
birth outcomes related to Firdapse®. Finally, the FDA required us to perform a second carcinogenicity study of amifampridine 
phosphate in mice, which we expect to complete on a timely basis.  

Expanded access program 

We continue to operate an expanded access program (EAP) that is currently making Firdapse® available to certain patients diagnosed 
with CMS or Downbeat Nystagmus (DN). While we are no longer seeking an indication for Firdapse® for the treatment of CMS and 
have closed enrollment in the EAP to new CMS and DN patients, we are currently providing Firdapse® to those patients who were 
previously enrolled in our EAP.  

Prior to the approval of our NDA for Firdapse® for LEMS, adult LEMS patients were also eligible to participate in our EAP program. 
We have since migrated the adult LEMS patients previously in our EAP to Catalyst Pathways™ and to commercial Firdapse®.  

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 were part of the field force targeted 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 utilized 
field force Patient Access Liaisons who work with the patients and provider offices to help navigate the insurance landscape, as well 
as National Account Managers who work 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 help 
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, MuSK antibody positive myasthenia gravis, and other neuromuscular diseases that may be treatable with Firdapse®, and 
to provide education for the physicians who treat these rare diseases and the patients they treat.  

In early 2020, we expanded our field sales group by almost one hundred percent and established a partnership with an experienced 
inside sales agency generating leads through telemarketing to targeted physicians. Through this expansion of our sales team, we are 
working to expand our sales efforts beyond the neuromuscular specialists who regularly treat LEMS patients to reach roughly 9,000 
neurology and neuromuscular healthcare providers that might be treating an adult LEMS patient who can benefit from Firdapse®. We 
also make available a no-cost LEMS voltage gated calcium channel (VGCC) antibody testing program for physicians who suspect 
their patient may have LEMS and wish to reach a definitive diagnosis.  

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. 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 

10

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 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 have begun 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.  

Access to Firdapse®

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 their medication for financial reasons.  

To date, Firdapse has been widely covered and reimbursed by private and public payors for the indicated small population of adult 
LEMS patients.  

FDA approval of Ruzurgi® for pediatric LEMS patients (ages 6 to under 17) 

In May 2019, the FDA approved an NDA for Ruzurgi®, Jacobus Pharmaceuticals’ version of amifampridine (3,4-DAP), for the 
treatment of pediatric LEMS patients (ages 6 to under 17). We believe that the vast majority of Ruzurgi® sales are to adult LEMS 
patients who are being prescribed the drug off label. If Jacobus is able to successfully sell Ruzurgi® off-label to additional adult LEMS 
patients, it could have a material adverse effect on our business, financial condition and results of operations.  

We believe that the FDA’s approval of Ruzurgi® violated our statutory rights and was in multiple other respects arbitrary, capricious 
and contrary to law. As a result, in June 2019 we filed suit against the FDA and several related parties challenging this approval and 
related drug labeling. Jacobus later intervened in the case. Our complaint, which was filed in the federal district court for the Southern 
District of Florida, alleged that the FDA’s approval of Ruzurgi® violated multiple provisions of FDA regulations regarding labeling, 
resulting in misbranding in violation of the Federal Food, Drug, and Cosmetic Act (FDCA); violated our statutory rights to Orphan 
Drug Exclusivity and New Chemical Entity Exclusivity under the FDCA; and was in multiple other respects arbitrary, capricious, and 
contrary to law, in violation of the Administrative Procedure Act. Among other remedies, the suit seeks an order vacating the FDA’s 
approval of Ruzurgi®.  

On July 30, 2020, the Magistrate Judge considering this lawsuit filed a Report and Recommendation in which she recommended to the 
District Judge handling the case that she grant the FDA’s and Jacobus’ motions for summary judgment and deny our motion for 
summary judgment. On September 29, 2020, the District Judge adopted the Report and Recommendation of the Magistrate Judge, 
granted the FDA’s and Jacobus’ motions for summary judgment, and dismissed our case.  

We believe that the District Judge’s decision is incorrect as a matter of law and contrary to the plain language of the Orphan Drug Act. 
We believe that if the District Judge’s decision to grant summary judgment is correct on the law, it means that the FDA has the 
authority to effectively eliminate the benefits of exclusivity under the Orphan Drug Act, which we believe will chill the incentive for 
drug companies to spend the millions of dollars necessary to develop an orphan drug. As a result, we have appealed the decision to the 
Eleventh Circuit Court of Appeals. There can be no assurance of the result of such proceeding.  

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, our experience has been that securing coverage and appropriate reimbursement from 
third-party payors requires 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 

11

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 continue to cover our product, and if so, at what level of 
reimbursement. Further, there can be no assurance as to whether payors will in the future require that patients try Ruzurgi® before they 
are treated with Firdapse®. In that regard, we have advised payors that we will provide free medication to support titration and confirm 
patient therapeutic benefit. Further, when necessary, we provide patients with access to therapy at no charge while those patients are 
awaiting coverage decisions.  

Our efforts to develop Firdapse® as a treatment for additional neuromuscular indications 

The current status of our clinical trials evaluating Firdapse® for additional indications is as follows:  

MuSK-MG studies 

In February 2016, we initiated 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. 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 published in SAGE Open Medicine and can be accessed at 
https://journals.sagepub.com/doi/pdf/10.1177/2050312118819013.  

Subsequently, we engaged in a Phase 3 clinical trial (MSK-002) evaluating Firdapse® for the treatment of adults with MuSK-MG. Our 
trial was a multi-site, international (United States, Italy and Serbia), double-blind, placebo-controlled, clinical trial being conducted 
under a Special Protocol Assessment (SPA) with the FDA. The trial enrolled more than 60 MuSK antibody positive patients. It also 
enrolled more than 10 generalized myasthenia gravis patients who were assessed with the same clinical endpoints. However, 
achieving statistical significance in this subgroup of patients was not required.  

On August 10, 2020, we announced the top-line results from our Phase 3 clinical trial (MSK-002) evaluating Firdapse® for the 
treatment of adults with MuSK-MG. Unfortunately, the MSK-002 trial did not achieve statistical significance on its primary endpoint 
or its secondary endpoint, even though clinical improvement was observed by patients and investigators during the initial dose-
titration period of the trial and in the company’s previous proof-of-concept trial. However, we have recently concluded a detailed 
analysis of the data from this trial in an effort to understand why the MuSK-MG Phase 3 trial did not meet statistical significance on 
its endpoints. We found in our analysis that there was a large degree of symptom variability during the double-blind withdrawal 
period. We believe that sources of such variability can be addressed in a redesigned study that may better demonstrate the efficacy of 
our drug for the treatment of MuSK-MG.  

With respect to the MuSK-MG indication, we plan to present our hypotheses and a revised protocol to the FDA for discussion during 
the first half of 2021. However, there can be no assurance that the FDA will either grant a meeting, agree with our protocol design or, 
even if the study is successful, accept the results of a single study of a different trial design as sufficient evidence for approval of the 
MuSK-MG indication. While we prepare for the meeting with FDA, we also plan to evaluate new clinical trial sites and discuss the 
new trial design with investigators. After meeting with the FDA, we will determine whether or not to proceed with a new trial that 
incorporates the new trial design.  

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

Our exploratory study, SMA-001 (A Randomized Placebo Controlled Crossover Study to Evaluate the Safety and Efficacy of 
Amifampridine Phosphate in Ambulatory Patients with Spinal Muscular Atrophy (SMA) Type 3, met the primary endpoint of a 
statistically significant difference for the Hammersmith Functional Motor Scale Expanded (HFMSE). Clinically, however, the effect 
was modest. The secondary endpoints were not statistically significant, although several individual quality of life measures 
demonstrated a positive nominally statistically significant change. Key opinion leaders with whom we have spoken believed that 
Firdapse® needed to show a large clinically significant change if there was the possibility to affect disease progression through 
retrograde signaling from enhanced neuromuscular junction function. After considering all of these factors, we have concluded that 
the modest results exhibited in this study are unlikely to result in a sufficient modification of disease progression, and, particularly in 
light of the fact that there are now three approved disease modifying medications for SMA Type 3, we have decided not to pursue the 
SMA Type 3 indication further.  

12

HNPP proof-of-concept study 

We intend to conduct a proof-of-concept study evaluating Firdapse® as a treatment for Hereditary Neuropathy with Liability to 
Pressure Palsies (HNPP). The scientific basis for considering this indication is that leakage of neuron potassium channels is observed 
in HNPP. Firdapse is a potassium channel blocker and may mitigate the pathological effects of the potassium channel leakage in 
HNPP patients.  

HNPP is an autosomal-dominantly inherited peripheral nerve disease caused by a heterozygous deletion of PMP22 gene, leading to a 
reduction of PMP22 proteins by 35-50% of normal level, which results in disruption of the myelin sheaths of motor neuron axons. 
Patients with HNPP often present with focal sensory and motor deficits. The events may be triggered by mild mechanical 
compressions innocuous to healthy humans. In addition, HNPP patients are also afflicted by fatigue. We believe that HNPP affects 
about 6,000 patients in the Unites States. There can be no assurance of the results of this trial.  

Kennedy’s disease 

We had previously reported that we planned to evaluate Firdapse® as a treatment of Kennedy’s disease (spinal bulbar muscular 
atrophy). Previously, key opinion leaders had suggested to us that Firdapse® might be an effective treatment for the symptoms of 
Kennedy’s disease. However, given the results of the SMA Type 3 proof-of-concept study and the lack of a targeted mechanism of 
action for Firdapse® in Kennedy’s disease, we have determined not to pursue this indication further.  

Long-acting version of amifampridine phosphate 

We have been developing a long-acting formulation of amifampridine phosphate, and our development remains on track. A large 
number of candidate formulations were prepared, and three of the most promising formulations were evaluated in a pharmacokinetic 
(PK) study completed during the fourth quarter of 2020. The results from this first PK study will be used to inform the design and 
refinement of future product formulations in 2021, and additional PK work is also expected to be conducted during 2021. Catalyst has 
also completed a number of advisory board meetings with both patients and doctors in order to establish the optimum target 
characteristics of a long-acting formulation of amifampridine phosphate that are desired by the LEMS patient community and treating 
physicians.  

There can be no assurance that we will be able to successfully develop a long-acting formulation of amifampridine phosphate, that any 
such formulation will be approved by the FDA for marketing, or that any such formulation will be commercially viable.  

Intellectual property and regulatory exclusivity protections for Firdapse®

All of our patent rights for Firdapse® are derived from our license agreement. In August 2020, the United States Patent and Trademark 
Office (USPTO) allowed a patent (the ’893 patent) to our licensor and thereby to us, and the patent issued on October 6, 2020. The 
patent is directed to the use of suitable doses of amifampridine to treat patients, regardless of the therapeutic indication, that are slow 
metabolizers of amifampridine. Any drug product containing amifampridine with a label that states the patented dosing regimens and 
doses in the Dosing and Administration section prior to April 7, 2034, the expiration date of the patent, could possibly infringe this 
patent. Generic drug product labels would necessarily have to do this, and we intend to take all appropriate actions to protect our 
intellectual property.  

In that regard, in October 2020, we filed a lawsuit in the U.S. District Court for New Jersey against Jacobus and a lawsuit in the U.S. 
District Court for the Western District of Pennsylvania against the specialty pharmacy marketing Ruzurgi®, PantherRx Rare LLC 
(PantherRx), for infringement of the ‘893 Patent. The suits have since been combined in the U.S. District Court for New Jersey. The 
lawsuit arises from Jacobus’ and PantherRx’s sales and marketing of Ruzurgi® (amifampridine, 10 mg). The lawsuit alleges that the 
Ruzurgi® product infringes the ‘893 patent when administered in accordance with its product labeling. The lawsuit seeks damages and 
injunctive relief to prevent further marketing of Ruzurgi® in violation of our patent rights.  

We are also pursuing additional patent applications for Firdapse® in an effort to further protect our drug product. There can be no 
assurance that any additional patents will be issued which provide additional intellectual property protection for our drug product.  

Further, there can be no assurance that we do not or will not infringe on patents held by third parties or that third parties in the future 
will not claim that we have infringed on their patents. In the event that our products or 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. For example, there may be patents or patent applications held by 
others that contain claims that our products or operations might be determined to infringe or that may be broader than we believe them 
to be. Given the complexities and uncertainties of patent laws, there can be no assurance as to the impact that future patent claims 
against us may have on our business, financial condition, results of operations, or prospects.  

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Until Firdapse® was approved in November 2018, no drug product containing amifampridine for any indication had been approved by 
the FDA such that we received five-year “new chemical entity” exclusivity from the FDA. New chemical entity exclusivity provides a 
five-year period of marketing exclusivity for all indications and in the absence of an Orange Book listed patent, precludes a generic 
from submitting an abbreviated new drug application (ANDA) until that five year period has expired. Further, when Firdapse® was 
approved for the treatment of LEMS patients, we received seven-year orphan drug exclusivity for our product for the treatment of 
LEMS.  

In light of the FDA’s decision to approve Ruzurgi®, the scope and protections afforded by the exclusivities that we received upon the 
approval of our product remain unclear, and our suit against the FDA seeking to undo the approval of Ruzurgi® is our attempt to undo 
what we believe was a violation of our statutory right to exclude others from the market. There can be no assurance that we will be 
successful in those efforts.  

We have licensed the Firdapse® trademark, 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. Our ability to protect and use 
our intellectual property rights and regulatory exclusivity in the future development and commercialization of our products, operate 
without infringing the proprietary rights of others, and prevent others from infringing our proprietary rights, is crucial to our future 
success. See Item 1A. “Risk Factors - Risks Related to Our Intellectual Property.”  

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. 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.  

On December 18, 2018, we entered into 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, in December 2018, we received an up-front payment of 
$500,000. We will be entitled to receive a milestone payment of $2.0 million on the commercial launch of the product. Further, we 
will receive 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.  

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 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 new drug application (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.  

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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.  

Before the approval of Firdapse®, LEMS was generally 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.  

In May 2019, we became aware that the FDA had approved an NDA for Jacobus Pharmaceuticals for Ruzurgi®, their version of 
amifampridine (3,4-DAP) for the treatment of pediatric LEMS patients (ages 6 to under 17). While we have filed suit against the FDA 
to vacate their approval of Ruzurgi®, there can be no assurance as to the outcome of this lawsuit or as to the impact of the approval of 
Ruzurgi® on our business, financial condition or results of operations.  

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 lawfully compounded by a pharmacist or 
physician for an individual patient may be entitled to exemptions from three key provisions of the FDCA: (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).  

To qualify for these statutory exemptions, a compounded drug product must satisfy several legal requirements. One of these 
requirements restricts the universe of bulk drug substances that a compounder may use. Specifically, 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 “Section 503A bulk substances list 1”). While 
the advertising provisions in Section 503A were ruled unconstitutional in part in the United States by the Supreme Court in 2002, the 
FDA, since 2013, has aggressively regulated and exercised oversight over the practice of pharmacy compounding following the 
compounding incident at the New England Compounding Center in Massachusetts that 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 (i.e., the Section 503B bulk substances list 1”).  

While the FDA has been aggressively enforcing Section 503A since its re-enactment, compounders may still compound “near copies” 
(but not “essentially 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, 

15

against a compounder that compounds less than four “essentially copies” of a commercially available drug product in a calendar 
month.  

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 $195 million in 2018 and $123 million in 2019. 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 depends in large part upon:  

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• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

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;  

the willingness of payors to reimburse for our product;  

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:  

• 

• 

• 

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;  

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• 

• 

• 

• 

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.  

The testing and approval process requires substantial time, effort and financial resources, and the receipt and timing of any approval is 
uncertain.  

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:  

• 

• 

• 

• 

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

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

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

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

17

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 filing it. The FDA may request additional 
information rather than file an NDA. In this event, the NDA must be resubmitted with the additional information. The resubmitted 
application also is subject to review before the FDA files it. Once the submission is filed, 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 2021 this fee is 
$2,875,842), 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 2021 is $336,432 per prescription drug product. User fees typically 
increase annually. The approval process is lengthy and difficult, and the FDA may refuse to approve an NDA if the applicable 
regulatory criteria are not satisfied or may require additional clinical or other data and information. Even if such data and information 
is submitted, the FDA may ultimately decide that the NDA does not satisfy the criteria for approval. The FDA may also refer 
applications for novel drug products or drug products which present difficult questions of safety or efficacy to an advisory committee, 
typically a panel that includes clinicians and other experts, for review, evaluation and a recommendation as to whether the application 
should be approved. The FDA is not bound by the recommendation of an advisory committee. The FDA reviews an NDA to 
determine, among other things, whether a product is safe and effective for its intended use. Before approving an NDA, the FDA will 
inspect the facility or facilities where the product is manufactured to determine whether its manufacturing is cGMP–compliant to 
assure and preserve the product’s identity, strength, quality, purity and stability.  

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

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 

A 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 a 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.  

A 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, a SPA agreement does not indicate FDA concurrence on every protocol detail. Further, the 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 the FDA or the scientific community recognizes a paradigm shift in 

18

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 a 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.  

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.  

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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) 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, 

20

lasts for 180 days, during which the FDA cannot grant final approval to other ANDA sponsors of an application for a generic 
equivalent to the same reference drug. Under certain circumstances, eligibility for 180-day exclusivity may be forfeited.  

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

There are also user fees for ANDA applicants, sponsors, and manufacturers. For fiscal year 2021, the application fees are $196,868 
per ANDA application and the facility fees are $184,022 per domestic finished dosage form facility, $199,022 per foreign finished 
dosage form facility, $41,671 per domestic active pharmaceutical ingredient facility, and $56,671 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 (though they decreased slightly for the 2020 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 revise the Affordable Care Act and replace it with another law. 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:  

• 

controls on government-funded reimbursement for drugs;  

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• 

• 

• 

• 

• 

• 

• 

mandatory rebates or additional charges to manufacturers for their products to be covered on Medicare Part D 
formularies;  

controls on healthcare providers;  

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, and from members of Congress in both parties. Some members of the medical community and Senator Bernie Sanders 
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 disease or 
condition 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, and a recent proposed change to the ODA would limit the availability of the 
benefits of the act for drugs that treat more than 200,000 individuals in the United States. 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 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.  

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

Breakthrough Therapy Designation 

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

• 

• 

• 

• 

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

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

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

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

• 

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

Fast Track Designation and Accelerated Approval 

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

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

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

23

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 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. Beginning in 2022, applicable 
manufacturers also will be required to report such information regarding their relationships with physician assistants, nurse 
practitioners, clinical nurse specialists, certified registered nurse anesthetists, anesthesiologist assistants and certified nurse midwives 
during the previous year.  

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In addition, several states now require prescription drug companies to report expenses relating to the marketing and promotion of drug 
products, to report gifts and payments to individual physicians in these states and to report certain pricing information, including price 
increases. 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. The DSCSA 
requires product identifiers (i.e., serialization) on prescription drug products in order to eventually establish an electronic interoperable 
prescription product to system to identify and trace certain prescription drugs distributed in the United States and preempts existing 
state drug pedigree laws and regulations on this topic. The DSCSA also establishes new requirements for the licensing of wholesale 
distributors and third-party logistic providers, although FDA regulations addressing wholesale distributors and third party logistics 
providers have not yet been promulgated. We serialize our product at both the package and homogeneous case level, pass serialization 
and required transaction information to our customers, and believe that we comply with all such requirements.  

Our Employees 

As of March 11, 2021, we had 74 employees, approximately 35 of whom are in our commercial organization, approximately 25 of 
whom are in our R&D organization, and the rest of whom are in our G&A organization. We also utilize the services of several 
consultants. None of our employees are covered by a collective bargaining agreement. We believe our relationship with our employees 
and consultants is good.  

Our goal in selecting employees is to retain high quality personnel with substantial prior experience who understand and support our 
mission as a company to develop and commercialize innovative therapies for people with rare, debilitating, chronic neuromuscular 
and neurological diseases and who are willing to work hard and in a collaborative manner to further that mission.  

Available Information 

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

Item 1A. 

Risk Factors 

Risk Factors Summary 

We are providing the following summary of the risk factors contained in our Form 10-K to enhance the readability and accessibility of 
our risk factor disclosures. We encourage our stockholders to carefully review the full risk factors contained in this Form 10-K in 
their entirety for additional information regarding the risks and uncertainties that could cause our actual results to vary materially 
from our recent results or from our anticipated future results. 

Risks related to the commercialization of Firdapse®

•  We depend substantially on the commercial success of Firdapse®.  

• 

• 

Our business may in the future require additional capital.  

Our success depends on our ability to continue to successfully commercialize Firdapse®. We are primarily a single 
product company with limited commercial experience, which makes it difficult to evaluate our current business, predict 
our future prospects and forecast our financial performance and growth.  

•  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.  

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• 

• 

• 

Our business is subject to substantial competition.  

Our recently adopted strategy of seeking to acquire or in-license innovative technical platforms or earlier stage drug 
development programs outside of the neuromuscular disease space may not be successful.  

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

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

• 

The ongoing COVID-19 pandemic and the worldwide attempts to contain it could harm our business and results of 
operations and financial condition and could be adversely impacted by it.  

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

• 

Business or economic disruptions or global health concerns could seriously harm our development efforts and increase 
our costs and expenses.  

Risks Related to the Development of Additional Indications for Firdapse®

• 

• 

Our efforts may fail.  

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

•  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 will need to continue to develop and maintain distribution and production capabilities or relationships to be 

successful.  

• 

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

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

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

• 

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.  

•  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.  

• 

• 

• 

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.  

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

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.  

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.  

•  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.  

• 

• 

• 

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.  

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

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.  

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• 

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.  

•  We cannot guarantee that the design of, or data collected from, that trial or any of our clinical trials conducted under a 

Special Protocol Assessment (SPA) will be sufficient to support filing or approval of an NDA.  

• 

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.  

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.  

• 

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

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

property rights.  

There are also general risk factors relating to us that you should consider that relate to our business and to our common stock.  

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®. 

Until we launched Firdapse® for the treatment of LEMS in January 2019, we 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. 
While we reported net income of $75.0 million for fiscal 2020 and $31.9 million for fiscal 2019, we have a prior history of operating 
losses in all prior fiscal years of our existence. There can be no assurance that we will remain profitable.  

Our business may in the future 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.  

27

Our success depends on our ability to continue to successfully commercialize Firdapse®. We are primarily a single product 
company with only limited commercial 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. Until we 
launched Firdapse®, we had never launched or commercialized a product, and there is no guarantee that we will be able to continue to 
be profitable based on our sales of Firdapse®. There are numerous examples of unsuccessful product launches and failures to meet 
high expectations of market growth 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®, or if patients discontinue from use of the medication at rates that are higher than we expect, or if payers 
decide not to reimburse for our product, the commercial potential of Firdapse® will be limited. Thus, significant uncertainty remains 
regarding the ultimate commercial potential of Firdapse®.  

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

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compete successfully with Ruzurgi®, Jacobus Pharmaceuticals’ version of amifampridine;  

be successful in our suit against the FDA seeking to maintain our exclusivity under the Orphan Drug Act for treating 
LEMS patients;  

educate patients and physicians successfully about efficacy expectations, side effects expectations, and how to 
successfully dose and titrate the medication to optimal patient benefit in order to minimize discontinuation due to 
perceived lack of efficacy or side effects;  

achieve and maintain compliance with regulatory requirements, including those related to our required post-approval 
studies, 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, support, and retain a qualified field sales and marketing force;  

secure continued 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 (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™ program in helping patients obtain access to Firdapse® at an 
acceptable patient out-of-pocket cost;  

maintain quality relationships with patient advocacy groups;  

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

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

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.  

28

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

Our strategy is to continue 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®, 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 continue to have 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.  

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

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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, as 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 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.  

Even with the FDA approval of Firdapse®, the bulk active pharmaceutical ingredient in the drug (i.e., amifampridine) may be used by 
compounding pharmacies pursuant to Section 503A of the Federal Food, Drug, and Cosmetic Act because the ingredient is a 
component of an FDA-approved drug product, and pharmacies may lawfully compound for individually identified patients under 
Section 503A 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.  

29

Our recently adopted strategy of seeking to acquire or in-license innovative technical platforms or earlier stage drug development 
programs outside of the neuromuscular disease space may not be successful. 

On January 6, 2021, we announced an expansion in our strategic focus to include acquiring or in-licensing innovative technology 
platforms and earlier stage programs in other therapeutic categories outside of neuromuscular diseases. We are evaluating 
opportunities to in-license or acquire products, product candidates and technologies on a selective and targeted basis. Our business 
development efforts may fail to result in our acquiring rights to additional products, product candidates or technologies, or may result 
in our consummating transactions with which you do not agree.  

The process of proposing, negotiating and implementing a license or acquisition of a product candidate is lengthy and complex, and 
we may be unable to in-license or acquire the rights to any such products, product candidates or technologies from third parties for 
several reasons. The success of this strategy depends partly upon our ability to identify, select and acquire or in-license promising 
product candidates and technologies.  

The in-licensing and acquisition of pharmaceutical products is an area characterized by intense competition, and a number of 
companies (both more established and early stage biotechnology companies) are also pursuing strategies to in-license or acquire 
product candidates or technologies that we may consider attractive. We believe that other companies may be particularly active in 
pursuing opportunities to in-license or acquire the same or similar products which we may seek to acquire. More established 
companies may have a competitive advantage over us due to their size, cash resources and greater research, preclinical or clinical 
development or commercialization capabilities, while earlier stage companies may be more aggressive or have a higher risk tolerance. 
In addition, companies that perceive us to be a competitor may be unwilling to assign or license rights to us. We also may be unable to 
in-license or acquire the rights to the relevant product candidate or technology on terms that would allow us to make an appropriate 
return on our investment. Moreover, we may devote resources to potential acquisitions or in-licensing opportunities that are never 
completed, or we may fail to realize the anticipated benefits of such efforts or we may incorrectly judge the value of an acquired or in-
licensed product candidate or technology.  

If we are unable to successfully obtain rights to suitable product candidates or technologies, our business, financial condition and 
prospects for growth could suffer. In addition, acquisitions and in-licensing arrangements for product candidates and technologies are 
inherently risky, and ultimately, if we do not complete an announced acquisition or license transaction or integrate an acquired or 
licensed product candidate or technology successfully and in a timely manner, we may not realize the benefits of the acquisition or 
license to the extent anticipated and the perception of the effectiveness of our management team and our company may suffer in the 
marketplace. In addition, even if we are able to successfully identify, negotiate and execute one or more transactions to acquire or in-
license new product candidates or technologies, our expenses and short-term costs may increase materially and adversely affect our 
liquidity.  

In addition, acquisitions and in-licenses may entail numerous operational, financial and legal risks, including:  

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exposure to known and unknown liabilities, including possible intellectual property infringement claims, violations of laws, tax 
liabilities and commercial disputes;  

incurrence of substantial debt, dilutive issuances of securities or depletion of cash to pay for acquisitions;  

higher than expected acquisition and integration costs;  

difficulty in combining the operations and personnel of any acquired businesses with our operations and personnel;  

inability to maintain uniform standards, controls, procedures and policies;  

restructuring charges related to eliminating redundancies or disposing of assets as part of any such combination;  

large write-offs and difficulties in assessing the relative percentages of in-process research and development expense that can be 
immediately written off as compared to the amount that must be amortized over the appropriate life of the asset;  

increased amortization expenses or, in the event that we write down the value of acquired assets, impairment losses;  

potential failure of the due diligence process to identify significant problems, liabilities or other shortcomings or challenges of 
an acquired or licensed product candidate or technology, including problems, liabilities or other shortcomings or challenges with 
respect to intellectual property, product quality, revenue recognition or other accounting practices, partner disputes or issues and 
other legal and financial contingencies and known and unknown liabilities; and  

entry into therapeutic modalities, indications or markets in which we have no or limited direct prior development or commercial 
experience and where competitors in such markets have stronger market positions.  

30

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.  

The ongoing COVID-19 pandemic and the worldwide attempts to contain it could harm our business and results of operations and 
financial condition and could be adversely impacted by it. 

The ongoing global outbreak of the coronavirus COVID-19, and the various attempts throughout the world to contain it, have created 
significant volatility, uncertainty and disruption. The COVID-19 pandemic has had, and may continue to have, significant effects on 
our operations. There can be no assurance as to whether and how long these effects will last and whether following the pandemic 
whatever trends have occurred will not remain in place and continue to affect our business.  

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.  

Business or economic disruptions or global health concerns could seriously harm our development efforts and increase our costs 
and expenses. 

Broad-based business or economic disruptions could adversely affect our ongoing or planned research and development activities. 
Global health concerns, such as the COVID-19 pandemic, could also result in social, economic, and labor instability in the countries in 
which we or the third parties with whom we engage operate. We cannot presently predict the scope and severity of any potential 
business shutdowns or disruptions, but if we or any of the third parties with whom we engage, including the suppliers, clinical trial 
sites, regulators and other third parties with whom we conduct business, were to experience shutdowns or other business disruptions, 
our ability to conduct our business in the manner and on the timelines presently planned could be materially and negatively impacted. 
It is also possible that global health concerns such as the COVID-19 pandemic could disproportionately impact the hospitals and 
clinical sites in which we conduct any of our clinical trials, which could have a material adverse effect on our business and our results 
of operation and financial condition.  

31

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:  

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

Firdapse® may not be economical to market or take substantially longer to obtain necessary 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 Firdapse® for the 
treatment of CMS, MuSK-MG and SMA Type 3. However, Firdapse® failed to meet the primary endpoints in a Phase 3 trial for CMS 
and we are no longer pursing this indication. Further, and even though we achieved statistical significance in the primary endpoint in 
our proof-of-concept trial for SMA Type 3 the lack of robust results in this trial has caused us to decide to no longer pursue this 
indication. Finally, our Phase 3 clinical trial (MSK-002) evaluating Firdapse® for the treatment of adults with MuSK-MG did not 
achieve statistical significance on its primary endpoint or its secondary endpoint even though clinical improvement was observed by 
patients and investigators during the initial dose-titration period of the trial and in the company’s previous proof-of-concept trial. We 
plan to redesign a Phase 3 study that may better demonstrate the efficacy of our drug for the treatment of MuSK-MG and discuss it 
with FDA during the first half of 2021. However, there can be no assurance that the FDA will either grant a meeting, agree with our 
protocol design or, even if the study is successful, accept the results of a single study of a different trial design as sufficient evidence 
for approval of the MuSK-MG indication.  

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:  

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

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

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

we may have to suspend or terminate one or more of our clinical trials if we, regulators, or IRBs determine that the 
participants are being subjected to unreasonable health risks;  

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

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

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

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

32

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 continue to develop and maintain 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, or epidemic, 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.  

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 

33

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. 

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 continue to 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 continue to successfully commercialize 
Firdapse®. Even if coverage is provided, the approved reimbursement amount may not be high enough to establish and maintain 
pricing sufficient to realize a meaningful return on our investment.  

Our ability to commercialize Firdapse® or any other product candidate will depend in large part on the extent to which coverage and 
reimbursement for these products and related treatments will be available from government health administration authorities, private 
health insurers and other organizations. Government authorities and third-party payors, such as private health insurers and health 
maintenance organizations, decide which medications they will cover and establish reimbursement levels. The healthcare industry is 
acutely focused on cost containment, both in the United States and elsewhere. Government authorities and third-party payors have 
attempted to control costs by limiting coverage and the amount of reimbursement for particular medications, which could affect our 
ability to sell our product 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.  

34

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. Former President Trump frequently discussed his intention to reduce drug prices, as has President Biden. 
The former Administration solicited public comment on a variety of regulatory proposals to reduce drug prices, and the Department of 
Health and Human Services (HHS) published an interim final rule that establishes a Most Favored Nation (MFN) Model for Medicare 
Part B drug payment. This regulation would substantially change the drug reimbursement landscape as it bases Medicare Part B 
payment for 50 selected drugs on prices in foreign countries instead of average sales price, or ASP. The MFN drug payment amount is 
expected to be lower than the current ASP-based payment limit because U.S. drug prices are generally the highest in the world. 
Although the MFN Model payment methodology was scheduled to begin on January 1, 2021, it faces uncertain prospects for 
implementation. By the end of December 2020, three federal courts had granted orders preventing implementation of the MFN Model 
rule. The likelihood of implementation of any of the former Administration reform initiatives is uncertain, particularly in light of the 
recent change in administration on January 20, 2021 and the new administration’s silence to date on these issues. 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 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 responded to Senator Sanders, who issued a public statement in response asking then-FDA Commissioner Scott 
Gottlieb to allow pharmacies and manufacturers who were previously making this drug to be permitted to resume providing it.  

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 a number of 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 other 
patients, to the FDA, and to politicians. We cannot assess the impact of these activities on our business.  

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 not be able to maintain 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.  

35

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

We are exposed to the risk of fraud or other misconduct by our employees, sales agents or consultants. Misconduct could include 
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. Misconduct could also involve the improper use of information obtained in the 
course of clinical trials, which could result in regulatory sanctions and serious harm to our reputation. It is not always possible to 
identify and deter such misconduct, and the precautions we take to detect and prevent this activity may not be effective in controlling 
unknown or unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming 
from a failure to be in compliance with such laws or regulations. If any such actions are instituted against us, and we are not successful 
in defending ourselves or asserting our rights, those actions could have a significant impact on our business, including the imposition 
of significant fines or other sanctions.  

Risks Related to Government Regulation 

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 candidates 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 for such 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. Firdapse® 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 or other regulatory 
authorities request 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 candidates 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 or sNDA we may 
submit for Firdapse®.  

36

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. The availability of approved therapies can also make enrollment difficult. We compete for 
study and trial subjects with others conducting clinical trials testing other treatments for the indications we are studying for our drug 
candidates. Further, unrelated third parties and investigators in the academic community have in the past and we expect will continue 
in the future to test our drug candidates, 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 considerably 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:  

• 

• 

• 

• 

• 

• 

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 our required 
nonclinical and clinical post-marketing studies, and other clinical results which are reported after our drug candidates become 
commercially available approved drugs. As greater numbers of patients use a drug following its approval, side effects and other 
problems may be observed after approval that were not seen or anticipated during preapproval clinical studies and trials. In addition, 
the manufacturer, and the manufacturing facilities we use to make any approved drugs, will also be subject to periodic review and 

37

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 are 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 candidates 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 candidates 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, former 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 program (excluding orphan drugs), including the creation 
of new penalties for non-compliance and included a discount (now 70%, 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).  

Beginning in January 2017, former President Trump signed two Executive Orders and other directives designed to delay the 
implementation of certain provisions of the Health Care Reform Law or otherwise circumvent some of the requirements for health 
insurance mandated by the Health Care Reform Law. These actions include directing applicable federal agencies to waive, defer, grant 
exemptions from, or delay the implementation of any provision of the Health Care Reform Law that would impose a fiscal or 
regulatory burden on states, individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medical devices. 

38

On October 13, 2017, an Executive Order was signed terminating the cost sharing subsidies that reimburse insurers under the Health 
Care Reform Law. Several state Attorneys Generals filed suit to stop the administration from terminating the subsidies, but their 
request for a restraining order was denied by a federal judge in California on October 25, 2017. Further, on June 14, 2018 the United 
States Court of Appeals for the Federal Circuit ruled that the federal government was not required to pay more than $12.0 billion in 
Health Care Reform Law risk corridor payments to third-party payors. The effects of this gap in reimbursement on third-party payors, 
the viability of the Health Care Reform Law marketplace, providers, and our business, are not yet known. On December 18, 2019, the 
United States Court of Appeals for the Fifth Circuit ruled that the Health Care Reform Law’s individual mandate is unconstitutional 
but sent the matter back down to a district court to determine whether that provision can be removed from the rest of the Health Care 
Reform Law. On March 2, 2020, the U.S. Supreme Court agreed to review the Fifth Circuit’s ruling, and oral argument was heard on 
November 10, 2020, and a decision may not be made until June 2021. President Biden has made statements regarding changes to the 
Health Care Reform Law, including possibly revoking some or all of former President Trump’s executive orders. The likelihood of 
implementation of any of former President Trump’s reform initiatives is uncertain, particularly in light of the recent change in 
administration.  

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

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

39

We cannot guarantee that the design of, or data collected from, that trial or any of our clinical trials conducted under a Special 
Protocol Assessment (SPA) 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 study will be successful or, 
even if the study is successful, that the NDA will meet the standard for approval.  

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 drug 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:  

• 

• 

• 

• 

• 

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, 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 

40

• 

• 

• 

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 based on information collected during the prior year;  

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 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. In August 2020, the United States Patent and Trademark 
Office (USPTO) allowed U.S. Patent No. 10,793,893 (the ’893 patent) to our licensor and thereby to us, and the patent issued on 
October 6, 2020. The patent is directed to the use of suitable doses of amifampridine to treat patients, regardless of the therapeutic 
indication, that are slow metabolizers of amifampridine. Any drug product containing amifampridine with a label that states the 
patented dosing regimens and doses in the Dosing and Administration section prior to April 7, 2034, the expiration date of the patent, 
could possibly infringe this patent. Generic drug product labels would necessarily have to do this, and we intend to take all appropriate 
actions to protect our intellectual property.  

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 the licensor. If we violate or fail to perform any term or covenant of the License 
Agreement, the licensor 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 the licensor, 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.  

41

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 the ’893 patent is interpreted by a court, and unless and until our other pending applications 
are granted, we will not know the breadth of protection that they will afford us. Our pending applications, if granted, 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 any Firdapse® patents that ultimately grant so as to compete with us without infringing our 
patents. Although granted patents enjoy a presumption of validity, there is a risk that the ’893 patent and any patents resulting from 
our ongoing prosecution efforts 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.  

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

Further, there can be no assurance that we do not or will not infringe on patents held by third parties or that third parties in the future 
will not claim that we have infringed on their patents. In the event that our products or technologies infringe one or more patents or 
violate other proprietary rights of any third parties, we may be prevented from pursuing product development, manufacturing or 
commercializing any of our products using such technologies. For example, there may be patents or patent applications held by others 
that contain claims that our products or operations might be determined to infringe or that may be broader than we believe them to be. 
Given the complexities and uncertainties of patent laws, there can be no assurance as to the impact that future claims of infringement 
against us may have on our business, financial condition, results of operations, or prospects.  

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

• 

• 

• 

• 

we may be preliminarily enjoined from making, using, selling, or offering to sell our allegedly infringing product by a 
court of competent jurisdiction in advance of any formal infringement determination;  

we may be required to pay substantial financial damages if a court formally decides that our technologies infringe the 
third party’s patent(s). Damages can be tripled if the infringement is deemed willful;  

we may be required to discontinue or significantly delay developing, marketing, selling and licensing the allegedly 
infringing product(s) absent 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 need to redesign our product so that it does not infringe the third party’s patent rights, which may not be 
possible or could require substantial funds or time and require additional studies.  

In addition, our employees, consultants, contractors and others may knowingly or unknowingly 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 third parties 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. In that 
regard, on October 19, 2020, we announced that we have filed a lawsuit in the U.S. District Court for New Jersey against Jacobus and 
a lawsuit in the U.S. District Court for the Western District of Pennsylvania against the specialty pharmacy marketing Ruzurgi®, 
PantherRx Rare LLC (PantherRx), for infringement of the ‘893 Patent. The suits have since been combined in the U.S. District Court 
for New Jersey. The lawsuit arises from Jacobus’ and PantherRx’s sales and marketing of Ruzurgi® (amifampridine, 10 mg). The 
lawsuit alleges that the Ruzurgi® product infringes the ‘893 patent when administered in accordance with its product labeling. The 
lawsuit seeks damages and injunctive relief to prevent further marketing of Ruzurgi® in violation of our patent rights. Under our 
License Agreements, we are responsible for all costs relating to such potential litigation and we have the right to any proceeds 

42

received as a result of such litigation. However, even if we are successful in this or any other litigation we may file, there is no 
assurance we would be awarded any monetary damages.  

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

In addition, if third parties have filed patent applications or have issued patents claiming technology that is also claimed by us in any 
of our pending applications, we may be required to participate in interference or derivation proceedings with the third party at the 
United States Patent Office. We may also need to participate in proceedings outside the United States, such as an opposition at the 
European Patent Office, to determine whether or not a patent issued by the EPO was properly granted. 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.  

General Risk Factors Relating to our Common Stock 

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

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

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

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

status of regulatory requirements for approval of our drug candidates;  

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 Agreement for Firdapse®), 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 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.  

43

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

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

• 

• 

• 

• 

• 

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

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

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

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

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

On September 20, 2011, the board of directors approved the adoption of a stockholder rights plan (“Rights Plan”), which was 
amended on September 19, 2016 and further amended on August 28, 2019. The rights will expire on September 20, 2022, unless the 
rights are earlier redeemed or exchanged.  

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

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

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

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

As of March 11, 2021, we had 103,824,973 shares of our common stock outstanding, of which 7,234,820 shares were held by our 
officers and directors. We also had outstanding: (i) stock options to purchase an aggregate of 13,888,670 shares at exercise prices 
ranging from $0.79 to $6.63 per share (8,625,621 of which are currently exercisable); and (ii) restricted stock units for 235,671 shares 
of common stock (none of which are currently vested). Sales of shares, 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.  

44

Item 1B. 

Unresolved Staff Comments 

None.  

Item 2. 

Properties 

We currently operate our business in leased office space in Coral Gables, Florida. During 2020 we leased approximately 7,800 square 
feet of space for which we paid annual rent of approximately $330,000. During May 2020 we amended our office lease to increase our 
leased space to approximately 10,700 square feet. The amended lease commenced in early 2021 when construction of the asset was 
completed and the space became available for use. Consequently, we will record the effects of the amended lease in Q1 2021.  

Item 3. 

Legal Proceedings 

Ruzurgi®

We believe that the FDA’s approval of Ruzurgi® violated our statutory rights and was in multiple other respects arbitrary, capricious 
and contrary to law. As a result, in June 2019 we filed suit against the FDA and several related parties challenging this approval and 
related drug labeling. Our complaint, which was filed in the federal district court for the Southern District of Florida, alleged that the 
FDA’s approval of Ruzurgi® violated multiple provisions of FDA regulations regarding labeling, resulting in misbranding in violation 
of the Federal Food, Drug, and Cosmetic Act (FDCA); violated our statutory rights to Orphan Drug Exclusivity and New Chemical 
Entity Exclusivity under the FDCA; and was in multiple other respects arbitrary, capricious, and contrary to law, in violation of the 
Administrative Procedure Act. Among other remedies, the suit sought an order setting aside the FDA’s approval of Ruzurgi®.  

On July 30, 2020, the Magistrate Judge considering our lawsuit against the FDA filed a Report and Recommendation in which she 
recommended to the District Judge handling the case that she grant the FDA’s and Jacobus’ motions for summary judgment and deny 
our motion for summary judgment. On September 29, 2020, the District Judge adopted the Report and Recommendation of the 
Magistrate Judge, granted the FDA’s and Jacobus’ motions for summary judgment, and dismissed our case.  

We believe that the District Judge’s decision is incorrect as a matter of law and contrary to the plain language of the Orphan Drug Act. 
We believe that if the District Judge’s decision to grant summary judgment is correct on the law, it means that the FDA has the 
authority to effectively eliminate the benefits of exclusivity under the Orphan Drug Act, which we believe will chill the incentive for 
drug companies to spend the millions of dollars necessary to develop an orphan drug. As a result, we have appealed the decision to the 
Eleventh Circuit Court of Appeals. There can be no assurance of the result of such proceeding.  

On August 10, 2020, Health Canada issued a Notice of Compliance (NOC) to Medunik for Ruzurgi® for the treatment of LEMS. We 
have since initiated a legal proceeding in Canada seeking judicial review of Health Canada’s decision to issue the NOC for Ruzurgi®
as incorrect and unreasonable under Canadian law. Data protection, per Health Canada regulations, is supposed to prevent Health 
Canada from issuing a NOC to a drug that directly or indirectly references an innovative drug’s data, for eight years from the date of 
the innovative drug’s approval. The Ruzurgi® Product Monograph clearly references pivotal nonclinical carcinogenicity and 
reproductive toxicity data for amifampridine phosphate developed by us. As such, we believe that our data was relied upon to establish 
the nonclinical safety profile of Ruzurgi® needed to meet the standards of the Canadian Food and Drugs Act. There can be no 
assurance of the results of this proceeding.  

Patent Litigation 

All of our patent rights for Firdapse® are derived from our license agreement. In August 2020, the United States Patent and Trademark 
Office (USPTO) allowed U.S. Patent No. 10,793,893 (the ’893 patent) to our licensor and thereby to us, and the patent issued on 
October 6, 2020. The patent is directed to the use of suitable doses of amifampridine to treat patients, regardless of the therapeutic 
indication, that are slow metabolizers of amifampridine. Any drug product containing amifampridine with a label that states the 
patented dosing regimens and doses in the Dosing and Administration section prior to April 7, 2034, the expiration date of the patent, 
could possibly infringe this patent. Generic drug product labels would necessarily have to do this, and we intend to take all appropriate 
actions to protect our intellectual property.  

In that regard, on October 19, 2020, we announced that we have filed a lawsuit in the U.S. District Court for New Jersey against 
Jacobus and a lawsuit in the U.S. District Court for the Western District of Pennsylvania against the specialty pharmacy marketing 
Ruzurgi®, PantherRx Rare LLC (PantherRx), for infringement of the ‘893 Patent. The suits have since been combined in the U.S. 
District Court for New Jersey. The lawsuit arises from Jacobus’ and PantherRx’s sales and marketing of Ruzurgi® (amifampridine, 10 
mg). The lawsuit alleges that the Ruzurgi® product infringes the ‘893 patent when administered in accordance with its product 
labeling. The lawsuit seeks damages and injunctive relief to prevent further marketing of Ruzurgi® in violation of our patent rights.  

45

Other Litigation 

From time to time we may become involved in legal proceedings arising in the ordinary course of business. Other than as set forth 
above, 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.  

46

PART II 

Item 5. 

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 

Performance Graph 

The graph below matches Catalyst Pharmaceuticals, Inc.’s cumulative 5-Year total shareholder return on common stock with the 
cumulative total returns of the NASDAQ Composite index, the Russell MicroCap index, and the NASDAQ Biotechnology index. The 
graph tracks the performance of a $100 investment in our common stock and in each index (with the reinvestment of all dividends) 
from 12/31/2015 to 12/31/2020.  

*$100 invested on 12/31/15 in stock or index, including reinvestment of dividends.  
Fiscal year ending December 31.  

Copyright© 2021 Russell Investment Group. All rights reserved.  

Catalyst Pharmaceuticals, Inc. 
NASDAQ Composite 
Russell MicroCap 
NASDAQ Biotechnology 

12/16

12/19

12/17

12/18

12/15
 100.00    42.86   159.59    78.37   153.06   136.33 
 100.00   108.87   141.13   137.12   187.44   271.64 
 100.00   120.37   136.22   118.40   144.96   175.34 
 100.00    78.65    95.67    87.19   109.08   137.90 

12/20

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

47

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 11, 2021 was $3.77. As of March 11, 2021, there were 31 holders of record of our common stock, which includes custodians 
who hold our securities for the benefit of others.  

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.  

Securities Authorized for Issuance under Equity Compensation Plans 

The following table presents information as of December 31, 2020 with respect to compensation plans under which shares of our 
common stock may be issued.  

Plan Category

Equity compensation plans approved by 

security holders (1)

Equity compensation plans not approved by 

security holders

Total 

Equity Compensation Plan Information

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

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

Number of securities 
remaining available for 
equity compensation plans

13,393,669 $ 

—  

13,393,669 $ 

3.10   

—     
3.10   

1,856,008 (2)

—    
1,856,008  

Includes our 2014 Stock Incentive Plan and our 2018 Stock Incentive Plan  

(1) 
(2)  Remaining shares are only under our 2018 Stock Incentive Plan  

Sales of Unregistered Securities 

None.  

Issuer Purchases of Unregistered Securities 

None.      

Item 6. 

Selected Financial Data 

Not applicable.  

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 our 
consolidated financial statements and related notes appearing elsewhere in this report. 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 report. 

Introduction 

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

•  Overview. This section provides a general description of our business and information about our business that we believe 

is important in understanding our financial condition and results of operations.  

48

 
• 

Basis of Presentation. This section provides information about key accounting estimates and policies that we followed in 
preparing our consolidated financial statements for the 2020 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 three fiscal years presented in 
the accompanying consolidated statements of operations and comprehensive income (loss).  

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 diseases. We are currently focusing our efforts on products that treat diseases in the neuromuscular and 
neurological space, but we recently decided to expand our strategic focus to include acquiring or in-licensing innovative technology 
platforms and earlier stage programs in other rare disease therapeutic categories outside of these spaces. 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.  

Impact of the COVID-19 pandemic on our business 

The COVID-19 pandemic has resulted, and is expected to continue to result, in significant economic disruption, and has adversely 
affected and will likely continue to adversely affect our business. We are actively monitoring the situation and are taking those actions 
that may be required by federal, state or local authorities or that we determine are in the best interests of our patients, investigators, 
employees and stockholders.  

In March 2020, in light of worsening conditions as a result of the pandemic, we implemented a number of safety related initiatives 
among our employees, including a travel ban and a work from home policy for all employees. This included our customer-facing 
employees, who began working remotely and utilizing telephone and web-based technologies to provide support to patients and their 
healthcare providers. We believe that because many healthcare providers have delayed seeing new patients because of the pandemic, 
there has been a delay in the diagnosis of new LEMS patients and their initiating therapy, which has slowed our efforts to locate new 
patients who could benefit from our therapy. However, we believe that as more healthcare providers resume seeing new patients on a 
regular basis, that this aspect of the COVID-19 pandemic on our business will lessen.  

Our Firdapse® supply chain remains robust and thus far we have observed no disruptions in the production of Firdapse®. We reiterate 
that we are committed to providing patients with the ability to obtain an uninterrupted supply of Firdapse®, and we believe that we 
have an adequate supply of Firdapse® to address patients’ needs for the foreseeable future. Further, we are advised by our U.S. 
manufacturing partners that they have implemented contingency plans to remain in operation. We are committed to meeting our 
patients’ needs for Firdapse® and believe that our supply chain will continue to remain solid and uninterrupted through the COVID-19 
outbreak and beyond.  

Until such time as the COVID-19 pandemic is over, it will likely adversely impact the timetable of our ongoing and contemplated 
clinical trials and studies, and increase the costs of such trials and studies, consistent with the impact that the COVID-19 pandemic has 
had on many biopharmaceutical companies.  

Strategic Plan for 2021 and Beyond 

Our Board of Directors recently approved an expansion in our company’s strategic focus to include acquiring or in-licensing 
innovative technology platforms and earlier stage programs in other therapeutic categories outside of neuromuscular diseases. To 
accomplish these new priorities, we are prepared to invest more heavily in research and development, including acquiring earlier stage 
opportunities and innovative technology. We believe that this strategic expansion will better position our company to build out a 
broader more diversified portfolio of drug candidates that we believe will add greater value to our company over the near and long-
term. However, there can be no assurance that whatever product candidates or technology platforms we acquire, if any, will be 
successfully developed.  

49

To spearhead this investment, we have commenced a national search for a key executive to manage this more progressive strategy. 
This person will likely be an M.D. or Ph.D. with at least 15-20 years of relevant pharmaceutical experience and experience in 
developing innovative drug technology. This person will be responsible for portfolio expansion planning and developing medicines 
from discovery through marketing authorizations, as well as strategic leadership across all R&D activities including, direct oversight 
of science and clinical research.  

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

On November 28, 2018, we received approval from the FDA for Firdapse® 10 mg tablets for the treatment of adult LEMS patients 
(ages 17 and 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 at the time of approximately 20 field personnel, including sales 
(Regional Account Managers), patient assistance and insurance navigation support (Patient Access Liaisons), and payor 
reimbursement (National Account Managers). 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, Anti-MuSK antibody positive myasthenia gravis, or MuSK-
MG, and other neurological diseases, and to provide education for the physicians who treat these rare diseases and the patients they 
treat.  

In early 2020, we expanded our field sales group by almost one hundred percent and contracted with an experienced inside sales 
agency generating leads through telemarketing to targeted physicians. We made these changes to expand our sales efforts beyond the 
neuromuscular specialists who regularly treat LEMS patients to reach the roughly 9,000 neurology and neuromuscular healthcare 
providers that may be treating an adult LEMS patient who can benefit from Firdapse®. We also continue to make available at no-cost a 
LEMS voltage gated calcium channel (VGCC) antibody testing program for use by physicians who suspect that one of their patients 
may have LEMS and wish to reach a definitive diagnosis. Further, we are continuing to expand our digital and social media activities 
in order to introduce our product and services to potential patients and their healthcare providers.  

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. 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 adult LEMS 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 not more than $10.00 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 any U.S. LEMS patients in financial need. Subject to compliance with regulatory requirements, our goal is that no LEMS 
patient is ever denied access to their medication for financial reasons.  

In May 2019, the FDA approved a New Drug Application (NDA) for Ruzurgi®, another version of amifampridine (3,4-DAP), for the 
treatment of pediatric LEMS patients (ages 6 to under 17). While the NDA for Ruzurgi® only covers pediatric patients, we believe that 
Ruzurgi® is regularly being prescribed off label to adult LEMS patients. We believe that under applicable law, Jacobus is not 
permitted to market its amifampridine product to adult LEMS patients in the United States, and we are continuing to aggressively take 
all steps available to us to protect Firdapse’s® exclusivity under the Orphan Drug Act. There can be no assurance, however, that we 
will be able to stop the off-label prescribing of Ruzurgi® to adult LEMS patients. If Jacobus is able to successfully sell Ruzurgi® off-
label to additional adult LEMS patients, it could have a material adverse effect on our business, financial condition and results of 
operations.  

50

We also believe that the FDA’s approval of Ruzurgi® violated our statutory rights and was in multiple other respects arbitrary, 
capricious and contrary to law. As a result, in June 2019 we filed suit against the FDA and several related parties challenging this 
approval and related drug labeling. Our complaint, which was filed in the federal district court for the Southern District of Florida, 
alleged that the FDA’s approval of Ruzurgi® violated multiple provisions of FDA regulations regarding labeling, resulting in 
misbranding in violation of the Federal Food, Drug, and Cosmetic Act (FDCA); violated our statutory rights to Orphan Drug 
Exclusivity and New Chemical Entity Exclusivity under the FDCA; and was in multiple other respects arbitrary, capricious, and 
contrary to law, in violation of the Administrative Procedure Act. Among other remedies, the suit sought an order setting aside the 
FDA’s approval of Ruzurgi®.  

On July 30, 2020, the Magistrate Judge considering our lawsuit against the FDA filed a Report and Recommendation in which she 
recommended to the District Judge handling the case that she grant the FDA’s and Jacobus’ motions for summary judgment and deny 
our motion for summary judgment. On September 29, 2020, the District Judge adopted the Report and Recommendation of the 
Magistrate Judge, granted the FDA’s and Jacobus’ motions for summary judgment, and dismissed our case.  

We believe that the District Judge’s decision is incorrect as a matter of law and contrary to the plain language of the Orphan Drug Act. 
We believe that if the District Judge’s decision to grant summary judgment is correct on the law, it means that the FDA has the 
authority to effectively eliminate the benefits of exclusivity under the Orphan Drug Act, which we believe will chill the incentive for 
drug companies to spend the millions of dollars necessary to develop an orphan drug. As a result, we have appealed the decision to the 
Eleventh Circuit Court of Appeals. There can be no assurance of the result of such proceeding.  

We are currently developing a long-acting formulation of amifampridine phosphate. A number of candidate formulations have been 
prepared, and three of the most promising formulations were evaluated in a pharmacokinetic (PK) study completed during the fourth 
quarter of 2020. The results of this first PK study will be used to inform the design and refinement of future product formulations and 
additional PK work to be conducted in 2021. We have also completed a number of advisory board meetings with both patients and 
doctors in order to establish the optimum target characteristics of the long-acting formulation of amifampridine phosphate that are 
desired by the LEMS patient community and treating physicians. There can be no assurance that we will be able to successfully 
develop a long-acting formulation of amifampridine phosphate, that any such formulation will be approved by the FDA for marketing, 
or that any such formulation will be commercially viable.  

On August 10, 2020, we announced the top-line results from our Phase 3 clinical trial (MSK-002) evaluating Firdapse® for the 
treatment of adults with MuSK-MG. Our trial was a multi-site, international (United States, Italy and Serbia), double-blind, placebo-
controlled, clinical trial being conducted under a Special Protocol Assessment (SPA) with the FDA. Unfortunately, the MSK-002 trial 
did not achieve statistical significance on its primary endpoint or its secondary endpoint. However, we have recently concluded a 
detailed analysis of the data from this trial in an effort to understand why the MuSK-MG Phase 3 trial did not meet statistical 
significance on its endpoints, even though clinical improvement was observed by patients and investigators during the initial dose-
titration period of the trial and in our previous proof-of-concept trial. We found in our analysis that there was a large degree of 
symptom variability during the double-blind withdrawal period. We believe that sources of such variability can be addressed in a 
redesigned study that may better demonstrate the efficacy of our drug for the treatment of MuSK-MG.  

We plan to present our hypotheses and a revised protocol to the FDA with respect to the MuSK-MG indication for discussion during 
the first half of 2021. However, there can be no assurance that the FDA will either grant a meeting, agree with our protocol design or, 
even if the study is successful, accept the results of a single study of a different trial design as sufficient evidence for approval of the 
MuSK-MG indication. While we prepare for the meeting with FDA, we also plan to evaluate new clinical trial sites and discuss the 
new trial design with investigators. After meeting with the FDA, we will determine whether or not to proceed with a new trial that 
incorporates the new trial design.  

Our exploratory study, SMA-001 (A Randomized Placebo Controlled Crossover Study to Evaluate the Safety and Efficacy of 
Amifampridine Phosphate in Ambulatory Patients with Spinal Muscular Atrophy (SMA) Type 3), met the primary endpoint of a 
statistically significant difference for the Hammersmith Functional Motor Scale Expanded (HFMSE). Clinically, however, the effect 
was modest. The secondary endpoints were not statistically significant, although several individual quality of life measures 
demonstrated a nominally positive statistically significant change. Key opinion leaders with whom we have spoken believed that 
Firdapse® needed to show a large clinically significant change if there was the possibility to affect disease progression through 
retrograde signaling from enhanced neuromuscular junction function. After considering all of these factors, we have concluded that 
the modest results exhibited in this study are unlikely to result in a sufficient modification of disease progression, and, particularly in 
light of the fact that there are now three approved disease modifying medications for SMA Type 3, we have decided not to pursue the 
SMA Type 3 indication further.  

We intend to conduct a proof-of-concept study evaluating Firdapse® as a treatment for Hereditary Neuropathy with Liability to 
Pressure Palsies (HNPP). The scientific basis for considering this indication is that leakage of neuron potassium channels is observed 

51

in HNPP. Since Firdapse® is a potassium channel blocker, it may mitigate the pathological effects of the potassium channel leakage in 
HNPP patients. There can be no assurance that this proof-of-concept study will be successful.  

There can be no assurance that clinical trials of Firdapse® that we undertake in the future will be successful. Further, there can be no 
assurance that we will ever be granted the right to commercialize Firdapse® for any additional indications.  

Our NDS filing for Firdapse® for the symptomatic treatment of LEMS was approved by Health Canada on July 31, 2020. In August 
2020, we entered into a license agreement with KYE Pharmaceuticals (KYE), pursuant to which we licensed the Canadian rights for 
Firdapse® for the treatment of LEMS to KYE. Pursuant to the license agreement, KYE is obligated to pay us an up-front payment 
based on approval and product supply, data protection milestones based on achievements of sales and regulatory milestones, and a 
sharing of defined net sales upon commercialization.  

On August 10, 2020, Health Canada issued a Notice of Compliance (NOC) to Medunik for Ruzurgi® for the treatment of LEMS. We 
have since initiated a legal proceeding in Canada seeking judicial review of Health Canada’s decision to issue the NOC for Ruzurgi®
as incorrect and unreasonable under Canadian law. Data protection, per Health Canada regulations, is supposed to prevent Health 
Canada from issuing a NOC to a drug that directly or indirectly references an innovative drug’s data, for eight years from the date of 
the innovative drug’s approval. The Ruzurgi® Product Monograph clearly references pivotal nonclinical carcinogenicity and 
reproductive toxicity data for amifampridine phosphate developed by us. As such, we believe that our data was relied upon to establish 
the nonclinical safety profile of Ruzurgi® needed to meet the standards of the Canadian Food and Drugs Act. There can be no 
assurance of the results of this proceeding.  

In May 2019, we entered into an amendment to our license agreement for Firdapse®. Under the amendment, we have expanded our 
commercial territory for Firdapse®, which originally was comprised of North America, to include Japan. Additionally, we have an 
option to further expand our territory under the license agreement to include most of Asia, as well as Central and South America, upon 
the achievement of certain milestones in Japan. Under the amendment, we will pay royalties on net sales in Japan of a similar 
percentage to the royalties that we are currently paying under our original license agreement for North America.  

We have met with Japanese regulatory authorities and believe that we have reached an agreement with them as to the scope of the 
clinical trial that we will be required to undertake in Japan before we will be permitted to submit an application to the Japanese 
regulatory authorities to seek to commercialize Firdapse® for the treatment of LEMS in Japan. We also have applied for orphan drug 
designation in Japan for the symptomatic treatment of LEMS. There can be no assurance that we will successfully obtain the right to 
commercialize Firdapse® in Japan or obtain orphan drug designation.  

All of our patent rights for Firdapse® are derived from our license agreement. In August 2020, the United States Patent and Trademark 
Office (USPTO) allowed Patent No. 10,798,893 (the ’893 patent) to our licensor and thereby to us, and the patent issued on October 6, 
2020. The patent is directed to the use of suitable doses of amifampridine to treat patients, regardless of the therapeutic indication, that 
are slow metabolizers of amifampridine. Any drug product containing amifampridine with a label that states the patented dosing 
regimens and doses in the Dosing and Administration section prior to April 7, 2034, the expiration date of the patent, could possibly 
infringe this patent. Generic drug product labels would necessarily have to do this, and we intend to take all appropriate actions to 
protect our intellectual property.  

In that regard, in October 2020, we filed a lawsuit in the U.S. District Court for New Jersey against Jacobus and a lawsuit in the U.S. 
District Court for the Western District of Pennsylvania against the specialty pharmacy marketing Ruzurgi®, PantherRx Rare LLC 
(PantherRx), for infringement of the ‘893 Patent. The suits have since been combined in the U.S. District Court for New Jersey. The 
lawsuit arises from Jacobus’ and PantherRx’s sales and marketing of Ruzurgi® (amifampridine, 10 mg). The lawsuit alleges that the 
Ruzurgi® product infringes the ‘893 patent when administered in accordance with its product labeling. The lawsuit seeks damages and 
injunctive relief to prevent further marketing of Ruzurgi® in violation of our patent rights.  

We are also pursuing additional patent applications for Firdapse® in an effort to further protect our drug product. There can be no 
assurance that any additional patents will be issued which provide additional intellectual property protection for our drug product.  

There can be no assurance that we do not or will not infringe on patents held by third parties or that third parties in the future will not 
claim that we have infringed on their patents. In the event that our products or technologies infringe or violate the patent or other 
proprietary rights of third parties, there is a possibility we may be prevented from pursuing product development, manufacturing or 
commercialization of our products that utilize such technologies until the underlying patent dispute is resolved. For example, there 
may be patents or patent applications held by others that contain claims that our products or operations might be determined to 
infringe or that may be broader than we believe them to be. Given the complexities and uncertainties of patent laws, there can be no 
assurance as to the impact that future patent claims against us may have on our business, financial condition, results of operations, or 
prospects.  

52

Generic Sabril®

In December 2018, we entered into 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, in December 2018, we received an up-front payment of $500,000. We will 
be entitled to receive a milestone payment of $2.0 million on the commercial launch of the product. Further, we will receive a sharing 
of defined net profits upon commercialization and we are obligated to share the costs of certain development expenses.  

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.  

Capital Resources 

At December 31, 2020, we had cash and investments of approximately $140.3 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 continue to be successful in commercializing Firdapse® or will continue to be profitable. Further, 
there can be no assurance that if we need additional funding in the future, whether such funding will be available to us. See “Liquidity 
and Capital Resources” below for further information on our liquidity and cash flow.  

Basis of Presentation 

Revenues. 

At December 31, 2020 we continued to generate revenues from product sales of Firdapse® in the U.S. We expect these revenues to 
fluctuate in future periods based on our sales of Firdapse®. We received approval from Health Canada on July 31, 2020, for Firdapse®
for the symptomatic treatment of LEMS and as of December 31, 2020, the Company has launched Firdapse® in Canada. At 
December 31, 2020 and 2019, we did not generate revenues under our collaborative agreement with Endo. We expect our revenues 
from the Endo collaborative agreement to fluctuate in future periods based on our collaborator’s ability to meet various regulatory 
milestones set forth in such agreement. At December 31, 2020, we generated revenues of $332,186 from our collaborative agreement 
with KYE Pharmaceuticals. We expect our revenue from the KYE collaborative agreement to fluctuate in future periods based on our 
collaborator’s ability to market and sell Firdapse® in Canada.  

Cost of Sales. 

Cost of sales consists of third-party manufacturing costs, freight, royalties, and indirect overhead costs associated with sales of 
Firdapse®. Cost of sales may also include period costs related to certain inventory manufacturing services, inventory adjustments 
charges, unabsorbed manufacturing and overhead costs, and manufacturing variances. Prior to FDA approval in November 2018, the 
cost of manufacturing Firdapse® was expensed, including our build-up of anticipated launch product. This will cause the cost of sales 
to appear artificially low as we consumed product manufactured and in process prior to approval, and will continue to do so until we 
deplete such product.  

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, 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 currently 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 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 

53

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 they begin and incurring additional expenditures as the study 
or trial progresses and reaches certain milestones.  

Selling, General and Administrative Expenses. 

During 2019, we actively committed funds to developing our commercialization program for Firdapse® and we have continued to 
incur substantial commercialization expenses, including sales, marketing, patient services, patient advocacy and other 
commercialization related expenses as we have continued our sales program for Firdapse®.  

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, and professional fees for 
legal including litigation cost, 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 
accounting principles generally accepted in the U.S. (U.S. GAAP). For stock options, we use the Black-Scholes option valuation 
model in calculating the fair value of the awards.  

Income Taxes. 

Our effective income tax rate is the ratio of income tax expense (benefit) over our income (loss) before income taxes.  

We incurred operating losses from inception through the three-month period ended March 31, 2019. As of December 31, 2020, and 
2019, we had net operating loss carryforwards of approximately $3 million and $45 million, respectively. The net operating loss carry-
forwards at December 31, 2020 will expire at various dates beginning 2035 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.  

In the third quarter of 2020, we determined that there was sufficient positive evidence to conclude that it is more likely than not that 
our additional deferred taxes of approximately $33.0 million are realizable. As a result, we reduced the valuation allowance 
accordingly.  

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 measure that we present exclude from the calculation of net income the expense associated with stock-based 
compensation. Further, we often report non-GAAP net income (loss) per share, which is calculated by dividing non-GAAP net income 
(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 income (loss) we may use may be different from, and not directly comparable to, 
similarly titled measures used by other companies.  

54

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 amounts of assets and liabilities reported in our consolidated balance sheets and the amounts reported in our consolidated 
statements of comprehensive income (loss) are affected by estimates and assumptions, which are used for, but not limited to, the 
accounting for revenue recognition, leases, preclinical study and clinical trial expenses, stock-based compensation and valuation 
allowance for deferred tax assets. The accounting policies described below are not intended to be a comprehensive list of all of our 
accounting policies but represent the accounting estimates which involve a significant level of estimation uncertainty and have had or 
are reasonably likely to have a material impact on our financial condition or results of operations. In many cases, the accounting 
treatment of a particular transaction is specifically dictated by U.S. 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 U.S. GAAP.  

Revenue Recognition. 

Revenue from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration 
for which reserves are established. Components of variable consideration include trade discounts and allowances, product returns, 
provider chargebacks and discounts, government rebates, and other incentives, such as voluntary patient assistance, and other 
allowances that are offered within contracts with our Customer, payors, and other indirect customers relating to the sale of our 
products. These reserves are based on the amounts earned, or to be claimed on the related sales, and are classified as reductions of 
accounts receivable (if the amount is payable to the Customer) or a current liability (if the amount is payable to a party other than a 
customer). These estimates take into consideration a range of possible outcomes which are probability-weighted in accordance with 
the expected value method in Topic 606 for relevant factors such as current contractual and statutory requirements, specific known 
market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best 
estimates of the amount of consideration to which we are entitled based on the terms of the respective underlying contracts.  

The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net sales 
price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the 
contract will not occur in a future period. Our analyses also contemplated application of the constraint in accordance with the 
guidance, under which it determined a material reversal of revenue would not occur in a future period for the estimates as of 
December 31, 2020 and 2019 and, therefore, the transaction price was not reduced further during the years ended December 31, 2020 
and 2019. Actual amounts of consideration ultimately received may differ from our estimates. If actual results in the future vary from 
our estimates, we will adjust these estimates, which would affect net product revenue and earnings in the period such variances 
become known. Refer to Note 2, “Basis of Presentation and Significant Accounting Policies,” in the consolidated financial statements 
included in this report for further details on revenue recognition.  

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, 2020 and 2019, the assumptions used were an estimated annual volatility of 81.4% and 75.5%, expected holding 
periods of four and a half years, and risk-free interest rates of 0.24% to 1.64% and 1.51% to 2.53%, respectively.  

Valuation Allowance for Deferred Tax Assets. 

We assess the need for a valuation allowance against our deferred tax asset each quarter through the review of all available positive 
and negative evidence. Deferred tax assets are reduced by a tax valuation allowance when, in the opinion of management, it is more 

55

likely than not that some portion of the deferred tax assets will not be realized. Management’s analysis depends on historical and 
projected taxable income. Projected taxable income includes significant assumptions related to revenue, commercial expenses and 
research and development activities. In the third quarter of 2020, we determined that there was sufficient positive evidence to 
conclude that it is more likely than not that our additional deferred taxes are realizable. As a result, we reduced the valuation 
allowance accordingly.  

Results of Operations 

Years Ended December 31, 2020 and 2019 

Revenues. 

For the year ended December 31, 2020, we recognized $118.7 million in net revenue from product sales of Firdapse® in the U.S. 
compared to $102.3 million for the year ended December 31, 2019. The increase of approximately $16.4 million was due to net price 
increases and increases in sales volumes of approximately 9.6%. For the year ended December 31, 2020, we also recognized $332,186 
in revenues from collaborative arrangements. We had no revenues from our collaborative arrangements for the year ended 
December 31, 2019.  

Cost of Sales. 

Cost of sales was approximately $17.0 million for the year ended December 31, 2020 compared to $14.8 million for the year ended 
December 31, 2019. Cost of sales consisted principally of royalty payments, which are based on net revenue as defined in the 
applicable license agreement. Further, cost of sales may be artificially low until we fully utilize product manufactured that was 
recorded as expense prior to FDA approval of Firdapse®.  

Research and Development Expenses. 

Research and development expenses for the years ended December 31, 2020 and 2019 were approximately $16.5 million and 
$18.8 million, respectively, and represented approximately 21% and 27% of total operating costs and expenses, respectively. Research 
and development expenses for the years ended December 31, 2020 and 2019 were as follows:  

For the year ended
December 31,

Change

2020

2019

$

%

Research and development expenses 
Employee stock-based compensation 

$14,911,513  $17,705,156    (2,793,643)  (15.8)
  39.3 

  1,137,596   

  1,585,202 

447,606 

Total research and development expenses 

$16,496,715  $18,842,752    (2,346,037)  (12.5)

For the year ended December 31, 2020, research and development expenses decreased approximately $2.3 million compared to the 
same period in 2019, primarily attributable to the decreases in medical and regulatory affairs and quality assurance expenses and 
expenses from our ongoing clinical trials evaluating Firdapse® for the treatment of MuSK-MG and SMA Type 3, as we closed out 
these trials in the latter part of 2020; partly offset by increases in employee stock-based compensation, which is non-cash and relates 
to the expense of stock compensation awards to certain employees and stock option awards due to headcount increases.  

We expect that research and development expenses will continue to be substantial in 2021 as we begin a proof-of-concept trial for 
HNPP, continue our Expanded Access Program, take steps to continue the development of a long-acting formulation of Firdapse®, 
continue our regulatory path to seek approval of Firdapse® in Japan and evaluate Firdapse® as a treatment for other neuromuscular 
diseases.  

56

 
Selling, General and Administrative Expenses. 

Selling, general and administrative expenses for the years ended December 31, 2020 and 2019 were approximately $44.2 million and 
$36.9 million, respectively, and represented approximately 57% and 52% of total operating costs and expenses for the years ended 
December 31, 2020, and 2019, respectively. Selling, general and administrative expenses for the years ended December 31, 2020 and 
2019 were as follows:  

Selling 
General and administrative 
Employee stock-based compensation 

Total selling, general and administrative expenses 

For the year ended
December 31,

2020

2019

Change

$

%

$23,567,221  $19,947,916  3,619,305   18.1 
15,990,812  14,246,052  1,744,760   12.2 
  2,687,219  1,988,502   74.0 
  4,675,721 

$44,233,754  $36,881,187  7,352,567   19.9 

For the year ended December 31, 2020, selling, general and administrative expenses increased approximately $7.4 million, compared 
to the same period in 2019, primarily attributable to the following:  

• 

• 

• 

increases in selling (commercialization) expenses, which consist primarily of the costs of the expansion of our sales 
force and the cost of contracting with a rare-disease experienced inside sales agency;  

increases in general and administrative expenses are primarily due to increases in legal cost, including litigation, investor 
relations costs and the expansion of our operations and headcount to support our ongoing efforts to increase our net 
revenues from sales of Firdapse® partly offset by decrease in 2020 contributions to 501(c)(3) organizations supporting 
LEMS patients, due to the accrual in the fourth quarter of 2019 of approximately $1.5 million in pledge contributions 
attributable to 2020 activities; and  

increases in employee stock-based compensation which is non-cash and relates to the expense of stock option awards to 
certain employees and directors and stock option awards due to headcount increases.  

We expect that selling, general and administrative expenses will be substantial in future periods as we continue our efforts to increase 
our revenues from Firdapse® and take steps to expand our business.  

Stock-Based Compensation. 

Total stock-based compensation for the years ended December 31, 2020 and 2019 was $6.3 million and $3.8 million, respectively. In 
2020, grants were principally of stock options relating to 2020 year-end bonus awards and grants to new employees. In 2019, option 
grants were principally for year-end bonus awards and to new employees hired in connection with the launch of Firdapse®.  

Other Income, Net. 

We reported other income, net in all periods, primarily relating to our investment of our cash and cash equivalents and investments. 
The decrease in other income, net for the year ended December 31, 2020 of approximately $1.0 million when compared to the same 
period in 2019 is primarily due to lower yields on investments, despite higher invested balances. Other income, net, consists of interest 
income, dividend income, and unrealized and realized gain (loss) on trading securities.  

Income Taxes. 

We incurred net operating losses from inception through the three-month period ended March 31, 2019. As of December 31, 2020, 
and 2019, we had net operating loss carryforwards of approximately $3 million and $45 million, respectively, available to reduce 
future taxable income. Remaining net operating loss carry-forwards will expire at various dates beginning 2035 and ending in 2037. If 
an ownership change, as defined under Internal Revenue Code 382, occurs, the use of these carry-forwards may be subject to 
limitations.  

We had no uncertain tax positions as of December 31, 2020 and December 31, 2019.  

As of December 31, 2019, our deferred tax assets were primarily the result of US net operating loss and tax credit carryforwards and a 
full valuation was recorded against our gross deferred tax asset balance. For the year ending December 31, 2020 we recorded a net 
valuation release of $41.6 million ($0.40 per basic share and $0.39 per diluted share) on the basis of management’s determination that 
it is more likely than not that the amount of its deferred tax assets will be realized.  

57

 
 
Net Income (Loss). 

Our net income was approximately $75.0 million in the year ended December 31, 2020 ($0.72 per basic and $0.71 per diluted share) 
as compared to net income of approximately $31.9 million in the year ended December 31, 2019 ($0.31 per basic and $0.30 per 
diluted share).  

Non-GAAP Net Income. 

Our non-GAAP net income for 2020, which excludes an approximately $6.3 million expense associated with non-cash stock-based 
compensation, was approximately $81.2 million ($0.78 per basic and $0.76 per diluted share). Our non-GAAP income for 2019, 
which excludes an approximately $3.8 million expense associated with non-cash stock-based compensation, was approximately 
$35.7 million ($0.35 per basic and $0.34 per diluted share).  

Years Ended December 31, 2019 and 2018 

Revenues. 

For the year ended December 31, 2019, we recognized $102.3 million in net revenue from product sales of Firdapse®. We had no 
revenues from product sales for the year ended December 31, 2018. We had no revenues from our collaborative arrangement in 2019. 
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.  

Cost of Sales. 

Cost of sales was $14.8 million for the year ended December 31, 2019, compared to $0 for the year ended December 31, 2018. The 
increase in cost of sales was entirely attributable to the commercial launch of Firdapse® in January 2019. Cost of sales includes royalty 
payments which are based on net revenue as defined in the applicable license agreement.  

Research and Development Expenses. 

Research and development expenses for the years ended December 31, 2019 and 2018 were approximately $18.8 million and 
$19.9 million, respectively, and represented approximately 27% and 56% of total operating costs and expenses for the years ended 
December 31, 2019, and 2018 respectively. Research and development expenses for the years ended December 31, 2019 and 2018 
were as follows:  

For the year ended
December 31,

2019

2018

Change

$

%

Research and development expenses 
Employee stock-based compensation 

Total research and development expenses 

$17,705,156  $18,839,974    (1,134,818)  (6.0)
  5.4 

  1,079,230   

  1,137,596 

58,366 

$18,842,752  $19,919,204    (1,076,452)  (5.4)

For the year ended December 31, 2019, research and development expenses decreased approximately $1.1 million compared to same 
period in 2018, primarily attributable to a decrease in milestone payments made as part of the settlement agreement with the former 
stockholders of Huxley Pharmaceuticals during the third quarter of 2018.  

Selling, General and Administrative Expenses. 

Selling, general and administrative expenses for the years ended December 31, 2019 and 2018 were approximately $36.9 million and 
$15.9 million, respectively, and represented approximately 52% and 44% of total operating costs and expenses for the years ended 
December 31, 2019, and 2018 respectively. Selling, general and administrative expenses for the years ended December 31, 2019 and 
2018 were as follows:  

For the year ended
December 31,

Change

2019

2018

$

%

Selling 
General and administrative 
Employee stock-based compensation 

$19,947,916  $ 

14,246,052  13,404,547   
  2,471,414   
  2,687,219 

 —    19,947,916   100.0 
841,505    6.3 
215,805    8.7 

Total selling, general and administrative expenses 

$36,881,187  $15,875,961  21,005,226   132.3 

58

 
 
 
For the year ended December 31, 2019, selling, general and administrative expenses increased approximately $21.0 million, compared 
to the same period in 2018, primarily attributable to the following:  

• 

• 

• 

• 

increases in selling (commercialization) expenses, which consist primarily of commercial systems implementation costs, 
hiring of the sales force and supporting personnel, product launch costs, and costs of our market access and market 
research efforts (pre-commercial expenses incurred in 2018 in the amount of $6,897,483 before our launch of 
commercial Firdapse® were included in general and administrative expenses);  

increases in general and administrative costs attributable to the growth of our organization as we have grown from an 
R&D company to a commercial stage pharmaceutical company;  

contributions to 501(c)(3) organizations supporting LEMS patients, including the accrual in the fourth quarter of 2019 of 
approximately $1.5 million in pledge contributions attributable to 2020 activities; and  

increases in employee stock-based compensation which is non cash and relates to the expense of stock options awarded 
to certain employees, officers and directors.  

Stock-Based Compensation. 

Total stock-based compensation expense for the years ended December 31, 2019 and 2018 was $3,824,815 and $3,550,644, 
respectively. The increase in stock-based compensation for the year ended December 31, 2019, when compared to the same period in 
2018, is primarily due to the expense of grants to new employees hired in connection with the launch of Firdapse®.  

Other Income, Net. 

We reported other income, net in all periods primarily relating to our investment of funds received from offerings of our securities and 
product sales. The increase in other income, net for the year ended December 31, 2019 when compared to the same period in 2018 is 
primarily due to higher invested balances and higher yields on investments. Other income, net, consists of interest income, dividend 
income, and realized gain (loss) on trading securities. For the year ended December 31, 2019, other income, net also includes 
$100,000 received as part of a settlement agreement between us and Northwestern University relating to CPP-115. These proceeds 
were used fund our drug development activities and our operations.  

Income Taxes. 

Our effective income tax rate was 4.6% and 0% for the year ended December 31, 2019 and 2018, respectively. Differences in the 
effective tax and the statutory federal income tax rate of 21% is driven by state income taxes and anticipated annual permanent 
differences, including orphan drug credit expense limitations and other items.  

We had no uncertain tax positions as of December 31, 2019 and December 31, 2018. We have a full valuation allowance for our 
deferred tax assets at December 31, 2019 and December 31, 2018.  

Net Income (Loss). 

Our net income was $31,875,337 in the year ended December 31, 2019 ($0.31 per basic and $0.30 per diluted share) as compared to a 
net loss of ($34,003,514) in the year ended December 31, 2018 ($0.33 per basic and diluted share).  

Non-GAAP Net Income. 

Our non-GAAP net income, which excludes for 2019 a $3,824,815 expense associated with stock-based compensation was 
$35,700,152 ($0.35 and $0.34, respectively, per basic and diluted share). Our non-GAAP net loss for the year ended December 31, 
2018 was $30,452,870 ($0.30 per basic and diluted share), which excludes non-cash stock compensation of $3,550,664.  

Liquidity and Capital Resources 

Since our inception, we have financed our operations primarily through multiple public and private offerings of our securities and, 
since January 2019, from revenues from product sales of Firdapse®. At December 31, 2020, we had cash and cash equivalents and 
investments aggregating $140.3 million and working capital of $136.5 million. At December 31, 2019, we had cash and cash 
equivalents and investments aggregating $94.5 million and working capital of $87.3 million. At December 31, 2020, substantially all 
of our cash and cash equivalents were deposited with one financial institution, and such balances were in excess of federally insured 
limits. Further, as of such date, substantially all such funds were invested in money market accounts, short-term interest bearing 
obligations and U.S. Treasuries.  

59

We incurred operating losses through the quarter ended March 31, 2019 and reported operating income for the first time during the 
three and six month periods ended June 30, 2019. 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 from the date of this report. There can be no assurance that we will remain profitable or that we will be able 
to obtain any additional funding that we may require in the future.  

In the future, we may require additional working capital to support our operations depending on our future success with Firdapse®
sales and whether our results continue to be profitable and cash flow positive. There can be no assurance as to the amount of any such 
funding that will be required for these purposes or whether any such funding will be available to us when it is required.  

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

• 

• 

• 

• 

• 

• 

• 

• 

• 

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

future clinical trial results;  

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

the cost and timing of regulatory approvals;  

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

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

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 may raise additional funds if required 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 further 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 23, 2020, we filed a shelf registration statement with the SEC to sell up to $200 million of common stock, preferred stock, 
warrants to purchase common stock, debt securities and units consisting of one or more of such securities (the “2020 Shelf 
Registration Statement”). The 2020 Shelf Registration Statement (file no. 333-240052) was declared effective by the SEC on July 31, 
2020. As of the date of this report, no offerings have been completed under the 2020 Shelf Registration Statement.  

Cash Flows. 

Net cash provided by operating activities was $45,034,864 and $34,611,473, respectively, for the years ended December 31, 2020 and 
2019. During the year ended December 31, 2020, net cash provided by operating activities was primarily attributable to our net 
income of $74,983,000, a decrease of $4,549,571 in accounts receivable, net, an increase of $138,573 in accounts payable, and 
$7,134,049 net of non-cash expenses. This was partially offset by increases of $3,976,697 in prepaid expenses and other current and 
non-current assets and $2,693,808 in inventory and decreases of $1,209,280 in accrued expenses and other liabilities, $919,280 in 
operating lease liability and $32,971,264 in non-cash deferred taxes. During the year ended December 31, 2019, net cash provided by 
operating activities was primarily attributable to our net income of $31,875,337, increases of $1,780,080 in accounts payable, 
$12,540,197 in accrued expenses and other liabilities, and of $3,831,736 of non-cash expenses. This was partially offset by increases 
of $10,536,997 in accounts receivable, net, $1,900,780 in inventory, and $2,701,293 in prepaid expenses and other current and non-
current assets and a decrease of $276,807 in operating lease liability.  

Net cash used in investing activities was $5,011,398 for the year ended December 31, 2020, consisting primarily of purchases of 
investments of $10,000,000 and partially offset by proceeds from sales/maturities of investments of $5,000,000. Net cash provided by 
investing activities was $37,224,595 for the year ended December 31, 2019, consisting primarily of proceeds from sales/maturities of 
investments of $71,969,365, partially offset by purchases of investments of $34,725,401.  

60

Net cash provided by financing activities during the years ended December 31, 2020 and 2019 was $701,933 and $1,116,242, 
respectively, consisting primarily of proceeds from the exercise of options to purchase shares of common stock.  

Contractual Obligations and Arrangements. 

We have entered into the following contractual arrangements:  

• 

Payments under our license agreement. We have agreed to pay the following royalties under our license agreement:  

o 

o 

Royalties to our licensor 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  

Royalties to the third-party licensor of the rights sublicensed to us 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 for the duration of regulatory exclusivity within a territory and 3.5% 
for territories in any calendar year in territories without regulatory exclusivity.  

For the year ended December 31, 2020, we recognized an aggregate of approximately $16.3 million of royalties, which 
is included in cost of sales in the accompanying consolidated statement of operations and comprehensive income (loss).  

• 

• 

• 

Employment agreements. We have entered into an employment agreement with our Chief Executive Officer that 
required us to make base salary payments of approximately $600,000 in 2020. The agreement expires in November 
2022.  

Purchase commitment. We have entered into a purchase commitment with our contract manufacturing organization for 
approximately $500,000 per year. The agreement expires in December 2023.  

Lease for office space. We operate our business in leased office space in Coral Gables, Florida. During 2020, we leased 
approximately 7,800 square feet of office space for which we pay annual rent of approximately $330,000. We entered 
into an agreement in May 2020 that amended our lease for the office facilities. Under the amended lease, our leased 
space will increase from approximately 7,800 square feet of space to approximately 10,700 square feet of space. We 
moved into the new space around March 1, 2021 when the space became available for use.  

Off-Balance Sheet Arrangements. 

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

Caution Concerning Forward-Looking Statements 

This report 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.”  

The continued successful commercialization of Firdapse® and the development of additional indications for Firdapse® is highly 
uncertain. Factors that will affect our success include the uncertainty of:  

• 

The impact of the COVID-19 pandemic on our business or on the economy generally;  

•  Whether we will be able to continue 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 Firdapse® for the treatment of Lambert-Eaton Myasthenic Syndrome 

(“LEMS”) 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 patients will discontinue from the use of our drug at rates that are higher than historically experienced or are 

higher than we project;  

•  Whether the daily dose taken by patients changes over time and affects our results of operations;  

61

•  Whether Firdapse® patients can be successfully titrated to stable therapy;  

•  Whether we can continue to market Firdapse® on a profitable and cash flow positive basis;  

•  Whether any revenue guidance that we provide to the public market will turn out to be accurate;  

•  Whether payors will reimburse for our product at the price that we charge for the product;  

• 

• 

• 

• 

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

The ability of our distributor and the specialty pharmacies that distribute our product to maintain compliance with 
applicable law;  

Our ability to maintain compliance with applicable rules relating to our patient assistance programs and our 
contributions to 501(c)(3) organizations that support LEMS patients;  

The scope of our intellectual property and the outcome of any future challenges or opposition to our intellectual 
property, and, conversely, whether any third-party intellectual property presents unanticipated obstacles for Firdapse®;  

•  Whether our lawsuits against Jacobus and the specialty pharmacy distributing its product for patent infringement will be 

successful;  

• 

The effect on our business and future results of operations arising from the approval by the FDA of Ruzurgi® for the 
treatment of pediatric LEMS patients (ages 6 to under 17);  

•  Whether our appeal of the District Court’s decision in our suit against the United States FDA seeking to vacate the 

FDA’s approval of Ruzurgi® will be successful;  

•  Whether we can continue to compete successfully if the approval of Ruzurgi® is not overturned and Ruzurgi® continues 

to be prescribed for off-label use by adult LEMS patients;  

•  Whether, because of the lower price of Ruzurgi®, payors will require that patients try off-label Ruzurgi® first before they 

approve Firdapse® as a treatment for adult LEMS patients;  

• 

• 

• 

• 

• 

• 

• 

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 organization, 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 public statements by politicians and a vocal group of LEMS 
patients and doctors who object to our pricing of Firdapse®;  

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

The state of the economy generally and its impact on our business;  

Changes to the healthcare industry occasioned by any changes 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 any clinical trials and studies that we may undertake on a timely basis and within the budgets we 
establish for such trials and studies;  

•  Whether COVID-19 will further affect the timing and costs of our currently ongoing and contemplated clinical trials;  

•  Whether Firdapse® will ever be approved for the treatment of any neuromuscular disease other than LEMS;  

•  Whether we can successfully commercialize Firdapse® in Canada on a profitable basis;  

•  Whether our suit to overturn the approval of Ruzurgi® in Canada will be successful;  

• 

The impact on sales of Firdapse® in the United States if an amifampridine product is purchased in Canada for use in the 
United States;  

•  Whether we will be able to successfully complete the clinical trial in Japan that will be required to seek approval to 

commercialize Firdapse® in Japan;  

•  Whether we will be able to obtain approval to commercialize Firdapse® in Japan;  

•  Whether we can successfully develop, obtain approval of and successfully market a long-acting version of amifapridine;  

62

•  Whether our efforts to grow our business beyond Firdapse® through acquisitions of companies or in-licensing of product 

opportunities will be successful;  

•  Whether we will have sufficient capital to finance any such acquisitions;  

•  Whether our version of generic vigabatrin tablets will ever be approved by the FDA;  

• 

Even if our version of vigabatrin tablets is approved for commercialization, whether Endo Ventures/Par Pharmaceutical 
(our collaborator in this venture) will be successful in marketing the product; and  

•  Whether we will earn milestone payments on the first commercial sale of vigabatrin tablets and royalties on sales of 

generic vigabatrin tablets.  

Our current plans and objectives are based on assumptions relating to the continued commercialization of Firdapse® and 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 

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

Our exposure to interest rate risk is currently confined to our cash and short-term investments that are from time to time invested in 
highly liquid money market funds, U.S. Treasuries and short-term bond funds. The primary objective of our investment activities is to 
preserve our capital to fund operations. We also seek to maximize income from our investments without assuming significant risk. We 
do not use derivative financial instruments in our investment portfolio. Our cash and investments policy emphasizes liquidity and 
preservation of principal over other portfolio considerations.  

Item 8. 

Financial Statements and Supplementary Data 

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

Item 9. 

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 

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, 2020, 
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.  

63

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, 2020 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, 2020.  

During the fourth quarter of 2020, 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.  

64

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 2021 Annual Meeting of Stockholders. Our Proxy Statement for the 2021 Annual Meeting of Stockholders is 
expected to be filed not later than 120 days after the end of our fiscal year ended December 31, 2020 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.  

65

Item 15. 

Exhibits and Financial Statement Schedules 

Documents filed as part of this report.  

PART IV 

The following financial statements of Catalyst Pharmaceuticals, Inc. and Reports of Grant Thornton LLP, independent registered 
public accounting firm, are included in this report:  

• 

• 

• 

• 

• 

• 

Reports of Grant Thornton LLP, Independent Registered Public Accounting Firm  

Consolidated Balance Sheets as of December 31, 2020 and 2019  

Consolidated Statements of Operations and Comprehensive Income (Loss) for the years ended December 31, 2020, 2019 
and 2018  

Consolidated Statements of Changes in Stockholders’ Equity for the years ended December 31, 2020, 2019 and 2018  

Consolidated Statements of Cash Flows for the years ended December 31, 2020, 2019 and 2018  

Notes to Consolidated Financial Statements  

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.  

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

Exhibits.  

Exhibit 
Number

2.1 

3.1 

3.2 

3.3 

3.4 

3.5 

3.6 

4.1 

4.2 

4.3 

4.4 

4.5 

Description of Exhibit

Form

File Number

Date of 
Filing

Exhibit 
Number

Filed 
Herewith

Incorporated by Reference

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

S-1 333-136039    9/1/2006   

10.9 

Certificate of Incorporation

Amendment to Certificate of Incorporation

S-1 333-136039    7/25/2006 

S-1 333-136039    7/25/2006 

3.1 

3.2 

Amendment to Certificate of Incorporation 

 DEF 14A   001-33057    3/30/2015  Annex A 

Amendment to Certificate of Incorporation

8-K   001-33057    8/21/2020 

3.1   

By-Laws

Amendment to By-Laws

S-1 333-136039    9/1/2006 

8-K   001-33057   11/27/2019 

Specimen Stock Certificate for Common Stock

S-1 333-136039    9/1/2006 

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

Amendment to Rights Agreement

Second Amendment to Rights Agreement

Description of the Company’s Capital Stock 

8-K   001-33057    9/23/2011 

8-K   001-33057    9/19/2016 

8-K   001-33057    8/30/2019 

3.3 

3.1 

4.1 

4.1 

4.1 

4.1 

X 

10.1(a)+  Employment Agreement between the Company and Patrick J. 

10-Q   001-33057   12/15/2006   

10.1 

McEnany

10.1(b)+

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

8-K   001-33057   12/23/2008   

10.1 

10.1(c)+  Second Amendment to Employment Agreement between the 

10-Q   001-33057   11/12/2009   

10.1 

Company and Patrick J. McEnany

10.1(d)+ Third Amendment to Employment Agreement between the 

8-K   001-33057    9/15/2011   

10.1 

66

 
 
Exhibit 
Number

Description of Exhibit

Form

File Number

Date of 
Filing

Exhibit 
Number

Filed 
Herewith

Incorporated by Reference

Company and Patrick J. McEnany

10.1(e)+  Fourth Amendment to Employment Agreement between the 

8-K   001-33057    8/29/2013   

10.1 

Company and Patrick J. McEnany

10.1(f)+ 

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

10.1(g)+

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

8-K   001-33057    6/24/2016   

10.1 

8-K   001-33057    5/31/2018   

10.1 

10.1(h)+

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

8-K   001-33057    9/11/2020   

10.1 

10.2(a)+ 

2014 Stock Incentive Plan

 DEF 14A   001-33057    3/19/2014  Annex A 

10.2(b)+ Amendment No. 1 to 2014 Stock Incentive Plan

 DEF 14A   001-33057    4/29/2016  Annex A 

10.2(c)+  Amendment No. 2 to 2014 Stock Incentive Plan

 DEF 14A   001-33057    4/14/2017  Annex A 

10.3(a)+ 

2018 Stock Incentive Plan

 DEF 14A   001-33057    4/17/2018  Annex A 

10.3(b)+ Amendment No. 1 to 2018 Stock Incentive Plan

 DEF 14A   001-33057    7/7/2020  Annex A 

10.4(a) 

10.4(b) 

10.4(c) 

10.4(d) 

10.4(e) 

10.4(f) 

10.5 

10.6(a) 

10.6(b) 

10.6(c) 

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

First Amendment to Lease Agreement between the Company 
and CPT 355 Alhambra Circle, LLC

Second Amendment to Lease Agreement between the 
Company and CPT 355 Alhambra Circle, LLC

Third Amendment to Lease Agreement between the Company 
and CPT 355 Alhambra Circle, LLC

Fourth Amendment to Lease Agreement between the Company 
and PRII 355 Alhambra Circle, LLC

Fifth Amendment to Lease Agreement between the Company 
and PRII 355 Alhambra Circle, LLC

License Agreement, dated as of December  13, 2011, among 
New York University, the Feinstein Institute for Medical 
Research, and the Company

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

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

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, and (iii) the 
Company

10-Q   001-33057    5/14/2007   

10.1 

10-Q   001-33057    8/15/2011   

10.1 

8-K   001-33057    2/20/2014   

10.1 

8-K   001-33057    3/27/2015   

10.1 

8-K   001-33057    8/17/2018   

10.1 

8-K   001-33057    5/13/2020   

10.1 

10-K   001-33057    3/30/2012   

10.15 

8-K   001-33057   10/31/2012   

10.2 

8-K   001-33057    4/17/2014   

10.1 

10-Q   001-33057    8/17/2018   

10.1 

10.6(d) 

Second Amendment to License Agreement, dated May 29, 
2019, between the Company and BioMarin

10.7 

10.8 

Development, License and Commercialization Agreement, 
dated effective as of December  18, 2018, by and between 
Endo Ventures Limited and the Company

License and Supply Agreement, dated as of August 14, 2020, 
by and between KYE Pharmaceuticals, Inc. and the Company

8-K   001-33057    5/30/2019   

10.1 

8-K   001-33057   12/26/2018   

10.1 

8-K   001-33057    8/20/2020   

10.1 

67

 
 
 
 
Exhibit 
Number

21.1 

23.1 

31.1 

31.2 

32.1 

32.2 

Description of Exhibit

Form

File Number

Date of 
Filing

Exhibit 
Number

Filed 
Herewith

Subsidiaries of the registrant 

10-K   001-33057    3/16/2020   

21.1 

Incorporated by Reference

Consent of Independent Registered Public Accounting Firm 

Section 302 CEO Certification 

Section 302 CFO Certification 

Section 906 CEO Certification 

Section 906 CFO Certification 

X 

X 

X 

X 

X 

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

104 

Cover Page Interactive Data File (formatted as Inline XBRL 
and contained in Exhibit 101)

68

 
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 15th day of March, 2021.  

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

/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 

Title

Date

Chairman of the Board of Directors, President and Chief 

March 15, 2021 

Executive Officer (Principal Executive Officer) 

Vice President, Treasurer, Chief Financial Officer 

March 15, 2021 

(Principal Financial Officer and Principal Accounting 
Officer)

March 15, 2021 

March 15, 2021 

March 15, 2021 

March 15, 2021 

March 15, 2021 

Director 

Director 

Director 

Director 

Director 

69

[This Page Intentionally Left Blank] 

INDEX TO FINANCIAL STATEMENTS 

Years ended December 31, 2020, 2019 and 2018 

Report of Independent Registered Public Accounting Firm

Report of Independent Registered Public Accounting Firm

Consolidated Balance Sheets

Consolidated Statements of Operations and Comprehensive Income (Loss)

Consolidated Statements of Changes in Stockholders’ Equity

Consolidated Statements of Cash Flows

Notes to Consolidated Financial Statements

  F-2 

  F-3 

  F-5 

  F-6 

  F-7 

  F-8 

  F-9 

F-1

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

Board of Directors and Stockholders  
Catalyst Pharmaceuticals, Inc.  

Opinion on internal control over financial reporting 

We have audited the internal control over financial reporting of Catalyst Pharmaceuticals, Inc. (a Delaware corporation) and 
subsidiary (the “Company”) as of December 31, 2020, 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, 2020, 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, 2020, and our report 
dated March 15, 2021 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 15, 2021  

F-2

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

Board of Directors and Stockholders  
Catalyst Pharmaceuticals, Inc.  

Opinion on the financial statements 

We have audited the accompanying consolidated balance sheets of Catalyst Pharmaceuticals, Inc. (a Delaware corporation) and 
subsidiary (the “Company”) as of December 31, 2020 and 2019, the related consolidated statements of operations and comprehensive 
income (loss), changes in stockholders’ equity, and cash flows for each of the three years in the period ended December 31, 2020, 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, 2020 and 2019, and the results of its operations and its 
cash flows for each of the three years in the period ended December 31, 2020, 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, 2020, 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 15, 2021, 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.  

Critical audit matter 

The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was 
communicated or required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material 
to the financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of 
critical audit matters does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by 
communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or 
disclosures to which it relates.  

As described further in Note 10 to the financial statements, deferred tax assets are reduced by a valuation allowance if, based on the 
evaluation of positive and negative evidence, in management’s judgment it is more likely than not that some portion, or all, of the 
deferred tax assets will not be realized. Once established, the valuation allowance is released when, based on the evaluation of positive 
and negative evidence, management concludes that related deferred tax assets are more likely than not to be realized. During the year 
ended December 31, 2020, management concluded that sufficient positive evidence existed to release its valuation allowance related 
to its deferred tax assets, resulting in an income tax benefit of $33.1 million for the year ended December 31, 2020. We identified the 
evaluation of the realizability of deferred tax assets as a critical audit matter.  

The principal considerations for our determination that the evaluation of the realizability of deferred tax assets is a critical audit matter 
are the significant judgment by management in determining whether the net deferred tax assets are more likely than not to be realized 
in the future, which in turn led to a high degree of auditor judgment and effort in performing procedures and evaluating audit evidence 
relating to management’s assessment of the realization of net deferred tax assets.  

F-3

Our audit procedures related to the evaluation of the realizability of deferred tax assets included the following, among others.  

•  We evaluated the design and tested the operating effectiveness of the key controls over the Company’s assessment of all 

positive and negative evidence and evaluation of the realizability of deferred tax assets.  

•  We tested the scheduling and reversal of certain deferred tax assets including start-up costs and tax credits.  

•  We reviewed management’s assessment of potential net operating loss carryforward limitations.  

•  We involved our income tax specialists to evaluate the application of tax laws and regulations used in the Company’s 

assumptions and calculations.  

/s/ GRANT THORNTON LLP  

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

Miami, Florida  
March 15, 2021  

F-4

CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED BALANCE SHEETS 

ASSETS
Current Assets:

Cash and cash equivalents 
Short-term investments 
Accounts receivable, net 
Inventory 
Prepaid expenses and other current assets 

Total current assets 

Operating lease right-of-use asset 
Property and equipment, net 
Deferred tax assets 
Deposits  

Total assets 

LIABILITIES AND STOCKHOLDERS’ EQUITY
Current Liabilities:

Accounts payable 
Accrued expenses and other liabilities   

Total current liabilities   
Operating lease liability, net of current portion 

Total liabilities 
Commitments and contingencies (Note 8)
Stockholders’ equity:
Preferred stock, $0.001 par value, 5,000,000 shares authorized: none issued and outstanding at 

December 31, 2020 and 2019

Common stock, $0.001 par value, 200,000,000 and 150,000,000 shares authorized; 103,781,641 

shares and 103,397,033 shares issued and outstanding at December 31, 2020 and 2019, 
respectively

Additional paid-in capital   
Accumulated deficit 
Accumulated other comprehensive income (loss) 

Total stockholders’ equity 

Total liabilities and stockholders’ equity   

December 31,
2020

December 31,
2019

$130,237,109 
  10,041,068 
5,987,426 
4,650,600 
8,327,771 

  159,243,974 
—   
129,800 
  32,971,264 
8,888 

$  89,511,710 
5,007,050 
10,536,997 
1,956,792 
4,351,074 

  111,363,623 
793,252 
210,467 
—   
8,888 

$192,353,926 

$ 112,376,230 

$  4,256,020 
  18,500,267 

  22,756,287 
—   

  22,756,287 

$ 

4,117,447 
19,981,295 

24,098,742 
647,532 

24,746,274 

—   

—   

103,782 
  223,168,149 
  (53,705,624)
31,332 

103,397 
  216,205,678 
  (128,688,624)
9,505 

  169,597,639 

87,629,956 

$192,353,926 

$ 112,376,230 

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

F-5

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

Revenues:

Product revenue, net  
Revenues from collaborative arrangements 

Total revenues  

Operating costs and expenses:

Cost of sales 
Research and development 
Selling, general and administrative 

Total operating costs and expenses 

Operating income (loss) 
Other income, net  

Net income (loss) before income taxes  

Income tax provision (benefit) 

Net income (loss) 

Net income (loss) per share:

Basic 

Diluted 

Weighted average shares outstanding:

Basic 

Diluted 

Net income (loss)
Other comprehensive income (loss):

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

Comprehensive income (loss) 

Year Ended December 31,

2020

2019

2018

$118,740,617  $102,306,337  $ 

332,186 

—   

119,072,803 

102,306,337 

—   
500,000 

500,000 

  17,039,157 
  16,496,715 
  44,233,754 

  14,759,139 
  18,842,752 
  36,881,187 

—   
  19,919,204 
  15,875,961 

  77,769,626 

  70,483,078 

  35,795,165 

  41,303,177 
586,897 

  31,823,259    (35,295,165)
  1,291,651 
  1,585,774 

  41,890,074 
  (33,092,926)

  33,409,033    (34,003,514)
—   
  1,533,696 

$  74,983,000  $  31,875,337  $  (34,003,514)

$ 

$ 

0.72  $ 

0.71  $ 

0.31  $ 

0.30  $ 

(0.33)

(0.33)

103,512,913 

102,944,316 

 102,633,884 

106,242,273 

106,020,936 

 102,633,884 

$  74,983,000  $  31,875,337  $  (34,003,514)

21,827 

29,753   

(20,248)

$  75,004,827  $  31,905,090  $  (34,023,762)

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

F-6

 
 
 
 
 
 
 
 
 
 
 
 
CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’ EQUITY 

For the years ended December 31, 2020, 2019 and 2018 

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 gain 

(loss)

Net income (loss)

Balance at December 31, 

2018 

Issuance of stock options for 

services

Exercise of stock options for 

common stock

Amortization of restricted 

stock for services

Other comprehensive gain 

(loss)

Net income (loss)

Balance at December 31, 

2019 

Issuance of stock options for 

services

Exercise of stock options for 

common stock

Amortization of restricted 

stock for services

Issuance of common stock 

upon vesting of restricted 
stock units, net

Other comprehensive gain 

(loss)

Net income (loss)

Balance at December 31, 

2020 

Preferred
Stock

Common Stock

Shares

Amount

Additional
Paid-in
Capital

Accumulated
Deficit

Accumulated
Other
Comprehensive
Gain (Loss)

Total

$  —    102,549,498  $ 102,549  $207,421,710  $ (126,560,447) $ 

 —  $  80,963,812 

—   

—   

3,094 

3 

10,546 

—   

  —   

  3,535,647 

—     

186,665 

187 

297,376 

—   

—   

—   

—   

10,549 

—   

  3,535,647 

—   

297,563 

—   
—   

—   
—   

  —   
  —   

—   
—   

—   
(34,003,514)

(20,248)  
—   

(20,248)
  (34,003,514)

—    102,739,257 

 102,739  211,265,279 

  (160,563,961)

(20,248)

  50,783,809 

—   

—   

  —   

  3,780,086 

—     

657,776 

658 

  1,115,584 

—   

  —   

44,729 

—   

—   

—   

—   

  3,780,086 

—   

  1,116,242 

—   

44,729 

—   
—   

  —   
  —   

—   
—   

—   
  31,875,337 

29,753 
—   

29,753 
  31,875,337 

—   

—   
—   

—    103,397,033 

 103,397  216,205,678 

  (128,688,624)

9,505 

  87,629,956 

—   

—   

  —   

  5,694,120 

—     

281,762 

282 

757,848 

—   

—   

  —   

566,803 

—     

102,846 

103 

(56,300)

—   

—   

—   

—   

—   

  5,694,120 

—   

—   

758,130 

566,803 

—   

(56,197)

—   
—   

—   
—   

  —   
  —   

—   
—   

—   
  74,983,000 

21,827 
—   

21,827 
  74,983,000 

$  —    103,781,641  $ 103,782  $223,168,149  $  (53,705,624) $ 

31,332  $169,597,639 

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

F-7

 
 
 
 
 
 
 
 
 
 
 
CATALYST PHARMACEUTICALS, INC. 
CONSOLIDATED STATEMENTS OF CASH FLOWS 

Operating Activities:
Net income (loss)
Adjustments to reconcile net income (loss) to net cash provided by (used in) 

operating activities:

Depreciation 
Amortization of right-of-use asset 
Stock-based compensation  
Deferred taxes 
Change in accrued interest and accretion of discount on investments 
(Increase) decrease in:

Accounts receivable, net 
Inventory 
Prepaid expenses and other current assets and deposits 

Increase (decrease) in:

Accounts payable 
Accrued expenses and other liabilities   
Operating lease liability 

Net cash provided by (used in) operating activities

Investing Activities:
Purchases of property and equipment 
Purchases of investments   
Proceeds from maturities and sales of investments 

Net cash provided by (used in) investing activities

Financing Activities:
Payment of employee withholding tax related to stock-based compensation

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 

Supplemental disclosures of cash flow information:
Cash paid for income taxes 
Non-cash investing and financing activities:
Unrealized gain (loss) on available-for-sale securities  

Year Ended December 31,

2020

2019

2018

$  74,983,000 

$  31,875,337 

$ (34,003,514)

92,065 
793,252 
6,260,923 
  (32,971,264)
(12,191)

54,327 
243,399 
3,824,815 
—   
(290,805)

4,549,571 
(2,693,808)
(3,976,697)

  (10,536,997)
(1,900,780)
(2,701,293)

138,573 
(1,209,280)
(919,280)

1,780,080 
  12,540,197 
(276,807)

37,978 
—   
3,550,644 
—   
(443,139)

—   
(56,012)
(476,037)

391,792 
4,850,743 
—   

  45,034,864 

  34,611,473 

  (26,147,545)

(11,398)
  (10,000,000)
5,000,000 

(19,369)
  (34,725,401)
  71,969,365 

(92,018)
  (36,790,854)
  21,800,000 

(5,011,398)

  37,224,595 

  (15,082,872)

(56,197)
758,130 

701,933 

—   
1,116,242 

1,116,242 

(4,448)
297,563 

293,115 

  40,725,399 
  89,511,710 

  72,952,310 
  16,559,400 

  (40,937,302)
  57,496,702 

$ 130,237,109 

$  89,511,710 

$  16,559,400 

$  2,785,497 

$ 

21,827 

$ 

$ 

—   

29,753 

$ 

$ 

—   

(20,248)

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

F-8

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CATALYST PHARMACEUTICALS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS 

1.  Organization and Description of Business. 

Catalyst Pharmaceuticals, Inc. and subsidiary (collectively, the “Company”) is a commercial-stage biopharmaceutical company 

focused on developing and commercializing innovative therapies for people with rare debilitating, chronic neuromuscular and 
neurological diseases, including Lambert-Eaton Myasthenic Syndrome (LEMS) and Anti-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 (ages 17 and above). On January 15, 2019, the Company launched its first product, Firdapse®, in the United States 
for the treatment of adults with LEMS.  

On August 6, 2020, the Company announced that Canada’s national healthcare regulatory agency, Health Canada, has approved 

Firdapse® for the treatment of patients in Canada with LEMS. On October 28, 2020, the Company launched Firdapse® in Canada for 
the treatment of patients with LEMS through a license agreement with KYE Pharmaceuticals.  

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, raising capital, and selling its product. The Company incurred 
operating losses in each period from inception and started reporting operating income during the year ended December 31, 2019. The 
Company has been able to fund its cash needs to date through several public and private offerings of its securities and from revenues 
from its product sales. See Note 11 (Stockholders’ Equity).  

Capital Resources 

While there can be no assurance, based on currently available information, the Company estimates that it 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 drug 
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 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.  

Risks and Uncertainties 

There are many uncertainties regarding the novel coronavirus (COVID-19) pandemic, and the Company is closely monitoring 
the impact of the pandemic on all aspects of its business, including how the pandemic is impacting its patients, employees, suppliers, 
vendors, business partners, clinical trials, and distribution channels. The Company is unable to predict the impact that COVID-19 will 
have on its financial position and operating results in future periods due to numerous uncertainties. The Company will continue to 
assess the evolving impact of the COVID-19 pandemic and make adjustments to its operations as necessary.  

2. 

Basis of Presentation and Significant Accounting Policies. 

a. 

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

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

F-9

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

c. 

d. 

e. 

f. 

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 
and U.S. Treasuries. The Company has substantially all of its cash and cash equivalents deposited with one financial 
institution. These amounts exceed federally insured limits.  

INVESTMENTS. The Company invests in high credit-quality instruments in order to obtain higher yields on its cash 
available for investments. At December 31, 2020, investments consisted of short-term bond funds and U.S. Treasuries. 
At December 31, 2019, investments consisted of U.S. Treasuries. Such investments are not insured by the Federal 
Deposit Insurance Corporation.  

The short-term bond funds and U.S. Treasuries held at December 31, 2020 are classified as available-for-sale securities. 
The short-term bond funds are classified as current assets, which reflects management’s intention to use the proceeds 
from the sale of these investments to fund the Company’s operations, as necessary. The Company classifies U.S. 
Treasuries with stated maturities of greater than three months and less than one year in short-term investments, U.S 
Treasuries with stated maturities greater than one year are classified as non-current investments in its consolidated 
balance sheets.  

The Company records available-for-sale securities at fair value with unrealized gains and losses reported in accumulated 
other comprehensive income (loss) in stockholders’ equity. Realized gains and losses are included in other income, net 
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 and 
comprehensive income (loss). 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 (Investments).  

The Company previously owned a short-term bond fund that was 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 recognized 
realized gains and losses and unrealized gains and losses to earnings. At December 31, 2020 and 2019, there were no 
investments classified as trading securities, as the Company sold its interest in the short-term bond fund classified as 
trading securities in 2019. There was no realized or unrealized gain (loss) on trading securities for the year ended 
December 31, 2020. Realized losses on trading securities during the years ended December 31, 2019 and 2018 were 
$80,045 and $0, respectively. Unrealized gain (loss) on trading securities was $0 and ($29,430) for the years ended 
December 31, 2019 and 2018, respectively, and is included in other income, net in the accompanying consolidated 
statements of operations.  

ACCOUNTS RECEIVABLE, NET. Accounts receivable are recorded net of customer allowance for distribution fees, 
trade discounts, prompt payment discounts, chargebacks and expected credit losses. Allowances for distribution fees, 
trade discounts, prompt payment discounts and chargebacks are based on contractual terms. The Company estimates the 
allowance for expected credit losses based on existing contractual payment terms, actual payment patterns of its 
customer and customer circumstances. At December 31, 2020 and 2019, the Company determined that an allowance for 
expected credit losses was not required. No accounts were written off during the periods presented.  

INVENTORY. Inventories are stated at the lower of cost or net realizable value. Inventories consist of raw materials, 
work-in-process and finished goods. Costs to be capitalized as inventories primarily include third party manufacturing 
costs and other overhead costs. Cost is determined using a standard cost method, which approximates actual cost, and 
assumes a first-in, first out (FIFO) flow of goods. 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® were recorded as research and development expenses 
in prior years’ consolidated statements of operations and comprehensive income (loss). 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. As of December 31, 2020 and 2019, inventory consisted mainly of work-in-process 
and finished goods.  

F-10

2. 

Basis of Presentation and Significant Accounting Policies (continued).

g. 

h. 

i. 

j. 

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 associated with clinical development programs are included in inventory 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 manufacturing, prepaid tax, prepaid insurance, prepaid subscription fees, prepaid research fees, 
prepaid commercialization expenses, and amounts due from collaborative arrangements. Prepaid research fees consist of 
advances for the Company’s product development activities, including contracts for pre-clinical studies, clinical trials 
and studies, regulatory affairs and consulting. Prepaid manufacturing consists of advances for the Company’s drug 
manufacturing activities. Such advances are recorded as expense as the related goods are received or the related services 
are performed.  

PROPERTY AND EQUIPMENT, NET. 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.  

FAIR VALUE OF FINANCIAL INSTRUMENTS. The Company’s financial instruments consist of cash and cash 
equivalents, investments, accounts receivable, accounts payable, and accrued expenses and other liabilities. At 
December 31, 2020 and 2019, 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 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.  

F-11

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

Cash and cash equivalents:
Money market funds 

U.S. Treasuries 

Short-term investments:
Short-term bond funds 

Cash and cash equivalents:
Money market funds 

U.S. Treasuries 

Short-term investments:
U.S. Treasuries 

Fair Value Measurements at Reporting Date Using

Balances as of 
December 31, 
2020

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

Significant Other
Observable Inputs
(Level 2)

Significant 
Unobservable Inputs
(Level 3)

$  15,673,626 

$ 104,994,400 

$ 

$ 

15,673,626 

—   

$  10,041,068 

$ 

10,041,068 

$ 

$ 

$ 

—   

104,994,400 

 —   

$ 

$ 

$ 

—   

—   

—   

Balances as of 
December 31, 
2019

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

Significant Other
Observable Inputs
(Level 2)

Significant 
Unobservable Inputs
(Level 3)

$  23,963,617 

$  59,932,200 

$ 

5,007,050 

$ 

$ 

$ 

23,963,617 

—   

—   

$ 

$ 

$ 

—   

59,932,200 

5,007,050 

$ 

$ 

$ 

—   

—   

—   

k.  OPERATING LEASES. The Company determines if an arrangement is a lease at inception. Operating leases are 

included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on its 
consolidated balance sheets. Operating lease ROU assets and operating lease liabilities are recognized based on the 
present value of the future minimum lease payments over the lease term at commencement date. As the Company’s 
leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information 
available at commencement date in determining the present value of future payments. The operating lease ROU asset 
also includes any lease payments made and excludes lease incentives and initial direct costs incurred. The Company’s 
lease terms do not include options to extend or terminate the lease as it is not reasonably certain that it will exercise these 
options. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. The 
Company has lease agreements with lease and non-lease components, which are generally accounted for separately.  

l. 

REVENUE RECOGNITION. The Company recognizes revenue when its customer obtains title of the promised goods, 
in an amount that reflects the consideration to which the Company expects to be entitled in exchange for these goods. 
The Company had no contracts with customers until the FDA approved Firdapse® in November 2018. Subsequent to 
receiving FDA approval, the Company entered into an arrangement with one distributor (the “Customer”), which is the 
exclusive distributor of Firdapse® in the United States. The Customer subsequently resells Firdapse® to a small group of 
exclusive specialty pharmacies (“SPs”) whose dispensing activities for patients with specific payors may result in 
government-mandated or privately negotiated rebate obligations for the Company with respect to the purchase of 
Firdapse®.  

To determine revenue recognition for arrangements that are within the scope of Accounting Standards Codification 
(“ASC”) Topic 606 – Revenue from Contracts with Customers (“Topic 606”), the Company performs the following five 
steps: (i) identify the contract(s) with a customer, (ii) identify the performance obligations in the contract, (iii) determine 
the transaction price, (iv) allocate the transaction price to the performance obligations in the contract, and (v) recognize 
revenue when (or as) the entity satisfies a performance obligation. The Company only applies the five-step model to 
arrangements that meet the definition of a contract under Topic 606, including when it is probable that the Company will 
collect the consideration it is entitled to in exchange for the goods or services it transfers to the customer. At contract 
inception, once the contract is determined to be within the scope of Topic 606, the Company assesses the goods or 
services promised within each contract and determines those that are performance obligations and assesses whether each 
promised good or service is distinct. The Company then recognizes as revenue the amount of the transaction price that is 
allocated to the respective performance obligation when (or as) the performance obligation is satisfied. For a complete 
discussion of accounting for product revenue, see Product Revenue, Net below.  

F-12

 
 
 
 
2. 

Basis of Presentation and Significant Accounting Policies (continued).

The Company also may generate revenues from payments received under a collaborative agreement. Collaborative 
agreement payments may include nonrefundable fees at the inception of the agreements, contingent payments for 
specific achievements designated in the collaborative agreements, and/or net profit-sharing payments on sales of 
products resulting from a collaborative arrangement. For a complete discussion of accounting for collaborative 
arrangements, see Revenues from Collaborative Arrangements below.  

Product Revenue, Net: The Company sells Firdapse® to the Customer (its exclusive distributor) who subsequently 
resells Firdapse® to both a small group of SPs who have exclusive contracts with the Company to distribute the 
Company’s products to patients and potentially to medical centers or hospitals on an emergency basis. In addition to the 
distribution agreement with its Customer, the Company enters into arrangements with health care providers and payors 
that provide for government-mandated and/or privately negotiated rebates, chargebacks, and discounts with respect to 
the purchase of the Company’s products.  

The Company recognizes revenue on product sales when the Customer obtains control of the Company’s product, which 
occurs at a point in time (upon delivery or upon dispense to patient). Product revenue is recorded net of applicable 
reserves for variable consideration, including discounts and allowances. The Company’s payment terms range between 
15 and 30 days.  

Shipping and handling costs for product shipments occur prior to the customer obtaining control of the goods and are 
recorded in cost of sales.  

If taxes should be collected from the Customer relating to product sales and remitted to governmental authorities, they 
will be excluded from revenue. The Company expenses incremental costs of obtaining a contract when incurred, if the 
expected amortization period of the asset that the Company would have recognized is one year or less. However, no such 
costs were incurred during the years ended December 31, 2020 and 2019.  

During the years ended December 31, 2020 and 2019, all of the Company’s sales of Firdapse® in the United States were 
to its Customer.  

Reserves for Variable Consideration: Revenue from product sales are recorded at the net sales price (transaction 
price), which includes estimates of variable consideration for which reserves are established. Components of variable 
consideration include trade discounts and allowances, prompt payment discounts, product returns, provider chargebacks 
and discounts, government rebates, and other incentives, such as voluntary patient assistance, and other allowances that 
are offered within contracts between the Company and its Customer, payors, and other indirect customers relating to the 
Company’s sale of its products. These reserves, as detailed below, are based on the amounts earned, or to be claimed on 
the related sales, and are classified as reductions of accounts receivable (if the amount is payable to the Customer) or a 
current liability (if the amount is payable to a party other than a customer).  

These estimates take into consideration a range of possible outcomes which are probability-weighted in accordance with 
the expected value method in Topic 606 for relevant factors such as current contractual and statutory requirements, 
specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, 
these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the 
terms of the respective underlying contracts.  

The amount of variable consideration which is included in the transaction price may be constrained, and is included in 
the net sales price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue 
recognized under the contract will not occur in a future period. The Company’s analyses also contemplates application 
of the constraint in accordance with the guidance, under which it determined a material reversal of revenue would not 
occur in a future period for the estimates detailed below as of December 31, 2020 and, therefore, the transaction price 
was not reduced further during the years ended December 31, 2020 and 2019. Actual amounts of consideration 
ultimately received may differ from the Company’s estimates. If actual results in the future vary from the Company’s 
estimates, the Company will adjust these estimates, which would affect net product revenue and earnings in the period 
such variances become known.  

F-13

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

Trade Discounts and Allowances: The Company provides its Customer with a discount that is explicitly stated in its 
contract and is recorded as a reduction of revenue in the period the related product revenue is recognized. In addition, the 
Company receives sales order management, data and distribution services from the Customer. To the extent the services 
received are distinct from the sale of Firdapse® to the Customer, these payments are classified in selling, general and 
administrative expenses in the Company’s consolidated statement of operations and comprehensive income (loss). 
However, if the Company has determined such services received to date are not distinct from the Company’s sale of 
products to the Customer, these payments have been recorded as a reduction of revenue within the consolidated 
statement of operations and comprehensive income (loss) through December 31, 2020 and 2019, as well as a reduction 
to accounts receivable, net on the consolidated balance sheets.  

Prompt Payment Discounts: The Company provides its customer with prompt payment discounts which may result in 
adjustments to the price that is invoiced for the product transferred, in the case that payments are made within a defined 
period. The prompt payment discount reserve is based on actual net sales and contractual discount rates. Reserves for 
prompt payment discounts are included in accounts receivable, net on the consolidated balance sheets.  

Funded Co-pay Assistance Program: The Company contracts with a third-party to manage the co-pay assistance 
program intended to provide financial assistance to qualified commercially-insured patients. The calculation of the 
accrual for co-pay assistance is based on an estimate of claims and the cost per claim that the Company expects to 
receive associated with Firdapse® that has been recognized as revenue, but remains in the distribution channel at the end 
of each reporting period. These payments are considered payable to the third-party vendor and the related reserve is 
recorded in the same period the related revenue is recognized, resulting in a reduction of product revenue and the 
establishment of a current liability which is included in accrued expenses and other current liabilities in the consolidated 
balance sheets.  

Product Returns: Consistent with industry practice, the Company offers the SPs and its distributor limited product 
return rights for damaged and expiring product, provided it is within a specified period around the product expiration 
date as set forth in the applicable individual distribution agreement. The Company estimates the amount of its product 
sales that may be returned by its Customer and records this estimate as a reduction of revenue in the period the related 
product revenue is recognized. The Company currently estimates product return liabilities using available industry data 
and its own sales information, including its visibility into the inventory remaining in the distribution channel. The 
Company has an insignificant amount of returns to date and believes that returns of its products will continue to be 
minimal.  

Provider Chargebacks and Discounts: Chargebacks for fees and discounts to providers represent the estimated 
obligations resulting from contractual commitments to sell products to qualified healthcare providers at prices lower than 
the list prices charged to the Customer who directly purchases the product from the Company. The Customer charges the 
Company for the difference between what they pay for the product and the ultimate selling price to the qualified 
healthcare providers. These reserves are established in the same period that the related revenue is recognized, resulting 
in a reduction of product revenue, net and accounts receivable, net. Chargeback amounts are generally determined at the 
time of resale to the qualified healthcare provider by the Customer, and the Company generally issues credits for such 
amounts within a few weeks of the Customer’s notification to the Company of the resale. Reserves for chargebacks 
consist principally of chargebacks that the Customer has claimed, but for which the Company has not yet issued a credit.  

Government Rebates: The Company is subject to discount obligations under state Medicaid programs and Medicare. 
These reserves are recorded in the same period the related revenue is recognized, resulting in a reduction of product 
revenue and the establishment of a current liability which is included in accrued expenses and other current liabilities on 
the consolidated balance sheets. For Medicare, the Company also estimates the number of patients in the prescription 
drug coverage gap for whom the Company will owe an additional liability under the Medicare Part D program. The 
Company’s liability for these rebates consists of invoices received for claims from prior quarters that have not been paid 
or for which an invoice has not yet been received, estimates of claims for the current quarter, and estimated future claims 
that will be made for product that has been recognized as revenue, but which remains in the distribution channel 
inventories at the end of each reporting period.  

F-14

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

Bridge and Patient Assistance Programs: The Company provides free Firdapse® to uninsured patients who satisfy pre-
established criteria for either the Bridge Program or the Patient Assistance Program. Patients who meet the Bridge 
Program eligibility criteria and are transitioning from investigational product while they are waiting for a coverage 
determination, or later, for patients whose access is threatened by the complications arising from a change of insurer may 
receive a temporary supply of free Firdapse® while the Company is determining the patient’s third-party insurance, 
prescription drug benefit or other third-party coverage for Firdapse®. The Patient Assistance Program provides free 
Firdapse® for longer periods of time for those who are uninsured or functionally uninsured with respect to Firdapse®
because they are unable to obtain coverage from their payor despite having health insurance, to the extent allowed by 
applicable law. The Company does not recognize any revenue related to these free products and the associated costs are 
classified in selling, general and administrative expenses in the Company’s consolidated statements of operations and 
comprehensive income (loss).  

Revenues from Collaborative Arrangements: The Company has entered into collaboration agreements for the further 
development and commercialization of generic Sabril® (vigabatrin) tablets as well as the commercialization of Firdapse®
in Canada. Pursuant to the terms of these agreements, 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 or net-profit sharing payments on sales of products resulting from the collaborative agreement.  

Nonrefundable upfront license fees are recognized upon receipt or over time based on a determination of whether access 
to the Company’s intellectual property is throughout the license period, or whether the right is provided as the 
intellectual property exists as the point in time in which the license is granted. In the third quarter of 2020, an upfront fee 
was earned under the collaboration agreement for the commercialization of Firdapse® in Canada.  

The collaborative agreements provide for milestone payments upon achievement of development and regulatory events. 
The Company accounts for milestone payments as variable consideration in accordance with Topic 606. The Company 
recognizes sales-based royalties or net profit-sharing when the later of (a) the subsequent sale occurs, or (b) the 
performance obligation to which the sales-based royalty or net profit-sharing has been satisfied.  

In arrangements where the Company does not deem the collaborator to be a customer, payments to and from the 
collaborator are presented in the statement of operations based on the nature of the Company’s business operations, the 
nature of the arrangement, including the contractual terms, and the nature of the payments.  

Under the arrangements, the Company will receive profit-sharing reports 60 days after quarter end from one 
collaborator, and within nine days after quarter end from the other collaborator. Since the Company will receive these 
reports 60 days after quarter end, profit-sharing revenue from sales of collaboration products by the Company’s 
collaborator will be recognized in the quarter following the quarter in which the corresponding sales occurred. In 
instances where profit-sharing reports are received within nine days after quarter end, revenue from sales of 
collaboration products by the Company’s collaborator will be recognized in the quarter in which the sales occurred. For 
the year ended December 31, 2020, there was profit-sharing revenue of approximately $33,000 from sales of the 
collaborative product in Canada. For the years ended December 31, 2019 and 2018, there was no profit-sharing revenue 
from sales of the collaborative product.  

Refer to Note 7 (Collaborative Arrangements), for further discussion on the Company’s collaborative arrangements.  

m.  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.  

n. 

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

F-15

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

o. 

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

The Company sells its product in the United States through an exclusive distributor (its Customer) to specialty 
pharmacies. Therefore, its distributor and specialty pharmacies account for all of its trade receivables and net product 
revenues. The creditworthiness of its Customer is continuously monitored, and the Company has internal policies 
regarding customer credit limits. The Company estimates an allowance for expected credit loss primarily based on the 
credit worthiness of its Customer, historical payment patterns, aging of receivable balances and general economic 
conditions.  

The Company currently has a single product with limited commercial sales experience, which makes it difficult to 
evaluate its current business, predict its future prospects and forecast financial performance and growth. The Company 
has invested a significant portion of its efforts and financial resources in the development and commercialization of the 
lead product, Firdapse®, and expects Firdapse® to constitute virtually all of product revenue for the foreseeable future. 
The Company’s success depends on its ability to continue to effectively commercialize Firdapse®.  

The Company relies exclusively on third parties to formulate and manufacture Firdapse® and its drug candidates. The 
commercialization of Firdapse® and any other drug candidates, if approved, could be stopped, delayed or made less 
profitable if those third parties fail to provide sufficient quantities of product or fail to do so at acceptable quality levels 
or prices. The Company does not intend to establish its own manufacturing facilities. The Company is using the same 
third-party contractors to manufacture, supply, store and distribute drug supplies for clinical trials and for the 
commercialization of Firdapse®. If the Company is unable to continue its relationships with one or more of these third-
party contractors, it could experience delays in the development or commercialization efforts as it locates and qualifies 
new manufacturers. The Company intends to rely on one or more third-party contractors to manufacture the commercial 
supply of its drugs.  

p.  ROYALTIES. Royalties incurred in connection with the Company’s license agreement, as disclosed in Note 9 

(Agreements), are expensed to cost of sales as revenue from product sales is recognized.  

q. 

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 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 2017. 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 March 27, 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law making 
several changes to the Internal Revenue Code. The changes include, but are not limited to: increasing the limitation on 
the amount of deductible interest expense, allowing companies to carryback certain net operating losses, and increasing 
the amount of net operating loss carryforwards that corporations can use to offset taxable income.  

The tax law changes in the CARES Act did not have a material impact on the Company’s income tax provision.  

F-16

2. 

Basis of Presentation and Significant Accounting Policies (continued). 

r. 

s. 

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 income (loss) is shown on the consolidated statements of operations and comprehensive income (loss) 
for the years ended December 31, 2020, 2019, and 2018, and is comprised of net unrealized gains (losses) on the 
Company’s available-for-sale securities.  

NET INCOME (LOSS) PER COMMON SHARE. Basic net income (loss) per share is computed by dividing net 
income (loss) for the period by the weighted average number of common shares outstanding during the period. With 
regard to common stock subject to vesting requirements, the calculation includes only the vested portion of such stock.  

Diluted net income (loss) per common share is computed by dividing net income (loss) by the weighted average number 
of common shares outstanding, increased by the assumed conversion of other potentially dilutive securities during the 
period.  

The following table reconciles basic and diluted weighted average common shares:  

Basic weighted average common shares outstanding
Effect of dilutive securities 

Diluted weighted average common shares 

outstanding

For the Years Ended 
December 31,

2020
 103,512,913
  2,729,360

2019
 102,944,316
  3,076,620

2018
 102,633,884
—  

 106,242,273

 106,020,936

 102,633,884

Outstanding common stock equivalents totaling approximately 7.1 million and 4.6 million, were excluded from the 
calculation of diluted net income (loss) per common share for the years ended December 31, 2020 and 2019, 
respectively, as their effect would be anti-dilutive. For the year ended December 31, 2018, approximately 10.5 million 
shares of outstanding stock options were excluded from the calculation of diluted net loss per common share because a 
net loss was reported in this period and therefore their effect was anti-dilutive. Potentially dilutive options to purchase 
common stock as of December 31, 2020, 2019 and 2018 had exercise prices ranging from $0.79 to $3.95, $0.79 to $4.20 
and $0.79 to $4.64, respectively.  

t. 

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

u.  RECLASSIFICATIONS. Certain prior year amounts in the consolidated financial statements have been reclassified to 

conform to the current year presentation.  

v. 

RECENTLY ISSUED ACCOUNTING STANDARDS. 

In November 2018, the FASB issued ASU 2018-18, Collaborative Arrangements (Topic 808), which amends ASC 808 
to clarify when transactions between participants in a collaborative arrangement under ASC 808 are within the scope of 
ASU 2014-09 (codified in ASC 606). The amendments require the application of ASC 606 existing guidance to 
determine the units of account that are distinct in a collaborative arrangement for purposes of identifying transactions 
with customers. If a unit of account within the collaborative arrangement is distinct and is with a customer, an entity 
shall apply the guidance in Topic 606 to that unit of account. In a transaction between collaborative participants, an 
entity is precluded by ASU 2018-18 from presenting a transaction together with “revenue from contracts with 
customers” unless the unit of account is within the scope of ASC 606 and the entity applies the guidance in ASC 606 to 
such unit of account. The Company adopted the new standard on January 1, 2020. The Company has a collaboration 
agreement with Endo Ventures Limited (Endo). See Note 7 (Collaborative Arrangement). However, these amendments 
did not have an impact on the Company’s consolidated financial statements, as Endo does not meet the definition of a 
customer.  

F-17

2. 

Basis of Presentation and Significant Accounting Policies (continued).

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 adopted the new standard on January 1, 2020. The adoption of this 
standard did not have a material impact on the Company’s consolidated financial statements.  

In August 2018, the FASB issued ASU 2018-15, Intangibles – Goodwill and Other – Internal-Use Software (Subtopic 
350-40), Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a 
Service Contract. The amendments in this update align the requirements for capitalizing implementation costs incurred 
in a hosting arrangement that is a services contract with the requirements for capitalizing implementation costs incurred 
to develop or obtain internal-use software (and hosting arrangements that include an internal-use software license). 
Accordingly, the amendments in this update require an entity in a hosting arrangement that is a service contract to follow 
the guidance in Subtopic 350-40 to determine which implementation costs to capitalize as an asset related to the service 
contract and which costs to expense. The Company adopted the new standard on January 1, 2020 and applied 
prospectively to all implementation costs incurred after the date of adoption. The adoption of this standard did not have a 
material impact on the Company’s consolidated financial statements.  

The Securities and Exchange Commission, or SEC, issued a final rule on November 19, 2020, adopting amendments to 
Regulation S-K to modernize, simplify and enhance certain disclosure requirements. The amendments reflect a 
principles-based, registrant-specific approach to disclosure intended to enhance the focus of financial disclosures on 
material information for the benefit of investors, while simplifying compliance efforts for registrants. Registrants are 
required to comply with the rule beginning with the first fiscal year ending on or after August 9, 2021, or the mandatory 
compliance date. Although registrants are not required to apply the amended rules until the mandatory compliance date, 
they may comply with the final amendments any time after the effective date, so long as disclosure responsive to an 
amended item is provided in its entirety. The Company early adopted these amendments, effective for this report.  

In December 2019, the FASB issued ASU 2019-12, Income Taxes: Simplifying the Accounting for Income Taxes, a new 
standard intended to simplify the accounting for income taxes by eliminating certain exceptions related to the approach 
for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of 
deferred tax liabilities for outside basis differences. The new standard also simplifies aspects of the accounting for 
franchise taxes and enacted changes in tax laws or rates and clarifies the accounting for transactions that result in a step-
up in the tax basis of goodwill. The standard is effective for annual periods beginning after December 15, 2020 and 
interim periods within, with early adoption permitted. Adoption of the standard requires certain changes to be made 
prospectively, with some changes to be made retrospectively. The Company is evaluating the impact of the standard on 
its financial condition and results of operations.  

F-18

3. 

Investments. 

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

At December 31, 2020:
U.S. Treasuries - Cash equivalents   
Bond Funds - ST  

Total 

At December 31, 2019:
U.S. Treasuries - Cash equivalents   
U.S. Treasuries - ST 

Total 

Estimated 
Fair Value

Gross 
Unrealized
Gains

Gross 
Unrealized
Losses

Amortized 
Cost

$ 104,994,400 
  10,041,068 

$  2,709 
  28,623 

$  —   
—   

$ 104,991,691 
  10,012,445 

$ 115,035,468 

$  31,332 

$  —   

$ 115,004,136 

$  59,932,200 
5,007,050 

$  2,042 
7,463 

$  —   
—   

$  59,930,158 
4,999,587 

$  64,939,250 

$  9,505 

$  —   

$  64,929,745 

There were no realized gains or losses from available-for-sale securities for the years ended December 31, 2020, 2019 or 2018.  

The Company did not hold any securities in an unrealized loss position for more than 12 months as of December 31, 2020.  

The estimated fair values of available-for-sale securities at December 31, 2020, by contractual maturity, are summarized as 

follows:  

Due in one year or less 

2020
$ 115,035,468

4. 

Prepaid Expenses and Other Current Assets. 

Prepaid expenses and other current assets consist of the following as of December 31:  

Prepaid manufacturing costs 
Prepaid tax 
Prepaid insurance  
Prepaid subscriptions fees   
Prepaid research fees 
Prepaid commercialization expenses 
Due from collaborative arrangements 
Other 

2020
$ 3,327,610 
  1,368,464 
  1,285,104 
729,065 
453,034 
199,095 
436,784 
528,615 

2019
$ 1,526,013 
—   
  1,263,129 
501,251 
481,057 
62,959 
—   
516,665 

Total prepaid expenses and other current assets  

$ 8,327,771 

$ 4,351,074 

F-19

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5.  Operating Leases. 

The Company has operating lease agreements for its corporate office. The leases include options to extend the leases for up to 1 

year and options to terminate the lease within 1 year. There are no obligations under finance leases.  

The Company entered into an agreement in May 2020 that amended its lease for its office facilities. Under the amended lease, 

the Company’s leased space will increase from approximately 7,800 square feet of space to approximately 10,700 square feet of space. 
The amended lease commenced in early 2021 when construction of the asset was completed and space became available for use. 
Consequently, the Company will record the effects of the amended lease during Q1 2021 which will be material to the Company’s 
consolidated financial statements. The lease disclosures for the year ended December 31, 2020 in these financial statements have been 
adjusted for the modification of the current lease. The components of lease expense for the old leased space were as follows:  

Operating lease cost 

Supplemental cash flow information related to leases was as follows:  

Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows 
Right-of-use assets obtained in exchange for lease obligations:

Operating leases 

Supplemental balance sheet information related to leases was as follows:  

Operating lease right-of-use assets   

Other current liabilities 
Operating lease liabilities, net of current portion 

Total operating lease liabilities 

Weighted average remaining lease  term 
Weighted average discount rate 

Remaining payments of lease liabilities as of December 31, 2020 were as follows:  

2021 
2022 

Total lease payments 

Less imputed interest 

Total 

For the Year 
Ended December 31,
2020
261,736    

$ 

  December 31, 2020  

$ 

$ 

339,605    

55,801    

December 31, 2020
—   
$ 

$ 

$ 

28,772 
—   

28,772 

0.1 years 

3.68%

$28,860 
  —   

  28,860 
(88)

$28,772 

Rent expense was $278,753, $318,346 and $242,155 for the years ended December 31, 2020, 2019 and 2018.  

F-20

 
 
 
 
 
 
 
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 
Accrued purchases 
Accrued contributions 
Operating lease liability 
Accrued variable consideration 
Accrued income tax 
Other 

2020
$ 
584,502 
  1,883,880 
  3,991,056 
  10,372,642 
258,067 
310,000 
28,772 
964,316 
—   
107,032 

2019
$  1,183,513 
  1,241,526 
  3,064,645 
  8,751,991 
  1,313,310 
  1,535,000 
300,518 
884,764 
  1,533,696 
172,332 

Current accrued expenses and other liabilities 

  18,500,267 

  19,981,295 

Lease liability – non-current 

Non-current accrued expenses and other liabilities 

—   

—   

647,532 

647,532 

Total accrued expenses and other liabilities   

$ 18,500,267 

$ 20,628,827 

7. 

Collaborative Arrangements. 

In December 2018, the Company entered into a collaboration and license agreement (Collaboration) with Endo, for the further 

development and commercialization of generic Sabril® (vigabatrin) tablets through Endo’s U.S. Generic Pharmaceuticals segment, 
doing business as Par Pharmaceutical.  

Under the Collaboration, Endo 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 a milestone payment, 

and a sharing of defined net profits upon commercialization from Endo consisting of a mid-double-digit percent of net sales of generic 
Sabril®. The Company has also agreed to a sharing of certain development expenses. Unless terminated earlier in accordance with its 
terms, the collaboration continues in effect until the date that is ten years following the commercial launch of the product.  

The collaborative agreement provides for a $2.0 million milestone payment on the commercial launch of the product by Par. As 

of December 31, 2020, 2019, and 2018, no milestone payments have been earned.  

Revenues from collaborative arrangement with Endo for years ended December 31, 2020, 2019, and 2018 were $0, $0 and 
$500,000 (for upfront license fees). Total expenses incurred, net, in connection with the collaborative agreement with Endo for years 
ended December 31, 2020, 2019, and 2018 were approximately $4,254, $65,061 and $0, respectively. These expenses have been 
included in research and development expenses in the accompanying consolidated statements of operations and comprehensive 
income (loss).  

In August 2020, the Company entered into a collaboration and license agreement with KYE Pharmaceuticals Inc (KYE), for the 

commercialization of Firdapse® in Canada.  

Under the agreement, KYE assumes all selling and marketing costs under the collaboration, while the Company is responsible 

for supply of Firdapse® based on the collaboration partner’s purchase orders.  

Under the terms of the agreement, the Company will receive an up-front payment, received payment upon transfer of Marketing 
Authorization and delivery of commercial product, received payment for supply of Firdapse®, will receive milestone payments, and a 
sharing of defined net profits upon commercialization from KYE consisting of a mid-double-digit percent of net sales of Firdapse®. 
The Company has also agreed to a sharing of certain development expenses. Unless terminated earlier in accordance with its terms, 
the collaboration continues in effect until the date that is ten years following the commercial launch of the product in Canada.  

F-21

 
 
 
 
 
 
 
 
 
 
 
 
 
 
7. 

Collaborative Arrangements (continued).

Revenues from arrangement with KYE for the year ended December 31, 2020 were approximately $332,000. Total expenses 
incurred, net, in connection with the agreement with KYE for the year ended December 31, 2020 were approximately $257,500. These 
expenses have been included in selling, general and administrative expenses in the accompanying consolidated statements of 
operations and comprehensive income (loss).  

The agreement provides for event-based payments subject to achievement of specified development, regulatory and sales-based 

milestones.  

8. 

Commitments and Contingencies. 

In 2018, the Company became aware that certain patents granted to Northwestern University (which patents have been licensed 

by Northwestern to a third party) for a new GABA aminotransferase inhibitor were developed from CPP-115, which had previously 
been licensed to the Company by Northwestern. As a result, on October 26, 2018, the Company terminated the license agreement for 
CPP-115 and commenced an arbitration proceeding against Northwestern seeking damages for alleged breaches of the license 
agreement. Shortly thereafter, Northwestern filed counterclaims against the Company in the arbitration action seeking damages for 
alleged breaches by the Company of the license agreement. On May 21, 2019, the Company entered into a settlement agreement with 
Northwestern that resolved all pending disputes between the parties with no admission of liability by either party, released all claims 
of liability or wrongdoing between the Company and Northwestern, and dismissed the pending arbitration. Under the settlement 
agreement, the Company received a $100,000 payment on May 21, 2019, which is reported as income in other income, net in the 
consolidated statement of operations and comprehensive income (loss). The Company is also entitled to receive certain contingent 
compensation that will be reported when and if received.  

In May 2019, the FDA approved a New Drug Application (NDA) for Jacobus Pharmaceuticals for Ruzurgi®, their version of 
amifampridine (3,4-DAP), for the treatment of pediatric LEMS patients (ages 6 to under 17). The Company believes that Jacobus is 
offering Ruzurgi® at a lower price than the Company is offering Firdapse®. While the NDA for Ruzurgi® only covers pediatric patients, 
the Company believes that Ruzurgi® is being prescribed off label to adult LEMS patients. If Jacobus is able to successfully sell 
Ruzurgi® off-label to adult LEMS patients, it could have a material adverse effect on the Company’s business, financial condition and 
results of operations.  

The Company believes that the FDA’s approval of Ruzurgi® violated its statutory rights and was in multiple other respects 
arbitrary, capricious and contrary to law. As a result, in June 2019 the Company filed suit against the FDA and several related parties 
challenging this approval and related drug labeling. The Company’s complaint, which was filed in the federal district court for the 
Southern District of Florida, alleged that the FDA’s approval of Ruzurgi® violated multiple provisions of FDA regulations regarding 
labeling, resulting in misbranding in violation of the Federal Food, Drug, and Cosmetic Act (FDCA); violated its statutory rights to 
Orphan Drug Exclusivity and New Chemical Entity Exclusivity under the FDCA; and was in multiple other respects arbitrary, 
capricious, and contrary to law, in violation of the Administrative Procedure Act. Among other remedies, the suit sought an order 
vacating the FDA’s approval of Ruzurgi®. Jacobus has intervened in the case.  

On July 30, 2020, the Magistrate Judge considering the Company’s lawsuit against the FDA filed a Report and 

Recommendation in which she recommended to the District Judge handling the case that she grant the FDA’s and Jacobus’ motions 
for summary judgment and deny the Company’s motion for summary judgment. On September 29, 2020, the District Judge adopted 
the Report and Recommendation of the Magistrate Judge, granted the FDA’s and Jacobus’s motions for summary judgment, and 
dismissed the Company’s case. The Company has appealed the decision to the Eleventh Circuit Court of Appeals. There can be no 
assurance as to the outcome of this lawsuit.  

On August 10, 2020, Health Canada issued a Notice of Compliance (NOC) to Medunik for Ruzurgi® for the treatment of LEMS. 

The Company has since initiated a legal proceeding in Canada seeking judicial review of Health Canada’s decision to issue the NOC 
for Ruzurgi® as incorrect and unreasonable under Canadian law. Data protection, per Health Canada regulations, is supposed to 
prevent Health Canada from issuing a NOC to a drug that directly or indirectly references an innovative drug’s data, for eight years 
from the date of the innovative drug’s approval. The Ruzurgi® Product Monograph clearly references pivotal nonclinical 
carcinogenicity and reproductive toxicity data for amifampridine phosphate developed by the Company. As such, the Company 
believes that its data was relied upon to establish the nonclinical safety profile of Ruzurgi® needed to meet the standards of the 
Canadian Food and Drugs Act. There can be no assurance of the result of this proceeding.  

Additionally, from time to time the Company may become involved in legal proceedings arising in the ordinary course of 

business. Except as set forth above, the Company believes that there is no other litigation pending at this time that could have, 
individually or in the aggregate, a material adverse effect on its results of operations, financial condition or cash flows.  

F-22

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 pays: (i) royalties to the licensor 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 for the duration of any regulatory exclusivity within a territory and 3.5% for 
territories in any calendar year in territories without regulatory exclusivity.  

On May 29, 2019, the Company entered into an amendment to its license agreement for Firdapse®. Under the 
amendment, the Company has expanded its commercial territory for Firdapse®, which originally was comprised of North 
America, to include Japan. Additionally, the Company has an option to further expand its territory under the license 
agreement to include most of Asia, as well as Central and South America, upon the achievement of certain milestones in 
Japan. Under the amendment, the Company will pay royalties on net sales in Japan of a similar percentage to the 
royalties that the Company is currently paying under its original license agreement for North America.  

In January 2020, the Company was advised that BioMarin has transferred certain rights under the license agreement to 
SERB S.A.  

b.  AGREEMENTS FOR DRUG MANUFACTURING, DEVELOPMENT, PRECLINICAL AND CLINICAL 

STUDIES. The Company has entered into agreements with contract manufacturers for the manufacture of commercial 
drug and 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, most of 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. 

The Company is subject to income taxes in the U.S. federal jurisdiction and various states jurisdictions.  

For the year ended December 31, 2018, due to the Company’s historical operating losses and the inability to recognize any 

income tax benefit, there was no provision for income taxes presented in these financial statements for that respective period. 
Commencing in 2019, the Company has recorded income taxes on their pretax income using an effective tax rate.  

The income tax expense (benefit) for the years ended December 31, 2020, 2019, and 2018 consists of:  

Current   
Deferred  

2020
$ 
 (121,662)
  (32,971,264)

2019
$  1,533,696 
—   

$ (33,092,926)

$  1,533,696 

2018

—   
—   

—   

$ 

$ 

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 
Tax credit 
Other 

2018

2019

2020
  21.0%   21.0%   21.0%
  2.2%   6.5%   4.2%
  (99.4)%   (20.9)%   (25.9)%
  (2.4)%   (2.5)%   1.4%
  (0.4)%   0.5%   (0.7)%

  (79.0)%   4.6%   0.0%

F-23

 
 
10. 

Income Taxes (continued).

Deferred tax assets and liabilities reflect the net tax effects of net operating loss and tax credit carryovers and the temporary 

differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax 
purposes. Significant components of the Company’s deferred tax assets as of December 31, 2020 and 2019 are as follows:  

Net operating loss
Start-up costs 
Tax credits 
Deferred compensation 
Inventory 
Prepaid expenses  
Other 

Gross deferred tax asset 

Valuation allowance 

Net deferred tax assets

2020
$  2,319,848 
  11,203,034 
  15,615,681 
  3,889,133 
212,045 
(398,979)
130,502 

2019
$  10,645,128 
  12,894,926 
  14,320,860 
3,183,767 
229,050 
—   
355,023 

  32,971,264 

  41,628,754 

—   

  (41,628,754)

$ 32,971,264 

$ 

—   

The Company has evaluated the positive and negative evidence bearing upon the realizability of its deferred tax assets. As of 

December 31, 2020, the Company determined that there is sufficient positive evidence to conclude that it is more likely than not that 
the above deferred taxes of approximately $33.0 million are realizable. Accordingly, the Company has released the full valuation 
allowance for deferred tax assets including net operating loss and tax credit carryover as of December 31, 2020. The valuation 
allowance released over the course of the year ended December 31, 2020 was $41.6 million. 

At December 31, 2020 and 2019, respectively, the Company had federal net operating loss carryforwards of approximately 
$3 million and $45 million available to reduce future taxable income. The federal net operating loss carryforwards are expected to be 
utilized within the next year. Additionally, at December 31, 2020 and 2019, respectively, the Company had state net operating loss 
carryforwards of approximately $42 million and $52 million available to reduce future Florida taxable income. The state net operating 
loss carryforwards will expire at various dates beginning in 2033.  

During 2020, the Company completed an analysis to determine whether, as a result of prior ownership changes, the utilization of 
certain net operating loss and orphan drug tax credit carryforwards would be subject to annual limitations under Sections 382 and 383 
of the Internal Revenue Code and similar state provisions. In this analysis, the Company determined that the total net operating loss 
and orphan drug tax credit carryforwards are fully utilizable. Thus, the deferred tax assets were adjusted accordingly.  

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. The orphan drug credit carryforwards will expire at various dates beginning in 2031.  

No interest or penalties were accrued through December 31, 2020. The Company’s policy is to recognize any related interest or 

penalties in income tax expense. The Company is not currently under income tax examinations by any tax authorities.  

11.  Stockholders’ Equity. 

Preferred Stock 

The Company has 5,000,000 shares of authorized preferred stock, $0.001 par value per share, at December 31, 2020 and 2019. 

No shares of preferred stock were outstanding at December 31, 2020 and 2019.  

Common Stock 

On August 20, 2020, the Company’s stockholders approved an increase in the Company’s authorized common stock par value 

$0.001 per share, from 150,000,000 shares to 200,000,000 shares. At December 31, 2020 and 2019, 103,781,641 and 103,397,033 
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.  

F-24

 
 
 
 
 
 
 
 
11.  Stockholders’ Equity (continued).

2020 Shelf Registration Statement 

On July 23, 2020, the Company filed a shelf registration statement with the SEC to sell up to $200 million of common stock, 

preferred stock, warrants to purchase common stock, debt securities and units consisting of one or more of such securities (the “2020 
Shelf Registration Statement”). The 2020 Shelf Registration Statement (file no. 333-240052) was declared effective by the SEC on 
July 31, 2020. As of the date of this report, no offerings have been completed under the Company’s 2020 Shelf Registration 
Statement.  

Stockholder Rights Plan 

On September 20, 2011, the Board of Directors approved the Company’s adoption of a Stockholder Rights Plan. Under the 
Stockholders’ Rights 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 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 was extended 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.  

On August 28, 2019, the Board of Directors unanimously adopted Amendment No. 2 to the Stockholders’ Rights Plan further 

extending the outside expiration date of the rights plan to September 20, 2022.  

12.  Stock Compensation. 

For the years ended December 31, 2020, 2019 and 2018, the Company recorded stock-based compensation expense as follows:  

Research and development  
Selling, general and administrative   

Total stock-based compensation 

2020
$ 1,585,202 
  4,675,721 

2019
$ 1,137,596 
  2,687,219 

2018
$ 1,079,230 
  2,471,414 

$ 6,260,923 

$ 3,824,815 

$ 3,550,644 

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, 2020, no shares remain available for future issuance under the 2014 
Plan. Under the 2018 Plan, 10,000,000 shares were reserved for issuance and as of December 31, 2020, 1,856,008 shares remain 
available for future issuance.  

F-25

12.  Stock Compensation (continued).

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 3 years of continuous service 
and have contractual terms of 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, 2020, 2019, and 2018, options to purchase 281,762, 654,332 and 186,665 shares, 

respectively, of the Company’s common stock were exercised with gross proceeds to the Company of $758,130, $1,116,242, and 
$297,563, respectively. During the years ended December 31, 2020 and 2018, no options to purchase shares of the Company’s 
common stock were exercised on a “cashless” basis. During the year ended December 31, 2019, options to purchase 6,666 shares of 
the Company’s common stock were exercised on a “cashless” basis, resulting in the issuance of an aggregate of 3,444 shares of the 
Company’s common stock.  

During the years ended December 31, 2020, 2019, and 2018 the Company recorded non-cash stock-based compensation 

expense related to stock options totaling $5,694,120, $3,780,086, and $3,535,647, respectively.  

During the years ended December 31, 2020, 2019, and 2018, the Company granted seven-year options to purchase an aggregate 

of 2,715,000, 2,183,500 and 5,882,500 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, 2020 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

Weighted 
Average 
Exercise Price

Weighted 
Average 
Remaining 
Contractual Term
(in years)

Aggregate 
Intrinsic Value

11,478,334  $ 
  2,715,000 
(281,762)
(160,668)
(357,235)

13,393,669  $ 

  7,926,136  $ 

2.95 
3.75 
2.69 
3.84 
3.38 

3.10   

2.64   

4.42  $  8,237,645 

3.38  $  7,381,601 

Other information pertaining to stock option activity during the years ended December 31, 2020, 2019, and 2018 was as follows:  

2020

2019

2018

Weighted–average fair value of granted stock options  
Total fair value of vested stock options 
Total intrinsic value of exercised stock options 

2.33 $ 

1.93 
$ 
$5,311,616 $3,864,995  $2,193,294 
$  325,102 $1,899,862  $  274,864 

2.69  $ 

As of December 31, 2020, there was approximately $10.02 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 
2.35 years.  

F-26

 
 
 
 
 
 
12.  Stock Compensation (continued).

The Company utilizes the Black-Scholes option-pricing model to determine the fair value of stock options on the date of grant. 
This model derives the fair value of stock options based on certain assumptions related to the expected stock price volatility, expected 
option life, risk-free interest rate and dividend yield. Expected volatility is based on reviews of historical volatility of the Company’s 
common stock. The estimated expected option life is based upon estimated employee exercise patterns and considers whether and the 
extent to which the options are in-the-money. The Company estimates the expected option life for options granted to employees and 
directors based upon the simplified method. Under this method, the expected life is presumed to be the mid-point between the vesting 
date and the end of the contractual term. The Company will continue to use the simplified method until it has sufficient historical 
exercise data to estimate the expected life of the options. The risk-free interest rate assumption is based upon the U.S. Treasury yield 
curve appropriate for the estimated life of the stock options awards. The expected dividend rate is zero. 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, 2020
0.24% to 1.64% 
4.5 years     
80.5% to 83.7% 
—% 
—% 

December 31, 2019
1.51% to 2.53% 
4.5 years     
75.5% 
—% 
—% 

December 31, 2018
2.09% to 2.88% 
0 to 7 years     
82% 
—% 
—% 

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 three-year period. 
Upon vesting, the restricted stock units will convert into an equivalent number of shares of common stock. The amount of expense 
relating to the restricted stock units is based on the closing market price of the Company’s common stock on the date of grant and is 
amortized on a straight-line basis over the requisite service period. Restricted stock unit activity during 2020 was as follows:  

2020

Nonvested balance at beginning of year

Granted 
Vested 
Forfeited 

Nonvested balance at end of year

  235,671  $ 

Weighted Average
Grant Date Fair 
Value

Number of
Restricted 
Stock Units
  352,500  $ 
30,000 
  (117,495)
(29,334)

4.64 
4.70 
4.64 
4.64 

4.65 

During the year ended December 31, 2019, 352,500 restricted stock units were granted and outstanding and there were no vested 

or forfeited shares. There was no restricted stock unit activity during 2018.  

During the year ended December 31, 2020 and 2019, the Company recorded non-cash stock-based compensation expense 
related to restricted stock units totaling $566,803 and $44,729, respectively. No stock-based compensation related to restricted stocks 
was recorded during 2018.  

Common Stock 

No shares of common stock were granted during the year ended December 31, 2020 or 2019. 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.  

F-27

 
 
 
 
 
 
 
 
 
 
 
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, 2020, 2019, and 2018, the Company’s matching contributions were approximately 
$465,000, $268,000 and $123,000, respectively.  

F-28