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Cumberland Pharmaceuticals Inc.
Annual Report 2013

CPIX · NASDAQ Healthcare
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Industry Drug Manufacturers - Specialty & Generic
Employees 91
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FY2013 Annual Report · Cumberland Pharmaceuticals Inc.
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A n n u a l   R e p o r t

2525 West End Avenue, Suite 950
Nashville, Tennessee 37203
P 
(615) 255-0068
TF  (877) 484-2700
F 
(615) 255-0094
www.cumberlandpharma.com

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2013 
 
 
 
 
 
 
Company Overview & Strategy

Cumberland Pharmaceuticals is a specialty 
pharmaceutical company that acquires, 
develops, and commercializes branded 
prescription products.  We are dedicated to 
providing innovative products that improve the 
quality of care for patients and address poorly 
met medical needs.

Founded in 1999, our commercial portfolio now includes:

•	 Acetadote® (acetylcysteine) Injection for the treatment of  
  acetaminophen poisoning;

•	 Caldolor® (ibuprofen) Injection for the treatment of pain and fever; 

•	 Kristalose® (lactulose) for Oral Solution, a prescription laxative  

for the treatment of acute and chronic constipation;

•	 Omeclamox®-Pak, a combination treatment for Helicobacter pylori  

infection and duodenal ulcer disease. 

We are also developing Hepatoren® (ifetroban) Injection for patients 
suffering from hepatorenal syndrome, a life-threatening condition 
involving progressive kidney failure for which there is no FDA -approved 
pharmaceutical treatment.  

Our strategy is to build a diversified specialty product portfolio while 
deploying our resources to sustain profitability. Through our sales and 
marketing campaigns we are seeking to maximize the potential of 
our currently available prescription brands. We are also seeking new 
products through select acquisitions that can complement our existing 
infrastructure and preferably provide an immediate financial contribution. 
Our proven clinical development team is working to expand our pipeline 
and progress innovative new product candidates to improve patient care. 
We are also establishing an international presence through select partners 
who can make our brands available to patients in their countries. 

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CPIX Annual Report 2013	
 
 
	
	
 
 
 
	
 
 
CPIX at a Glance

Selected Financial Data

(dollars in thousands except per share data) 

2009 

2010 

2011 

2012 

2013

Net Revenues 
Operating Income (loss) 
Operating Margin 
Net Income (loss) 
Diluted Earnings (loss) Per Share 
Total Assets 
Long-Term Obligations 
Shareholders’ Equity 

 $  43,537  
   5,777  

  $45,876  
6,502  

  $51,143  
 9,849  

  $48,851  
 8,818  

 $32,027 
   (3,801)

13.3 % 

14.2 % 

19.3 % 

18.1 % 

(11.9) %

   3,059  
0.17  
  103,724  
   20,155  
   72,221  

 2,427  
0.12  
   92,054  
 7,802  
   77,715  

  5,658  
0.28  
   95,518  
  5,438  
   82,835  

5,842  
0.30  
  98,594  
4,972  
  85,566  

(2,105)
 (0.11)
   87,614 
 776 
   79,292 

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1

NET REVENUES0910111213SHAREHOLDERS’EQUITY0910111213 
 
 
  
  
  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Milestones

JANUARY 2013

Cumberland signs exclusive 
agreement with PT. SOHO 
Industri Pharmasi
Cumberland and SOHO partner 
to register and commercialize 
Caldolor® in Indonesia.

FEBRUARY 2013
Caldolor® Reduces Pain 
and Fever in Adults
Top-line results from two registry 
studies demonstrate the safety and 
efficacy of Caldolor® administered 
over a shortened infusion time in 
treating pain and fever in 450 adult 
patients.

FEBRUARY 2013
Cumberland signs exclusive 
agreement with Sandor 
Medicaids Pvt. Ltd
Cumberland and Sandor partner 
to register and commercialize 
Caldolor® in India.

APRIL 2013
Second Acetadote® 
Patent Issued
The United States Patent and 
Trademark Office issues a second 
patent regarding the use of the 200 
mg/ml Acetadote® formulation to 
treat patients with acetaminophen 
overdose. The patent term extends 
until August 2025.

JUNE 2013
Acetadote® Receives FDA 
Approval for Updated Labeling
The new labeling revises the 
product’s indication and offers
new dosing guidance for specific 
patient populations.

OCTOBER 2013
Cumberland Enters into 
Exclusive Agreement for 
Omeclamox®-Pak
Cumberland assumes responsibility 
for marketing and distributing 
the product in the United States. 
Cumberland will promote the 
product to gastroenterologists, 
while Pernix Therapeutics will 
promote it to select primary care 
and other physicians.

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2013 
Corporate Update 

To Our Shareholders, Employees & Partners:

Cumberland encountered new challenges in 2013 and I am pleased to report that our team rose to 
the occasion and has never been more energized. 

The company was faced with a decision on whether to change strategy given the FDA’s decision 
to approve a generic to our Acetadote® product.  Should we preserve our corporate infrastructure 
or enact significant expense reductions to maintain profitability - which could jeopardize our 
development and commercial capabilities?

Given our ability to respond to the challenges, the potential of our marketed and pipeline products, 
as well as our financial strength, our Board determined that staying the course was the best 
approach for building the future value of the company.  We developed a company-wide action plan 
with specific objectives and have been successfully executing on them. 

A.J. Kazimi
Chairman and 
Chief Executive Officer

When Acetadote, our largest revenue product, encountered generic competition, we quickly 
launched our Authorized Generic in order to also participate in the generic segment of the market. 
As a result, I am pleased to report that we were able to maintain a majority share of the market 
between sales of Acetadote and our Authorized Generic, which both contain our new formulation.

In 2013, we also brought a heightened focus on business development to help reestablish our 
path to profitability and top-line growth. That goal also yielded positive results, as we added 
Omeclamox®-Pak, an excellent strategic fit for our company. We are now responsible for the 
product’s marketing and distribution in the U.S.  Our field sales force will promote this brand to the 
gastroenterology market alongside Kristalose®, which continued its steady performance in 2013. 

Meanwhile, Caldolor® became our fastest growing product with sales nearly doubling over the prior 
year. Caldolor is now available in over 1,000 medical facilities across the United States. Our hospital 
force is expanding the product’s use and helping many more patients in key accounts. During 
2013, we also continued developing important new clinical data to support Caldolor for use in both 
adults and children.

On the international front, we added agreements to register and commercialize Caldolor in the 
Pacific Rim, South America and the Arabian Peninsula. Registration activities for Caldolor are 
underway though our existing partners in China, India and Indonesia.  We are also supporting the 
product’s launch in Canada, Australia and South Korea.

We believe that we can deliver important new products through our internal development team 
which was responsible for taking two of our brands through the FDA approval process. Our lead 
development candidate is Hepatoren®, which we are progressing in a Phase II study in patients 
suffering from life threatening liver and kidney failure.

We were able to absorb a slight loss in 2013 based on our strong financial position. We ended the 
year with significant assets, mostly in cash and short term investments. During 2013, we continued 
to actively repurchase Cumberland shares and have now bought back a total of 3.5 million shares 
since we launched this initiative. We believe this repurchase program will help in our goal to build 
long term value for our shareholders. Given our significant insider ownership, the interests of this 
organization and our shareholders remain closely aligned.

Our strategic theme for 2014 is to continue to build a diversified specialty product portfolio 
while deploying our resources to sustain long term profitability.  Cumberland enjoys a lean, 
high performance organization with outstanding individuals at all levels.  I would like to take 
this opportunity to thank each of them for their dedicated efforts and many contributions to our 
company.  We will continue to focus on our mission of improving patient care through the delivery 
of high quality pharmaceutical products. 

3

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CPIX Annual Report 2013Acetadote®

P R E C L I N I C A L             P H A S E   1 

          P H A S E   2            P H A S E   3            M A R K E T E D

Acetadote® (acetylcysteine) Injection, Cumberland’s 
first product, introduced our Company to the medical 
community and pharmaceutical industry in the United 
States. We developed Acetadote, obtained FDA 
approval in 2004 and then launched it into the U.S. 
hospital market. It was the first injectable treatment for 
acetaminophen overdose available in the United States. 

Acetadote is used in the emergency department, the intensive care unit, and the 
hospital inpatient setting to prevent or lessen liver damage from an 
overdose of acetaminophen, a common ingredient in many over-the-
counter and prescription medications. Though safe at recommended 
doses, acetaminophen can cause liver damage with excessive 
use and is a leading cause of drug poisoning in the U.S.  
Acetadote, promoted by Cumberland’s hospital sales force, 
has become a standard of care for these acetaminophen 
toxicity patients.

Based on our Phase IV commitments to the FDA, we 
provided data to support a pediatric indication for the 
product in 2006 and additional safety data in 2008.  We 
then completed development of a new formulation of 
Acetadote and launched the resulting next generation 
product following FDA approval in January 2011. This new 
formulation is the subject of two issued patents and is free of 
chelating, stabilizing and preservative chemicals.

In June 2013, we received FDA approval for 
updated Acetadote labeling which revises the 
product’s indication and offers new dosing 
guidance for specific patient populations. 

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CPIX Annual Report 2013Caldolor®

P R E C L I N I C A L             P H A S E   1 

          P H A S E   2            P H A S E   3            M A R K E T E D

Caldolor® (ibuprofen) Injection was also developed and 
registered with the FDA by our company following clinical 
studies in over 900 patients. It is the first FDA-approved 
intravenous treatment of both pain and fever.  Approved 
in 2009, Caldolor is designed primarily for use in adult 
patients in hospitals and surgery centers who are unable 
to receive oral therapies for pain relief or fever reduction. 

Our clinical trials have established Caldolor’s safety and efficacy profile. The resulting data 
indicates that the product significantly reduces fever, has beneficial anti-inflammatory 
properties, and significantly reduces pain while also reducing opioid consumption.

Caldolor may be administered prior to, during and after surgical procedures. In addition 
to working peripherally at the site of trauma, Caldolor also acts centrally to blunt the 
perception of pain. We introduced Caldolor to hospitals and surgical centers across 
the country through our hospital sales organization. By the end of 2013, Caldolor 
was stocked in over 1,000 U.S. medical facilities. We have turned our sales focus to 
expanding use and helping more patients in key hospitals that have approved and 
stocked the product.

Following Caldolor’s approval, we continued to build our patient safety and efficacy 
database. We have conducted several Phase IV studies in over 900 additional patients. 
In September 2012, top-line results were released regarding results from a clinical 
pediatric pain study evaluating the safety and analgesic efficacy of Caldolor in treating 
pain in pediatric tonsillectomy patients. When administered prior to surgery, Caldolor 
use was associated with a significant reduction in the number of post-operative narcotic 
doses required in patients in the efficacy evaluable population. 

In 2013, top-line results were released from two registry studies evaluating the safety and 
efficacy of Caldolor when administered over a shortened infusion time in treating pain and 
fever in adult patients. The studies involved 450 patients receiving Caldolor at 35 leading 
medical centers throughout the United States.

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CPIX Annual Report 2013Kristalose®

P R E C L I N I C A L             P H A S E   1 

          P H A S E   2            P H A S E   3            M A R K E T E D

Kristalose® (lactulose) for Oral Solution is the only 
branded prescription laxative available in a powder 
formulation. Used to treat acute and chronic 
constipation, it is the only laxative that features the 
established safety and efficacy of lactulose, plus the 
convenience of a pre-measured dose. Cumberland 
acquired exclusive U.S. commercial rights to 
Kristalose in 2006 and began marketing the product to 
gastroenterologists, internists and other high prescribers 
of laxatives using our field sales force. 

A unique, dry powder crystalline formulation of lactulose, Kristalose is the only 
prescription laxative available in pre-measured powder packets, making it easily 
portable. Kristalose dissolves quickly in 4 ounces of water, offering patients a virtually 
tasteless, grit-free and essentially calorie-free alternative to lactulose syrups. There are 
no age limitations or length of use restrictions for Kristalose and it is the only osmotic 
prescription laxative sampled to physicians.

We conducted a patient preference trial evaluating Kristalose compared to similar 
products in liquid forms.  The study results appeared in Clinical and Experimental 
Gastroenterology, demonstrating that 83% of patients in the study preferred the taste, 
consistency and portability of Kristalose over similar products in syrup forms. This data 
is highly relevant to our marketing activities for Kristalose, as a key differentiating factor 
for the product is its patient preference.  

In 2011, we reached an agreement to acquire the Kristalose FDA registration and 
trademark, allowing us to streamline the supply chain for the product.

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CPIX Annual Report 2013Omeclamox®-Pak

P R E C L I N I C A L             P H A S E   1 

          P H A S E   2            P H A S E   3            M A R K E T E D

Omeclamox®-Pak is a branded prescription product 
used for the treatment of Helicobacter pylori (H. pylori) 
infection and duodenal ulcer disease.  It combines 
three well-known and widely prescribed medications 
packaged together for patient convenience: omeprazole, 
clarithromycin, and amoxicillin. 

It is the first FDA approved triple therapy combination medication to contain omeprazole 
as the proton pump inhibitor, which works to decrease the amount of acid the stomach 
produces.  Clarithromycin and amoxicillin are both antibiotic agents which 
hinder the growth of H. pylori, allowing the stomach lining to heal.  

With a simple-to-follow 10-day course of therapy, Omeclamox-Pak 
has been shown to eradicate H. pylori in up to 90% of patients.

The three medications are packaged together on convenient daily 
dosing cards, making it simple to follow the AM/PM twice a day 
dosing before meals.  

We feature Omeclamox-Pak through our field based sales 
force. We acquired rights to this brand through an agreement 
with Pernix Therapeutics in October 2013. Under the terms of 
this agreement, Cumberland is responsible for the product’s 
marketing and distribution in the U.S. Cumberland is 

responsible for promotion to gastroenterologists and 

Pernix is responsible for promotion to certain 
primary care and other physicians.

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CPIX Annual Report 2013Hepatoren®

P R E C L I N I C A L             P H A S E   1 

          P H A S E   2            P H A S E   3             M A R K E T E D

In early 2011, Cumberland acquired the rights to 
ifetroban from CET, and initiated clinical development for 
the intravenous formulation of this product candidate, 
under the brand name Hepatoren®.  

Ifetroban had previously been developed by a large pharmaceutical company 
through multiple Phase II studies targeting significant cardiovascular indications. 
That development program did not meet all of its goals for these indications, and the 
product was subsequently donated to Vanderbilt University. Researchers at Vanderbilt 
identified ifetroban as a potentially valuable compound in treating patients for several 
new indications.  Vanderbilt in turn partnered with CET, Cumberland’s majority-owned 
subsidiary, to transfer all of the data and manufacturing associated with this product 
and establish a plan to complete its development.  

Cumberland plans to initially focus on an injectable formulation to treat patients suffering 
from hepatorenal syndrome, a life-threatening condition involving progressive kidney 
failure for which there is no FDA approved pharmaceutical treatment.  Approximately 
450,000 patients in the United States suffer from medical conditions that make them 
susceptible to cirrhosis and a subset of these patients develop hepatorenal syndrome 
every year.  Hepatoren® will be targeted to hospital critical care physicians and share 
many of the same call points as Acetadote®.  

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CPIX Annual Report 2013Cumberland Emerging Technologies (CET) provides access to 
a long term pipeline of innovative, biopharmaceutical product 
candidates. CET was established as a joint initiative between 
Cumberland Pharmaceuticals Inc., Vanderbilt University, and 
the Tennessee Technology Development Corporation, 
known as Launch Tennessee, to identify innovative product 
candidates and advance them from the laboratory to the 
marketplace. CET has formal collaboration agreements with 
leading academic research centers located in the mid-south 
region of the United States. Through these research centers 
CET evaluates a range of new emerging technologies and then 
teams with scientists to develop promising candidates. 

DUAL FOCUS

Development Partnerships – CET works with researchers at universities and other 
organizations who seek a corporate partner to develop innovative research projects. CET 
identifies promising therapeutics, diagnostics, and other technologies with high commercial 
potential and provides support to expedite development and improve the probability of success. 
CET’s role includes technology evaluation, product development, grant program management 
and commercialization support.

CET Life Sciences Center – CET has also formed the CET Life Sciences Center, a business 
incubator facility that provides laboratory and office space, equipment, and infrastructure to early-
stage biomedical companies. Located in the heart of downtown Nashville and just minutes away from 
renowned research centers including Vanderbilt University, this vibrant Life Sciences Center houses 
CET’s activities and also creates a collaborative setting to support other life science initiatives. 

Due to the high demand for life sciences incubator space in Nashville, the facility completed an 
expansion in 2012, doubling its size and providing additional wet lab, office and storage space to 
current and prospective tenants.

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CPIX Annual Report 2013Partnerships Around the World 

We rely on carefully selected partners for the distribution and international commercialization of our products. 
Through these arrangements, we are expanding our global presence to bring our products to countries throughout 
the world. Partnering with companies with established infrastructure and capabilities allows us to focus resources 
on our core capabilities—acquisition, development and commercialization of innovative pharmaceutical products.  

These partners represent an important component of our infrastructure and we work closely with each of them to 
deliver high quality products to patients. 

Canada— 
Alveda Pharmaceuticals Inc.,
is our commercial partner 
for Caldolor®

Spain & Portugal— 
Grifols is our commercial 
partner for Caldolor® 

Tennessee (Distribution)— 
Cardinal Health Inc. facility provides 
warehousing, shipping and other 
distribution support for our products 
in the U.S.

Venezuela— 
Valmorca is our commercial 
partner for Caldolor® 

Latin America— 
Grifols is our commercial 
partner for Caldolor® 

10

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CPIX Annual Report 2013 
 
 
Arabian Gulf — 
GerminMed is our commercial 
partner for Caldolor® and 
Acetadote®

United Arab Emirates (Dubai)— 
Al-Nabil International is our commercial 
partner for Caldolor® and Acetadote®

China— 
Harbin Gloria Pharmaceuticals Co., Ltd 
is our commercial partner for Caldolor® 
and Acetadote®

South Korea— 
DB Pharm Korea Co. Ltd., 
is our commercial partner 
for Caldolor®

Indonesia & Pacific Rim— 
The SOHO Group is our 
commercial partner for Caldolor®

Australia & 
New Zealand— 
Phebra Pty Ltd., is our 
commercial partner for 
Caldolor® and Acetadote®

India— 
Sandor Medicaids Pvt. Ltd. 
is our commercial partner 
for Caldolor®

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Board of Directors

A.J. Kazimi
Chairman
Cumberland Pharmaceuticals

Dr. Gordon R. Bernard
Associate Vice-Chancellor 
for Research
Vanderbilt University

Martin E. Cearnal
Senior Vice President and 
Chief Commercial Officer
Cumberland Pharmaceuticals

Management Team

A.J. Kazimi
Chief Executive Officer

Martin E. Cearnal
Senior Vice President, 
Marketing & Sales and 
Chief Commercial Officer

Leo Pavliv, R.Ph.
Senior Vice President, 
Operations and 
Chief Development Officer

Rick S. Greene
Vice President, Finance & 
Accounting and 
Chief Financial Officer 

James R. Jones
Former Managing Partner
KPMG LLP-Nashville

Thomas R. Lawrence
Chairman
Aetos Technologies Inc.

Dr. Robert G. Edwards
Former Deputy Director
Institute for Medicine and Veterinary 
Science-South Australia

Jonathan I. Griggs
Former Vice President 
Human Resources
Warner Lambert Corporation

Joey A. Jacobs
Chairman & CEO
Acadia Healthcare Co. Inc.

James L. Herman
Vice President, National Accounts 
and Chief Compliance Officer

Barry L. Lee
Product Director

Amy D. Rock, Ph.D.
Senior Director, Regulatory & 
Scientific Affairs

Arthur P. Wheeler, M.D.
Director, Medical Affairs

Kelly Menzel
Director, Hospital Sales

Todd M. Anthony
Director, Sales Training & 
Development

Tan Cheow Choon
Director, International Business

Michael P. Bonner
Director, Financial &
Tax Reporting

Cindy B. Patton
Director, Sales & Marketing

John Lane
Director, Corporate Development

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12

CPIX Annual Report 2013Directors and OfficersCumberland Pharmaceuticals
2013 Form 10-K 

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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549

Form 10-K

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

For the fiscal year ended December 31, 2013

of

CUMBERLAND PHARMACEUTICALS INC.

A Tennessee Corporation
IRS Employer Identification No.  62-1765329
Commission file number 001-33637

2525 West End Avenue, Suite 950
Nashville, Tennessee 37203
(615) 255-0068

Cumberland Pharmaceuticals Inc. Common Stock, no par value, shares are registered pursuant to Section 12(b) of the Act and are 

listed on the Nasdaq Global Select Market.

Cumberland Pharmaceuticals Inc. is not a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.  

Cumberland Pharmaceuticals Inc. is required to file reports pursuant to Section 13 or Section 15(d) of the Act.  Cumberland 

Pharmaceuticals Inc. (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, and (2) has been subject to such filing requirements for the past 90 days.

Cumberland Pharmaceuticals Inc. has submitted electronically and posted on its corporate Web site every Interactive Data File 
required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months. 

Disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405) will be contained, to the best of registrant’s 

knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this 
Form 10-K.  

Cumberland Pharmaceuticals Inc. is an accelerated filer as defined in Rule 12b-2 of the Exchange Act and is not a shell company.

The aggregate market value of common stock held by non-affiliates as of June 30, 2013 was $51,343,000. The number of shares 

of the registrant’s Common Stock, no par value, outstanding as of March 3, 2014 was 17,878,619.

DOCUMENTS INCORPORATED BY REFERENCE
Certain information required in Part III of Form 10-K is incorporated by reference from the registrant’s Proxy Statement for its 2014 

annual meeting of shareholders.

  
 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Index

Page Number

PART I

Item 1: Business

Item 1A: Risk Factors

Item 1B: Unresolved Staff Comments

Item 2: Properties

Item 3: Legal Proceedings

PART II

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

Item 6: Selected Financial Data

Item 7: Management’s Discussion and Analysis of Financial Condition and Results of 
Operations

Item 7A: Quantitative and Qualitative Disclosures About Market Risk

Item 8: Financial Statements and Supplementary Data

Item 9: Changes in and Disagreements with Accountants on Accounting and Financial 
Disclosure

Item 9A: Controls and Procedures

Item 9B: Other Information

PART III

PART IV

Item 15: Exhibits, Financial Statement Schedules

SIGNATURES

1

1

19

34

34

35

35

35

37

39

48

49

49

49

50

50

50

50

56

2

PART I

Item 1. Business.

THE COMPANY

Cumberland Pharmaceuticals Inc. (“Cumberland,” the “Company,” or as used in the context of “we,” “us,” or 
“our”),  is  a  specialty  pharmaceutical  company  focused  on  the  acquisition,  development  and  commercialization  of 
branded prescription products. Our primary target markets are hospital acute care and gastroenterology. These markets 
are characterized by relatively concentrated prescriber bases that we believe can be penetrated effectively by small, 
targeted sales forces. Cumberland is dedicated to providing innovative products that improve quality of care for patients 
and address unmet or poorly met medical needs. We market and sell our approved products through our hospital and 
field sales forces in the United States, which together comprised approximately 60 sales representatives and managers 
as of December 31, 2013.

Our product portfolio includes:

•  Acetadote® (acetylcysteine) Injection, for the treatment of acetaminophen poisoning, 

•  Caldolor® (ibuprofen) Injection, for the treatment of pain and fever, 

•  Kristalose® (lactulose) for Oral Solution, a prescription laxative, for the treatment of chronic 

and acute constipation,

•  Omeclamox®-Pak, triple therapy combination medication for Helicobacter pylori (H. pylori) 

infection and duodenal ulcer disease, 

•  Hepatoren® (ifetroban) Injection, a Phase II candidate for the treatment of hepatorenal syndrome.

We  have  both  product  development  and  commercial  capabilities,  and  believe  we  can  leverage  our  existing 
infrastructure to support our expected growth. Our management team consists of pharmaceutical industry veterans 
experienced in business development, product development, regulatory, manufacturing, sales, marketing and finance. 
Our business development team identifies, evaluates and negotiates product acquisition, in-licensing and out-licensing 
opportunities. Our product development team develops proprietary product formulations, manages our clinical trials, 
prepares all regulatory submissions and manages our medical call center. Our quality and manufacturing professionals 
oversee the manufacture and release of our products. Our marketing and sales professionals are responsible for our 
commercial activities, and we work closely with our distribution partners to ensure availability and delivery of our 
products.

Our strategy includes maximizing the potential of our existing products and selectively expanding our portfolio 
of differentiated products. We market four products approved for sale in the United States.  Through our international 
partners, we are working to bring our products to patients in countries outside the U.S. We also look for opportunities 
to expand our products into additional patient populations through clinical trials, new indications, and select investigator-
initiated  studies.  We  actively  pursue  opportunities  to  acquire  additional  marketed  products  as  well  as    late-stage 
development product candidates in our target medical specialties. Further, we are supplementing these activities with 
the  pipeline  drug  development  activities  at  Cumberland  Emerging  Technologies  ("CET"),  our  majority-owned 
subsidiary. CET partners with universities and other research organizations to develop promising, early-stage product 
candidates, which Cumberland has the opportunity to commercialize.

We were incorporated in 1999 and have been headquartered in Nashville, Tennessee since inception. During 2009, 
we completed an initial public offering of our common stock and listing on the NASDAQ exchange. Our website 
address is www.cumberlandpharma.com. We make available through our website our Annual Reports on Form 10-K, 
Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and all other press releases, filings and amendments 
to those reports as soon as reasonably practicable after their filing with the U.S. Securities and Exchange Commission, 
(“SEC”). These filings are also available to the public at www.sec.gov.

1

PRODUCTS

Our key products include:

Products

Indication

Status

Acetadote®

Acetaminophen Poisoning

Caldolor®

Pain and Fever

Kristalose®
Chronic and Acute Constipation
Omeclamox®-Pak H. pylori infection and duodenal
ulcer disease

Marketed following FDA approval in 
2004; new formulation FDA approved 
in 2011.

Marketed following FDA approval in 
2009.

Marketed by us since 2006.

Marketed by us since January 1, 2014.

Hepatoren®

Hepatorenal Syndrome

In Phase II clinical development.

Acetadote

Acetadote  is  an  intravenous  formulation  of  N-acetylcysteine,  or  ("NAC"),  indicated  for  the  treatment  of 
acetaminophen  poisoning.  Acetadote,  which  has  been  available  in  the  United  States  since  Cumberland's  2004 
introduction of the product, is currently used in hospital emergency departments to prevent or lessen potential liver 
damage resulting from an overdose of acetaminophen, a common ingredient in many over-the-counter and prescription 
pain relieving and fever-reducing products. Acetaminophen continues to be the leading cause of poisonings reported 
by hospital emergency departments in the United States, and Acetadote has become a standard of care for treating this 
potentially life-threatening condition.

Originally approved in January 2004, Acetadote received U.S. Food and Drug Administration ("FDA") approval 
as an orphan drug, which provided seven years of marketing exclusivity from the date of approval. In connection with 
the FDA's approval of Acetadote, we committed to certain post-marketing activities for the product. Our first Phase IV 
commitment (pediatric) was completed in 2004 and resulted in the FDA's 2006 approval of expanded labeling for 
Acetadote for use in pediatric patients. Our second Phase IV commitment (clinical) was completed in 2006 and resulted 
in further revised labeling for the product with FDA approval of additional safety data in 2008. We completed our third 
and final Phase IV commitment (manufacturing) for Acetadote in 2010, which culminated in the approval and launch 
of a new, next generation formulation of the product.

In October 2010, we submitted a supplemental new drug application (“sNDA”) to the FDA for approval of the 
new formulation of Acetadote designed to replace our original formulation. The new formulation, which is the result 
of  the  aforementioned  Phase  IV  commitment,  contains  no  ethylene  diamine  tetracetic  acid  ("EDTA")  or  other 
stabilization agent, chelating agent or preservative. In January 2011, we received FDA approval and commenced U.S. 
launch activities for this new Acetadote formulation. The original formulation has been removed from FDA reference 
materials and we no longer manufacture it.  In April 2012, the United States Patent and Trademark Office (the “USPTO”) 
issued U.S. Patent number 8,148,356 (the “356 Acetadote Patent”) which is assigned to us. The claims of the 356 
Acetadote Patent encompasses the Acetadote formulation and includes composition of matter claims. The 356 Acetadote 
Patent will expire in May 2026.

In  March  2013,  the  USPTO  issued  U.S.  Patent  number  8,399,445  (the  “445 Acetadote  Patent”)  which  is  also 
assigned to us. The claims of the 445 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acetaminophen overdose.  The 445 Acetadote Patent will expire in August 2025.  

On February18, 2014, the USPTO issued U.S. Patent number 8,653,061 (the “061 Acetadote Patent”) which is 
assigned to us. The claims of the 061 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acetaminophen overdose.  Following its issuance, the 061 Acetadote Patent was listed in the FDA 
Orange Book. The 061 Acetadote Patent is scheduled to expire in August 2025.  We are continuing to seek additional 
claims to protect our intellectual property associated with Acetadote.

2

On February 24, 2014, we received a Notice of Allowance from the USPTO for a patent relating to the use of the 
Acetadote formulation to treat patients with acetaminophen overdose. The new patent will include claims regarding 
the administration method of acetylcysteine injection, without specification of the presence or lack of EDTA in the 
injection, and is scheduled to expire in April 2032.

On November 8, 2012, we learned that the FDA approved the ANDA referencing Acetadote filed by InnoPharma, 
Inc.  That product, with the formulation containing EDTA, was subsequently introduced by APP, a division of Fresenius 
Kabi USA, around the end of 2012. On January 7, 2013, Perrigo announced initial distribution of our authorized generic 
acetylcysteine injection product. Both Acetadote and our authorized generic utilize the new, EDTA-free formulation 
which accounted for significant market share in 2013.

Acetadote Labeling Update

       In June 2013, we announced that the FDA has approved updated labeling for Acetadote. The new labeling 
revises the product's indication and offers new dosing guidance for specific patient populations.  The new indication 
states, "Acetadote is an antidote for acetaminophen overdose indicated to prevent or lessen hepatic injury after 
ingestion of a potentially hepatotoxic quantity of acetaminophen." The product's previous indication included the 
qualifying phrase, "administered intravenously within 8 to 10 hours," which was originally intended to impress the 
urgency for early treatment. This phrase has been removed to avoid any potential confusion concerning efficacy 
when administration within that time period is not possible.

     In addition, specific dosing guidance is now included for patients weighing over 100 kg. New language has also 
been added to alert health care providers that in certain clinical situations, therapy should be extended for some 
patients.

Supplemental New Drug Application for Acetadote

In the first quarter of 2010, we submitted an application to the FDA for the use of Acetadote in patients with non-
acetaminophen acute liver failure. This sNDA included data from a clinical trial led by investigators at the University 
of Texas Southwestern Medical Center indicating that early-stage acute liver failure patients treated with Acetadote 
have a significantly improved chance of survival without a transplant and that these patients can also survive a significant 
number of days longer without transplant. In December 2010, the FDA issued a Complete Response Letter indicating 
that it had completed its review of the application and identified additional items that must be addressed prior to approval 
of the potential new indication. Since then, we have been gathering additional data to determine whether we can address 
the FDA’s additional requirements.  

Caldolor

Caldolor, our intravenous formulation of ibuprofen, was the first injectable product approved in the United States 
for the treatment of both pain and fever. We conducted a series of clinical studies in over nine hundred adult patients 
to develop the data to support our submission for FDA approval. The FDA approved Caldolor for marketing in the 
United States in June 2009 following a priority review. The product is indicated for use in adults for the management 
of mild to moderate pain, for the management of moderate to severe pain as an adjunct to opioid analgesics, and for 
the reduction of fever.

In  September  2009,  we  launched  Caldolor  and  stocked  the  product  at  major  wholesalers  serving  hospitals 
nationwide. We initially worked to establish a core group of medical facilities approving and purchasing the product.  
We then focused on building more sales volume and treating a broader range of patients within those stocked facilities. 

We completed a series of Phase IV studies to gather additional data to support our Caldolor product. Those completed 
studies involved another 1,000 patients. The studies included evaluation of the product for the treatment of pediatric 
pain and pediatric fever in order to address our Phase IV commitment to the FDA for Caldolor.  We are also evaluating 
improved packaging for the product.

We have worldwide commercial rights to Caldolor. We promote Caldolor in the United States through our dedicated 
hospital sales force.  We have entered into several licensing agreements with experienced international partners to reach 
markets and patients outside the United States. 

3

Kristalose

Kristalose is a prescription laxative administered orally for the treatment of constipation. An innovative, dry powder 
crystalline formulation of lactulose, Kristalose is designed to enhance patient compliance and acceptance. We acquired 
exclusive U.S. commercialization rights to Kristalose in 2006, assembled a dedicated field sales force and re-launched 
the product in September 2006 as a Cumberland brand. We direct our sales efforts to physicians who are the most 
prolific writers of prescription laxatives, including gastroenterologists, pediatricians and internists.

In November 2011, through a series of transactions, we entered into an agreement with Mylan Inc. to acquire 
certain assets associated with the Kristalose brand including the Kristalose trademark and the FDA registration.  We 
also entered into a long-term supply agreement for the product. By entering into these transactions, we streamlined the 
supply chain for the product and are exploring opportunities to further develop the product.

Omeclamox-Pak

Omeclamox-Pak is a branded prescription product used for the treatment of Helicobacter pylori (H. pylori) infection 
and duodenal ulcer disease.  This innovative product combines three well-known and widely prescribed medications: 
omeprazole, clarithromycin, and amoxicillin.  Omeclamox-Pak is the first FDA approved triple therapy combination 
medication to contain omeprazole as the proton pump inhibitor, which works to decrease the amount of acid the stomach 
produces. Clarithromycin and amoxicillin are both antibiotic agents which hinder the growth of H. pylori.  Interaction 
of these agents allows the stomach lining to heal effectively.  The medications are packaged together on convenient 
daily dosing cards, making it simple to follow the AM/PM twice a day dosing before meals. 

Our involvement with Omeclamox-Pak was effective October 2013, through an agreement with Pernix Therapeutics 
("Pernix"). Under the terms of the agreement, we promote the product to gastroenterologists across the United States 
through our field sales force that also promotes our Kristalose brand. Pernix continues to promote the product through 
its specialty sales force focusing on select primary care physicians. We are responsible for the marketing, sale and 
distribution of the product. We launched our promotion and distribution efforts to support Omeclamox-Pak in early 
2014.    

Hepatoren

In April 2011, we entered into an agreement to acquire the rights to ifetroban, a new Phase II product candidate. 
We have initiated clinical development under the brand name Hepatoren (ifetroban) Injection and are evaluating this 
candidate for the treatment of critically ill hospitalized patients suffering from hepatorenal syndrome ("HRS"), a life-
threatening condition involving progressive kidney failure for which there is no U.S. approved pharmaceutical treatment. 
We would also seek orphan drug status and the associated seven years of marketing exclusivity for this indication.

Our acquisition of the rights to the ifetroban program includes an extensive clinical database and non-clinical data 
package as well as manufacturing processes, know-how and intellectual property. Ifetroban was initially developed by 
a large pharmaceutical company for significant cardiovascular indications. They conducted extensive studies for their 
target  indications  and  eventually  donated  the  entire  program  to  Vanderbilt  University.  Researchers  at  Vanderbilt 
identified ifetroban as a potentially valuable compound in treating patients for several niche indications. We acquired 
the rights to the ifetroban program from Vanderbilt through CET and intend to develop the product for several potential 
indications. 

We  have  commenced  manufacturing  of  an  intravenous  formulation  of  ifetroban  and  the  FDA  has  cleared  our 
Investigational New Drug ("IND") application for this product candidate. We have initiated a Phase II dose escalation 
clinical study to evaluate Hepatoren for the treatment of HRS and significantly progressed study enrollment in 2013. 
We have also filed patent applications to protect intellectual property related to the new indications for this product. 
We believe this product candidate is an excellent strategic fit given our established presence in the hospital acute care 
market.

4

OUR STRATEGY

Continue to build a high-performance sales organization to address our target markets

We believe that our commercial infrastructure can help drive prescription volume and product sales. We currently 
utilize two distinct sales teams to address our primary target markets:  a hospital sales force for the acute care market 
and a field sales force for the gastroenterology market.

Hospital market:  We promote Caldolor and Acetadote through our dedicated hospital sales team. This team 
targets key hospitals across the U.S., and is comprised of sales professionals with substantial experience in 
the hospital market. According to IMS Health, U.S. hospitals accounted for approximately $28 billion, or 9%, 
of U.S. pharmaceutical sales in 2011. However, IMS also reports that only 2% of approximately $23 billion 
total pharmaceutical industry promotional spending was focused on hospital-use drugs in 2011. The majority 
of promotional spending is directed toward large, outpatient markets on drugs intended for chronic use rather 
than short-term, hospital use. We believe the hospital market is underserved and highly concentrated, and that 
it can be penetrated effectively by a small, dedicated sales force without large-scale promotional activity.  Our 
strategy  has  also  involved  increasing  the  focus  of  the  hospital  sales  team  on  our  Caldolor  product  and 
specifically our high priority accounts that already carry Caldolor.  This strategy continues to contribute to 
Caldolor sales growth. 

Gastroenterology market:  We promote Kristalose and Omeclamox-Pak through a dedicated field sales team 
addressing a targeted group of physicians who are responsible for a majority of total retail  prescriptions for 
both products. Because the market for gastrointestinal diseases is broad in patient scope, yet relatively narrow 
in physician base, we believe it provides product opportunities that can be penetrated with a modest sized 
sales force.  By investing in our sales and marketing activities  we believe that we can increase market share 
for both the products. Our focus on the gastroenterology market and our existing field sales infrastructure 
provided us with the rationale to add another gastroenterology product in 2013.   We believe that our newest 
product, Omeclamox-Pak is an excellent fit for our field sales force. This force can feature both Kristalose 
and Omeclamox-Pak during most of their physician calls, expanding our presence in the gastroenterology 
market.

Expand our product portfolio by acquiring rights to additional products and late-stage product candidates

In addition to our product development activities, we are also seeking to acquire products or late-stage development 
product candidates to continue to build a portfolio of complementary products. We focus on under-promoted, FDA-
approved drugs as well as late-stage development products that address poorly met medical needs, which we believe 
helps mitigate our exposure to risk, cost and time associated with drug discovery and research. We plan to continue to 
target products that are competitively differentiated, have valuable intellectual property or other protective features, 
and allow us to leverage our existing infrastructure. The addition of Omeclamox-Pak reflects our strategy as it meets 
our select criteria and our commitment to expanding our product portfolio. We will also continue to explore opportunities 
for label expansion to bring our products to new patient populations.

Expand our global presence through select international partnerships

We have established our own commercial capabilities, including a sales organization to cover the U.S. market for 
our products.  We have established a network of select international partners to register our products and make them 
available to patients in their countries.  We will continue to expand our network of international partners and continue 
to encourage our partners’ commercialization efforts in their respective territories. 

Develop a pipeline of early-stage products through CET

In order to build our product pipeline, we are supplementing our acquisition and late-stage development activities 
with the early-stage drug development activities of CET, our majority-owned subsidiary. CET partners with universities 
and  other  research  organizations  to  develop  promising,  early-stage  product  candidates,  and  Cumberland  has  the 
opportunity to negotiate rights to further develop and commercialize them.

5

CLINICAL DEVELOPMENT OVERVIEW

Caldolor Pediatric Fever Study

In August  2013,  we  announced top-line  results  from  a  clinical pediatric fever  study  evaluating the  safety  and  
efficacy of Caldolor compared to acetaminophen in treating fever (greater than or equal to 101.0ºF) in hospitalized 
patients ranging from birth to 16 years old. One hundred and three patients were enrolled in this multi-center, randomized, 
open-label active comparator study. The pediatric patients received either 10 mg/kg intravenous ibuprofen (not to exceed 
400 mg per dose) or 10 mg/kg acetaminophen (not to exceed 650 mg per dose).

The primary endpoint of the study was to assess the area under the change in temperature versus time curve from 
baseline to two hours after the start of the initial dose of the study drug. In the two hours following dosing, pediatric 
patients receiving intravenous ibuprofen experienced a greater temperature reduction compared to patients receiving 
acetaminophen,  p=0.012; therefore meeting the primary endpoint of the study. 

After a single dose, significantly more patients receiving intravenous ibuprofen (93%) were no longer considered 

to be febrile (temperature less than 100.4ºF) compared to patients receiving acetaminophen (78%), p= 0.036. 

Patients  receiving  intravenous  ibuprofen  experienced  a  greater  temperature  reduction  compared  to  patients 
receiving acetaminophen at all temperature assessments during the four hours after dosing with reductions reaching 
statistical significance by ninety minutes post-dose.

No safety concerns were identified in the study and the incidence of adverse events was similar across treatment 

groups.

Caldolor Follow-Up Knee Arthroscopy Study

In February 2013, we announced favorable top-line results from a pilot clinical study evaluating the safety and 
analgesic efficacy of Caldolor compared to ketorolac injection in treating pain following knee arthroscopy procedures 
in adult patients. A follow-up, larger, multi-center study has been initiated to further study the safety and analgesic 
efficacy of Caldolor compared to ketorolac injection in treating pain following knee arthroscopy procedures in adult 
patients. One hundred patients are to be enrolled across four U.S. medical centers.

Caldolor Poster Presentations

Posters with data from three Caldolor studies were presented at the Annual Meeting of the American Society of 
Anesthesiologists in San Francisco in October 2013. The poster presentations were presented by Dr. Alberto Uribe, 
Post-Doctoral Researcher, Department of Anesthesiology, Wexner Medical Center at the Ohio State University.

A poster entitled "Multicenter, Open-label Surveillance Trials to Evaluate the Safety and Efficacy of a Shortened 
Infusion Time of Intravenous Ibuprofen" was presented. Two registry studies made up this presentation.  In the first 
registry study eligible patients were enrolled to receive one of two dose strengths (400 mg for treatment of fever, 800 
mg for treatment of pain) of intravenous ibuprofen for up to a 24-hour dosing period. One hundred fifty patients from 
13 clinical sites were enrolled in this study. Intravenous ibuprofen reduced fever and pain and the shortened infusion 
time was well tolerated.

The second registry study was a Phase IV multi-center, open-label surveillance clinical study to assess the safety 
of ibuprofen administered intravenously over five to ten minutes to adult hospitalized patients undergoing surgical 
procedures. Eligible patients were enrolled to receive 800 mg of intravenous ibuprofen administered at induction of 
anesthesia and could continue Caldolor therapy for up to 24 hours. Three hundred patients from 21 clinical sites were 
enrolled in this study. The shortened infusion time was well tolerated.

Another poster presentation was entitled "A Pilot Study to Determine the Efficacy of Intravenous Ibuprofen for 
Pain Control Following Arthroscopic Knee Surgery." This study was conducted at the Ohio State University Medical 
Center. The study enrolled fifty-one patients and the results indicate, compared to patients receiving ketorolac, patients 
receiving intravenous ibuprofen experienced less postoperative pain prior to discharge. Patients receiving Caldolor also 

6

needed fewer narcotics and were less likely to require narcotics prior to discharge. This data supports the benefits of 
using Caldolor in a pre-emptive model of multimodal analgesia.

Caldolor Safety Summary

Extensive use and worldwide literature support the strong safety profile of oral ibuprofen. Building on the oral 
safety profile, we have assembled an integrated intravenous ibuprofen safety database combining data from our clinical 
trials as well as previously published study data. We used this data to support our NDA filing and continue to use and 
update the data as a part of our ongoing safety evaluation. In addition, this data will be used by our sales force and in 
our marketing materials to promote Caldolor. 

In clinical trials supporting our proposed indications, the number and percentage of all patients in pivotal studies 
who reported treatment emergent adverse events was comparable between IV ibuprofen and placebo treatment groups. 
Additionally,  there  have  been  no  safety  related  differences  between  Caldolor  and  placebo  involving  side  effects 
sometimes observed with oral Nonsteroidal Anti-Inflammatory Drugs ("NSAIDs"), such as changes in renal function, 
bleeding events or gastrointestinal disorders.

Hepatoren Study

We are evaluating Hepatoren as a treatment for hepatorenal syndrome - a life threatening condition, with a high 
mortality rate and no approved treatment in this country.  We have launched a sixty four patient study to evaluate the 
safety, efficacy and pharmacokinetics of Hepatoren for this unmet medical need. The study is designed to evaluate 
escalating dose levels of Hepatoren. Progression to higher dose levels is reviewed and approved by an independent 
safety committee. Enrollment is well underway at major medical centers across the U.S.  Recently, several top tier 
research institutions have been added to the study as we evaluate enrollment rates at all the centers.  

Kristalose Pilot Study 

We obtained clearance from the FDA for an IND to evaluate the use of Kristalose in a new patient population.  In 
June 2013, we initiated a pilot study and completed enrollment of forty patients at one site.  The study is pending our 
final report to the FDA. 

Acetadote Study

We initiated a study to evaluate the safety and efficacy of the new Acetadote formulation and dosing through a 
multi-center, double blind randomized controlled study. The study was terminated in 2013 due to lack of enrollment.

BUSINESS DEVELOPMENT

Since inception, we have had an active business development program focused on acquiring rights to marketed 
products and product candidates that fit our strategy and target markets. We source our business development leads 
through our senior executives and our international network of pharmaceutical and medical industry insiders. A multi-
disciplinary internal management team reviews these opportunities on a regular basis using a list of selection criteria. 
We  have  historically  focused  on  product  opportunities  that  are  a  strategic  fit  with  our  commercial  organization, 
development expertise and medical focus., employing a variety of transaction structures.  Our addition of Omeclamox-
Pak reflects our business development process and follows our selection criteria. 

We intend to continue to build a portfolio of complementary, niche products largely through product acquisitions 
and late-stage product development. Our primary targets are under-promoted, FDA-approved drugs with existing brand 
recognition and late-stage development product candidates that address unmet or poorly met medical needs in the 
hospital acute care and gastroenterology markets. We believe that by focusing mainly on approved or late-stage products, 
we can minimize the significant risk, cost and time associated with drug development.  

Through CET, we collaborate with a select group of academic research institutions located in the mid-south region 
of the U.S. Our business development team is responsible for identifying appropriate CET product candidates and 

7

negotiating with our university partners to secure rights to these candidates. Although we believe that these collaborations 
may be important to our business in the future, they are not material to our business at this time.

CET  currently  has  five  collaboration  agreements  with  University's  to  co-develop  promising  biomedical 
technologies, including: Vanderbilt University, Washington University, the University of Virginia, the University of 
Tennessee and the University of Mississippi.

These agreements allow us to play an important role in fostering and shaping early-stage biomedical research to 
improve patient care and provide CET and Cumberland with access to promising pipeline candidates such as Hepatoren.

CLINICAL AND REGULATORY AFFAIRS

We have in-house capabilities for the management of our clinical, professional and regulatory affairs. Our team 
develops and manages our clinical trials, prepares regulatory submissions, manages ongoing product-related regulatory 
responsibilities and manages our medical information call center. Team members have been responsible for devising 
the regulatory and clinical strategies and obtaining FDA approvals for Acetadote and Caldolor.

Clinical development

Our clinical development personnel are responsible for: 

• 

• 

• 

creating clinical development strategies; 

designing, implementing and monitoring our clinical trials; 

creating case report forms and other study-related documents.

Regulatory and quality affairs

Our internal regulatory and quality affairs team is responsible for: 

• 

• 

preparing and submitting INDs for clearance to begin patient studies;

preparing and submitting NDAs and fulfilling post-approval marketing commitments; 

•  maintaining investigational and marketing applications through the submission of appropriate reports; 

• 

• 

submitting  supplemental  applications  for  additional  label  indications,  product  line  extensions  and 
manufacturing improvements;

evaluating  regulatory  risk  profiles  for  product  acquisition  candidates,  including  compliance  with 
manufacturing, labeling, distribution and marketing regulations;

•  monitoring  applicable  third-party  service  providers  for  quality  and  compliance  with  current  Good 
Manufacturing Practices ("GMPs", Good Laboratory Practices ("GLPs"), and Good Clinical Practices 
("GCPs"), and performing periodic audits of such vendors; and

•  maintaining  systems  for  document  control,  product  and  process  change  control,  customer  complaint 

handling, product stability studies and annual drug product reviews.

PROFESSIONAL AND MEDICAL AFFAIRS

Our  medical  team  provides  in-house,  medical  information  support  for  our  marketed  products.  This  includes 
interacting  directly  with  healthcare  professionals  to  address  any  product  or  medical  inquiries  through  our  medical 
information call center. In addition to coordinating the call center, our clinical/regulatory group generates medical 
information letters, provides informational memos to our sales forces and assists with ongoing training for the sales 
forces.

8

SALES AND MARKETING

Our sales and marketing team has broad industry experience in selling branded pharmaceuticals. Our sales and 
marketing professionals manage our dedicated hospital and gastroenterology sales forces, including approximately 60 
sales representatives and district managers, direct our national marketing campaigns and maintain key national account 
relationships. In January 2007, we converted our hospital sales force, which had previously been contracted to us by 
Cardinal Health Inc., to Cumberland employees through our wholly-owned subsidiary, Cumberland Pharma Sales Corp. 

Our gastroenterology-focused team was formed in September 2006, to coincide with our launch of Kristalose as 
a Cumberland product, and is a field sales force addressing high prescribers of laxatives. This gastroenterology sales 
force was previously contracted to us by Ventiv Commercial Services, LLC. In September 2010, we converted the field 
sales force to Cumberland employees.

Our  sales  and  marketing  executives  conduct  ongoing  market  analyses  to  evaluate  marketing  campaigns  and 
promotional programs. The evaluations include development of product profiles, testing of the profiles against the 
needs of the market, determining what additional product information or development work is needed to effectively 
market  the  products  and  preparing  financial  forecasts. We  utilize  professional  branding  and  packaging  as  well  as 
promotional items to support our products, including direct mail, sales brochures, journal advertising, educational and 
reminder leave-behinds, patient educational pieces and product sampling. We also regularly attend targeted trade shows 
to promote broad awareness of our products. Our national accounts group is responsible for key large buyers and related 
marketing programs. This group supports sales and marketing efforts by maintaining relationships with our wholesaler 
customers as well as with third-party payors such as group purchasing organizations, pharmacy benefit managers, 
hospital buying groups, state and federal government purchasers and health insurance companies.

INTERNATIONAL PARTNERSHIPS

We have focused our products commercial efforts and sales organization on the U.S. market.  Our international strategy 
focuses on successfully entering into agreements with a network of select international partners for commercialization of 
our products in  international territories.   Our international partners register our products and make them available to patients 
in their countries.  Our international partners, licensed product rights and territories include the following:

International Partner

Product(s)

Territory

Alveda Pharmaceuticals

Caldolor

Canada

Phebra Pty Ltd

Caldolor and Acetadote

Australia and New Zealand

DB Pharm Korea Co. Ltd

Caldolor

South Korea

Harbin Gloria Pharmaceuticals Co. Ltd

Caldolor and Acetadote

China, Hong Kong and Macau

Sandor Medicaids Pvt. Ltd.

Caldolor

India

GerminMED

PT. SOHO Industri Pharmasi

PT. ETHICA Industri Farmasi

Grifols

Valmorca

Caldolor, Acetadote and
Kristalose

Qatar and the greater Arabian
Peninsula

Caldolor

Caldolor

Caldolor

Caldolor

Pacific Rim

Indonesia

Spain, Portugal and the majority of
South America

Venezuela

Al-Nabil International

Caldolor and Acetadote

U.A.E.

9

Our international commercialization agreements include a license to one or more Cumberland products for a specific 
territory as noted in the table above. We seek partners who have the local infrastructure to support the registration and 
commercialization of our products in their territory. 

Under the terms of our agreements our partners are responsible for:

Seeking regulatory approvals for the products,

• 
•  Launching the brand,
•  Managing the ongoing marketing, sales and product distribution, 
•  Addressing the ongoing regulatory requirements in the international territories,
•  Remitting any upfront, regulatory and sales  milestone payments, 
• 
Providing the transfer price for supplies of product,
•  Calculating and paying any royalties, as applicable. 

Our responsibilities include:

Providing a dossier of relevant information to support product registration,

• 
•  Maintaining our intellectual property associated with the product,
• 
•  Manufacturing and providing finished product for sale.

Sharing our marketing strategy, experience and materials for the brand,

We are currently working to support our existing international partners and to identify other companies to represent our 
products in select additional territories.

MANUFACTURING AND DISTRIBUTION

We partner certain non-core, capital-intensive functions, including manufacturing and distribution. Our executives 
are experienced in these areas and manage these third-party relationships with a focus on quality assurance.

Manufacturing

Our key manufacturing relationships include:

• 

In  July  2000,  we  established  an  international  manufacturing  alliance  with  a  predecessor  to  Hospira 
Australia  Pty.  Ltd.,  or  Hospira.  Hospira  sources  active  pharmaceutical  ingredients,  or  APIs,  and 
manufactures Caldolor for us under an agreement that expires in June 2014, subject to early termination 
upon 45 days prior notice in the event of uncured material breach by us or Hospira. The agreement will 
automatically renew for successive three-year terms unless Hospira or we provide at least 12 months prior 
written notice of non-renewal. Under the agreement, we pay Hospira a transfer price per unit of Caldolor 
supplied. In addition, we reimburse Hospira for agreed-upon development, regulatory and inspection and 
audit costs. 

•  Mylan Inc. ("Mylan") formerly Bioniche Teoranta sources APIs and manufactures our Acetadote product 
for sale in the U.S. at its FDA-approved manufacturing facility in Ireland. Our relationship with Bioniche 
began in January 2002. Mylan manufactures and packages Acetadote for us, and we purchase Acetadote 
from Mylan pursuant to an agreement which expires in April 2014. 

•  We entered into an agreement with Bayer Healthcare, LLC, or Bayer, in February 2008 for the manufacture 
of Caldolor and Acetadote. The agreement expired in September 2013. Bayer completed its obligations 
under the agreement in January 2014.  Under the agreement, we paid Bayer a transfer price per each unit 
of Caldolor or Acetadote supplied.

• 

In November 2011, we entered into an agreement with Mylan Inc. to package Kristalose.  Under the terms 
of the agreement, we provide Kristalose API to Mylan and they package it into 10 gram and 20 gram 
finished product units for which we pay a per unit packaging fee.  The agreement expires in 2016 and 
automatically renews for one year unless either party provides 180 day notice prior to expiration.

•  We entered into agreements with three international manufacturers for the commercial supply of Caldolor. 
We are working to transfer the Caldolor manufacturing process to these three manufacturers under these 
new agreements.  

•  Under the agreement we signed with Pernix, they are responsible for providing Omeclamox-Pak inventory.

10

Distribution

Like many other pharmaceutical companies, we engage a third party contractor with appropriate facilities and 
logistical expertise to support our distribution efforts. Since August 2002, Cardinal Health ("Cardinal") has exclusively 
handled U.S. product logistics efforts, including warehousing, shipping, customer billing and collections. 

We  extended  our  distribution  relationship  with  Cardinal  during  May  2013,  when  we  entered  into  the  First 
Amendment ("First Amendment") to the Exclusive Distribution Agreement under which we have operated since August 
2010.  The Amendment primarily serves to extend the term of the Agreement through June 30, 2016 and revises the 
fee  schedule  under  the Agreement.    Combined,  the Agreement  and Amendment  appoint  Cardinal  as  the  exclusive 
distribution agent for Acetadote, Caldolor and Kristalose in the United States and Puerto Rico. Under the Amendment, 
we have also engaged Cardinal to assist with our physician sample orders based on the Prescription Drug Marketing 
Act of 1987 (the “PDMA”) for samples shipping.  After June 30, 2016, the contract is automatically renewed on a year-
to-year basis that is terminable by either party with ninety days' notice. Under the Amendment and Agreement, Cardinal 
agrees to provide various services, including storage, distribution, returns, customer support, and system access support 
to us in connection with the distribution of our products under certain guidelines at established fees. 

TRADEMARKS AND PATENTS

We own all the trademarks for each of our branded pharmaceutical products as well as for our corporate name and 
logo. We have applied for trademark registration for various other names and logos.  Over time, we intend to maintain 
registrations on trademarks that remain valuable to our business.

We seek to protect our products from competition through a combination of patents, trademarks, trade secrets, 
FDA  exclusivity  and  contractual  restrictions  on  disclosure.  Proprietary  rights,  including  patents,  are  an  important 
element  of  our  business. We  seek  to  protect  our  proprietary  information  by  requiring  our  employees,  consultants, 
contractors and other advisors to execute agreements providing for protection of our confidential information upon 
commencement of their employment or engagement. We also require confidentiality agreements from entities that 
receive our confidential data or materials.

Acetadote and related litigation

We developed a new formulation of Acetadote (acetylcysteine) Injection as part of a Phase IV commitment in 
response to a request by the FDA to evaluate the reduction of EDTA from the product's formulation.  In April 2012, 
the USPTO issued U.S. Patent number 8,148,356 (the “356 Acetadote Patent” which is assigned to us. The claims of 
the 356 Acetadote Patent encompasses the Acetadote formulation and includes composition of matter claims. Following 
its issuance, the 356 Acetadote Patent was listed in the FDA Orange Book. The 356 Acetadote Patent is scheduled to 
expire in May 2026, which time period includes a 270-day patent term adjustment granted by the USPTO.

Following the issuance of the 356 Acetadote Patent, we received separate Paragraph IV certification notices from 
InnoPharma,  Inc.  ("InnoPharma"),  Paddock  Laboratories,  LLC  (“Paddock”),  Mylan  Institutional  LLC  (“Mylan”), 
Sagent Agila LLC ("Sagent") and Perrigo Company ("Perrigo") challenging the 356 Acetadote Patent on the basis of 
non-infringement  and/or  invalidity. We  responded  by  filing  five  separate  infringement  lawsuits,  in  the  appropriate 
United States District Courts, to contest each of the challenges. 

On November 12, 2012, we entered into a Settlement Agreement (the “Settlement Agreement”) with Paddock and 
Perrigo to resolve the challenges and the pending litigation with those two companies.  On November 1, 2013, the 
United States District Court filed opinions granting Sagent’s and InnoPharma’s motions to dismiss our suits and we 
agreed not to file an appeal or motion to reconsider, thereby resolving the challenges and the pending litigation with 
those two companies. The remaining infringement suit with Mylan is pending.

Under the Settlement Agreement, Paddock and Perrigo admit that the 356 Acetadote Patent is valid and enforceable 
and that any Paddock or Perrigo generic Acetadote product (with or without EDTA) would infringe upon the 356 
Acetadote  Patent.  In  addition,  Paddock  and  Perrigo  will  not  challenge  the  validity,  enforceability,  ownership  or 
patentability of the 356 Acetadote Patent through its expiration currently scheduled for May 2026. On November 12, 

11

2012, in connection with the execution of the Settlement Agreement, we entered into a License and Supply Agreement 
with Paddock and Perrigo (the “License and Supply Agreement”).  Under the terms of the License and Supply Agreement, 
once a third party receives final approval from the FDA for an ANDA to sell a generic Acetadote product and such 
third party made such generic version available for purchase in commercial quantities in the United States, we  supply 
Perrigo with an authorized generic version of our Acetadote product (the “Authorized Generic”).   

On May 18, 2012, we also submitted a Citizen Petition to the FDA requesting that the FDA refrain from approving 
any applications for acetylcysteine injection that contain EDTA, based in part on the FDA's request that we evaluate 
the reduction or removal of EDTA from its original Acetadote formulation. On November 7, 2012, the FDA responded 
to the Citizen Petition denying our request and on November 8, 2012, we learned that the FDA approved the ANDA 
referencing Acetadote filed by InnoPharma, Inc.  We brought suit against the FDA contesting the FDA's decision to 
approve the InnoPharma generic On November 13, 2012.   On September 30, 2013, the United States District Court 
filed an opinion granting a summary judgment in favor of the FDA regarding this suit.

As noted above, during 2012 the FDA approved the ANDA referencing Acetadote filed by InnoPharma, Inc. Upon 
this condition, in accordance with the License and Supply agreement with Perrigo, we began to supply Perrigo with 
our Authorized  Generic.    On  January  7,  2013,  Perrigo  announced  initial  distribution  of  our Authorized  Generic 
acetylcysteine injection product.

On March  19, 2013, the USPTO  issued U.S. Patent number 8,399,445 (the “445 Acetadote Patent”) which is 
assigned to us. The claims of the 445 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acetaminophen overdose. On April 8, 2013, the 445 Acetadote Patent was listed in the FDA Orange 
Book. The 445 Acetadote Patent is scheduled to expire in August 2025. Following the issuance of the 445 Acetadote 
Patent we received separate Paragraph IV certification notices from Perrigo, Sagent Pharmaceuticals, Inc., and Mylan 
Institutional  LLC  challenging  the  445 Acetadote  Patent  on  the  basis  of  non-infringement,  unenforceability  and/or 
invalidity.

On June 10, 2013, we became aware of a Paragraph IV certification notice from Akorn, Inc. challenging the 445 
Acetadote Patent and the 356 Acetadote Patent on the basis of non-infringement. On July 12, 2013, we filed a lawsuit 
for infringement of the 356 Acetadote Patent against Akorn, Inc. in United States District Court.   

We are considering our legal options and intend to continue to vigorously defend and protect our Acetadote product 

and related intellectual property rights.

We also have additional patent applications relating to Acetadote which are pending with the USPTO.

Caldolor

We are the owner of U.S. Patent No. 6,727,286, which is directed to ibuprofen solution formulations, methods of 
making the same, and methods of using the same, and which expires in 2021. This U.S. patent is associated with our 
completed  international  application  No.  PCT/US01/42894.  We  have  filed  for  international  patent  protection  in 
association with this PCT application in various countries, some of which have been allowed and some of which remain 
pending.

We have an exclusive, worldwide license to clinical data for intravenous ibuprofen from Vanderbilt University, in 

consideration for royalty obligations related to Caldolor.

COMPETITION

The pharmaceutical industry is characterized by intense competition and rapid innovation. Our continued success 
in developing and commercializing pharmaceutical products will depend, in part, upon our ability to compete against 
existing and future products in our target markets. Competitive factors directly affecting our markets include but are 
not limited to: 

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• 

• 

• 

• 

• 

• 

• 

product attributes such as efficacy, safety, ease-of-use and cost-effectiveness; 

brand awareness and recognition driven by sales and marketing and distribution capabilities; 

intellectual property and other exclusivity rights; 

availability of resources to build and maintain developmental and commercial capabilities; 

successful business development activities; 

extent of third-party reimbursements; and 

establishment of advantageous collaborations to conduct development, manufacturing or commercialization 
efforts.

A number of our competitors possess research and development and sales and marketing capabilities as well as 
financial resources greater than ours. These competitors, in addition to emerging companies and academic research 
institutions, may be developing, or in the future could develop, new technologies that could compete with our current 
and future products or render our products obsolete.

Acetadote

Acetadote is our injectable formulation of NAC for the treatment of acetaminophen overdose. NAC is accepted 
worldwide as the standard of care for acetaminophen overdose. Our competitors in the acetaminophen overdose market 
are those companies selling orally administered NAC including, but not limited to, Geneva Pharmaceuticals, Inc., 
Bedford Laboratories division of Ben Venue Laboratories, Inc., Roxane Laboratories, Inc., InnoPharma Inc., and Hospira 
Inc.

In November 2012, InnoPharma Inc. was granted approval by the FDA to distribute their generic form of the old 
formulation of the Acetadote containing EDTA.  In late 2012, we entered into the Settlement agreement with Paddock 
and Perrigo that included the right to distribute our Authorized Generic Acetadote injection product.  Our branded 
Acetadote now competes with both the EDTA free Authorized Generic Acetadote distributed by Paddock and Perrigo 
along with generic Acetadote that contains EDTA. 

Caldolor

Caldolor is marketed for the treatment of pain and fever, primarily in a hospital setting. A variety of other products 

address the acute pain market:

•  Morphine,  the  most  commonly  used  product  for  the  treatment  of  acute,  post-operative  pain,  is 

manufactured and distributed by several generic pharmaceutical companies;

•  Other generic injectable opioids, including fentanyl, meperidine and hydromorphone, address this market;

•  Ketorolac(brand name Toradol®), an injectable NSAID, is also manufactured and distributed by several 

generic pharmaceutical companies;

•  Ofirmev®, an injectable acetaminophen product is marketed by Cadence Pharmaceuticals, Inc;

•  Exparel®, a bupivacaine delivery platform marketed by Pacira Pharmaceuticals, Inc.

We are aware of other product candidates in development to treat acute pain including injectable NSAIDs, novel 
opioids, new formulations of existing therapies and extended release anesthetics. We believe non-narcotic analgesics 
for the treatment of post-surgical pain are the primary potential competitors to Caldolor.

In addition to the injectable analgesic products above, many companies are developing analgesics for specific 
indications such as migraine and neuropathic pain, oral extended-release forms of existing narcotic and non-narcotic 
products, and products with new methods of delivery such as transdermal. We are not aware of any approved injectable 
products indicated for the treatment of fever in the U.S. other than Caldolor and Ofirmev. There are, however, numerous 

13

drugs  available  to  physicians  to  reduce  fevers  in  hospital  settings  via  oral  administration  to  the  patient,  including 
ibuprofen, acetaminophen, and aspirin. These drugs are manufactured by numerous pharmaceutical companies.

Kristalose

Kristalose  is  a  dry  powder  crystalline  prescription  formulation  of  lactulose  indicated  for  the  treatment  of 
constipation. The U.S. constipation therapy market includes various prescription and over the counter, or OTC, products. 
The prescription products which we believe are our primary competitors are Amitiza®, Linzess® and liquid lactuloses. 
Amitiza  is  indicated  for  the  treatment  of  chronic  idiopathic  constipation  in  adults  and  is  marketed  by  Sucampo 
Pharmaceuticals Inc. and Takeda Pharmaceutical Company Limited. Linzess is indicated for the treatment of irritable 
bowel syndrome with constipation and chronic idiopathic constipation. It is marketed by Forest Laboratories, Inc. and 
Ironwood Pharmaceuticals, Inc. Liquid lactulose products are marketed by a number of pharmaceutical companies.

There are several hundred OTC products used to treat constipation marketed by numerous pharmaceutical and 
consumer health companies. MiraLax (polyethylene glycol 3350), previously a prescription product, was indicated for 
the treatment of constipation and manufactured and marketed by Braintree Laboratories, Inc. Under an agreement with 
Braintree, Schering-Plough introduced MiraLax as an OTC product in February 2007.

Omeclamox-Pak

Omeclamox-Pak is a branded prescription product used for the treatment of Helicobacter pylori (H. pylori) infection 
and duodenal ulcer disease.  It combines three well-known and widely prescribed medications packaged together for 
patient convenience: omeprazole, clarithromycin, and amoxicillin. The three individual components of Omeclamox-
Pak are also available through three separate prescriptions. The prescription combination products which we believe 
are our primary competitors are PrevPac (including a recently approved generic of PrevPac), Pylera and Helidax.  All 
the  competitor  products  are  indicated  for  treatment  of  H.  pylori.  While  there  are  several  competitor  products, 
Omeclamox-Pak is one of the few actively marketed products for this condition.  In addition, compared to the branded 
competing products, Omeclamox-Pak has the lowest pill burden, fewest days of therapy and the lowest cost.

GOVERNMENT REGULATION

Governmental authorities in the U.S. and other countries extensively regulate the research, development, testing, 
manufacturing, distribution, marketing and sale of pharmaceutical products.  In the U.S., the FDA under the Federal 
Food, Drug, and Cosmetic Act, ("FDCA"), the Public Health Service Act, and other federal statutes and regulations, 
subjects pharmaceutical products to rigorous review.  Failure to comply with applicable U.S. requirements may subject 
a  company  to  a  variety  of  administrative  or  judicial  sanctions,  such  as  FDA  refusal  to  approve  pending  NDAs  or 
biologics license applications, ("BLAs"), warning letters, product recalls, product seizures, total or partial suspension 
of production or distribution, injunctions, fines, civil penalties, and criminal prosecution.

We and our manufacturers and clinical research organizations may also be subject to regulations under other federal, 
state and local laws, including the Occupational Safety and Health Act, the Resource Conservation and Recovery Act, 
the Clean Air Act and import, export and customs regulations as well as the laws and regulations of other countries.

FDA Approval Process

The FDA is a regulatory agency within the Department of Health and Human Services. A key responsibility is to 
regulate the safety and effectiveness of drugs sold in the United States. The FDA divides that responsibility into two 
phases: pre-approval (premarket) and post approval (post market). The FDA reviews manufacturers' applications to 
market drugs in the United States; a drug may not be sold unless it has FDA approval. The agency continues its oversight 
of drug safety and effectiveness as long as the drug is on the market.

To market a prescription drug in the United States, a manufacturer needs FDA approval. To get that approval, the 
manufacturer must demonstrate the drug's safety and effectiveness according to criteria specified in law and agency 
regulations, ensure that its manufacturing plant passes FDA inspection, and obtain FDA approval for the drug's labeling, 
a term that includes all written material about the drug, including, for example, packaging, prescribing information for 
physicians, promotional materials and patient brochures.

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The progression to drug approval begins before FDA involvement. First, basic scientists work in the laboratory 
and with animals; second, a drug or biotechnology company develops a prototype drug. That company must seek and 
receive FDA approval, by way of an IND application, to test the product with human subjects. Those tests, called 
clinical trials, are carried out sequentially in Phase I, II, and III studies, which involve increasing numbers of subjects. 
The manufacturer then compiles the resulting data and analysis in a NDA. The FDA reviews the NDA with three major 
concerns: (1) safety and effectiveness in the drug's proposed use; (2) appropriateness of the proposed labeling; and (3) 
adequacy of manufacturing methods to assure the drug's identity, strength, quality, and purity. 

The FDCA and associated regulations detail the requirements at each step. The FDA uses a few special mechanisms 
to expedite drug development and the review process when a drug might address an unmet need or a serious disease 
or condition. Those mechanisms include accelerated approval, animal efficacy approval, fast track applications, and 
priority review.

The sponsor of the drug typically conducts human clinical trials in three sequential phases, but the phases may 
overlap. Phase I clinical trials are generally conducted in a small number of healthy volunteers, primarily to collect and 
assess pharmacokinetics and safety data at one or more dosages prior to proceeding into patients. In Phase II clinical 
trials, the sponsor evaluates the early efficacy of the product in short term trials on the targeted indication and identifies 
possible adverse effects and safety risks in a patient population. Phase III clinical trials typically involve testing for 
patients in long term trials examining safety and clinical efficacy in an expanded population at geographically-dispersed 
test sites. 

The FDA requires that clinical trials be conducted in accordance with the FDA's GCP requirements. The FDA may 
order the partial, temporary or permanent discontinuation of a clinical trial at any time or impose other sanctions if it 
believes that the clinical trial is not being conducted in accordance with FDA requirements or presents an unacceptable 
risk to the clinical trial patients. The institutional review board ("IRB"), or ethics committee (outside of the U.S.), of 
each clinical site generally must approve the clinical trial design and patient informed consent and may also require 
the  clinical  trial  at  that  site  to  be  halted,  either  temporarily  or  permanently,  for  failure  to  comply  with  the  IRB's 
requirements, or may impose other conditions. 

The  results  of  the  nonclinical  and  clinical  trials,  together  with  detailed  information  on  the  manufacture  and 
composition of the product and proposed labeling, are submitted to the FDA in the form of an NDA for marketing 
approval. The NDA undergoes a 60 day validation review period before it is accepted for filing. If the NDA is found 
to be incomplete it will not be accepted.  Once the NDA is validated and accepted for filing, the FDA begins an in-
depth review of the NDA. Under policies agreed to by the FDA under the Prescription Drug User Fee Act, or PDUFA 
(currently PDUFA V - effective October 1, 2012), the FDA has 10 months in which to complete its initial review of a 
standard NDA and respond to the applicant. The review process and the PDUFA goal date may be extended by two 
months to address deficiencies, or by three months if the FDA requests or the NDA sponsor otherwise provides additional 
information or clarification regarding information already provided in the submission at any time during the review 
clock period. If the FDA's evaluations of the NDA and the clinical and manufacturing procedures and facilities are 
favorable, the FDA will issue an approval letter. If not, a Complete Response letter will be sent informing applicants 
of  changes  that  must  be  made  before  the  application  can  be  approved,  with  no  implication  regarding  whether  the 
application will    ultimately be  approved.   An  approval  letter  authorizes  commercial marketing  of  the  drug  for  the 
proposed indication(s) under study. The General Accounting Office ("GAO") reported that standard NDAs showed a 
steadier increase with the percentage of first-cycle approval letters rising from 43% for FY 2000 applications to 69% 
for FY 2010 applications. The percentage of priority NDAs receiving an approval letter at the end of the first review 
cycle fluctuated from FY 2000 through FY 2010, ranging between 47% and 80% during this time. The time and cost 
of completing these steps and obtaining FDA approval can vary dramatically depending on the drug. However, to 
complete these steps for a novel drug can take many years and cost millions of dollars.

Section 505(b) (2) New Drug Applications

An NDA may be submitted under different methods, a 505(b)(1), 505(b)(2) or 505(j). Section 505(b) provides for 
the submission of an NDA to support the approval of a drug. Upon approval, a drug may be marketed only for the FDA-
approved indication(s) in the approved dosage form. Further clinical trials may be necessary to gain approval for the 
use of the product for any additional indications or dosage forms. The FDA also requires post market safety surveillance 
reporting to monitor the side effects of the drug, which may result in withdrawal of approval after marketing begins. 

15

Section  505(b)(1)  or  the  'full'  NDA  is  used  for  new  chemical  entities  ("NCEs")  and  requires  full  clinical  and 
nonclinical development of a compound. Marketing exclusivity assigned to a 505(b)(1) approval is five years. A 505
(b)(2) NDA permits the submission of an NDA where at least some of the information required for approval comes 
from studies not conducted by or for the applicant using previously reported safety and efficacy data, and for which 
the applicant has not obtained a right of reference. Generally new studies are required to provide data on the proposed 
change. Some examples of products that may be allowed to follow a 505(b)(2) path to approval are drugs which have 
a  new  dosage  form,  strength,  route  of  administration,  formulation  or  indication  or  combination  drugs.  Marketing 
exclusivity for a 505(b)(2) submission is three years. Any marketing exclusivity is independent of patent exclusivity.

We successfully secured FDA approvals for Acetadote in January 2004 and for Caldolor in June 2009 pursuant to 

the 505(b)(2) pathway. 

Special protocol assessment process

The special protocol assessment, or SPA, process is designed to assess whether a planned protocol is adequate to 
meet  scientific  and  regulatory  requirements  identified  by  the  sponsor. Three  types  of  protocols  related  to  PDUFA 
products are eligible for this special protocol assessment under the PDUFA goals: (1) animal carcinogenicity protocols, 
(2) final product stability protocols, and (3) clinical protocols for phase III trials whose data will form the primary basis 
for an efficacy claim if the trials had been the subject of discussion at an end-of-phase 2/pre-phase 3 meeting with the 
review  division,  or  in  some  cases,  if  the  division  agrees  to  such  a  review  because  the  division  is  aware  of  the 
developmental context in which the protocol is being reviewed and the questions are being answered. The clinical 
protocols for phase III trials can relate to efficacy claims that will be part of an original NDA or BLA or that will be 
part of an efficacy supplement to an approved NDA or BLA.

New section 505(b)(4)(B) of the Modernization Act directs FDA to meet with sponsors, provided certain conditions 
are met, for the purpose of reaching agreement on the design and size of clinical trials intended to form the primary 
basis of an efficacy claim in a marketing application submitted under section 505(b) of the Act or section 351 of the 
Public  Health  Service  Act  (42  U.S.C.  262).3.  Such  marketing  applications  include  NDAs,  BLAs,  and  efficacy 
supplements to approved NDAs and BLAs. Under new sections 505(b)(4)(B) and (C) of the Act, if a sponsor makes a 
reasonable written request to meet with the FDA for the purpose of reaching agreement on the design and size of a 
clinical trial, the FDA will meet with the sponsor. If an agreement is reached, the FDA will reduce the agreement to 
writing and make it part of the administrative record. An agreement may not be changed by the sponsor or FDA after 
the trial begins, except (1) with the written agreement of the sponsor and FDA, or (2) if the director of the FDA reviewing 
division determines that "a substantial scientific issue essential to determining the safety or effectiveness of the drug" 
was identified after the testing began (section 505(b)(4)(C) of the Act). If a sponsor and the FDA meet regarding the 
design and size of a clinical trial under section 505(b)(4)(B) of the Act and the parties cannot agree that the trial design 
is adequate to meet the goals of the sponsor, the FDA will clearly state the reasons for the disagreement in a letter to 
the sponsor. However, the absence of an articulated disagreement on a particular issue should not be assumed to represent 
an agreement reached on that issue. Final determinations by the FDA with respect to a product candidate, including as 
to the scope of its “labeling”, are made after a complete review of the applicable NDA and are based on the entire data 
in the application.

On June 14, 2004, we submitted a request for SPA of our Caldolor Phase III clinical study. During a meeting with 
the FDA on September 29, 2004, the FDA confirmed that the efficacy data from our study of post-operative pain with 
a positive outcome was considered sufficient to support a 505(b)(2) application for the pain indication. 

Orphan drug designation

The Orphan Drug Act of 1983, ("Orphan Drug Act"), encourages manufacturers to seek approval of products 
intended to treat “rare diseases and conditions” with a prevalence of fewer than 200,000 patients in the U.S. or for 
which there is no reasonable expectation of recovering the development costs for the product. For products that receive 
orphan drug designation by the FDA, the Orphan Drug Act provides tax credits for clinical research, FDA assistance 
with protocol design, eligibility for FDA grants to fund clinical studies, waiver of the FDA application fee, and a period 
of seven years of marketing exclusivity for the product following FDA marketing approval. Acetadote received Orphan 
Drug designation in October 2001 and in 2004 the FDA approved the product to prevent or lessen hepatic injury after 

16

ingestion of a potentially hepatotoxic quantity of acetaminophen. Acetadote was entitled to marketing exclusivity until 
January 2011 for the treatment of this approved indication.  

Section 505(j) abbreviated new drug applications

An ANDA is a type of NDA where approval of a generic drug is based on demonstrating comparability to an 
innovator drug product (the RLD or Reference Listed Drug). Applications are "abbreviated" because they generally 
don't include preclinical and clinical data to establish safety and effectiveness. Generics must demonstrate that the 
product  is  bioequivalent  (i.e.,  performs  in  the  same  manner  and  is  comparable to  the  'innovator'  product  in  active 
ingredient, dosage form, strength, route of administration, labeling, quality, performance characteristics and intended 
use). Abbreviated applications may be submitted for drug products that are the same as a listed drug and must be 
identical in active ingredient(s), form, strength, route of administration, and identical in conditions of use (non-exclusive 
uses).  Products are declared suitable based on a suitability petition to the FDA. If the petition is approved, the Sponsor 
may then submit the ANDA.

The Hatch-Waxman Act

The Drug Price Competition and Patent Term Restoration Act, informally known as the "Hatch-Waxman Act", is 
a 1984 United States federal law which established the modern system of generic drugs. Hatch-Waxman amended the 
Federal Food, Drug, and Cosmetic Act. Section 505(j) 21 U.S.C. 355(j) sets forth the process by which would-be 
marketers of generic drugs can file  ANDAs to seek FDA approval of the generic. Section 505(j)(2)(A)(vii)(IV), the 
so-called Paragraph IV, allows 180 day exclusivity to companies that are the "first-to-file" an ANDA against holders 
of patents for branded counterparts.

Hatch-Waxman Amendments  grant  generic  manufacturers  the  ability  to  mount  a  validity  challenge  without 
incurring  the  cost  of  entry  or  risking  enormous  damages  flowing  from  any  possible  infringement.  Hatch-Waxman 
essentially redistributes the relative risk assessments and explains the flow of settlement funds and their magnitude. 
Hatch-Waxman gives generics considerable leverage in patent litigation.

Recent health care legislation

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, or PPACA. 
On March 30, 2010, the Health Care and Education Reconciliation Act of 2010, or HCERA, was enacted into law, 
which modified the revenue provisions of the PPACA. The PPACA as amended by the HCERA constitutes the healthcare 
reform legislation. The following highlights certain provisions of the legislation that may affect us.

Pharmaceutical Industry Fee: Beginning in calendar-year 2011, an annual fee was imposed on pharmaceutical 
manufacturers and importers that sell branded prescription drugs to specified government programs (e.g., Medicare 
Part D, Medicare Part B, Medicaid, Department of Veterans Affairs programs, Department of Defense programs 
and TRICARE). The annual fee is allocated to companies based on their previous calendar-year market share using 
sales data that the government agencies that purchase the pharmaceuticals will provide to the Treasury Department. 
Although we participate in governmental programs that subject us to this fee, our sales volume in such programs 
is less than $10 million, with the first $5 million of sales being exempt from the fee. This fee has not had a material 
impact and is not expected to have a material impact on our results of operations.

Physician Payments Sunshine Act: The Affordable Care Act also includes provisions known as the Physician 
Payments Sunshine Act, or Sunshine Act, which require manufacturers of pharmaceuticals and medical devices 
covered under Medicare and Medicaid to record any transfers of value to physicians and teaching hospitals and to 
report this data  to the Centers for Medicare and Medicaid Services, or CMS for aggregation and subsequent public 
disclosure. Under the Sunshine Act, beginning August 1, 2013, we have been required to collect data regarding 
reportable transfers of value and will report such data to CMS by March 31, 2014. Failure to report appropriate 
data may result in civil or criminal fines and/or penalties.  In addition to the Federal Sunshine Act, similar reporting 
requirements have also been enacted on the state level  requiring transparency of interactions with health care 
professionals. 

Medicaid  Rebate  Rate:  We  currently  provide  rebates  for  Kristalose  sold  to  Medicaid  beneficiaries.  Effective 
January 1, 2010, the rebate increased from eleven percent to thirteen percent of the average manufacturer price. 
Our sales of Kristalose under the Medicaid program have been increasing.

17

Post approval activities 

Once a drug is on the U.S. market (following FDA approval of the NDA), the FDA continues to address drug 
production,  distribution,  and  use.  FDA  activities are  based  on  ensuring  drug  safety  and  effectiveness,  and  address 
product  integrity,  labeling,  reporting  of  research  and  adverse  events,  surveillance,  drug  studies,  risk  management, 
information dissemination, off-label use, and direct-to-consumer advertising. 

If we amend the NDA for an FDA approved product, such as adding safety or efficacy labeling claims, promoting 
those new claims, making certain manufacturing changes or product enhancements we will need FDA review and 
approval before the change can be implemented. While physicians may use products for indications that have not been 
approved by the FDA, we may not label or promote the product for an indication that has not been approved. Securing 
FDA approval for new indications, product enhancements, and manufacturing and labeling changes may require us to 
conduct additional clinical trials under FDA's IND regulations. Even if such studies are conducted, they are still subject 
to the same requirements and timelines as an original NDA. 

The FDA continuously gathers information about possible adverse reactions to the products it has approved for 
use. The FDA requires all manufacturers to report adverse events. It also provides a procedure for consumers and 
physicians to voluntarily report their concerns about drugs. The agency collects those reports through MedWatch and 
uses its Adverse Event Reporting System (AERS) to store and analyze them. Because some events may occur after the 
use of a drug for reasons unrelated to it, the FDA reviews the events to assess which ones may indicate a drug problem. 
They then use information gleaned from the surveillance data to determine a course of action. They might recommend 
a change in drug labeling to alert users to a potential problem, or, perhaps, to require the manufacturer to study the 
observed association between the drug and the adverse event.

In addition to FDA restrictions on marketing of pharmaceutical products, several other types of 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 health care 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  health  care  item  or  service 
reimbursable  under  Medicare,  Medicaid  or  other  federally  financed  health  care  programs.  This  statute  has  been 
interpreted to apply to arrangements between pharmaceutical manufacturers on the one hand and 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 health care programs. 

Federal False Claims Act

The 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 health care 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.

ICH - International Committee on Harmonization

Outside of the U.S., our ability to market our products will depend on receiving marketing authorizations from the 
appropriate regulatory authorities. The International Committee on Harmonization (ICH) provides a set of standards 
that  most  Regulatory Authorities  adhere  to  (e.g.  U.S.,  Europe,  and  Japan)  allowing  greater  harmonization  in  the 
interpretation and application of technical guidelines and requirements for pharmaceutical product registration, thereby 
reducing or obviating duplication of testing carried out during the research and development of new human medicines. 
Regulatory harmonization offers many direct benefits to both regulatory authorities and the pharmaceutical industry 
with beneficial impact for the protection of public health. 

18

ENVIRONMENTAL MATTERS

We are subject to federal, state and local environmental laws and regulations and we believe that our operations 
comply  with  such  regulations. We  anticipate  that  the  effects  of  compliance  with  federal,  state  and  local  laws  and 
regulations relating to the discharge of materials into the environment will not have any material effect on our capital 
expenditures, earnings or competitive position.

SEASONALITY

There are no significant seasonal aspects to our business.

BACKLOG

Due to the relatively short lead-time required to fill orders for our products, backlog of orders is not considered 

material to our business.

EMPLOYEES

As of December 31, 2013, we had 96 full-time employees.  We believe that our future will depend in part on our 
continued ability to attract, hire, and retain qualified personnel, including hospital and field sales personnel in particular.

Item 1A. Risk Factors.

You should carefully consider the risk factors described below and throughout this report, which could materially 
affect our business. There are also risks that are not presently known or not presently material, as well as the other 
information set forth in this report that could materially affect our business. In addition, in our periodic filings with 
the SEC, press releases and other statements, we discuss estimates and projections regarding our future performance 
and  business  outlook.  By  their  nature,  such  “forward-looking  statements”  involve  known  and  unknown  risks, 
uncertainties and other factors that in some cases are out of our control. For a further discussion of forward-looking 
statements, please refer to the section entitled “Special Note Regarding Forward-Looking Statements.” These factors 
could cause our actual results to differ materially from our historical results or our present expectations and projections. 
These risk factors and uncertainties include, but are not limited to the following:

RISKS RELATED TO OUR BUSINESS

An adverse development regarding our products could have a material and adverse impact on our future revenues and 
profitability.

A number of factors may impact the effectiveness of our marketing and sales activities and the demand for our products, 

including:

•  Changes in intellectual property protection available for our products or competing treatments; 

•  Any unfavorable publicity concerning us, our products, or the markets for these products such as information 
concerning product contamination or other safety issues in any of our product markets, whether or not directly 
involving our products;

• 

Perception by physicians and other members of the healthcare community of the safety or efficacy of our 
products or competing products;

•  Regulatory developments related to our marketing and promotional practices or the manufacture or continued 

use of our products;

19

•  The prices of our products relative to other drugs or competing treatments;

•  The  impact of current or additional generic competitors;

•  The availability and level of third-party reimbursement for sales of our products; and

•  The continued availability of adequate supplies of our products to meet demand.

If demand for our products weaken, our revenues and profitability will likely decline. Known adverse effects of our 
marketed products are documented in product labeling, including the product package inserts, medical information disclosed 
to medical professionals and all marketing-related materials. At this time, no unforeseen or serious adverse effects outside 
of those specified in current product labeling have been directly attributed to our approved products.

We  currently  market  and  sell  four  products:  Acetadote,  Caldolor,  Kristalose  and  Omeclamox-Pak.  A  product 
contamination or other safety or regulatory issues, such as a failure to meet certain FDA reporting requirements involving 
our products could negatively impact us and possibly lead to a product recall. In addition, changes impacting any of our 
products in areas such as competition, lack of market acceptance or demand, government regulation, intellectual property, 
reimbursement and manufacturing could have an adverse impact on our future revenues and profitability.

In 2011, the FDA issued a press announcement asking manufacturers of prescription combination products that contain 
acetaminophen to limit the amount of acetaminophen to no more than 325 milligrams (mg) in each tablet or capsule by 
January 2014. The FDA requested this action to protect consumers from the risk of severe liver damage which can result 
from excess acetaminophen. This category of prescription drugs combines acetaminophen with another ingredient intended 
to treat pain (most often an opioid), and these products are commonly prescribed to consumers for pain, such as pain from 
acute injuries, post-operative pain, or pain following dental procedures.

The FDA also is requiring manufacturers to update labels of all prescription combination acetaminophen products to 
warn of the potential risk for severe liver injury. The actions the FDA is taking for prescription acetaminophen combination 
products do not affect over-the-counter acetaminophen products. The FDA's regulation of acetaminophen in prescription 
combination products and over-the-counter products may reduce the number of acetaminophen overdoses which could result 
in a lower demand for Acetadote. If the demand for Acetadote decreases, it could have an adverse impact on our future 
revenues and profitability. 

Caldolor was approved by the FDA in June 2009, and we started commercializing Caldolor in the United States in 
September 2009. The commercial success of Caldolor is dependent on many third-parties, including physicians, pharmacists, 
hospital pharmacy and therapeutics committees, or P&T committees, suppliers and distributors, all of whom we have little 
or no control over. We expect Caldolor to be administered primarily to hospitalized patients who are unable to receive oral 
therapies for the treatment of pain or fever. Before we can distribute Caldolor to any new hospital customers, Caldolor must 
be approved for addition to the hospitals’ formulary lists by their P&T committees. A hospital’s P&T committee generally 
governs all matters pertaining to the use of medications within the institution, including review of medication formulary data 
and recommendations of drugs to the medical staff. We cannot guarantee that we will be successful in getting the approvals 
we need from enough P&T committees to be able to optimize hospital sales of Caldolor. Even if we obtain hospital approval 
for Caldolor, we must still convince individual hospital physicians to prescribe Caldolor repeatedly. Because Caldolor is 
relatively new compared to some of its competitors, any mistakes made in the timely supply of Caldolor, education about 
how to properly administer Caldolor or any unexpected side effects that develop from use of the drug, may lead physicians 
to not accept Caldolor as a viable treatment alternative. The commercial success of Caldolor also depends on our ability to 
coordinate supply, distribution, marketing, sales and education efforts. We have set a price for Caldolor that we believe 
hospitals and other purchasers are willing to pay, but that will also generate sufficient profits. If we have set a price for 
Caldolor that hospitals consider too high, we may need to subsequently reduce the price for Caldolor. As with our other 
products, if the price for Caldolor is not accepted in the marketplace, it could have an adverse impact on our future revenues 
and profitability.

If any manufacturer we rely upon fails to produce our products in the amounts we require on a timely basis, or fails to 
comply with stringent regulations applicable to pharmaceutical drug manufacturers, we may be unable to meet demand 
for our products and may lose potential revenues.

We do not manufacture any of our products, and we do not currently plan to develop any capacity to do so. Our dependence 
upon third parties for the manufacture of products could adversely affect our profit margins or our ability to develop and 
deliver products on a timely and competitive basis. If for any reason we are unable to obtain or retain third-party manufacturers 
on commercially acceptable terms, we may not be able to sell our products as planned. Furthermore, if we encounter delays 
or difficulties with contract manufacturers in producing our products, the distribution, marketing and subsequent sales of 
these products could be adversely affected.

20

Caldolor has historically been manufactured at Hospira Australia Pty. Ltd.’s facility in Australia and Bayer’s facility in 
Kansas. We entered into agreements with three international manufacturers for the commercial supply of Caldolor and we 
are working to transfer the Caldolor manufacturing process to each of these manufacturers. Commercial units have not yet 
been supplied by these manufacturers. If the new international manufacturers of Caldolor are unable to begin producing 
inventory in the agreed upon time period,we could suffer an inability to meet demand for our products.   Acetadote was 
previously manufactured at Bayer’s facility in Kansas and Bayer completed its obligations under the agreement in January 
2014.  Acetadote is currently manufactured and packaged in Ireland by Mylan pursuant to an agreement which expires in 
April 2014.  If new manufacturer(s) of Acetadote are unable to begin producing inventory and Mylan is unable to continue 
to produce inventory after April 2014,we could suffer an inability to meet demand for our products. The active pharmaceutical 
ingredient for Kristalose is manufactured at a single facility in Italy. If any one of these facilities is damaged or destroyed, 
or if local conditions result in a work stoppage, we could suffer an inability to meet demand for our products. Kristalose is 
manufactured through a complex process. It would be particularly difficult to find a new manufacturer of Kristalose on an 
expedited  basis. As  a  result  of  these  factors,  our  ability  to  manufacture  Kristalose  may  be  substantially  impaired  if  the 
manufacturer is unable or unwilling to supply sufficient quantities of the product.

In addition, all manufacturers of our products and product candidates must comply with current good manufacturing 
practices, ("GMPs"), enforced by the FDA through its facilities inspection program. These requirements include quality 
control, quality assurance and the maintenance of records and documentation. Manufacturers of our products may be unable 
to comply with GMP requirements and with other FDA, state and foreign regulatory requirements.

We  have  no  control  over  our  manufacturers’  compliance  with  these  regulations  and  standards.  If  our  third-party 

manufacturers do not comply with these requirements, we could be subject to:

• 

• 

• 

• 

Fines and civil penalties;

Suspension of production or distribution;

Suspension or delay in product approval;

product seizure or recall; and

•  withdrawal of product approval.

We are dependent on a variety of other third parties. If these third parties fail to perform as we expect, our operations 
could be disrupted and our financial results could suffer.

We have a relatively small internal infrastructure. We rely on a variety of third parties, in addition to our manufacturers, 

to help us operate our business. Other third parties on which we rely include:

•  Cardinal Health Specialty Pharmaceutical Services, a logistics and fulfillment company and business unit of 

Cardinal, which bills for, collects, warehouses and ships our marketed products; and

•  Vanderbilt University and the Tennessee Technology Development Corporation, co-owners with us of CET, and 

the universities that collaborate with us in connection with CET's research and development programs.

If these third parties do not continue to provide services to us, or collaborate with us, we might not be able to obtain 
others who can serve these functions. This could disrupt our business operations, increase our operating expenses or otherwise 
adversely affect our operating results.

Competitive pressures could reduce our revenues and profits.

The pharmaceutical industry is intensely competitive. Our strategy is to target differentiated products in specialized 
markets. However, this strategy does not relieve us from competitive pressures and can entail distinct competitive risks. 
Certain of our competitors do not aggressively promote their products in our markets. An increase in promotional activity 
in our markets could result in large shifts in market share, adversely impacting us.

Our competitors may sell or develop drugs that are more effective and useful or less costly than ours, and they may be 
more successful in manufacturing and marketing their products. Many of our competitors have significantly greater financial 
and marketing resources than we do. Additional competitors may enter our markets.

The pharmaceutical industry is characterized by constant and significant investment in new product development, which 
can result in rapid technological change. The introduction of new products could substantially reduce our market share or 
render our products obsolete. The selling prices of pharmaceutical products tend to decline as competition increases, through 
new product introduction or otherwise, which could reduce our revenues and profitability.

21

Governmental and private healthcare payors emphasize substitution of branded pharmaceuticals with less expensive 
generic equivalents. An increase in the sales of generic pharmaceutical products could result in a decrease in revenues of our 
branded pharmaceuticals.

Any attempt by us to expand the potential market for any of our products is subject to limitations.

Expansion of the market for our products may be subject to certain limitations. In the past, these limitations have included 
FDA required Phase IV commitments. We may also experience delays associated with future required Phase IV clinical 
studies potentially resulting from, among other factors, difficulty enrolling patients. Such delays could impact our ability to 
explore opportunities for label expansion and limit our ability to bring our products to new patient populations.

In addition, we have only obtained regulatory approval to market our products in the United States. In foreign jurisdictions, 
we have licensed the right to market some of our products to third parties. These third parties are responsible for seeking 
regulatory approval for the products in their respective jurisdictions. We have no control over these third parties and cannot 
be sure that marketing approval for our products will be obtained outside the United States.

Our future growth depends on our ability to identify and acquire rights to products. If we do not successfully identify and 
acquire rights to products, our growth opportunities may be limited.

We  acquired  rights  to  Caldolor, Acetadote,  Omeclamox-Pak,  Kristalose  and  Hepatoren.  Our  business  strategy  is  to 
continue to acquire rights to FDA-approved products as well as pharmaceutical product candidates in the late stages of 
development. We do not plan to conduct basic research or pre-clinical product development, except to the extent of our 
investment in CET. As compared to large multi-national pharmaceutical companies, we have limited resources to acquire 
third-party  products,  businesses  and  technologies  and  integrate  them  into  our  current  infrastructure.  Many  acquisition 
opportunities  involve  competition  among  several  potential  purchasers  including  large  multi-national  pharmaceutical 
companies and other competitors that have access to greater financial resources than we do. With future acquisitions, we 
may face financial and operational risks and uncertainties. We may not be able to engage in future product acquisitions, and 
those we do complete may not be beneficial to us in the long term.

Furthermore, other products in development may encounter unforeseen issues during their clinical trials. Any unforeseen 

issues or lack of FDA approval will negatively affect marketing and development plans for those products.

Our future growth depends on our ability to successfully integrate acquired product rights into our operations, if we do 
not successfully integrate acquired product rights into our operations our growth opportunities may be limited.

We  recently  acquired  rights  to  Omeclamox-Pak  and  under  the  terms  of  the  agreement,  we  promote  the  product  to 
gastroenterologists across the United States through our field sales force that also promotes our Kristalose brand. We are 
responsible for the marketing, sale and distribution of the product. We launched our promotion and distribution efforts to 
support Omeclamox-Pak in early 2014. If we are unable to successfully integrate the marketing, sale and distribution of 
Omeclamox-Pak or any other potential product candidates into our current infrastructure or if they require significantly 
greater resources and investments than originally anticipated, we may face financial and operational risks and uncertainties. 
If we are unable to successfully integrate any acquired product rights, both current and future, these product rights acquisitions 
may not be beneficial to us in the long term.

Our Hepatoren product candidate has not been approved for sale and may never be successfully commercialized.

We anticipate that a portion of our future revenue growth will come from sales of our Hepatoren product candidate. 
Hepatoren, which is injectable ifetroban, is a drug used to treat hepatorenal syndrome ("HRS"). However, Hepatoren has 
not been approved by the FDA for marketing, and it is still subject to risks associated with its development. 

The  FDA  has  cleared  our  IND  for  this  product  candidate  as  we  evaluate  Hepatoren  as  a  treatment  for  HRS,  a  life 
threatening condition with no approved treatment in this country.   We have launched a 64 patient study to evaluate the safety, 
efficacy and pharmacokinetics of Hepatoren for this unmet medical need. The study is designed to evaluate escalating dose 
levels of Hepatoren.  Enrollment is underway at major medical centers across the U.S. We have commenced manufacturing 
and have filed patent applications to protect intellectual property related to the new indication. Delays in the enrollment and  
completion of the clinical study could significantly delay commercial launch and affect our product development costs. 
Moreover, results from the clinical study may not be favorable. 

Even  if  Hepatoren  is  eventually  successfully  developed  and  approved  by  the  FDA,  it  may  never  gain  significant 
acceptance in the marketplace and therefore never generate substantial revenue or profits for us. Physicians may determine 
that existing drugs are adequate to address patients' needs. The extent to which Hepatoren will be reimbursed by the U.S. 
government or third-party payors is also currently unknown.

22

As a result of the foregoing and other factors, we do not know the extent to which Hepatoren will contribute to our future 

growth.

If we are unable to maintain, train and build an effective sales and marketing infrastructure, we will not be able to 
commercialize and grow our products and product candidates successfully.

As we grow, we may not be able to secure sales personnel or organizations that are adequate in number or expertise to 
successfully market and sell our products. This risk would be accentuated if we acquire products in areas outside of hospital 
acute care and gastroenterology since our sales forces specialize in these areas. If we are unable to expand our sales and 
marketing capability, train our sales force effectively or provide any other capabilities necessary to commercialize our products 
and product candidates, we will need to contract with third parties to market and sell our products. We must train our employees 
on proper regulatory compliance, including, but not limited to, “fair balance” promotion of our products and anti-kickback 
laws. If we are unable to establish and maintain compliant and adequate sales and marketing capabilities, we may not be 
able to increase our product revenue, may generate increased expenses and may have regulatory compliance issues.

If governmental or third-party payors do not provide adequate reimbursement for our products, our revenue and prospects 
for profitability may be limited.

Our financial success depends, in part, on the availability of adequate reimbursement from third-party healthcare payors. 
Such third-party payors include governmental health programs such as Medicare and Medicaid, managed care providers and 
private health insurers. Third-party payors are increasingly challenging the pricing of medical products and services, while 
governments continue to propose and pass legislation designed to reduce the cost of healthcare. Adoption of such legislation 
could further limit reimbursement for pharmaceuticals.

In March 2010, the U.S. government passed into law the Patient Protection and Affordable Care Act, ("PPACA") along 
with the Health Care and Education Reconciliation Act of 2010, ("HCERA"), which modified the revenue provisions of the 
PPACA. The PPACA, as amended by the HCERA, constitutes the healthcare reform legislation.  The legislation calls for an 
increase  in  certain  Medicare  drug  rebates  paid  by  pharmaceutical  manufacturers  and  an  industry  fee  imposed  on 
pharmaceutical  manufacturers  according  to  the  individual  manufacturer’s  relative  percentage  of  total  industry  sales  to 
specified government programs. At this time no assurances can be given that these measures, or any other measures included 
in the Healthcare Reform Act, will not have an adverse effect on our revenues in the future. Furthermore, future cost control 
initiatives, legislation and regulations could decrease the price that we would receive for any products, which would limit 
our revenue and profitability.

Also, reimbursement practices of third-party payors might preclude us from achieving market acceptance for our products 
or maintaining price levels sufficient to realize an appropriate return on our investment in product acquisition and development. 
If we cannot obtain adequate reimbursement levels, our business, financial condition and results of operations would be 
materially and adversely affected.

Our employees have been trained to submit accurate and correct pricing information to payors. If, despite the training, 
our employees provide incorrect or fraudulent information, then we will be subject to various administrative and judicial 
investigations and litigation.

“Formulary” practices of third-party payors could adversely affect our competitive position.

Many managed healthcare organizations are now controlling the pharmaceutical products included on their formulary 
lists. Having products listed on these formulary lists creates competition among pharmaceutical companies which, in turn, 
has created a trend of downward pricing pressure in our industry. In addition, many managed care organizations are pursuing 
various ways to reduce pharmaceutical costs and are considering formulary contracts primarily with those pharmaceutical 
companies that can offer a full line of products for a given therapy sector or disease state. Our products might not be included 
on  the  formulary  lists  of  managed  care  organizations,  and  downward  pricing  pressure  in  our  industry  generally  could 
negatively impact our operations.

Continued  consolidation  of  distributor  networks  in  the  pharmaceutical  industry  as  well  as  increases  in  retailer 
concentration may limit our ability to profitably sell our products.

We sell most of our products to large pharmaceutical wholesalers, who in turn sell to hospitals and retail pharmacies. 
The  distribution  network  for  pharmaceutical  products  has  become  increasingly  consolidated  in  recent  years.  Further 
consolidation or financial difficulties could also cause our customers to reduce the amounts of our products that they purchase, 
which would materially and adversely impact our business, financial condition and results of operations.

23

Our CET joint initiative may not result in our gaining access to commercially viable products.

Our CET joint initiative with Vanderbilt University and Tennessee Technology Development Corporation is designed 
to help us investigate, in a cost-effective manner, early-stage products and technologies. However, we may never gain access 
to commercially viable products from CET for a variety of reasons, including:

•  CET  investigates  early-stage  products,  which  have  the  greatest  risk  of  failure  prior  to  FDA  approval  and 

commercialization;

• 

In some programs, we do not have pre-set rights to product candidates developed by CET. We would need to 
agree with CET and its collaborators on the terms of any product licensed to, or acquired by, us;

•  We rely principally on government grants to fund CET’s research and development programs. If these grants 
were no longer available, we or our co-owners might be unable or unwilling to fund CET operations at current 
levels or at all;

•  We may become involved in disputes with our co-owners regarding CET policy or operations, such as how 
best to deploy CET assets or which product opportunities to pursue. Disagreement could disrupt or halt product 
development; and

•  CET  may  disagree  with  one  of  the  various  universities  with  which  CET  is  collaborating  on  research. A 

disagreement could disrupt or halt product development.

We depend on our key personnel, the loss of whom would adversely affect our operations. If we fail to attract and retain 
the talent required for our business, our business will be materially harmed.

We are a relatively small company, and we depend to a great extent on principal members of our management and 
scientific staff. If we lose the services of any key personnel, in particular, A.J. Kazimi, our Chief Executive Officer, it could 
have a material adverse effect on our business prospects. Mr. Kazimi, plays a key role in several operational and strategic 
decisions such that any loss of his services due to death or disability would adversely impact our day-to-day operations. We 
currently have a key man life insurance policy covering the life of Mr. Kazimi. We have entered into agreements with each 
of our employees that contain restrictive covenants relating to non-competition and non-solicitation of our customers and 
suppliers for one year after termination of employment. Nevertheless, each of our officers and key employees may terminate 
his or her employment at any time without notice and without cause or good reason, and so as a practical matter these 
agreements do not guarantee the continued service of these employees. Our success depends on our ability to attract and 
retain  highly  qualified  scientific,  technical  and  managerial  personnel  and  research  partners.  Competition  among 
pharmaceutical companies for qualified employees is intense, and we may not be able to retain existing personnel or attract 
and retain qualified staff in the future. If we experience difficulties in hiring and retaining personnel in key positions, we 
could suffer from delays in product development, loss of customers and sales and diversion of management resources, which 
could adversely affect operating results.

The size of our organization and our potential growth may lead to difficulties in managing operations.

As  of  December  31,  2013,  we  had  96 full-time  employees.  We  may  need  to  continue  to  expand  our  managerial, 
operational, financial and other resources in order to increase our marketing efforts with regard to our currently marketed 
products, continue our business development and product development activities and commercialize our product candidates. 
We have experienced, and may continue to experience, growth and increased expenses in the scope of our operations in 
connection with the continued marketing and development of our products. Our financial performance will depend, in part, 
on our ability to manage any such growth and expenses of the current organization effectively.

We face potential product liability exposure, and if successful claims are brought against us, we may incur substantial 
liability for a product or product candidate and may have to limit its commercialization.

We face an inherent risk of product liability lawsuits related to the testing of our product candidates and the commercial 
sale of our products. An individual may bring a liability claim against us if one of our product candidates or products causes, 
or appears to have caused, an injury. If we cannot successfully defend ourselves against the product liability claim, we may 
incur substantial liabilities. Liability claims may result in:

•  Decreased demand for our products;

• 

Injury to our reputation;

•  Withdrawal of clinical trial participants;

24

• 

• 

• 

Significant litigation costs;

Substantial monetary awards to or costly settlement with patients;

Product recalls;

•  Loss of revenue; and

•  The inability to commercialize our product candidates.

We are highly dependent upon medical and patient perceptions of us and the safety and quality of our products. We 
could be adversely affected if we or our products are subject to negative publicity. We could also be adversely affected if 
any of our products or any similar products sold by other companies prove to be, or are asserted to be, harmful to patients. 
Also, because of our dependence upon medical and patient perceptions, any adverse publicity associated with illness or other 
adverse effects resulting from the use or misuse of our products or any similar products sold by other companies could have 
a material adverse impact on our results of operations.

We have product liability insurance that covers our clinical trials, the marketing and sale of our products up to a $10 million 
annual aggregate limit, subject to specified deductibles. Our current or future insurance coverage may prove insufficient to 
cover any liability claims brought against us.

Because of the increasing costs of insurance coverage, we may not be able to maintain insurance coverage at a reasonable 

cost or obtain insurance coverage that will be adequate to satisfy any liability that may arise.

Regulatory approval for any approved product is limited by the FDA to those specific indications and conditions for which 
clinical safety and efficacy have been demonstrated.

Any regulatory approval is limited to those specific diseases and indications for which a product is deemed to be safe 
and effective by the FDA. In addition to the FDA approval required for new formulations, any new indication for an approved 
product also requires FDA approval. If we are not able to obtain FDA approval for any desired future indications for our 
products, our ability to effectively market and sell our products may be reduced and our business may be adversely affected.

While physicians may choose to prescribe drugs for uses that are not described in the product’s labeling and for uses 
that differ from those tested in clinical studies and approved by the regulatory authorities, our ability to promote the products 
is limited to those indications that are specifically approved by the FDA. These “off-label” uses are common across medical 
specialties and may constitute an appropriate treatment for some patients in varied circumstances. Regulatory authorities in 
the U.S. generally do not regulate the behavior of physicians in their choice of treatments. Regulatory authorities do, however, 
restrict communications by pharmaceutical companies on the subject of off-label use. If our promotional activities fail to 
comply with these regulations or guidelines, we may be subject to warnings from, or enforcement action by, these authorities. 
In addition, our failure to follow FDA rules and guidelines relating to promotion and advertising may cause the FDA to 
suspend or withdraw an approved product from the market, require a recall or institute fines, or could result in disgorgement 
of money, operating restrictions, injunctions or criminal prosecution, any of which could harm our business.

Our business and operations would suffer in the event of system failures or adverse events at our corporate headquarters.

Despite  the  implementation  of  security  measures,  our  internal  computer  systems,  including  those  at  our  corporate 
headquarters, are vulnerable to damage from computer viruses, unauthorized access, natural disasters, terrorism, war and 
telecommunication and electrical failures. In the event that our corporate headquarters and/or our computer systems are 
disabled or materially damaged, it would have a substantial and material negative effect on our operations. Furthermore, any 
system failure, accident or security breach that causes interruptions in our operations could result in a material disruption of 
our drug development programs. To the extent that any disruption or security breach results in a loss or damage to our data 
or applications, or inappropriate disclosure of confidential or proprietary information, we may incur liability and the further 
development of our products or product candidates may be delayed.

RISKS RELATING TO GOVERNMENT REGULATION

We are subject to stringent government regulation. All of our products face regulatory challenges.

Virtually all aspects of our business activities are regulated by government agencies. The manufacturing, processing, 
formulation, packaging, labeling, distribution, promotion and sampling, advertising of our products, and disposal of 
waste products arising from such activities are subject to governmental regulation. These activities are regulated by 
one or more of the FDA, the Federal Trade Commission, ("FTC"), the Consumer Product Safety Commission, the 
U.S. Department of Agriculture and the U.S. Environmental Protection Agency, ("EPA"), as well as by comparable 

25

agencies in foreign countries. These activities are also regulated by various agencies of the states and localities in which 
our products are sold. For more information, see “Business—Government Regulation".

Like all pharmaceutical manufacturers, we are subject to regulation by the FDA under the FDCA. All new drugs 
must be the subject of an FDA-approved new drug application, ("NDA"), before they may be marketed in the United 
States. The FDA has the authority to withdraw existing NDA approvals and to review the regulatory status of products 
marketed under the enforcement policy. The FDA may require an approved NDA for any drug product marketed under 
the enforcement policy if new information reveals questions about the drug’s safety and effectiveness. All drugs must 
be manufactured in conformity with GMP, and drug products subject to an approved NDA must be manufactured, 
processed, packaged, held and labeled in accordance with information contained in the NDA. Since we rely on third 
parties to manufacture our products, GMP requirements directly affect our third party manufacturers and indirectly 
affect us. The manufacturing facilities of our third-party manufacturers are continually subject to inspection by such 
governmental  agencies,  and  manufacturing  operations  could  be  interrupted  or  halted  in  any  such  facilities  if  such 
inspections prove unsatisfactory. Our third-party manufacturers are subject to periodic inspection by the FDA to assure 
such compliance.

Pharmaceutical products must be distributed, sampled and promoted in accordance with FDA requirements. We 
must train our employees on proper regulatory compliance, including, but not limited to, “fair balance” promotion of 
our products and anti-kickback laws. The FDA also regulates the advertising of prescription drugs. The FDA has the 
authority to request post-approval commitments that can be time-consuming and expensive.

Under the FDCA, the federal government has extensive enforcement powers over the activities of pharmaceutical 
manufacturers to ensure compliance with FDA regulations. Those powers include, but are not limited to, the authority 
to initiate court action to seize unapproved or non-complying products, to enjoin non-complying activities, to halt 
manufacturing operations that are not in compliance with GMP, and to seek civil monetary and criminal penalties. The 
initiation of any of these enforcement activities, including the restriction or prohibition on sales of our products, could 
materially adversely affect our business, financial condition and results of operations.

Any  change  in  the  FDA’s  enforcement  policy  could  have  a  material  adverse  effect  on  our  business,  financial 

condition and results of operations.

We cannot determine what effect changes in regulations or statutes or legal interpretation, when and if promulgated 
or enacted, may have on our business in the future. Such changes, or new legislation, could have a material adverse 
effect on our business, financial condition and results of operations.

Proposed  legislation  may  permit  re-importation  of  drugs  from  other  countries  into  the  U.S.,  including  foreign 
countries where the drugs are sold at lower prices than in the U.S., which could materially adversely affect our 
operating results and our overall financial condition.

In previous years, legislation has been introduced in Congress that, if enacted, would permit more widespread re-
importation of drugs from foreign countries into the U.S., which may include re-importation from foreign countries 
where the drugs are sold at lower prices than in the U.S. Such legislation, or similar regulatory changes, if enacted, 
could decrease the price we receive for any approved products which, in turn, could materially adversely affect our 
operating results and our overall financial condition.

RISKS RELATING TO INTELLECTUAL PROPERTY

Our strategy to secure and extend marketing exclusivity or patent rights may provide only limited protection from 
competition.

We seek to secure and extend marketing exclusivity for our products through a variety of means, including FDA 
exclusivity and patent rights. Additional barriers for competitors seeking to enter the market include the time and cost 
associated with the development, regulatory approval and manufacturing of a similar product formulation. 

Acetadote is indicated to prevent or lessen hepatic (liver) injury when administered intravenously within eight to 
ten hours after ingesting quantities of acetaminophen that are potentially toxic to the liver.  As discussed in Part I, 
Item 1, Business - Trademarks, Patents and Proprietary Rights, of this Form 10-K, during April 2012, the United States 

26

Patent and Trademark Office (the “USPTO”) issued U.S. Patent number 8,148,356 (the “356 Acetadote Patent”) which 
is  assigned  to  us. The  claims  of  the  356 Acetadote  Patent  encompass  the  new Acetadote  formulation  and  include 
composition of matter claims. Following its issuance, the 356 Acetadote Patent was listed in the FDA Orange Book. 
The  356 Acetadote  Patent  is  scheduled  to  expire  in  May  2026,  which  time  period  includes  a  270-day  patent  term 
adjustment granted by the USPTO. 

Following the issuance of the 356 Acetadote Patent, we received separate Paragraph IV certification notices from 
InnoPharma, Inc., Paddock Laboratories, LLC ("Paddock") and Mylan Institutional LLC challenging the 356 Acetadote 
Patent  on  the  basis  of  non-infringement  and/or  invalidity.  On  May 17,  2012,  we  responded  to  the  Paragraph  IV 
certification notices by filing three separate lawsuits for infringement of the 356 Acetadote Patent. The first lawsuit 
was filed against Mylan Institutional LLC and Mylan Inc. ("Mylan") in the United States District Court for the Northern 
District of Illinois, Eastern Division. The second lawsuit was filed against InnoPharma, Inc. in the United States District 
Court for the District of Delaware. The third lawsuit was also filed in the United States District Court for the District 
of  Delaware  against  Paddock  and  Perrigo  Company  ("Perrigo").    On  May 20,  2012,  we  received  a  Paragraph  IV 
certification notice from Sagent Agila LLC challenging the 356 Acetadote Patent.  On June 26, 2012, we filed a lawsuit 
for infringement of the 356 Acetadote Patent against Sagent Agila LLC and Sagent Pharmaceuticals, Inc. ("Sagent") 
in the United States District Court for the District of Delaware.  On July 9, 2012, we received a Paragraph IV certification 
notice from Perrigo.  On August 9, 2012, we filed a lawsuit for infringement of the 356 Acetadote Patent against Perrigo 
in the United States District Court for the Northern District of Illinois, Eastern Division.

On November 12, 2012, we entered into a Settlement Agreement (the “Settlement Agreement”) with Paddock and 
Perrigo to resolve the challenges and the pending litigation with each of Paddock and Perrigo involving the 356 Acetadote 
Patent.    Under  the  Settlement Agreement,  Paddock  and  Perrigo  admit  that  the  356 Acetadote  Patent  is  valid  and 
enforceable and that any Paddock or Perrigo generic Acetadote product (with or without EDTA) would infringe upon 
the 356 Acetadote Patent. In addition, Paddock and Perrigo will not challenge the validity, enforceability, ownership 
or patentability of the 356 Acetadote Patent through its expiration currently scheduled for May 2026. On November 
12, 2012, in connection with the execution of the Settlement Agreement, we entered into a License and Supply Agreement 
with Paddock and Perrigo (the “License and Supply Agreement”).  Under the terms of the License and Supply Agreement, 
if a third party receives final approval from the FDA for an ANDA to sell a generic Acetadote product and such third 
party has made such generic version available for purchase in commercial quantities in the United States, we will supply 
Perrigo with an authorized generic version of our Acetadote product (the “Authorized Generic”).

By  statute,  where  the  Paragraph  IV  certification  is  to  a  patent  timely  listed  before  an Abbreviated  New  Drug 
Application (“ANDA”) is filed, a company has 45 days to institute a patent infringement lawsuit during which period 
the FDA may not approve another application. In addition, such a lawsuit for patent infringement filed within such 45-
day period may stay, or bar, the FDA from approving another product application for two and a half years or until a 
district court decision that is adverse to the asserted patents, whichever is earlier. On May 18, 2012, we requested the 
aforementioned bar or stay in connection with the filing of the three lawsuits on May 17, 2012. The aforementioned 
bar or stay may or may not be available to us with respect to the remaining lawsuits.

On May 18, 2012, we also submitted a Citizen Petition to the FDA requesting that the FDA refrain from approving 
any applications for acetylcysteine injection that contain EDTA, based in part on the FDA's request that we evaluate 
the reduction or removal of EDTA from its original Acetadote formulation. On November 7, 2012, the FDA responded 
to the Citizen Petition denying our request and stating that ANDAs referencing Acetadote that contain EDTA may be 
accepted and approved  provided they meet all applicable requirements. We believe this response contradicts the FDA's 
request to evaluate the reduction or removal of EDTA. On November 8, 2012, we learned that the FDA approved the 
ANDA referencing Acetadote filed by InnoPharma, Inc.  On November 13, 2012, we brought suit against the FDA in 
the United States District Court for the District of Columbia alleging that the FDA's denial of our Citizen Petition and 
acceptance for review and approval of any InnoPharma, Inc. product containing EDTA was arbitrary and in violation 
of law. 

We  found  during  the  resulting  legal  proceedings  that  the  FDA  initially  concluded  that  the  original Acetadote 
formulation was withdrawn for safety reasons and no generic versions should be approved. The FDA later reversed its 
position based on the possibility of drug shortages and the presence of EDTA in other formulations. At the same time, 

27

the  FDA  noted  that  exclusively  marketing  a  non-EDTA  containing  product  would  be  preferable  because  it  would 
eliminate the potential risk of EDTA. 

On  January  7,  2013,  Perrigo  announced  initial  distribution  of  our  authorized  generic  acetylcysteine  injection 

product.

On March 19, 2013, the USPTO issued U.S. Patent number 8,399,445 (the “445 Acetadote Patent”) which is also 
assigned to us. The claims of the 445 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acetaminophen overdose.   On April 8, 2013, the 445 Acetadote Patent was listed in the FDA Orange 
Book. The 445 Acetadote Patent is scheduled to expire in August 2025. Following the issuance of the 445 Acetadote 
Patent we have received separate Paragraph IV certification notices from Perrigo, Sagent, and Mylan challenging the 
445 Acetadote Patent on the basis of non-infringement, unenforceability and/or invalidity.

On June 10, 2013, we became aware of a Paragraph IV certification notice from Akorn, Inc. challenging the 445 
Acetadote Patent and the 356 Acetadote Patent on the basis of non-infringement. On July 12, 2013, we filed a lawsuit 
for infringement of the 356 Acetadote Patent against Akorn, Inc. in the United States District Court for the District of 
Delaware.

On June 10, 2013, we announced that the FDA approved updated labeling for Acetadote.  The new labeling revises 

the product's indication and offers new dosing guidance for specific patient populations. 

On September 30, 2013, the United States District Court for the District of Columbia filed an opinion granting a 
Summary Judgment in favor of the FDA regarding Cumberland’s November 13, 2012 suit.  On November 1, 2013, the 
United States District Court for the District of Delaware filed opinions granting Sagent’s and InnoPharma’s motions 
to dismiss our May 2012 and June 2012 suits. We are considering our legal options and intend to continue to vigorously 
defend and protect our Acetadote product and related intellectual property.

On February18, 2014, the USPTO issued U.S. Patent number 8,653,061 (the “061 Acetadote Patent”) which is 
assigned to us. The claims of the 061 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acetaminophen overdose.  Following its issuance, the 061 Acetadote Patent was listed in the FDA 
Orange Book. The 061 Acetadote Patent is scheduled to expire in August 2025.

On February 24, 2014, we received a Notice of Allowance from the USPTO for a patent relating to the use of the 
Acetadote formulation to treat patients with acetaminophen overdose. The new patent will include claims regarding 
the administration method of acetylcysteine injection, without specification of the presence or lack of EDTA in the 
injection, and is scheduled to expire in April 2032.

We also have additional patent applications relating to Acetadote which are pending with the USPTO and may or 
may not be issued.  As noted, we intend to continue to vigorously defend and protect our Acetadote product and related 
intellectual  property  rights.  If  we  are  unsuccessful  in  protecting  our  Acetadote  intellectual  property  rights,  our 
competitors may be able to introduce products into the marketplace that reduce the sales and market share of our 
Acetadote product which may require us to take measures such as reducing prices or increasing our marketing expense, 
any of which may result in a material adverse effect to our financial condition and results of operations. 

We have a U.S. patent and related international patents which include composition of matter claims that emcompass 
the Caldolor formulation and claims directed to ibuprofen solution formulations, methods of making the same, and 
methods of using the same, and which are related to our formulation and manufacture of Caldolor. Additionally, the 
active ingredient in Caldolor, ibuprofen, is in the public domain, and  a competitor could try to develop, test and seek 
FDA approval for a sufficiently distinct formulation for another ibuprofen product that competes with Caldolor.  The 
U.S. patent is listed in the FDA Orange Book and expires in November of 2021.

While we consider patent protection when evaluating product acquisition opportunities, any products we acquire 
in the future may not have significant patent protection. Neither the USPTO nor the courts have a consistent policy 
regarding the breadth of claims allowed or the degree of protection afforded under many pharmaceutical patents. Patent 
applications in the U.S. and many foreign jurisdictions are typically not published until 18 months following the filing 
date of the first related application, and in some cases not at all. In addition, publication of discoveries in scientific 
literature often lags significantly behind actual discoveries. Therefore, neither we nor our licensors can be certain that 

28

we or they were the first to make the inventions claimed in our issued patents or pending patent applications, or that 
we or they were the first to file for protection of the inventions set forth in these patent applications. In addition, changes 
in either patent laws or in interpretations of patent laws in the U.S. and other countries may diminish the value of our 
intellectual property or narrow the scope of our patent protection. Furthermore, our competitors may independently 
develop similar technologies or duplicate technology developed by us in a manner that does not infringe our patents 
or other intellectual property. As a result of these factors, our patent rights may not provide any commercially valuable 
protection from competing products. 

If  we  are  unable  to  protect  the  confidentiality  of  our  proprietary  information  and  know-how,  the  value  of  our 
technology and products could be adversely affected.

In addition to patents, we rely upon trade secrets, unpatented proprietary know-how and continuing technological 
innovation where we do not believe patent protection is appropriate or attainable. For example, the manufacturing 
process for Kristalose involves substantial trade secrets and proprietary know-how. We have entered into confidentiality 
agreements with certain key employees and consultants pursuant to which such employees and consultants must assign 
to  us  any  inventions  relating  to  our  business  if  made  by  them  while  they  are  our  employees,  as  well  as  certain 
confidentiality agreements relating to the acquisition of rights to products. Confidentiality agreements can be breached, 
though, and we might not have adequate remedies for any breach. Also, others could acquire or independently develop 
similar technology.

We may depend on certain licensors for the maintenance and enforcement of intellectual property rights and 
have limited, if any, control over the amount or timing of resources that our licensors devote on our behalf.

When  we  license  products,  we  often  depend  on  our  licensors  to  protect  the  proprietary  rights  covering  those 
products. We have limited, if any, control over the amount or timing of resources that our licensors devote on our behalf 
or the priority they place on maintaining patent or other rights and prosecuting patent applications to our advantage. 
While any such licensor is expected to be under contractual obligations to us to diligently pursue its patent applications 
and allow us the opportunity to consult, review and comment on patent office communications, we cannot be sure that 
it will perform as required. If a licensor does not perform and if we do not assume the maintenance of the licensed 
patents in sufficient time to make required payments or filings with the appropriate governmental agencies, we risk 
losing the benefit of all or some of those patent rights.

If the use of our technology conflicts with the intellectual property rights of third parties, we may incur substantial 
liabilities, and we may be unable to commercialize products based on this technology in a profitable manner or at 
all.

If our products conflict with the intellectual property rights of others, they could bring legal action against us or 
our licensors, licensees, manufacturers, customers or collaborators. If we were found to be infringing a patent or other 
intellectual property rights held by a third party, we could be forced to seek a license to use the patented or otherwise 
protected technology. We might not be able to obtain such a license on terms acceptable to us or at all. If legal action 
involving an alleged infringement or misappropriation were to be brought against us or our licensors, we would incur 
substantial  costs  in  defending  the  action.  If  such  a  dispute  were  to  be  resolved  against  us,  we  could  be  subject  to 
significant damages, and the manufacturing or sale of one or more of our products could be enjoined.

We may be involved in lawsuits to protect or enforce our patents or the patents of our collaborators or licensors, 
which could be costly and time consuming.

We have been involved in lawsuits for infringement of the Acetadote Patents as previously described.  Because of 
their nature, these lawsuits can be costly and time-consuming, and we only experience limited benefits and patent 
protection.  A significant adverse ruling in any such lawsuit could put the Acetadote Patents at risk of being invalidated 
or interpreted narrowly and could put our existing patent applications at risk of not issuing. 

Competitors  may  infringe  on  our  other  patents  or  the  patents  of  our  collaborators  or  licensors.  To  counter 
infringement or unauthorized use, we may be required to file infringement claims, which can be expensive and time-
consuming. In addition, in an infringement proceeding, a court may decide that a  patent of  ours is not  valid or  is 
unenforceable, or may refuse to stop the other party from using the technology at issue on the grounds that our patents 
do not cover the technology in question. An adverse result in any litigation or defense proceeding could put one or 

29

more of our patents at risk of being invalidated or interpreted narrowly and could put our patent applications at risk of 
not issuing.

Interference proceedings brought by the USPTO may be necessary to determine the priority of inventions with 
respect to our patent applications or those of our collaborators or licensors. Litigation or interference proceedings may 
fail and, even if successful, may result in substantial costs and distract our management. We may not be able, alone or 
with our collaborators and licensors, to prevent misappropriation of our proprietary rights, particularly in countries 
where the laws may not protect such rights as fully as in the United States.

Furthermore, because of the substantial amount of discovery required in connection with intellectual property 
litigation, some of our confidential information could be disclosed during this type of litigation. In addition, there could 
be public announcements of the results of hearings, motions or other interim proceedings or developments. 

If we breach any of the agreements under which we license rights to our products and product candidates from 
others,  we  could  lose  the  ability  to  continue  commercialization  of  our  products  and  development  and 
commercialization of our product candidates.

We have exclusive licenses for the marketing and sale of certain products and may acquire additional licenses. 
Such licenses may terminate prior to expiration if we breach our obligations under the license agreement related to 
these pharmaceutical products. For example, the licenses may terminate if we fail to meet specified quality control 
standards, including GMP with respect to the products, or commit a material breach of other terms and conditions of 
the licenses. Such early termination could have a material adverse effect on our business, financial condition and results 
of operations.

We may be subject to claims that our employees have wrongfully used or disclosed alleged trade secrets of their 
former employers.

As is common in the biotechnology and pharmaceutical industry, we employ individuals who were previously 
employed at other biotechnology or pharmaceutical companies, including our competitors or potential competitors. 
Although no claims against us are currently pending, we may be subject to claims that we or these employees have 
inadvertently or otherwise used or disclosed trade secrets or other proprietary information of their former employers. 
Litigation may be necessary to defend against these claims. Even if we are successful in defending against these claims, 
litigation could result in substantial costs and be a distraction to management.

RISKS RELATED TO OUR FINANCIAL CONDITION AND RESULTS OF OPERATIONS

Our operating results are likely to fluctuate from period to period.

We are a relatively new company seeking to capture significant growth. As we execute our business strategy of 
adding new products like Omeclamox-Pak, increasing market share in Caldolor and striving to maintain market share 
in our Acetadote product, we anticipate that there may be fluctuations in our future operating results. We may not be 
able to maintain or improve our current levels of revenue or income. Potential causes of future fluctuations in our 
operating results may include:

•  New product launches, which could increase revenues but also increase sales and marketing expenses;

•  Acquisition activity and other charges (such as for inventory expiration);

• 

Increases in research and development expenses resulting from the acquisition of a product candidate that 
requires significant additional studies and development;

•  Changes in the competitive, regulatory or reimbursement environment, which could drive down revenues 

or drive up sales and marketing or compliance costs; and

•  Unexpected product liability or intellectual property claims and lawsuits.

30

See also “Management’s discussion and analysis of financial condition and results of operations—Liquidity and 
capital resources.” Fluctuation in operating results, particularly if not anticipated by investors and other members of 
the financial community, could add to volatility in our stock price.

Our focus on acquisitions as a growth strategy has created intangible assets whose amortization could negatively 
affect our results of operations.

Our total assets include intangible assets related to our acquisitions. As of December 31, 2013, intangible assets 
relating to product and data acquisitions represented approximately 18% of our total assets. We may never realize the 
value of these assets. U.S. Generally Accepted Accounting Principles ("GAAP") require that we evaluate on a regular 
basis whether events and circumstances have occurred that indicate that all or a portion of the carrying amount of the 
asset may no longer be recoverable, in which case we would write down the value of the asset and take a corresponding 
charge to earnings. Any determination requiring the write-off of a significant portion of unamortized intangible assets 
would adversely affect our results of operations.

We may need additional funding and may be unable to raise capital when needed, which could force us to delay, 
reduce or eliminate our product development or commercialization and marketing efforts.

We  may  need  to  raise  additional  funds  in  order  to  meet  the  capital  requirements  of  running  our  business  and 
acquiring and developing new pharmaceutical products. If we require additional funding, we may seek to sell common 
stock or other equity or equity-linked securities, which could result in dilution to our shareholders. We may also seek 
to raise capital through a debt financing, which would result in ongoing debt-service payments and increased interest 
expense. Any financings would also likely involve operational and financial restrictions being imposed on us. We might 
also seek to sell assets or rights in one or more commercial products or product development programs. Additional 
capital might not be available to us when we need it. In addition, if recent trends in the stability in global credit markets 
continue or grow we could be adversely impacted. We are unable to predict the impact of these trends, and if economic 
conditions deteriorate, our business, results of operations and ability to raise needed capital could be materially and 
adversely affected. If we are unable to raise additional capital when needed due to the reasons listed above and lack of 
creditworthiness, bank failures, or price decline in market investments, we could be forced to scale back our operations 
to conserve cash.

If we are unable to establish appropriate internal financial reporting controls and procedures, it could cause us to 
fail to meet our reporting obligations, result in the restatement of our financial statements, harm our operating 
results, subject us to regulatory scrutiny and sanction, cause investors to lose confidence in our reported financial 
information and have a negative effect on the market price for shares of our common stock.

Effective internal controls are necessary for us to provide reliable financial reports and mitigate the risk of fraud. 
We maintain a system of internal control over financial reporting, which is defined as a process designed by, or under 
the supervision of, our principal executive officer and principal financial officer, or persons performing similar functions, 
and affected by our board of directors, management and other personnel, to provide reasonable assurance regarding 
the reliability of financial reporting and the preparation of financial statements for external purposes in accordance 
with GAAP.

We cannot assure you that we will not, in the future, identify areas requiring improvement in our internal control 
over financial reporting. We cannot assure you that the measures we will take to improve these controls will be successful 
or that we will implement and maintain adequate controls over our financial processes and reporting in the future as 
we continue to expand. If we are unable to establish appropriate internal financial reporting controls and procedures, 
it could cause us to fail to meet our reporting obligations, result in the restatement of our financial statements, harm 
our operating results, subject us to regulatory scrutiny and sanction, cause investors to lose confidence in our reported 
financial information and have a negative effect on the market price for shares of our common stock.

In addition, we maintain a system of internal controls and provide training to employees designed to provide 
reasonable assurance that unlawful and fraudulent activity, including misappropriation of assets, fraudulent financial 
reporting, and unauthorized access to sensitive or confidential data is either prevented or timely detected. However, in 
the event that our employees engage in such fraudulent behavior, we could suffer material adverse consequences.

Changes in, or interpretations of, accounting principles and tax laws could have a significant impact on our 

financial position and results of operations.

31

We  prepare  our  consolidated  financial  statements  in  accordance  with  GAAP.  These  principles  are  subject  to 
interpretation by the SEC and various bodies formed to interpret and create appropriate accounting principles. A change 
in these principles can have a significant effect on our reported results and may even retroactively affect previously 
reported transactions.

For example, the U.S.-based Financial Accounting Standards Board, ("FASB"), continues to work together with 
the International Accounting Standards Board, ("IASB"), on several projects to further align accounting principles and 
facilitate  more  comparable  financial  reporting  between  companies  who  are  required  to  follow  GAAP  under  SEC 
regulations and those who are required to follow International Financial Reporting Standards, ("IFRS"), outside of the 
U.S. These efforts by the FASB and IASB may result in different accounting principles under GAAP that may result  
in materially different financial results for us in areas including, but not limited to principles for recognizing revenue 
and lease accounting.

RISKS RELATED TO OWNING OUR STOCK

The market price of our common stock may fluctuate substantially.

The price for the shares of our common stock sold in our initial public offering was determined by negotiation 
between the representatives of the underwriters and us. This price may not have reflected the market price of our 
common stock following our initial public offering. Through March 3, 2014, the closing price of our common stock 
since our initial public offering has ranged from a low of $4.03 to a high of $17.05 per share. Moreover, the market 
price of our common stock might decline below current levels. In addition, the market price of our common stock is 
likely to be highly volatile and may fluctuate substantially. Sales of a substantial number of shares of our common 
stock in the public market or the perception that these sales may occur could cause the market price of our common 
stock to decline.

The realization of any of the risks described in these “Risk Factors” could have a dramatic and material adverse 
impact on the market price of our common stock. In addition, securities class action litigation has often been instituted 
against companies whose securities have experienced periods of volatility in market price. Any such securities litigation 
brought against us could result in substantial costs and a diversion of management’s attention and resources, which 
could negatively impact our business, operating results and financial condition. Sales of a substantial number of shares 
of our common stock in the public market or the perception that these sales may occur could cause the market price of 
our common stock to decline.

Unstable market conditions may have serious adverse consequences on our business.

Our general business strategy may be adversely affected by unpredictable and unstable market conditions. While 
we believe we have adequate capital resources to meet current working capital and capital expenditure requirements, 
a radical economic downturn or increase in our expenses could require additional financing on less than attractive rates 
or on terms that are dilutive to existing shareholders. Failure to secure any necessary financing in a timely manner and 
on favorable terms could have a material adverse effect on our growth strategy, financial performance and stock price 
and could require us to delay or abandon clinical developments plans. There is a risk that one or more of our current 
service providers, manufacturers and other partners may encounter difficulties during challenging economic times, 
which would directly affect our ability to attain our operating goals on schedule and on budget.

We are experiencing increased costs and regulatory risk as a result of operating as a public company, and our 
management will be required to devote additional time to new compliance initiatives.

We have and will continue to incur increased costs as a result of operating as a public company, and our management 
is required to devote additional time to new compliance initiatives. As a public company, we have and will continue 
to incur legal, accounting and other expenses that we did not incur as a private company. In addition, the Sarbanes-
Oxley Act of 2002, or Sarbanes-Oxley Act, Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010, 
and  other  rules  and  regulations  subsequently  implemented  by  the  SEC  and  NASDAQ,  have  imposed  various 
requirements  on  public  companies,  including  requiring  establishment  and  maintenance  of  effective  disclosure  and 
financial controls and changes in corporate governance practices. These rules and regulations have and will continue 
to increase our legal and financial compliance costs and will render some activities more time-consuming and costly. 
Despite the internal controls and procedure put in place to maintain compliance with securities laws and regulations, 
our employees may still fail to comply with all SEC disclosure and reporting requirements. Such failure could lead to 

32

administrative and civil penalties, criminal penalties, and private litigation with shareholders. The consequences could 
have a significant material effect on our ability to operate and market out products.

The Sarbanes-Oxley Act requires, among other things, that we maintain effective internal controls for financial 
reporting and disclosure controls and procedures. In particular, we must perform system and process evaluation and 
testing of our internal controls over financial reporting to allow management and our independent registered public 
accounting firm to report on the effectiveness of our internal controls over financial reporting. Our testing, or the 
subsequent testing by our independent registered public accounting firm, may reveal deficiencies in our internal controls 
over financial reporting that are deemed to be material weaknesses.

Our compliance with Section 404 of the Sarbanes-Oxley Act requires that we incur substantial accounting expense 
and expend significant management efforts. Moreover, if we are not able to comply with the requirements of Section 404 
of the Sarbanes-Oxley Act in a timely manner, or if we or our independent registered public accounting firm identifies 
deficiencies in our internal controls over financial reporting that are deemed to be material weaknesses, the market 
price of our stock could decline and we could be subject to sanctions or investigations by NASDAQ, the SEC or other 
regulatory authorities, which would require additional financial and management resources.

We must comply with the Foreign Corrupt Practices Act.

We are required to comply with the United States Foreign Corrupt Practices Act, which prohibits U.S. companies 
from engaging in bribery or other prohibited payments to foreign officials for the purpose of obtaining or retaining 
business. Foreign companies, including some of our competitors, are not subject to these prohibitions. If our competitors 
engage  in  these  practices,  they  may  receive  preferential  treatment  from  personnel  of  some  companies,  giving  our 
competitors an advantage in securing business or from government officials who might give them priority in obtaining 
new licenses, which would put us at a disadvantage. We have established formal policies or procedures for prohibiting 
or monitoring this conduct, but we cannot assure you that our employees or other agents will not engage in such conduct 
for which we might be held responsible. If our employees or other agents are found to have engaged in such practices, 
we could suffer severe penalties.

Some provisions of our third amended and restated charter, bylaws, credit facility and Tennessee law may inhibit 
potential acquisition bids that you may consider favorable.

Our corporate documents contain provisions that may enable our board of directors to resist a change in control 
of our company even if a change in control were to be considered favorable by you and other shareholders. These 
provisions include:

•  The authorization of undesignated preferred stock, the terms of which may be established and shares of 

which may be issued without shareholder approval;

•  Advance notice procedures required for shareholders to nominate candidates for election as directors or 

to bring matters before an annual meeting of shareholders;

•  Limitations on persons authorized to call a special meeting of shareholders;

•  A staggered board of directors;

•  A restriction prohibiting shareholders from removing directors without cause;

•  A requirement that vacancies in directorships are to be filled by a majority of the directors then in office 

and the number of directors is to be fixed by the board of directors; and

•  No cumulative voting.

These and other provisions contained in our third amended and restated charter and bylaws could delay or discourage 
transactions involving an actual or potential change in control of us or our management, including transactions in which 
our shareholders might otherwise receive a premium for their shares over then current prices, and may limit the ability 
of shareholders to remove our current management or approve transactions that our shareholders may deem to be in 
their best interests and, therefore, could adversely affect the price of our common stock.

33

In addition, we are subject to control share acquisitions provisions and affiliated transaction provisions of the 
Tennessee Business Corporation Act, the applications of which may have the effect of delaying or preventing a merger, 
takeover or other change in control of us and therefore could discourage attempts to acquire our company.

We have never paid cash dividends on our capital stock, and we do not anticipate paying any cash dividends in the 
foreseeable future.

We  have  never  paid  cash  dividends  on  our  capital  stock.  We  do  not  anticipate  paying  cash  dividends  to  our 
shareholders in the foreseeable future. The availability of funds for distributions to shareholders will depend substantially 
on our earnings. Even if we become able to pay dividends in the future, we expect that we would retain such earnings 
to enhance capital and/or reduce long-term debt.

SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

Statements in this Annual Report on Form 10-K that are not historical factual statements are “forward-looking 
statements.”  Forward-looking  statements  include,  among  other  things,  statements  regarding  our  intent,  belief  or 
expectations, and can be identified by the use of terminology such as “may,” “will,” “expect,” “believe,” “intend,” 
“plan,” “estimate,” “should,” “seek,” “anticipate” and other comparable terms or the negative thereof. In addition, we, 
through our senior management, from time to time make forward-looking oral and written public statements concerning 
our expected future operations and other developments. While forward-looking statements reflect our good-faith beliefs 
and best judgment based upon current information, they are not guarantees of future performance and are subject to 
known  and  unknown  risks  and  uncertainties,  including  those  mentioned  in  Item 1A,  “Risk  Factors,”  Item 7, 
“Management’s  Discussion  and Analysis  of  Financial  Condition  and  Results  of  Operations”  and  elsewhere  in  this 
Form 10-K. Actual results may differ materially from the expectations contained in the forward-looking statements as 
a result of various factors. Such factors include, without limitation:

•  Legislative, regulatory or other changes in the healthcare industry at the local, state or federal level which 

increase the costs of, or otherwise affect our operations;

•  Changes in reimbursement available to us by government or private payers, including changes in Medicare 

and Medicaid payment levels and availability of third-party insurance coverage;

•  Competition; and

•  Changes in national or regional economic conditions, including changes in interest rates and availability 

and cost of capital to us.

Item 1B. Unresolved Staff Comments.

None.

Item 2. Properties.

As of December 31, 2013, we leased approximately 25,500 square feet of office space in Nashville, Tennessee for 
our corporate headquarters. The lease expires in October 2016. Of the 25,500 square feet of leased office space, we 
have subleased to others approximately 9,900 square feet. We believe these facilities are adequate to meet our current 
needs  for  office  space.  We  currently  do  not  plan  to  purchase  or  lease  facilities  for  manufacturing,  packaging  or 
warehousing, as such services are provided to us by third-party contract groups.

Under an agreement amended in July 2012 and expiring in April 2018, CET leases approximately14,200 square 
feet of office and wet laboratory space in Nashville, Tennessee. CET uses this space to operate the CET Life Sciences 
Center for product development work to be carried out in collaboration with universities, research institutions and 
entrepreneurs. The CET Life Sciences Center provides laboratory and office space, equipment and infrastructure to 
early-stage life sciences companies and university spin-outs.

34

Item 3. Legal Proceedings.

See the discussion of legal proceedings contained in Part I, Item 1, Business - Trademarks, Patents and Proprietary 

Rights, of this Form 10-K, which is incorporated herein by reference. 

PART II

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

Market Information

Our common stock, no par value, has been traded on the Nasdaq Global Select Market since August 11, 2009 under 
the symbol “CPIX.” Prior to that time, there was no public market for our common stock. As of March 3, 2014, there 
were 81 shareholders of record, which excludes shareholders whose shares are held in nominee or street name by 
brokers. The closing price of our common stock on the Nasdaq Global Select Market on March 3, 2014 was $4.67 per 
share. The following table sets forth the high and low trading sales prices for our common stock as reported on the 
Nasdaq Global Select Market for the full quarterly periods during 2012 and 2013:

Fiscal year ended December 31, 2013:

First quarter

Second quarter

Third quarter

Fourth quarter

Fiscal year ended December 31, 2012:

First quarter

Second quarter

Third quarter

Fourth quarter

High

Low

$5.10

5.37

5.85

5.41

7.93

7.81

6.67

6.40

$4.03

4.52

4.33

4.53

5.68

5.96

5.91

4.12

Dividend Policy

We have not declared or paid any cash dividends on our common stock nor do we anticipate paying dividends for 
the foreseeable future. We currently intend to retain any future earnings for use in the operation of our business and to 
fund future growth. The payment of dividends by us on our common stock is limited by our loan agreement. Any future 
decision to declare or pay dividends will be at the sole discretion of our Board of Directors.

35

Performance Graph

The stock performance graph below illustrates a comparison of the total cumulative stockholder return on our 
common stock since August 10, 2009, which is the date of our initial public offering on the Nasdaq Global Select 
Market, to the Nasdaq Composite and a composite of ten Nasdaq Pharmaceutical and Specialty Pharmaceutical Stocks 
which most closely compare to our Company. The graph assumes an initial investment of $100 on August 10, 2009, 
and that all dividends were reinvested.

Purchases of Equity Securities

On May 13, 2010, we announced a share repurchase program to purchase up to $10 million of our common stock 
pursuant to Rule 10b-18 of the Securities Act. In January 2011, April 2012 and January 2013, our Board of Directors 
replaced the prior authorizations with  $10 million authorizations for repurchases of our outstanding common stock. 

36

The following table summarizes the activity, by month, during the fourth quarter of 2013:

Period

October

November

December

Total

Total Number
of Shares (or
Units)
Purchased

52,607

72,673 (1)

54,274

179,554

Average
Price Paid
per Share
(or Unit)

$4.76

4.91

5.08

Total Number of
Shares (or
Units)
Purchased as
Part of Publicly
Announced
Plans or
Programs

52,607

72,673

54,274

Maximum Number (or
Approximate Dollar
Value) of Shares (or
Units) that May Yet Be
Purchased Under the
Plans or Programs

$6,234,591

5,877,852

5,602,293

(1)  Of this amount, 19,291 shares were repurchased directly in a private purchase at the then-current fair market value of 

common stock.

Item 6. Selected Financial Data.

The selected consolidated financial data set forth below should be read in conjunction with the audited consolidated 
financial statements and related notes and Item 7, “Management’s Discussion and Analysis of Financial Condition and Results 
of Operations” and other financial information appearing elsewhere in this Form 10-K. The historical results are not necessarily 
indicative of the results to be expected for any future periods.

Statement of income data:

2013

Years Ended December 31,

2010
2011
2012
(in thousands, except per share data)

2009

$

32,027

$

48,851

$

51,143

$

45,876

$

43,537

40,033

8,818

41,293

9,849

39,375

6,502

5,842

0.30

0.30

$

$

5,658

0.28

0.28

$

$

2,457

0.12

0.12

$

$

37,761

5,777

3,091

0.22

0.17

Net revenues

Costs and expenses

Operating (loss) income

Net (loss) income attributable to common
shareholders

35,829

(3,801)

(2,105)

Earnings (loss) per share – basic

Earnings (loss) per share – diluted

$

$

(0.11) $

(0.11) $

37

 
 
Balance sheet data:

2013

2012

As of December 31,

2011
(in thousands)

2010

2009

Cash and cash equivalents

$

40,869

$

54,349

$

70,599

$

65,894

$

78,702

Marketable securities
Working capital

Total assets

Total long-term debt and other long-term
obligations (including current portion)

Retained earnings

Total equity

14,020

61,134

87,614

869

16,395

79,292

16,686

79,177

98,594

5,042

18,499

85,566

—

80,708

95,518

5,485

12,657

82,835

—

71,811

92,054

7,802

6,999

77,715

—

74,549

103,724

20,155

4,542

72,221

38

 
 
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.

The following discussion and analysis of our financial position and results of operations should be read together 
with our audited consolidated financial statements and related notes appearing elsewhere in this Form 10-K. This 
discussion and analysis may contain forward-looking statements that involve risks and uncertainties – please refer to 
the  section  entitled,  “Special  Note  Regarding  Forward-Looking  Statements,”  Contained  in  Part  I,  Item 1A,  “Risk 
Factors,” of this Form 10-K. You should review the “Risk Factors” section of this Form 10-K for a discussion of 
important factors that could cause actual results to differ materially from the results described in or implied by the 
forward-looking statements described in the following discussion and analysis.

EXECUTIVE SUMMARY

We  are  a  growing  specialty  pharmaceutical  company  focused  on  the  acquisition,  development  and 
commercialization  of  branded  prescription  products.  Our  primary  target  markets  are  hospital  acute  care  and 
gastroenterology. These markets are characterized by relatively concentrated prescriber bases that we believe can be 
penetrated effectively by small, targeted sales forces. Cumberland is dedicated to providing innovative products that 
improve quality of care for patients and address unmet or poorly met medical needs

Our product portfolio includes Acetadote® (acetylcysteine) Injection for the treatment of acetaminophen poisoning, 
Caldolor® (ibuprofen) Injection, the first injectable treatment for pain and fever, Kristalose® (lactulose) for Oral Solution, 
a prescription laxative, Omeclamox®-Pak, triple therapy combination medication for Helicobacter pylori (H. pylori) 
infection and duodenal ulcer disease, and Hepatoren (ifetroban) Injection, a Phase II candidate for the treatment of 
critically ill hospitalized patients suffering from HRS. We market and sell our approved products through our hospital 
and  field  sales  forces  in  the  United  States,  which  together  comprised  approximately  60  sales  representatives  and 
managers as of December 31, 2013.

We  have  both  product  development  and  commercial  capabilities,  and  believe  we  can  leverage  our  existing 
infrastructure to support our expected growth. Our management team consists of pharmaceutical industry veterans 
experienced in business development, product development, regulatory, manufacturing, sales, marketing and finance. 
Our business development team identifies, evaluates and negotiates product acquisition, in-licensing and out-licensing 
opportunities. Our product development team develops proprietary product formulations, manages our clinical trials, 
prepares all regulatory submissions and manages our medical call center. Our quality and manufacturing professionals 
oversee the manufacture and release of our products. Our marketing and sales professionals are responsible for our 
commercial activities, and we work closely with our distribution partners to ensure availability and delivery of our 
products.

We were incorporated in 1999 and have been headquartered in Nashville, Tennessee since inception. During 2009, 

we completed an initial public offering of our common stock and listing on the NASDAQ exchange. 

The following is a summary of our 2013 highlights and recent developments. For more information, please see 

Part I, Item I, Business, of this Form 10-K. 

• 

In 2013, we added Omeclamox-Pak, a branded prescription product used for the treatment of Helicobacter 
pylori (H. pylori) infection and duodenal ulcer disease.  This innovative product combines three well-
known and widely prescribed medications: omeprazole, clarithromycin, and amoxicillin.  Our involvement 
with  Omeclamox-Pak  was  effective  October  2013,  including  recognition  of  $1.0  million  in  product 
revenue during the fourth quarter of 2013, through an agreement with Pernix. We launched our promotion 
and distribution efforts to support Omeclamox-Pak in early 2014 and we are responsible for the marketing, 
sale and distribution of the product. 

• 

In June 2013, we announced that the FDA has approved updated labeling for Acetadote. The new labeling 
revises the product's indication and offers new dosing guidance for specific patient populations.  

•  We continued our international expansion throughout 2013 by finalizing agreements to commercialize 
Caldolor in several new large markets including: India, Indonesia, the Pacific Rim, the Arabian Peninsula, 
Spain, Portugal and the majority of South America.

•  A poster with data from two Caldolor studies involving four hundred fifty patients was presented at the 
Annual Meeting of the American Society of Anesthesiologists in San Francisco in October 2013. The 
poster presentation included the safety and efficacy of a shortened infusion time of intravenous ibuprofen. 

39

•  We obtained our second U.S. patent for Acetadote in March 2013. The claims of the 445 Acetadote Patent 
encompass the use of the 200 mg/ml Acetadote formulation to treat patients with acetaminophen overdose.  
The 445 Acetadote Patent will expire in August 2025.  We are continuing to seek additional claims to 
protect our intellectual property associated with Acetadote.

•  We extended our relationship with our long-serving, third party distribution contractor, Cardinal Health 
through June 30, 2016.  Since August 2002 they have exclusively handled U.S. product logistics efforts, 
including warehousing, shipping, customer billing and collections.  

CRITICAL ACCOUNTING POLICIES AND SIGNIFICANT JUDGMENTS AND ESTIMATES

Accounting Estimates and Judgments

The preparation of the consolidated financial statements in conformity with GAAP requires management to make 
estimates,  judgments  and  assumptions  that  affect  the  reported  amounts  of  assets  and  liabilities  and  disclosure  of 
contingent liabilities at the date of the financial statements and the reported amounts of revenues and expenses during 
the period. We base our estimates on past experience and on other factors we deem reasonable given the circumstances. 
Past results help form the basis of our judgments about the carrying value of assets and liabilities that are not determined 
from other sources. Actual results could differ from these estimates. These estimates, judgments and assumptions are 
most critical with respect to our accounting for revenue recognition, marketable securities, inventory, intangible assets, 
research and development accounting, provision for income taxes and share-based payment.

Revenue Recognition

We recognize revenue in accordance with the SEC’s Staff Accounting Bulletin (SAB) No. 101, Revenue Recognition 
in  Financial  Statements,  as  amended  by  SAB  No. 104  (together,  SAB  101),  and Topic  605-15  of  the Accounting 
Standards Codification.

Our revenue is derived primarily from the product sales of Acetadote, Caldolor, Omeclamox-Pak and Kristalose. 
Revenue is recognized when persuasive evidence of an arrangement exists, delivery has occurred, the fee is fixed and 
determinable and collectibility is probable. Delivery is considered to have occurred upon either shipment of the product 
or arrival at its destination based on the shipping terms of the transaction. When these conditions are satisfied, we 
recognize gross product revenue, which is the price we charge generally to our wholesalers for a particular product. 
Other revenue, which is a component of net revenues, includes upfront payments under licensing agreements along 
with grant and rental income. Other income was less than 3 percent of net revenues in 2013, less than two percent in 
2012, and less than one percent in 2011.

Our net product revenue reflects the reduction of gross product revenue at the time of initial sales recognition for 
estimated accounts receivable allowances for chargebacks, cash discounts and damaged product as well as provisions 
for sales related accruals of rebates, product returns and administrative fees and fee for services. Our financial statements 
reflect accounts receivable allowances of $0.6 million and $0.2 million at December 31, 2013 and 2012, respectively 
for chargebacks, discounts and allowances for product damaged in shipment.

The following table reflects our sales-related accrual activity for the periods indicated below:

2013

2012

2011

Balance, January 1

Current provision

Current provision for prior period sales

Actual product returns and credits issued

Balance, December 31

$

3,371,863

$

3,216,622

$

4,181,403

—
(5,116,126)
2,437,140

$

6,000,830
(367,060)
(5,478,529)
3,371,863

$

$

2,626,313

4,719,231

380,235
(4,509,157)
3,216,622

The allowances for chargebacks, discounts, and damaged products and sales related accruals for rebates and product 
returns are determined on a product-by-product basis and are established by management as our best estimate at the 

40

time of sale based on each product’s historical experience, adjusted to reflect known changes in the factors that impact 
such allowances and accruals. Additionally, these allowances and accruals are established based on the following:

•  The contractual terms with customers;

•  Analysis of historical levels of discounts, returns, chargebacks and rebates;

•  Communications with customers;

• 

Purchased information about the rate of prescriptions being written and the level of inventory remaining 
in the distribution channel, if known; and

•  Expectations about the market for each product, including any anticipated introduction of competitive 

products.

The allowances for chargebacks and accruals for rebates and product returns are the most significant estimates 
used in the recognition of our revenue from product sales. Of the accounts receivable allowances and our sales related 
accruals, our accrual for fee for services and product returns represents the majority of the balance. Sales related accrued 
liabilities for rebates, product returns, service fees, and administrative fees totaled $2.4 million, $3.4 million and $3.2 
million as of December 31, 2013, 2012 and 2011, respectively. Of these amounts, our estimated liability for fee for 
services represented $0.5 million, $1.1 million and $1.0 million, respectively, while our accrual for product returns 
totaled $1.6 million, $1.8 million and $1.8 million, respectively. If the actual amount of cash discounts, chargebacks, 
rebates, and product returns differs from the amounts estimated by management, material differences may result from 
the amount of our revenue recognized from product sales. A change in our rebate estimate of one percentage point 
would have impacted net sales by approximately $0.1 million in each of the three years ended December 31, 2013. A 
change in our product return estimate of one percentage point would have impacted net sales by $0.3 million, $0.6 
million and $0.6 million for the years ended December 31, 2013, 2012 and 2011, respectively. 

Fair  Value of Marketable Securities

We invest in variable rate demand notes and a portfolio of government-backed securities (including U.S. Treasuries, 
government-sponsored enterprise debentures and government-sponsored adjustable rate mortgage-backed securities), 
in order to maximize our return on cash.  We classify these investments as trading securities, and mark the investments 
to fair value at the end of each reporting period, with the adjustment being recognized in the statement of income as a 
component of interest income.  These investments are generally valued using observable market prices by third-party 
pricing services, or are derived from such services' pricing models. The level of management judgment required in 
establishing fair value of financial instruments for which there is a quoted price in an active market is minimal. Similarly 
there is little subjectivity or judgment required for instruments valued using valuation models that are standard across 
the industry and where all parameter inputs are quoted in active markets. Inputs to the models may include, but are not 
limited to, reported trades, executable bid and ask prices, broker/dealer quotations, prices or yields of securities with 
similar characteristics, benchmark curves or information pertaining to the issuer, as well as industry and economic 
events.  The pricing services may use a matrix approach, which considers information regarding securities with similar 
characteristics to determine the valuation for a security.

Inventories

We record amounts for estimated obsolescence or unmarketable inventory in an amount equal to the difference 
between the cost of inventory and the estimated market value based upon assumptions about remaining shelf life, future 
demand and market conditions. The estimated inventory obsolescence amounts are calculated based upon specific 
review of the inventory expiration dates and the quantity on-hand at December 31, 2013 in comparison to our expected 
inventory usage. The amount of actual inventory obsolescence and unmarketable inventory could differ (either higher 
or lower) in the near term from the estimated amounts. Changes in our estimates would be recorded in the income 
statement in the period of the change.

Income Taxes

We provide for deferred taxes using the asset and liability approach. Under this method, deferred tax assets and 
liabilities are recognized for the future tax consequences attributable to operating loss and tax credit carry-forwards 

41

and differences between the financial statement carrying amounts of existing assets and liabilities and their respective 
tax bases. Our principal differences are related to the timing of deductibility of certain items such as depreciation, 
amortization and expense for options issued to nonemployees. Deferred tax assets and liabilities are measured using 
management’s estimate of tax rates expected to apply to taxable income in the years in which management believes 
those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of 
a change in tax rates is recognized in our results of operations in the period that includes the enactment date.

In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that 
some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is 
dependent upon the generation of future taxable income during the periods in which those temporary differences become 
deductible. Management considers the scheduled reversal of deferred tax liabilities, projected future taxable income 
and tax planning strategies in making this assessment.

The tax benefit associated with the exercise of nonqualified stock options is recognized when the benefit is used 
to offset income taxes payable. As of December 31, 2013, we have unrecognized federal net operating loss carryforwards 
associated with the exercise of nonqualified options of $43.4 million.  In addition to these unrecognized federal net 
operating loss carryforwards, as of December 31, 2013, we have recognized federal Orphan Drug and Research and 
Development tax credits of $1.0 million that expire between 2021 and 2033.

Share-Based Payments

We recognize compensation expense for all share-based payments based on the fair value of the award on the date 

of grant. In addition, incremental compensation expense is recognized upon the modification of equity awards. 

During 2011, we began issuing restricted stock awards at no cost in lieu of stock options to employees, directors 
and consultants. Compensation expense for restricted stock granted to employees and directors is generally equal to 
the fair market value of the underlying common stock on the date of grant. If a sufficient disincentive for nonperformance 
does not exist at the date of grant, the compensation cost is remeasured at each reporting date at the then-current fair 
market value of the underlying common stock until the award vests.

The fair value of stock options and warrants are calculated using the Black-Scholes option-pricing model on the 
date of grant. We estimate volatility in accordance with SAB No. 107, as amended by SAB No. 110. As there was no 
public market for our common stock prior to our initial public offering and, therefore, a lack of company-specific 
historical  or  implied  volatility  data,  we  have  determined  the  share-price  volatility  based  on  an  analysis  of  certain 
publicly-traded companies that we consider to be our peers. The comparable peer companies used for our estimated 
volatility are publicly-traded companies with operations which we believe to be similar to ours. When identifying 
companies as peers, we consider such characteristics as the type of industry, size and/or type of product(s), research 
and/or product development capabilities, and stock-based transactions. If we need to evaluate volatility in the future 
to value stock options, we intend to use our own historical volatility to the extent it is sufficient.  We would supplement 
the estimate of our volatility using peer companies in the above manner until historical information regarding the 
volatility of our own shares is sufficient.  We estimate the expected life of employee share options based on the simplified 
method allowed by SAB No. 107, as amended by SAB No. 110. Under this approach, the expected term is presumed 
to be the average between the weighted-average vesting period and the contractual term. The expected term for options 
granted to non-employees is generally the contractual term of the option. The risk-free interest rate is based on the 
U.S. Treasury Note, Stripped Principal, on the date of grant with a term substantially equal to the corresponding option’s 
expected term. We have never declared or paid any cash dividends nor do we plan to pay cash dividends in the foreseeable 
future.

In the second quarter of 2012, we implemented an Option Exchange Program (the “Exchange Program”) whereby 
certain outstanding stock options could be exchanged for shares of restricted stock.  The Exchange Program was designed 
to provide a value-for-value exchange of equity instruments.  The fair value of each exchanged option was determined 
on  the  date  the  Exchange  Program  commenced  using  the  Black-Scholes  option  fair  value  model.   The  following 
assumptions were used in calculating the fair value of options exchanged in 2012 as part of the Exchange Program.

42

Dividend yield

Expected term (years)

Expected volatility

Risk-free interest rate

Research and Development

2012

Exchange Program

—

1.3 - 7.3

37% - 78%

0.23% - 1.50%

We  accrue  for  and  expense  research  and  development  costs  based  on  estimates  of  work  performed,  patient 
enrollment or fixed-fee-for-services. As work is performed and/or invoices are received, we adjust our estimates and 
accruals. To date, our accruals have been within our estimates. Total research and development costs are a function of 
studies being conducted and will increase or decrease based on the level of activity in any particular year.

Intangible Assets

Intangible assets include product rights, license agreements and other identifiable intangible assets. We assess the 
impairment of identifiable intangible assets whenever events or changes in circumstances indicate the carrying value 
may not be recoverable. In determining the recoverability of our intangible assets, we make assumptions regarding 
estimated future cash flows and other factors. If the estimated undiscounted future cash flows do not exceed the carrying 
value of the intangible assets, we must determine the fair value of the intangible assets. If the fair value of the intangible 
assets is less than the carrying value, an impairment loss will be recognized in an amount equal to the difference. Fair 
value  is  determined  through  various  valuation  techniques  including  quoted  market  prices,  third-party  independent 
appraisals and discounted cash flow models, as considered necessary.

43

RESULTS OF OPERATIONS

Year ended December 31, 2013 compared to year ended December 31, 2012

Net revenues. Net revenues in 2013 decreased approximately $16.8 million compared to 2012. The decline in 
net revenues was primarily attributable to decreases in Acetadote product revenue of $18.7 million.  This decrease 
was partially offset by an increase in Caldolor product revenue of $1.1 million and revenue of $1.0 million 
generated from our new product, Omeclamox-Pak.

The increase in Caldolor revenue was primarily due to increased volume associated with continued success in 

penetrating our target market. We have continued to focus more of our sales and marketing resources to driving pull-
through use of Caldolor in facilities stocking the product. 

The decrease in Acetadote net revenue was a result of decreased sales volume of the branded Acetadote product 
largely as a result of generic competition during 2013.  Our Acetadote product revenue also included $9.2 million in 
sales of our authorized generic in 2013 and $0.3 million in 2012.

Other revenue. We recognized $0.9 million of other revenue in both 2013 and 2012, primarily as the result of 
upfront payments we received in connection with out-licensing agreements with international commercial partners.   

Cost of products sold. As a percentage of net revenues, cost of products sold increased to 17.0% in 2013 

compared to 10.3% in 2012.  The increase in costs of sales as a percentage of revenue was attributable to a change in 
the sales mix along with the recognition of $0.9 million of inventory write-downs during 2013 for potentially 
obsolete inventory.  

Selling and marketing. Selling and marketing expense for 2013 totaled $14.4 million, compared to $20.3 
million for 2012.  The $5.9 million decrease was driven primarily by decreased salaries, benefits and other selling 
expenses of $4.4 million along with $1.1 million in decreased travel, convention and promotion expense.  These 
reductions were primarily a result of our new commercial strategy and sales force realignment that went into effect 
during the fourth quarter of 2012.   

Research and development. Research and development costs for 2013 was $5.6 million, compared to $5.1 
million in 2012, representing an increase of $0.5 million, or 10.2%.   The increase was a result of increased product 
development and study costs in 2013 compared to 2012.

General and administrative. General and administrative expense totaled $9.5 million in 2013, representing an 

increase of $0.4 million, or 4.8%, over 2012. The increase was primarily due to several small cost increases 
including CET rent, stock-based compensation and retirement expense.

Amortization. Amortization expense is the ratable use of our capitalized intangible assets including product and 
license rights, patents, trademarks and patent defense costs. Amortization for 2013 totaled $0.9 million, representing 
an increase of approximately $0.4 million compared to 2012. The increase was primarily due to increased 
capitalized patents and capitalized patent defense costs.

Income taxes. Income tax benefit for 2013 was $1.5 million, representing a decrease in tax expense of $4.8 
million from the $3.2 million of income tax expense in 2012.  As a percentage of loss before income taxes, the 
income tax benefit was 41.4% for 2013 compared to expense of 35.8% of income before income taxes for 2012.  
The tax rate for 2013 was positively impacted by the reinstatement of the U.S. research and development tax credit 
during 2013.  The tax rate percentage in 2012 was primarily due to the recognition of a deferred tax benefit 
associated with the exchange of certain incentive stock options.

Year ended December 31, 2012 compared to year ended December 31, 2011

Net product revenues. Net product revenue decreased $2.9 million, or 6%, in 2012 as compared to 2011. The 
decrease was primarily due to a decrease in Acetadote revenue of $4.9 million, offset by the positive impact of both 
increased Kristalose revenue of $0.9 million and increased Caldolor revenue of $1.1 million.

44

The  decrease  in Acetadote  revenue  was  primarily  driven  by  lower  volumes  of   Acetadote  sales,  especially  in 
comparison to 2011 where we experienced a 13% increase over 2010 volumes. The increase in volumes during 2011 
was due in part to our introduction of the new formulation of Acetadote. The formulation is free of EDTA and other 
stabilization and chelating agents and is also preservative-free. The new formulation of Acetadote has been well-received 
in the market, and continues to be the treatment of choice for acetaminophen overdose. Additionally, Acetadote revenue 
was positively impacted by the shortage of the oral form of n-acetylcysteine due to manufacturing delays.   During 
2012, the volume decline was partially offset by the impact of increases in the average selling price.  During 2012, 
Acetadote product revenue was positively impacted by $0.3 million in sales under our product licensing agreement 
with Perrigo for our Authorized Generic product.  

The increase in Kristalose net revenue was primarily due to an increase in the average selling price of the 10g and 

20g packets, with a small increase in overall sales volumes.  

The increase in Caldolor revenue was due to increased volume. Gross product revenue for Caldolor increased $1.1 
million in 2012 as compared to 2011.  The increase in revenue and gross revenue was primarily due to increased volume 
associated with continued success in penetrating our target market. We have continued to focus more of our sales and 
marketing resources to driving pull-through use of Caldolor in facilities stocking the product. In the fourth quarter of 
2011,  we  notified  our  wholesalers  that  we  discontinued  the  400mg  offering  of  Caldolor  in  the  United  States  and 
concentrate our sales efforts on 800mg. As a result, during 2011, we recognized additional expense amounts for potential 
returns related to the 400mg product, of which a majority was related to sales in prior years.   

Other revenue. Other revenue increased $0.7 million in 2012 as compared to 2011. The increase was primarily a 
result of  an upfront payment we received in connection with an out-licensing agreement with our commercial partner 
in China, Harbin Gloria Pharmaceuticals.        

Cost of products sold. Cost of products sold as a percentage of net revenues decreased from 10.5% in 2011 to 

10.3% in 2012.  The decrease is primarily due to a change in product mix.  

Selling and marketing. Selling and marketing expense totaled $20.3 million in 2012, representing a decrease of 
$0.6 million, or 3%, as compared to 2011. The decrease was primarily due to decreases in royalty expenses and employee 
related  expenses  for  recruitment,  travel  and  training,  partially  offset  by  increased  costs  incurred  as  a  result  of  the 
realignment of our sales force of $0.7 million.  

Research  and  development.  Research  and  development  expense  totaled  $5.1  million  in  2012,  representing  an 
increase of $0.1 million, or 1%, over 2011.  The increase consisted of a $0.4 million increase in salaries and hiring 
expense due to the expansion of our research and development team, mostly offset by $0.3 million in decreased expenses 
for studies and lower consulting expenses.  

General  and  administrative.  General  and  administrative  expense  totaled  $9.1  million  in  2012,  representing  a 
decrease of $0.3 million, or 3%, over 2011. The decrease was primarily due to a decrease in charitable donations of 
inventory partially offset by increased legal and printing costs associated with our stock option exchange program 
during 2012.

Interest income.   Interest income totaled $0.3 million in 2012 as compared to $0.2 million in 2011, representing 
an increase of  $0.1 million due primarily to the investment of a portion of our cash balances in longer duration marketable 
securities beginning in the first quarter of 2012.

Interest expense.   Interest expense totaled $0.1 million in 2012, representing a decrease of  $0.3 million or 80% 

over 2011.  This decrease was due to the early payoff of our term debt in 2011. 

Income tax expense. As a percentage of income before income taxes, the effective tax rate decreased from 42% in 
2011 to 36% in 2012.  The decrease in effective tax rate was primarily due to the recognition of a deferred tax asset in 
2012 related to the recognition of a deferred tax benefit associated with the option Exchange Program during the second 
quarter of 2012.

45

LIQUIDITY AND CAPITAL RESOURCES

Our primary sources of liquidity are cash flows provided by our operations, our availability under our line of credit 
and the cash proceeds from our initial public offering of common stock that was completed in August 2009.  For the 
years  ended December 31, 2013, 2012 and 2011, we generated $0.7 million, $7.1 million and $8.7 million in cash flow 
from operations, respectively.  We believe that our internally generated cash flows and amounts available under our 
line of credit will be adequate to service existing debt, finance internal growth and fund capital expenditures. 

In  2012,  we  began  investing  a  portion  of  our  cash  reserves  in  variable  rate  demand  notes  and  a  portfolio  of 
government-backed  securities  (including  U.S.  Treasuries,  government-sponsored  enterprise  debentures  and 
government-sponsored adjustable rate, mortgage-backed securities).  The variable rate demand notes, or VRDNs, are 
generally issued by municipal governments and are backed by a financial institution letter of credit.  We hold a put 
right  on  the  VRDNs,  which  allows  us  to  liquidate  the  investments  relatively  quickly  (less  than  one  week).   The 
government-backed securities have an active secondary market that generally provides for liquidity in less than one 
week.  At December 31, 2013 and 2012, we had approximately $14.0 million and $16.7 million invested in marketable 
securities, respectively.

The following table summarizes our liquidity and working capital as of the years ended December 31:

Cash and cash equivalents

Marketable securities

Total cash, cash equivalents and marketable securities

Working capital (current assets less current liabilities)

Current ratio (multiple of current assets to current liabilities)

Revolving line of credit availability

2013

2012

40,869,457

14,019,761

54,889,218

61,133,945

9.1

$

$

$

54,349,381

16,686,136

71,035,517

79,176,882

10.8

10,000,000

$

5,640,049

$

$

$

$

The following table summarizes our net changes in cash and cash equivalents for the years ended December 31:

Cash provided by (used in):

Operating activities

Investing activities

Financing activities

Net (decrease) increase in cash and 
cash equivalents 

2013

2012

2011

$

$

746,126
(5,071,939)
(9,154,111)

$

7,135,182
(19,177,141)
(4,207,806)

8,722,147
(437,771)
(3,579,200)

$

(13,479,924) $

(16,249,765) $

4,705,176

 The net use of cash and cash equivalents for the year ended December 31, 2013 was partly attributable to net 
investing and repayment of financing activities during the year.   Net investing activities which used cash included $0.1 
million in purchases of equipment and investment in intangible assets of $7.5 million.  The investment in intangible 
assets includes our $4.0 million investment in Omeclamox-Pak. The cash used in investing activities was offset by our 
decrease of $2.5 million in net investment in marketable securities, with the decrease primarily in our VRDN's.  In 
addition, we continue to repurchase shares of our common stock, totaling $4.8 million during the period, discussed in 
Part II, Item 5, Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 
Securities, of this Form 10-K.  We also repaid the outstanding balance of our revolving line of credit of $4.4 million 

46

 
 
 
during the year. While net cash provided by operating activities was $0.7 million, the net loss of $2.2 million  contributed 
to the net decrease in cash equivalents.

The net decrease in cash and cash equivalents of $16.2 million for the year ended December 31, 2012 was primarily 
due to the previously noted investment of our cash reserves in government and government-backed securities which 
are reflected as a net use of cash in investing activities of  $16.6 million. Our cash flows from operating activities were 
primarily due to the $5.8 million in net income for the year supplemented by cash inflows from our receivables.  In 
addition, our financing activities included the repurchase of common stock of $8.1 million in connection with our share 
repurchase program.  During 2012, we recognized approximately $3.8 million of excess tax benefits. The excess tax 
benefit represents the income taxes that would have been paid if not for the tax deductions created upon the exercise 
of nonqualified stock options. 

The net increase in cash and cash equivalents of $4.7 million for the year ended December 31, 2011 was primarily 
due to cash generated from our operating activities.  Our net income increased from $2.4 million in 2010 to $5.6 million 
in 2011. The increase in cash and cash equivalents from operating activities was offset by increased purchases of fixed 
assets and intangibles of $0.4 million and cash used in financing activities of $3.6 million. During 2011, we paid in 
full our term debt facility of $5.3 million. In connection with the termination of the term debt facility, we increased our 
borrowings under our line of credit by $3.0 million. In addition, our financing activities included the repurchase of 
common stock of $4.2 million in connection with our share repurchase program discussed above. During 2011, we 
recognized approximately $2.4 million of excess tax benefits. The excess tax benefit represents the income taxes that 
would have been paid if not for the tax deductions created upon the exercise of nonqualified stock options. 

In July 2011, we paid in full the outstanding term debt balance.  In August 2011, we entered into a Fifth Amended 
and Restated Loan Agreement with our primary lender (the Agreement) to provide for an increase in the line of credit 
to $10 million. The credit facility may be increased up to $20 million upon the satisfaction of certain conditions. The 
interest rate is the BBA LIBOR Daily Floating Rate plus an Applicable Margin, as those terms are defined in the 
Agreement (2.17% at December 31, 2013). In addition, a commitment fee of 0.25% per annum is charged on the unused 
line of credit. The credit facility was extended to expire on December 31, 2014, and we currently do not have any 
outstanding principal amounts on this credit facility. Interest and the unused line fee are payable quarterly. Borrowings 
under the line of credit are collateralized by substantially all of our assets.  We are no longer required to maintain 
minimum  deposits  with  the  lender.   The Amendment  includes  certain  financial  and  restrictive  covenants.    During 
March 2014, we amended certain provisions of the Agreement with our primary lender related to the aggregate ownership 
of the Company's common stock over 30% as well as amending certain covenants in which we were not in compliance 
with as a result of the net loss during 2013.  As a result of the amendment, the Company is in compliance with all 
covenants.

Our manufacturing and supply agreement with one manufacturer, which expires in 2014, contains a minimum 
annual purchase obligation. We expect our normal inventory purchasing levels to be above the required minimum 
amounts. As of December 31, 2013, we had met our purchase obligations under this agreement.

47

The following table summarizes our contractual cash obligations as of December 31 2013:

Contractual obligations(1)

Total (2)

2014

2015

2016

2017

2018

Payments Due by Year

Amounts reflected in the
balance sheet:

Line of credit

Estimated interest on 
debt (3)

Other cash obligations not
reflected on the balance
sheet:

Operating leases
Purchase obligations (4)

$

— $

— $

— $

— $

— $

21,000

21,000

—

—

—

—

—

3,327,744

1,022,019

1,052,662

941,247

232,964

78,852

609,375

609,375

—

—

—

—

Total (1)

$3,958,119

$1,652,394

$1,052,662

$ 941,247

$ 232,964

$ 78,852

(1)  The table of contractual obligations excludes amounts due under the Kristalose purchase agreement as these amounts 
cannot be determined until sales of the product have occurred. As consideration for the purchase of certain Kristalose 
assets  in  November  2011,  we  agreed  to  pay  the  seller  a  percentage  of  net  sales  for  a  seven-year  period  beginning 
November 15, 2011. Payments are due quarterly, in arrears.

(2)  The sum of the individual amounts may not agree due to rounding.

(3)  Represents the estimated interest and unused line of credit payments on our line of credit based on the December 31, 2013 
interest rate of LIBOR plus an applicable margin, or 2.17%.  Interest  and unused line of credit payments are due and 
payable quarterly in arrears. Any outstanding amounts due on the line of credit becomes due and payable in December 
2014.  Estimated interest for the line of credit is based on the assumption of a consistent zero outstanding balance.

(4)  Represents minimum purchase obligations under our manufacturing agreements.

OFF-BALANCE SHEET ARRANGEMENTS

During 2013, 2012 and 2011, we did not engage in any off-balance sheet arrangements.

RECENTLY ISSUED BUT NOT YET ADOPTED ACCOUNTING PRONOUNCEMENTS

There are no recently issued but not yet adopted accounting pronouncements that would materially impact our 

financial condition or results of operations.

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

Interest Rate Risk

We are exposed to market risk related to changes in interest rates on our cash on deposit in highly-liquid money 
market accounts and revolving credit facility. We do not utilize derivative financial instruments or other market risk-
sensitive instruments to manage exposure to interest rate changes. The main objective of our cash investment activities 
is to preserve principal while maximizing interest income through low-risk investments. Our investment policy focuses 
on principal preservation and liquidity.

We believe that our interest rate risk related to our cash and cash equivalents is not material. The risk related to 
interest rates for these accounts would produce less income than expected if market interest rates fall. Based on current 
interest rates, we do not believe we are exposed to significant downside risk related to a change in interest on our money 
market accounts.

48

 
 
In the first quarter of 2012, we analyzed our return on our investments and determined investing in variable rate 
demand  notes  and  a  portfolio  of  government  backed  securities  (including  U.S. Treasuries,  government  sponsored 
enterprise debentures and government sponsored adjustable rate mortgage backed securities), would yield a higher 
return with minimal additional risk. The variable rate demand notes, or VRDNs, are generally issued by municipal 
governments and are backed by a financial institution letter of credit. We hold a put right on the VRDN's, which allows 
us to liquidate the investment relatively quickly (less than one week). The government backed securities have an active 
secondary market that generally provides for liquidity in less than one week. The risk related to interest rates for these 
accounts will produce less income than expected if market interest rates fall.  Based on the $14.0 million in marketable 
securities outstanding at December 31, 2013, a 1% decrease in the fair value of the securities would result in a reduction 
in pretax net income of $0.1 million. 

Based on current interest rates, we do not believe we are exposed to significant downside risk related to change 

in interest on our investment accounts.

The interest rate risk related to borrowings under our line of credit is a variable rate of LIBOR plus an applicable 
margin, as defined in the loan agreement (2.17% at December 31, 2013).  As of December 31, 2013, no borrowings 
were outstanding under our line of credit. 

Exchange Rate Risk

While we operate primarily in the U.S., we are exposed to foreign currency risk. A portion of our research and 

development is performed abroad. 

Currently, we do not utilize financial instruments to hedge exposure to foreign currency fluctuations. We believe 
our exposure to foreign currency fluctuation is minimal as our purchases in foreign currency have a maximum exposure 
of 90 days based on invoice terms with a portion of the exposure being limited to 30 days based on the due date of the 
invoice. Foreign currency exchange losses were immaterial for 2013, 2012 and 2011. Neither a five percent increase 
nor decrease from current exchange rates would have had a material effect on our operating results or financial condition.

Item 8. Financial Statements and Supplementary Data.

See consolidated financial statements, including the reports of the independent registered public accounting firm, 

starting on page F-1, which is incorporated herein by reference.

Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.

None.

Item 9A. Controls and Procedures.

Our    Chief  Executive  Officer  and  Chief  Financial  Officer  have  evaluated  the  effectiveness  of  the  design  and 
operation of our disclosure controls and procedures as of December 31, 2013. Based on that evaluation, they have 
concluded that our disclosure controls and procedures were effective as of December 31, 2013 to ensure that material 
information relating to us and our consolidated subsidiaries is made known to officers within these entities in order to 
allow for timely decisions regarding required disclosure.

Management’s report on internal control over financial reporting and the related attestation report of KPMG LLP, 
our independent registered public accounting firm, are included on page F-1 and F-3, respectively, of this annual report 
on Form 10-K, and incorporated herein by reference.

During our fourth quarter of 2013, there were no changes in our internal control over financial reporting (as defined 

in Rule 13a-15(f) or 15d-15(f)).

49

Item 9B. Other Information.

None.

PART III

The  information  called  for  by  Part  III  of  Form  10-K  (Item  10  –  Directors,  Executive  Officers  and  Corporate 
Governance, Item 11 – Executive Compensation, Item 12 – Security Ownership of Certain Beneficial Owners and 
Management and Related Stockholder Matters, Item 13 – Certain Relationships and Related Transactions, and Director 
Independence, Item 14 – Principal Accounting Fees and Services), is incorporated by reference from our proxy statement 
related to our 2014 annual meeting of shareholders, which is expected to be filed with the SEC on or around March 12, 
2014.

PART IV

Item 15. Exhibits, Financial Statement Schedules.

(a)  Documents filed as part of this report:

(1)  Financial Statements

Management’s Report on Internal Control over Financial Reporting

Report of Independent Registered Public Accounting Firm – Consolidated 
Financial Statements

Report of Independent Registered Public Accounting Firm – Internal Control 
over Financial Reporting

Consolidated Balance Sheets

Consolidated Statements of Operations and Comprehensive (Loss) Income

Consolidated Statements of Cash Flows

Consolidated Statements of Equity

Notes to the Consolidated Financial Statements

(2)  Financial Statement Schedule

Valuation and Qualifying Accounts

(b)  Exhibits

Page Number

F-1

F-2

F-3

F-4

F-5

F-6

F-7

F-8

F-33

50

Exhibit
Number

Description

3.1

3.2

4.1

4.2

4.3

4.4

4.5#

4.6.1#

4.6.2#

4.7#

4.8

4.9

4.10

Third Amended and Restated Charter of Cumberland Pharmaceuticals Inc., incorporated herein 
by reference to the corresponding exhibit to Amendment No. 19 of the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on July 17, 2009

Second Amended and Restated Bylaws of Cumberland Pharmaceuticals Inc., incorporated herein 
by reference to the corresponding exhibit to Amendment No. 19 of the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on July 17, 2009

Specimen Common Stock Certificate of Cumberland Pharmaceuticals Inc., incorporated herein 
by reference to the corresponding exhibit to Amendment No. 5 of the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on August 6, 2007

Warrant to Purchase Common Stock of Cumberland Pharmaceuticals Inc., issued to Bank of 
America, N.A. on October 21, 2003, incorporated herein by reference to the corresponding exhibit 
to the Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the 
SEC on May 1, 2007

Stock  Purchase  Warrant,  issued  to  S.C.O.U.T.  Healthcare  Fund  L.P.  on  April  15,  2004, 
incorporated  herein  by  reference  to  the  corresponding  exhibit  to  Amendment  No.  1  of  the 
Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the SEC 
on June 22, 2007

Warrant to Purchase Common Stock of Cumberland Pharmaceuticals Inc., issued to Bank of 
America, N.A. on April 6, 2006, incorporated herein by reference to the corresponding exhibit 
to the Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the 
SEC on May 1, 2007

Form of Option Agreement under 1999 Stock Option Plan of Cumberland Pharmaceuticals Inc., 
incorporated herein by reference to the corresponding exhibit to the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on May 1, 2007

Form of Incentive Stock Option Agreement under the Amended and Restated 2007 Long-Term 
Incentive  Compensation  Plan  of  Cumberland  Pharmaceuticals  Inc.  incorporated  herein  by 
reference to the corresponding exhibit to the Registrant’s Annual Report on Form 10-K (File No. 
001-33637) as filed with the SEC on March 12, 2013

Form of Non-Statutory Stock Option Agreement under the Amended and Restated 2007 Long-
Term Incentive Compensation Plan of Cumberland Pharmaceuticals Inc. incorporated herein
by reference to the corresponding exhibit to the Registrant’s Annual Report on Form 10-K
(File No. 001-33637) as filed with the SEC on March 12, 2013

  Form  of  Non-Statutory  Stock  Option  Agreement  under  the  Amended  and  Restated  2007 
Directors’  Compensation  Plan  of  Cumberland  Pharmaceuticals  Inc.  incorporated  herein  by 
reference to the corresponding exhibit to the Registrant’s Annual Report on Form 10-K (File No. 
001-33637) as filed with the SEC on March 12, 2013

Warrant to Purchase Common Stock of Cumberland Pharmaceuticals Inc., issued to Bank of
America, N.A. on July 22, 2009, incorporated herein by reference to the corresponding exhibit
to the Registrant’s Annual Report on Form 10-K (File No. 001-33637) as filed with the SEC
on March 19, 2010

Form of Senior Indenture, incorporated herein by reference to the corresponding exhibit to
Registrant's Registration Statement Form S-3 (File No. 333-184091) as filed with the SEC on
September 25, 2012.

Form of Subordinated Indenture, incorporated herein by reference to the corresponding
exhibit to Registrant's Registration Statement Form S-3 (File No. 333-184091) as filed with
the SEC on September 25, 2012

51

  
  
Exhibit
Number
10.1†

10.2

10.3†

10.3.1†

10.3.2†

10.7†

10.7.1†

10.8†

10.10†

10.11#

10 .12#

10.13#

Description
Manufacturing and Supply Agreement for N-Acetylcysteine, dated January 15, 2002, by and 
between Bioniche Life Sciences, Inc. and Cumberland Pharmaceuticals Inc., incorporated herein 
by reference to the corresponding exhibit to Amendment No. 5 of the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on August 6, 2007

Novation Agreement,  dated  January  27,  2006,  by  and  among  Bioniche  Life  Sciences,  Inc., 
Bioniche  Pharma  Group  Ltd.,  and  Cumberland  Pharmaceuticals  Inc.,  incorporated  herein  by 
reference to the corresponding exhibit to the Registrant’s Registration Statement on Form S-1 
(File No. 333-142535) as filed with the SEC on May 1, 2007

First  Amendment  to  Manufacturing  and  Supply  Agreement  for  N-Acetylcysteine,  dated 
November 16, 2006, by and between Bioniche Teoranta and Cumberland Pharmaceuticals Inc., 
incorporated  herein  by  reference  to  the  corresponding  exhibit  to  Amendment  No.  3  of  the 
Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the SEC 
on July 11, 2007

Second Amendment to Manufacturing and Supply Agreement for N-Acetylcysteine, dated March 
25, 2008, by and between Bioniche Teoranta and Cumberland Pharmaceuticals Inc., incorporated 
herein  by  reference  to  the  corresponding  exhibit  to Amendment  No.  10  of  the  Registrant’s 
Registration Statement on Form S-1 (File No. 333-142535) as filed with the SEC on May 21, 
2008

Third Amendment to Manufacturing and Supply Agreement for N-Acetylcysteine, effective April 
25, 2011, by and between Bioniche Teoranta and Cumberland Pharmaceuticals Inc., incorporated 
herein by reference to the corresponding exhibit to the Registrant’s Current Report on Form 8-
K (File No. 001-33637) as filed with the SEC on June 24, 2011

Exclusive Distribution Agreement, effective as of July 1, 2010, by and between Cardinal Health 
105,  Inc.  and  Cumberland  Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the 
corresponding exhibit of the Registrant’s Current Report on Form 8-K (File No. 001-33637) as 
filed with the SEC on August 13, 2010

First Amendment to Exclusive Distribution Agreement, dated March 31, 2013, by and between 
Cardinal Health 105, Inc. and Cumberland Pharmaceuticals Inc., incorporated herein by reference 
to the corresponding exhibit of the Registrant's Current Report of Form 8-K (File No. 001-33637) 
as filed with the SEC on June 3, 2013

Strategic Alliance Agreement, dated July 21, 2000, by and between F.H. Faulding & Co. Limited 
and Cumberland Pharmaceuticals Inc., including notification of assignment from F.H. Faulding 
& Co. Limited to Mayne Pharma Pty Ltd., dated April 16, 2002, incorporated herein by reference 
to the corresponding exhibit to Amendment No. 4 of the Registrant’s Registration Statement on 
Form S-1 (File No. 333-142535) as filed with the SEC on July 23, 2007

License Agreement, dated May 28, 1999, by and between Vanderbilt University and Cumberland 
Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the  corresponding  exhibit  to 
Amendment No. 3 of the Registrant’s Registration Statement on Form S-1 (File No. 333-142535) 
as filed with the SEC on July 11, 2007

Employment Agreement dated March 7, 2014, effective as of January 1, 2014, by and between 
A.J. Kazimi and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 7, 2014, effective as of January 1, 2014, by and between 
Martin E. Cearnal and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 7, 2014, effective as of January 1, 2014, by and between 
Leo Pavliv and Cumberland Pharmaceuticals Inc.

52

10.14#

10.15#

10.16†

10.16.1

10.16.2

Employment Agreement dated March 7, 2014, effective as of January 1, 2014, by and between 
Rick S. Greene and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 7, 2014, effective as of January 1, 2014, by and between 
James L. Herman and Cumberland Pharmaceuticals Inc.

Fifth Amended and Restated Loan Agreement by and between Cumberland Pharmaceuticals Inc. 
and  Bank  of America,  N.A.,  dated August 2,  2011,  incorporated  herein  by  reference  to  the 
corresponding exhibit to the Registrant’s Quarterly Report on Form 10-Q (File No. 001-33637) 
as filed with the SEC on August 8, 2011

First Amendment to Fifth Amended and Restated Loan Agreement, dated March 29, 2012, by 
and between Cumberland Pharmaceuticals Inc. and Bank of America, N.A., originally  dated 
August 2, 2011 incorporated herein by reference to the corresponding exhibit to the Registrant’s 
Annual Report on Form 10-K (File No. 001-33637) as filed with the SEC on March 12, 2013

Waiver and Second Amendment to Fifth Amended and Restated Loan Agreement, dated March 
7, 2013, by and between Cumberland Pharmaceuticals Inc. and Bank of America, N.A., originally 
dated August  2,  2011,  incorporated  herein  by  reference  to  the  corresponding  exhibit  to  the 
Registrant’s Annual Report on Form 10-K (File No. 001-33637) as filed with the SEC on March 
12, 2013

10.16.3

Waiver to Fifth Amended and Restated Loan Agreement, dated March 6, 2014, by and between 
Cumberland Pharmaceuticals Inc. and Bank of America, N.A., originally dated August 2, 2011

53

Exhibit
Number

10.17#

10.18#

10.19#

10.20

10.21†

10.21.1†

10.21.2†

10.23†

10.24

10.24.1

10.24.2†

Description

1999 Stock Option Plan of Cumberland Pharmaceuticals Inc., incorporated herein by reference 
to the corresponding exhibit to the Registrant’s Registration Statement on Form S-1 (File No. 
333-142535) as filed with the SEC on May 1, 2007

Amended  and  Restated  2007  Long-Term  Incentive  Compensation  Plan  of  Cumberland 
Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  Appendix  A  of  the  Registrant’s 
Schedule  14A  as  filed  with  the  SEC  on  March  12,  2012  and  approved  by  the  Registrant's 
shareholders on April 17, 2012 

Amended  and  Restated  2007  Directors’ Incentive  Plan  of  Cumberland  Pharmaceuticals  Inc., 
incorporated herein by reference to Appendix B of the Registrant's Schedule 14A as filed with 
the SEC on March 12, 2012 and approved by the Registrant's shareholders on April 17, 2012

Form of Indemnification Agreement between Cumberland Pharmaceuticals Inc. and all members 
of its Board of Directors, incorporated herein by reference to the corresponding exhibit to the 
Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the SEC 
on May 1, 2007

Lease Agreement, dated September 10, 2005, by and between Nashville Hines Development, 
LLC  and  Cumberland  Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the 
corresponding exhibit to Amendment No. 3 of the Registrant’s Registration Statement on Form 
S-1 (File No. 333-142535) as filed with the SEC on July 11, 2007

First Amendment to Office Lease Agreement, dated April 25, 2008, by and between 2525 West 
End,  LLC  (successor  in  interest  to  Nashville  Hines  Development  LLC)  and  Cumberland 
Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the  corresponding  exhibit  to 
Amendment No. 10 of the Registrant’s Registration Statement on Form S-1 (File No. 333-142535) 
as filed with the SEC on May 21, 2008

Second Amendment to Office Lease Agreement, dated March 2, 2010, by and between 2525 
West End, LLC (successor in interest to Nashville Hines Development LLC) and Cumberland 
Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the  corresponding  exhibit  to  the 
Registrant’s Quarterly Report on Form 10-Q (File No. 001-33637) as filed with the SEC on May 
17, 2010

Amended  and  Restated  Lease  Agreement,  dated  November  11,  2004,  by  and  between  The 
Gateway to Nashville LLC and Cumberland Emerging Technologies, Inc., incorporated herein 
by reference to the corresponding exhibit to the Registrant’s Registration Statement on Form S-1 
(File No. 333-142535) as filed with the SEC on May 1, 2007

First Amendment to Amended and Restated Lease Agreement, dated August 23, 2005, by and 
between  The  Gateway  to  Nashville  LLC  and  Cumberland  Emerging  Technologies,  Inc., 
incorporated herein by reference to the corresponding exhibit to the Registrant’s Registration 
Statement on Form S-1 (File No. 333-142535) as filed with the SEC on May 1, 2007

Second Amendment to Amended and Restated Lease Agreement, dated January 9, 2006, by and 
between  The  Gateway  to  Nashville  LLC  and  Cumberland  Emerging  Technologies,  Inc., 
incorporated  herein  by  reference  to  the  corresponding  exhibit  to Amendment  No.  10  of  the 
Registrant’s Registration Statement on Form S-1 (File No. 333-142535) as filed with the SEC 
on May 21, 2008

Third Amendment to Amended and Restated Lease Agreement, dated July 3, 2012, by and
between The Gateway to Nashville LLC and Cumberland Emerging Technologies, Inc.,
incorporated herein by reference to the corresponding exhibit to the Registrant's Quarterly
Report on Form 10-Q (File No. 001-33637) as filed with the SEC on August 9, 2012

54

Exhibit
Number

10.25††

10.28†

10.29†

10.30#

10.31†

10.32†

21

23.1

31.1

31.2

32.1

Description

Omeclamox-Pak® Promotion Agreement, dated October 1, 2013, by and between Cumberland 
Pharmaceuticals Inc. and Pernix Therapeutics, LLC

Asset Purchase and Royalty Agreement for Kristalose dated November 15, 2011 by and between 
Mylan  Inc.  and  Cumberland  Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the 
corresponding exhibit of the Registrant’s Current Report on Form 8-K (File No. 001-33637) as 
filed with the SEC on November 22, 2011

Packaging Agreement effective November 1, 2011 by and among Mylan Institutional Inc., Mylan 
Pharmaceuticals Inc. and Cumberland Pharmaceuticals Inc. incorporated herein by reference to 
the corresponding exhibit to the Registrant’s Annual Report on Form 10-K (File No. 001-33637) 
as filed with the SEC on March 7, 2012

Supplemental Executive Retirement and Savings Plan, incorporated herein by reference to the 
corresponding exhibit to the Registrant's Current Report on Form 8-K (File No. 001-33637) as 
filed with the SEC on May 24, 2012

Settlement Agreement, dated November 9, 2012, by and between Cumberland Pharmaceuticals 
Inc., Paddock Laboratories, LLC and Perrigo Company incorporated herein by reference to the 
corresponding exhibit to the Registrant’s Annual Report on Form 10-K (File No. 001-33637) as 
filed with the SEC on March 12, 2013

License  and  Supply  Agreement,  dated  November  9,  2012,  by  and  between  Cumberland 
Pharmaceuticals Inc., Paddock Laboratories, LLC and Perrigo Company incorporated herein by 
reference to the corresponding exhibit to the Registrant’s Annual Report on Form 10-K (File No. 
001-33637) as filed with the SEC on March 12, 2013

Subsidiaries  of  Cumberland  Pharmaceuticals  Inc.,  incorporated  herein  by  reference  to  the 
corresponding  exhibit  to  the  Registrant’s  Registration  Statement  on  Form  S-1  (File  No. 
333-142535) as filed with the SEC on May 1, 2007

Consent of KPMG LLP

Certification of Chief Executive Officer Pursuant to Rule 13-14(a) of the Securities Exchange 
Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

Certification of Chief Financial Officer Pursuant to Rule 13-14(a) of the Securities Exchange 
Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

Certification of Chief Executive Officer and Chief Financial Officer Pursuant to 18 U.S.C. Section 
1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

#

†

††

Indicates a management contract or compensatory plan.

Confidential treatment has been granted for portions of this exhibit. These portions have been 
omitted from the Registration Statement and submitted separately to the Securities and Exchange 
Commission.

Confidential treatment has been requested for portions of this exhibit. These portions have been 
omitted from the Registration Statement and submitted separately to the Securities and Exchange 
Commission.

55

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has 
duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized, on March 11, 2014.

SIGNATURES

Cumberland Pharmaceuticals, Inc.

/s/ A. J. Kazimi

By: A. J. Kazimi

Chief Executive Officer
(Principal Executive Officer)

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

following persons on behalf of the registrant and in the capacities and on the dates indicated.

Signature

Title

Date

/s/ A. J. Kazimi
A. J. Kazimi

/s/ Rick S. Greene
Rick S. Greene

/s/ Robert G. Edwards
Robert G. Edwards

/s/ Thomas R. Lawrence
Thomas R. Lawrence

/s/ Martin E. Cearnal
Martin E. Cearnal

/s/ Gordon R. Bernard
Gordon R. Bernard

/s/ Jonathan I. Griggs
Jonathan I. Griggs

/s/ James R. Jones
James R. Jones

/s/ Joey A. Jacobs
Joey A. Jacobs

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

March 11, 2014

Chairman and CEO
(Principal Executive Officer and
Director)

Vice President and CFO
(Principal Financial and 
Accounting Officer

Director

Director

Director

Director

Director

Director

Director

56

MANAGEMENT’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING

The management of Cumberland Pharmaceuticals Inc. is responsible for establishing and maintaining adequate 
internal control over financial reporting. Cumberland Pharmaceuticals Inc.’s internal control system was designed to 
provide reasonable assurance to the Company’s management and board of directors regarding the preparation and fair 
presentation of published financial statements. All internal control systems, no matter how well designed, have inherent 
limitations. Therefore, even those systems determined to be effective can provide only reasonable assurance with respect 
to financial statement preparation and presentation.

Cumberland Pharmaceuticals Inc.’s management assessed the effectiveness of the Company’s internal control over 
financial reporting as of December 31, 2013. In making this assessment, it used the criteria set forth by the Committee 
of Sponsoring Organizations of the Treadway Commission (COSO) in Internal Control – Integrated Framework (1992).

Based on its assessment, management has concluded that, as of December 31, 2013, the Company’s internal control 

over financial reporting was effective based on those criteria.

Cumberland Pharmaceuticals Inc.’s independent registered public accounting firm has issued an audit report on 
the effectiveness of Cumberland Pharmaceuticals Inc.’s internal control over financial reporting. This report appears 
on page F-3 of this annual report on Form 10-K.

/s/ A. J. Kazimi
A. J. Kazimi
Chief Executive Officer
March 11, 2014

/s/ Rick S. Greene
Rick S. Greene
Chief Financial Officer
March 11, 2014

F-1

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors
Cumberland Pharmaceuticals Inc.:

We  have  audited  the  accompanying  consolidated  balance  sheets  of  Cumberland  Pharmaceuticals  Inc.  and 
subsidiaries (the Company) as of December 31, 2013 and 2012, and the related consolidated statements of operations 
and  comprehensive  (loss)  income,  equity,  and  cash  flows  for  each  of  the  years  in  the  three-year  period  ended 
December 31, 2013. In connection with our audits of the consolidated financial statements, we have also audited the 
financial statement Schedule II - Valuation and Qualifying Accounts for each of the years in the three-year period ended 
December 31, 2013. These consolidated financial statements and financial statement schedule are the responsibility of 
the Company's management. Our responsibility is to express an opinion on these consolidated financial statements and 
financial statement schedule based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board 
(United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether 
the  financial  statements  are  free  of  material  misstatement. An  audit  includes  examining,  on  a  test  basis,  evidence 
supporting the amounts and disclosures in the financial statements.  An audit also includes assessing the accounting 
principles used and significant estimates made by management, as well as evaluating the overall financial statement 
presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the 
financial position of Cumberland Pharmaceuticals Inc. and subsidiaries as of December 31, 2013 and 2012, and the 
period ended December 31, 2013, 
results of their operations and their cash flows for each of the years in the 
in conformity with U.S. generally accepted accounting principles. Also, in our opinion, the related financial statement 
schedule, when considered in relation to the consolidated financial statements taken as a whole, presents fairly, in all 
material respects, the information set forth herein.

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United 
States), the Company's internal control over financial reporting as of December 31, 2013, based on criteria established 
in  Internal  Control  -  Integrated  Framework  (1992)  issued  by  the  Committee  of  Sponsoring  Organizations  of  the 
Treadway  Commission  (COSO),  and  our  report  dated  March 11,  2014  expressed  an  unqualified  opinion  on  the 
effectiveness of the Company’s internal control over financial reporting.

/s/ KPMG LLP
Nashville, Tennessee
March 11, 2014

F-2

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors
Cumberland Pharmaceuticals Inc.:

We have audited Cumberland Pharmaceuticals Inc.'s (the Company) internal control over financial reporting as of 
December 31, 2013, based on criteria established in Internal Control - Integrated Framework (1992) issued by the 
Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission  (COSO).  The  Company's  management  is 
responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness 
of internal control over financial reporting, included in the accompanying Management's Report on Internal Control 
over Financial Reporting. Our responsibility is to express an opinion on the Company's internal control over financial 
reporting based on our audit.

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board 
(United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether 
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, and 
testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit 
also included performing such other procedures as we considered necessary in the circumstances. We believe that our 
audit provides a reasonable basis for our opinion.

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.

In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting 
as of December 31, 2013, based on criteria established in Internal Control - Integrated Framework (1992) issued by 
the Committee of Sponsoring Organizations of the Treadway Commission.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United 
States), the consolidated balance sheets of Cumberland Pharmaceuticals Inc. and subsidiaries as of December 31, 2013 
and 2012, and the related consolidated statements of operations and comprehensive (loss) income, equity, and cash 
flows for each of the years in the three-year period ended December 31, 2013, and our report dated March 11, 2014 
expressed an unqualified opinion on those consolidated financial statements.

/s/ KPMG LLP
Nashville, Tennessee
March 11, 2014 

F-3

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Balance Sheets

December 31, 2013 and 2012

ASSETS

Current assets:

Cash and cash equivalents
Marketable securities

Accounts receivable, net of allowances

Inventories

Prepaid and other current assets

Deferred tax assets

Total current assets

Property and equipment, net

Intangible assets, net

Deferred tax assets

Other assets

Total assets

LIABILITIES AND EQUITY

Current liabilities:

Accounts payable

Other current liabilities

Total current liabilities

Revolving line of credit

Other long-term liabilities

Total liabilities

Commitments and contingencies

Equity:

Shareholders’ equity:

2013

2012

$

40,869,457
14,019,761

$

54,349,381
16,686,136

4,530,424

5,722,882

825,675

2,711,516

6,017,201

6,218,355

1,671,091

2,290,078

68,679,715

87,232,242

880,647

15,498,819

1,208,891

1,345,666

1,188,914

9,476,798

50,411

645,366

$

87,613,738

$

98,593,731

$

2,035,853

$

5,509,917

7,545,770

—

776,125

8,321,895

2,790,554

5,264,806

8,055,360

4,359,951

611,933

13,027,244

Common stock – no par value; 100,000,000 shares authorized;
17,985,503 and 18,937,107 shares issued and outstanding as of
December 31, 2013 and 2012, respectively

Retained earnings

Total shareholders’ equity

Noncontrolling interests

Total equity

Total liabilities and equity

63,073,941

16,394,540

79,468,481
(176,638)
79,291,843

67,197,167

18,499,154

85,696,321
(129,834)
85,566,487

$

87,613,738

$

98,593,731

See accompanying notes to consolidated financial statements.

F-4

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Operations and Comprehensive (Loss) Income

Years ended December 31, 2013, 2012 and 2011

Revenues:

Net product revenue

Other revenue

Net revenues

Costs and expenses:

Cost of products sold

Selling and marketing

Research and development

General and administrative

Amortization

Total costs and expenses

Operating (loss) income

Interest income

Interest expense

(Loss) income before income taxes

Income tax benefit (expense)

Net (loss) income

Net loss at subsidiary attributable to noncontrolling
interests

Net (loss) income attributable to common
shareholders

Earnings (loss) per share attributable to common
shareholders:

Basic

Diluted

Weighted-average common shares outstanding:

$

$

$

Basic

Diluted

2013

2012

2011

$

31,100,698

$

47,944,031

$

50,893,794

926,764

32,027,462

907,206

48,851,237

248,982

51,142,776

5,439,422

14,387,745

5,615,501

9,489,976

896,156

35,828,800
(3,801,338)
230,291
(103,422)
(3,674,469)
1,523,051
(2,151,418)

5,046,179

20,329,493

5,095,172

9,055,959

506,332

40,033,135

8,818,102

304,865
(71,985)
9,050,982
(3,244,776)
5,806,206

5,362,554

20,940,060

5,028,072

9,307,301

655,302

41,293,289

9,849,487

210,727
(353,497)
9,706,717
(4,080,204)
5,626,513

46,804

36,286

31,343

(2,104,614) $

5,842,492

$

5,657,856

(0.11) $
(0.11) $

0.30

0.30

$

$

0.28

0.28

18,332,997

18,332,997

19,564,625

19,787,537

20,342,913

20,572,132

Comprehensive (loss) income

$

(2,151,418) $

5,806,206

$

5,626,513

See accompanying notes to consolidated financial statements.

F-5

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Cash Flows

Years ended December 31, 2013, 2012 and 2011

Cash flows from operating activities:

Net (loss) income
Adjustments to reconcile net (loss) income to net cash flows
provided by operating activities:

Depreciation and amortization expense
Deferred tax (benefit) expense
Share-based compensation
Excess tax benefit derived from exercise of stock options

Noncash interest expense
Noncash investment losses (gains)
Net changes in assets and liabilities affecting operating activities:

Accounts receivable
Inventories
Prepaid, other current assets and other assets
Accounts payable and other accrued liabilities
Other long-term liabilities

Net cash provided by operating activities

Cash flows from investing activities:

Additions to property and equipment
Additions to intangible assets
Proceeds from sale of marketable securities
Purchases of marketable securities

Net cash used in investing activities

Cash flows from financing activities:

Net (repayments) borrowings on line of credit
Principal payments on note payable
Repurchase of common shares

Costs of financing for long-term debt and credit facility
Exercise of stock options
Excess tax benefit derived from exercise of stock options

Net cash used in financing activities
Net (decrease) increase in cash and cash equivalents

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

Supplemental disclosure of cash flow information:
Net cash paid (refunded) during the year for:

Interest
Income taxes

Noncash investing and financing activities:

2013

2012

2011

$

(2,151,418) $

5,806,206

$

5,626,513

1,301,835
(1,579,918)
674,955
(48,024)
24,075
178,822

1,486,777
495,473
117,021
58,855
187,673
746,126

(97,412)
(7,462,080)
6,859,061
(4,371,508)
(5,071,939)

(4,359,951)
—
(4,800,908)
—
(41,276)
48,024
(9,154,111)
(13,479,924)
54,349,381
40,869,457

79,347
(129,509)

$

$

901,649
(829,846)
636,528
(3,760,766)
24,075
(45,814)

1,065,689
(443,661)
(648,941)
4,373,276
56,787
7,135,182

(464,893)
(2,071,926)
5,220,480
(21,860,802)
(19,177,141)

(500,000)
—
(8,086,594)
—
618,022
3,760,766
(4,207,806)
(16,249,765)
70,599,146
54,349,381

47,910
112,381

$

$

1,040,407
1,665,110
779,305
(2,355,345)
137,487
—

(1,937,396)
1,909,148
(399,393)
2,296,535
(40,224)
8,722,147

(257,502)
(180,269)
—
—
(437,771)

3,034,000
(5,333,333)
(4,247,440)
(17,637)
629,865
2,355,345
(3,579,200)
4,705,176
65,893,970
70,599,146

191,410
304,480

$

$

Change in unpaid invoices for purchases of intangibles

543,905

888,141

97,806

See accompanying notes to consolidated financial statements.

F-6

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Equity

Years ended December 31, 2013, 2012 and 2011

Cumberland Pharmaceuticals Inc.
Shareholders

Common stock

Shares

Amount

Retained
earnings

Non-
controlling
interest

Total equity

Balance, December 31, 2010

20,338,461

$ 70,778,874

$ 6,998,806

$

Net income (loss)

5,657,856

(62,205) $ 77,715,475
(31,343)
5,626,513

Share-based compensation

10,144

755,511

Exercise of options and
related tax benefit

Repurchase of common
shares

415,003

2,985,210

Balance, December 31, 2011

20,020,535

Net income (loss)

(743,073)

(4,247,440)
70,272,155

12,656,662

5,842,492

(93,548)
(36,286)

Share-based compensation

20,199

632,818

Exercise of options and
related tax benefit

Repurchase of common
shares

Balance, December 31, 2012

Net loss

165,182

4,378,788

(1,268,809)

18,937,107

(8,086,594)
67,197,167

Share-based compensation

19,743

670,934

18,499,154
(2,104,614)

(129,834)
(46,804)

755,511

2,985,210

(4,247,440)
82,835,269

5,806,206

632,818

4,378,788

(8,086,594)
85,566,487
(2,151,418)
670,934

6,748

Exercise of options and
related tax benefit

Repurchase of common
shares

Balance, December 31, 2013

36,758

6,748

(1,008,105)

17,985,503

(4,800,908)
$ 63,073,941

$ 16,394,540

$

(4,800,908)
(176,638) $ 79,291,843

See accompanying notes to consolidated financial statements.

F-7

 
 
 
 
 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements

(1) 

Organization

Cumberland Pharmaceuticals Inc. and its subsidiaries (the "Company" or "Cumberland") is a specialty 
pharmaceutical  company  focused  on  the  acquisition,  development  and  commercialization  of  branded 
prescription products.  The Company's primary target markets are hospital acute care and gastroenterology. 
These markets are characterized by relatively concentrated prescriber bases that the Company believes can 
be penetrated effectively by small, targeted sales forces. Cumberland is dedicated to providing innovative 
products that improve quality of care for patients and address poorly met medical needs.

Cumberland focuses its resources on maximizing the commercial potential of its products, as well as 
developing  new  product  candidates,  and  has  both  internal  development  and  commercial  capabilities. The 
Company’s products are manufactured by third parties, which are overseen by Cumberland’s quality control 
and manufacturing professionals. The Company works closely with its third-party distribution partner to make 
its products available in the United States.

In order to create access to a pipeline of early-stage product candidates, the Company formed a subsidiary, 
Cumberland Emerging Technologies, Inc. ("CET"), which assists universities and other research organizations 
to help bring biomedical projects from the laboratory to the marketplace. The Company’s ownership in CET 
is 85%. The remaining interest is owned by Vanderbilt University and the Tennessee Technology Development 
Corporation.  The  operating  results  of  CET  allocated  to  the  noncontrolling  interests  in  the  consolidated 
statements of operations were approximately $46,804, $36,286 and $31,343 for the years ended December 31, 
2013, 2012 and 2011, respectively.

Effective January 1, 2007, the Company formed a wholly-owned subsidiary, Cumberland Pharma Sales 

Corp. ("CPSC").  CPSC is the subsidiary that employs the Company's hospital and field sales forces.

(2) 

Significant Accounting Policies

Principles of Consolidation

The consolidated financial statements of the Company are stated in U.S. dollars and are prepared using 
U.S. generally accepted accounting principles. These financial statements include the accounts of the Company 
and its wholly and majority-owned subsidiaries. All significant intercompany transactions and accounts have 
been eliminated in consolidation.

Use of Estimates

The  preparation  of  the  consolidated  financial  statements  in  conformity  with  U.S.  generally  accepted 
accounting principles requires management of the Company to make estimates and assumptions that affect 
the  reported  amounts  of  assets  and  liabilities  and  disclosure  of  contingent  liabilities  at  the  date  of  the 
consolidated financial statements and the reported amounts of revenues and expenses during the period.  Actual 
results could differ from those estimates under different assumptions and conditions.  The Company's most 
significant estimates include: (1) its allowances for chargebacks and accruals for rebates and product returns 
and (2) the  allowances for obsolescent or unmarketable inventory. 

Segment Reporting

The Company has one operating segment which is specialty pharmaceutical products. Management has 
chosen to organize the Company based on the type of products sold.  Substantially all of the Company’s assets 
are located in the United States. Total revenues are primarily attributable to U.S. customers.  Net revenues 
from customers outside the United States were approximately $0.8 million, $0.7 million and $0.1 million for 
2013, 2012 and 2011, respectively.

F-8

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Reclassifications

In 2013, the Company began reflecting all amortization expense of intangible assets in Amortization in 
the consolidated statements of operations and comprehensive (loss) income.  A portion of these amounts were 
previously included as a component of General and Administrative.  The prior year consolidated financial 
statements have been reclassified to conform to the presentation in 2013. 

Fair Value of Financial Instruments

Fair value of financial assets and liabilities is the price the Company would receive to sell an asset or pay 
to transfer a liability in an orderly transaction with a market participant at the measurement date.  The Company's 
fair value measurements follow the appropriate rules as well as the fair value hierarchy that prioritizes the 
information used to develop the measurements.  It applies whenever other guidance requires (or permits) assets 
or liabilities to be measured at fair value and gives the highest priority to unadjusted quoted prices in active 
markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to unobservable inputs 
(Level 3 measurements). 

A summary of the fair value hierarchy that prioritizes observable and unobservable inputs used to measure 

fair value into three broad levels is described below:

Level 1 -  Quoted prices for identical instruments in active markets.

Level 2 -  Quoted prices for similar instruments in active markets; quoted prices for identical or 
similar instruments in markets that are not active; and model-derived valuations whose 
inputs are observable or whose significant value drivers are observable.

Level 3 -  Significant inputs to the valuation model are unobservable.

We maintain policies and procedures to value instruments using the best and most relevant data available. 
The following section describes the valuation methodologies we use to measure different financial instruments 
at fair value on a recurring basis.

The Company’s financial instruments include cash and cash equivalents, marketable securities, accounts 
receivable, accounts payable, accrued liabilities, and a revolving line of credit. The carrying values for cash 
and  cash  equivalents,  accounts  receivable, accounts  payable  and  accrued  liabilities approximate their  fair 
values due to their short-term nature. The revolving line of credit has a variable interest rate, which approximates 
the current market rate.

The Company's fair values of marketable securities are determined based on valuations provided by a 
third-party pricing service, as derived from such services' pricing models, and are considered either Level 1 
or  Level  2  measurements,  depending  on  the  nature  of  the  investment.   The  Company  has  no  marketable 
securities in which the fair value is determined based on Level 3.    The level of management judgment required 
in evaluating fair value for Level 1 investments is minimal.  Similarly, there is little subjectivity or judgment 
required for Level 2 investments valued using valuation models that are standard across the industry and whose 
parameter inputs are quoted in active markets.  Inputs to the models may include, but are not limited to, reported 
trades,  executable  bid  and  ask  prices,  broker/dealer  quotations,  prices  or  yields  of  securities  with  similar 
characteristics, benchmark curves or information pertaining to the issuer, as well as industry and economic 
events. Based on the information available, the Company believes that the valuations provided by the third-
party pricing service, as derived from such services' pricing models, are representative of prices that would 
be received to sell the assets at the measurement date (exit prices).

Cash and Cash Equivalents

Cash and cash equivalents include highly liquid investments with original maturities of three months or 

less.  As of December 31, 2013 and 2012, cash equivalents consist primarily of money market funds. 

F-9

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Marketable Securities

The Company invests in marketable debt securities in order to maximize its return on cash. Marketable 
securities consist of U.S. Treasury notes and bonds, U.S. Government Agency notes and bonds and bank-
guaranteed, variable rate demand notes (VRDN).  At the time of purchase, the Company classifies marketable 
securities as either trading securities or available-for-sale securities, depending on the intent at that time.  As 
of December 31, 2013 and 2012, marketable securities were comprised solely of trading securities.  Trading 
securities are carried at fair value with unrealized gains and losses recognized as a component of interest 
income in the consolidated statements of operations.

Accounts Receivable

Trade accounts receivable are recorded at the invoiced amount.  The Company records allowances for 
amounts that could become uncollectible in the future based on historical experience, including amounts related 
to chargebacks, cash discounts and credits for damaged product. The Company reviews each customer balance 
to assess collectibility.

The majority of the Company’s products are distributed through independent pharmaceutical wholesalers.  
Net  product  revenues  and  accounts  receivable  take  into  account  the  sale  of  the  product  at  the  wholesale 
acquisition cost, and an accrual is recorded to reflect the difference between the wholesale acquisition cost 
and the estimated average end-user contract price. This accrual is calculated on a product-specific basis and 
is based on the estimated number of outstanding units sold to wholesalers that will ultimately be sold in end-
user contracts. When the wholesaler sells the product to the end-user at the agreed upon end-user contract 
price, the wholesaler charges the Company for the difference between the wholesale acquisition price and the 
end-user contract price and this chargeback is offset against the initial accrual balance.

Cash discounts are reductions to invoiced amounts offered to customers for payment within a specified 

period of time from the date of the invoice.

At the time a transaction is recognized as a sale, the Company records a reduction in revenues for an 
estimate of damaged product in the shipment.  The Company’s estimate of the allowance for damaged product 
is based upon historical experience of claims made for damaged product.

Inventories

The Company works closely with third parties to manufacture and package finished goods for sale.  Based 
on the customer relationship with the manufacturer or packager, the Company will either take title to finished 
goods at the time of shipment or at the time of arrival from the manufacturer.  The Company then warehouses 
such goods until distribution and sale.  Inventories are stated at the lower of cost or market with cost determined 
using the first-in, first-out method.

The  Company  continually  evaluates  inventories  for  potential  losses  due  to  excess,  obsolete  or  slow-
moving inventory by comparing sales history and sales projections to the inventory on hand. When evidence 
indicates the carrying value of a product may not be recoverable, a charge is recorded to reduce the inventory 
to its current net realizable value.

Prepaid and Other Current Assets

Prepaid and other current assets consist of the current portion of unamortized deferred financing costs, 
prepaid insurance premiums, prepaid consulting services and annual fees paid to the U.S. Food and Drug 
Administration ("FDA").  The Company expenses all prepaid amounts as used or over the period of benefit 
primarily on a straight-line basis, as applicable.

F-10

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Property and Equipment

Property and equipment, including leasehold improvements, are stated at cost. Depreciation is recognized 
using  the  straight-line  method  over  the  estimated  useful  lives  of  the  assets.  Leasehold  improvements  are 
amortized over the shorter of the initial lease term plus renewal options, if reasonably assured, or the remaining 
useful life of the asset. Upon retirement or disposal of assets, any gain or loss is reflected as a component of 
operating income in the consolidated statement of operations.  Improvements that extend an asset’s useful life 
are capitalized.  Repairs and maintenance costs are expensed as incurred.

Intangible Assets

The Company’s intangible assets consist of capitalized costs related to product and license rights, patents 

and trademarks.

The cost of acquiring product and license rights are capitalized at fair value at the date of acquisition for 
products that are approved by the FDA for commercial use.  These costs are amortized ratably over the estimated 
economic life of the product. The economic life is estimated based upon the term of the license agreement, 
patent life or market exclusivity of the product and based on management's assessment of future sales and 
profitability of the product. This estimate is evaluated on a regular basis during the amortization period and 
adjusted if appropriate.  

Capitalized patent costs consist of outside legal costs associated with obtaining and protecting patents on 
products that have been approved for marketing by the FDA. If it becomes probable that a patent will not be 
issued, related costs associated with the patent application is expensed at the time such determination is made. 
All costs associated with obtaining patents for products that have not been approved for marketing by the FDA 
are expensed as incurred.

Amortization expense is recognized on a straight-line basis over the following periods:

Product rights
License rights
Patents

Estimated economic life
Term of license agreement
Life of patent

Impairment of Long-Lived Assets

Long-lived  assets,  such  as  property  and  equipment  and  intangible  assets  subject  to  amortization,  are 
reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an 
asset may not be recoverable. If events or circumstances arise that require a long-lived asset to be tested for 
potential impairment, the Company first compares undiscounted cash flows expected to be generated by the 
asset to its carrying value. If the carrying amount of the long-lived asset is not recoverable on an undiscounted 
cash flow basis, an impairment charge is recognized to the extent that the carrying value exceeds the fair value. 
Fair value is determined through various valuation techniques including quoted market prices, third-party 
independent appraisals and discounted cash flow models.  

Assets to be disposed of, if any, are separately presented in the consolidated balance sheet and reported 
at the lower of the carrying amount or fair value less costs to sell, and no further depreciation or amortization 
is recorded on the asset upon classification as held-for-sale. The assets and liabilities of a disposal group 
classified as held-for-sale, if any, are presented separately in the appropriate asset and liability sections of the 
consolidated balance sheet. The Company recorded no impairment charges during 2013, 2012 and 2011.

F-11

 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Revenue Recognition

Revenue is realizable and earned when all of the following criteria are met: persuasive evidence of an 
arrangement exists; delivery has occurred or services have been rendered; the seller’s price to the buyer is 
fixed and determinable; and collectibility of the related receivable is reasonably assured. Delivery is considered 
to have occurred upon either shipment of the product or arrival at its destination, depending upon the shipping 
terms of the transaction.

Product Revenues

The  Company’s  net  product  revenue  reflects  the  reduction  from  gross  product  revenue  for  estimated 
allowances for chargebacks, discounts and damaged goods, and reflects sales related accruals for rebates, 
product returns, certain administrative and service fees. 

As discussed above, the allowances against accounts receivable for chargebacks, discounts and damaged 
goods are determined on a product-by-product basis, and established by management as the Company’s best 
estimate at the time of sale based on each product’s historical experience adjusted to reflect known changes 
in the factors that impact such allowances. These allowances are established based on the contractual terms 
with  direct  and  indirect  customers  and  analyses  of  historical  levels  of  chargebacks,  discounts  and  credits 
claimed for damaged product.

Other  organizations,  such  as  managed  care  providers,  pharmacy  benefit  management  companies  and 
government agencies, may receive rebates from the Company based on either negotiated contracts to carry 
the  Company’s  products  or  reimbursements for filled  prescriptions. These entities are  considered indirect 
customers  of  the  Company.  In  addition,  the  Company  may  provide  rebates  to  end-user  customers.  In 
conjunction with recognizing a sale to a wholesaler, sales revenues are reduced and accrued liabilities are 
increased by the Company’s estimate of the rebate that may be claimed.

Consistent with industry practice, the Company maintains a return policy that allows customers to return 
product within a specified period prior to and subsequent to the expiration date. The Company’s estimate of 
the provision for returns is based upon historical experience. Any changes in the assumptions used to estimate 
the provision for returns are recognized in the period those assumptions changed.

The Company has agreements with certain key wholesalers that include a fee for service costs. These 

costs are netted against product revenues.

Other Revenues

Other revenues primarily consist of income from grant funding programs, licensing agreements, leases 
and contract services.  Revenue related to grants is recognized when all conditions related to such grants have 
been met.  All other revenue is recognized when earned.

The Company is a party to several licensing arrangements with customers that purchase product from the 
Company.  Under these licensing arrangements, the third-party licensee may have access to the Company's 
FDA registration file.  Licensing arrangements typically include an up-front payment for gaining access to 
the FDA registration file, royalties and milestone payments upon the achievement of specific sales levels. The 
amounts received for access to the FDA registration file are evaluated and based on the evaluation, the resulting 
revenue either recognized upfront or recognized over the term of the arrangement.  Royalties and milestones 
are recognized as revenue when earned.  For substantive milestones, the Company uses the milestone method 
of recognizing revenue if it is commensurate with either the performance to achieve the milestone or the 
enhancement of the value of the delivered item, it relates solely to past performance and it is reasonable relative 
to other milestones.

F-12

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Cost of Products Sold

Cost of products sold consists principally of the cost to acquire each unit of product sold, including in-
bound freight expense. Cost of products sold also includes expenses associated with the write-down of slow-
moving or expired product.

Selling and Marketing Expense

Selling  and  marketing  expense  consists  primarily  of  expense  relating  to  the  advertising,  promotion, 

distribution and sale of products, including royalty expense, salaries and related costs.

Distribution Costs

Distribution costs are expensed as incurred and totaled $0.9 million in both 2013 and 2012, and $1.2 
million in 2011. They are included as a component of selling and marketing expenses in the consolidated 
statements of operations.

Advertising Costs

Advertising costs are expensed as incurred and totaled $2.1 million, $3.0 million and $0.9 million in 2013, 
2012  and  2011,  respectively,  and  are  included  as  a  component  of  selling  and  marketing  expenses  in  the 
consolidated statements of operations. 

Research and Development

Research and development costs are expensed in the period incurred. Research and development costs 
are comprised mainly of clinical trial expenses, salaries and wages, and other related costs such as materials 
and supplies. Development expense includes activities performed by third-party providers participating in the 
Company’s clinical studies. The Company accounts for these costs based on estimates of work performed, 
patients enrolled or fixed fees for services.

Income Taxes

The  Company  provides  for  deferred  taxes  using  the  asset  and  liability  approach.  Under  this  method, 
deferred tax assets and liabilities are recognized for future tax consequences attributable to operating loss and 
tax credit carryforwards, as well as differences between the carrying amounts of existing assets and liabilities 
and their respective tax bases. The Company’s principal differences are related to the timing of deductibility 
of certain items, such as inventory, depreciation, amortization and expense for nonqualified stock options. 
Deferred tax assets and liabilities are measured using enacted statutory tax rates that are expected to apply to 
taxable income in the years such temporary differences are anticipated to be recovered or settled. The effect 
on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period of enactment. 
The Company only recognizes income tax benefits associated with an income tax position in which it is “more 
likely than not” that the position would be sustained upon examination by the taxing authorities.

In assessing the realizability of deferred tax assets, management considers whether it is more likely than 
not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred 
tax assets is dependent upon the generation of future taxable income during the periods in which those temporary 
differences  become  deductible.  Management  considers  the  scheduled  reversal  of  deferred  tax  liabilities, 
projected future taxable income and tax planning strategies in making this assessment. 

The tax benefit associated with the exercise of nonqualified stock options is recognized when the benefit 

is used to offset income taxes payable.

The  Company’s  accounting  policy  with  respect  to  interest  and  penalties  arising  from  income  tax 

settlements is to recognize them as part of the provision for income taxes.

F-13

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Comprehensive (Loss) Income

Total comprehensive (loss) income was comprised solely of net (loss) income for all periods presented.

Earnings per Share

Basic earnings per share is calculated by dividing net income attributable to common shareholders by the 
weighted-average number of shares outstanding. Except where the result would be antidilutive to income from 
continuing operations, diluted earnings per share is calculated by assuming the vesting of unvested restricted 
stock and the exercise of stock options and warrants, unrecognized compensation costs, as well as the related 
income tax benefits.

Share-Based Payments

The Company recognizes compensation cost for all share-based payments issued, modified, repurchased 
or canceled. The cost of stock options is measured based on the grant-date fair value using the Black-Scholes 
option-pricing model, and the expense is recognized over the employee’s requisite service period. Depending 
on the nature of the vesting provisions, restricted stock awards are measured using either the fair value on the 
grant date or the fair value of common stock on the date the vesting provisions lapse. Prior to the lapse for 
those equity grants not valued on the grant date, the fair value is measured on the last day of the reporting 
period.

Collaborative Agreements

The Company is a party to several collaborative arrangements with certain research institutions to identify 
and pursue promising pre-clinical pharmaceutical product candidates. The Company has determined these 
collaborative agreements do not meet the criteria for accounting under Accounting Standards Codification 
808,  Collaborative  Agreements.  The  agreements  do  not  specifically  designate  each  party's  rights  and 
obligations to each other under the collaborative arrangements. Except for patent defense costs, expenses 
incurred by one party are not required to be reimbursed by the other party. The funding for these programs is 
generally  provided  through  private  sector  investments  or  federal  Small  Business Administration  ("SBIR/
STTR") grant programs. Expenses incurred under these collaborative agreements are included in research and 
development expenses in the consolidated statements of operations. Funding received from private sector 
investments and grants are recorded as net revenues in the consolidated statements of operations.

Recent Accounting Guidance

In July 2013, the FASB issued updated guidance in the form of a FASB Accounting Standards Update on 
"Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, a Similar Tax Loss, 
or a Tax Credit Carryforward Exists".  This update requires, unless certain conditions exists, an unrecognized 
tax benefit, or a portion of an unrecognized tax benefit, to be presented in the financial statements as a reduction 
to a deferred tax asset for a net operating loss carryforward, similar tax loss, or a tax credit carryforward. The 
Accounting Guidance is effective prospectively for reporting periods beginning after December 15, 2013, 
with early adoption permitted.   Retrospective application is permitted. The Company is currently evaluating 
the impact of ASU 2013-11 on its consolidated financial statements and related disclosures.

F-14

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(3) 

Revenues

Product Revenues

The Company’s net product revenues consisted of the following for the years ended December 31:

Acetadote

Omeclamox-Pak

Kristalose

Caldolor

2013

2012

2011

$

18,846,753

$

37,522,180

$

42,454,055

1,045,815

9,118,475

2,089,655

—

9,429,741

992,110

—

8,517,873
(78,134)
50,893,794

Total net product revenues

$

31,100,698

$

47,944,031

$

As part of the October 28, 2013 agreement further discussed in Note 6, the Company entered into an 
agreement with Pernix Therapeutics to promote Omeclamox-Pak. Under the terms of the agreement, effective 
October 1, 2013, the Company began to share in the revenue of this product including $1.0 million during 
2013. Effective January 2014 the Company began promoting Omeclamox-Pak to gastroenterologists across 
the United States through its field sales force. 

As part of the November 12, 2012, Settlement Agreement with Paddock and Perrigo, the Company supplies 
Perrigo with an Authorized Generic version of the Company's Acetadote product.  Acetadote product revenue 
in 2013 includes $9.2 million in the Company's share of the Authorized Generic distributed by Perrigo, and 
2012 includes $0.3 million. 

In December 2011, the Company discontinued sales of the 400mg Caldolor offering domestically and 
focused on the 800mg Caldolor offering.  Gross product revenue for Caldolor was approximately $2.9 million, 
$1.3 million and $0.3 million for the years ended December 31, 2013, 2012 and 2011, respectively.  The 
Company recognized approximately $0.4 million of sales allowances in the fourth quarter of 2011 primarily 
for estimated return of the discontinued product. 

The allowances in accounts receivable for chargebacks, cash discounts and damaged goods were $0.6 
million at December 31, 2013 and  $0.2 million at 2012,  and the accruals for rebates, product returns and 
certain administrative and service fees included in other current liabilities were $2.4 million and $3.4 million, 
respectively, at December 31, 2013 and 2012.

Other Revenues  

During  2013,  the  Company  entered  into  six  new  agreements  with  international  partners  for 
commercialization of certain of the Company's products into additional international territories and amended 
its  agreement  with  Harbin  Gloria  Pharmaceuticals  Co.,  Ltd  ("Harbin  Gloria"),  a  Chinese  pharmaceutical 
company, to extend its territory. As a result of the new and amended agreements, the Company recognized 
approximately $0.6 million of non-refundable up-front payments as other revenue in the consolidated statement 
of operations during 2013. 

The agreements entered into during 2013 provide that each of the partners are responsible for seeking 
regulatory approvals for the products, and following approvals, will handle ongoing distribution and sales in 
the respective international territories.  The Company maintains responsibility for the intellectual property 
and product formulations.  Under the licensing agreements, the Company is entitled to receive additional 
milestone payments upon the partners' achievement of defined regulatory approvals and sales milestones.  The 
Company will recognize revenue for these substantive milestones using the milestone method. The agreements 

F-15

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

provide for up to $0.6 million in milestone payments related to regulatory approvals and up to $4.0 million 
in milestone payments related to total and annual product sales. As of December 31, 2013, the Company has 
not recognized any revenues related to milestones associated with the new agreements. The Company is also 
entitled to receive royalties on future sales of the products under the agreements. 

In 2012, the Company entered into an exclusive licensing agreement for Acetadote and Caldolor with 
Harbin Gloria.  In connection with the agreement, the Company has certain protective rights, including the 
right to review and approve all documents submitted to the Chinese State Drug Administration.  During 2012, 
the Company received nonrefundable, up-front payments totaling approximately $0.7 million in exchange for 
the transfer of certain intellectual property, including its product dossiers, and recognized these payments as 
other revenue in the consolidated statement of operations when the intellectual property was provided to the 
licensee. The licensing agreement provides for the Company to receive additional milestone payments of $0.7 
million when the licensee receives notice from the regulatory authority granting approval to conduct clinical 
trials, or stating that no clinical trials are necessary.  The Company is also entitled to receive milestone payments 
of $1.1 million upon receiving regulatory approval for each of Acetadote and Caldolor in China.  The Company 
will recognize revenue for these substantive milestones using the milestone method.  As of December 31, 
2013, no revenue has been recognized related to milestones associated with Harbin Gloria.

Other revenues during 2013, 2012 and 2011 also includes revenue generated by CET through grant funding 
from federal Small Business grant programs, and lease income generated by CET’s Life Sciences Center and 
contract services. The Life Sciences Center is a research center that provides scientists with access to flexible 
lab space and other resources to develop biomedical products. Grant revenue from SBIR/STTR programs 
totaled approximately $0.1 million for each of the years ended December 31, 2013, 2012 and 2011.  

(4) 

Inventories

The Company's inventories consisted of the following as of December 31:

Raw materials and work in process

Finished goods

Total inventories

2013

2012

$

$

2,025,020

3,697,862

5,722,882

$

$

1,310,670

4,907,685

6,218,355

Caldolor  inventory  represented  the  majority  of  net  inventory  on  hand  at  December  31,  2013  and 
December 31, 2012, and had varying original expiration dates that began in the second quarter of 2014 and 
extended through January 2015. During 2013, the Company provided stability data to the FDA supporting 
that the Caldolor product expiration dates may be extended by up to a year.  In January 2014, the FDA notified 
the Company that it had approved its request to extend the original shelf life of the Caldolor 800mg vials from 
five to six years.   

 At December 31, 2013 and 2012, the Company has recognized amounts for potential obsolescence and 
discontinuance of approximately $3.5 million and $2.6 million, respectively, primarily for Caldolor. If actual 
sales in future periods are less than projected sales, the Company could incur additional obsolescence losses. 

In connection with the acquisition of certain product right assets related to the Kristalose brand as discussed 
in Note 6, the Company is responsible for purchasing the active pharmaceutical ingredient for Kristalose and 
maintains this raw material inventory at its third-party manufacturer.  As the ingredients are consumed in 
production, the value of the ingredients is transferred from raw materials to finished goods.

F-16

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(5) 

Property and Equipment

Property and equipment consisted of the following at December 31:

Computer equipment

Office equipment

Furniture and fixtures

Leasehold improvements

Total property and 
equipment, gross

Less: accumulated depreciation 
and amortization

Total property and 
equipment, net

Range of
useful lives

3 – 5 years

3 – 15 years

5 – 15 years

3 – 15 years, or
remaining lease term

2013

2012

$

754,088

$

132,999

616,759

710,099

123,937

609,544

1,223,453

1,186,306

2,727,299

2,629,886

(1,846,652)

(1,440,972)

$

880,647

$

1,188,914

Depreciation  expense,  including  amortization  expense  related  to  leasehold  improvements,  was  $0.4 
million during 2013, 2012 and 2011, and is included in general and administrative expense in the consolidated 
statements of operations.

(6) 

Intangible Assets

Intangible assets consisted of the following at December 31:

Product and license rights

Less: accumulated amortization

Total product and license rights

Patents

Less: accumulated amortization

Total patents

Trademarks

Less: accumulated amortization

Total trademarks

Total intangible assets

2013

2012

$

$

12,139,031
(1,096,238)
11,042,793

4,866,570
(410,544)
4,456,026

9,020
(9,020)
—

7,352,308
(520,385)
6,831,923

2,735,117
(90,242)
2,644,875

9,020
(9,020)
—

$

15,498,819

$

9,476,798

On  October  28,  2013,  the  Company  entered  into  an  agreement  with  Pernix Therapeutics  to  promote 
Omeclamox-Pak. Omeclamox-Pak is a branded prescription product that combines omeprazole, amoxicillin 
and clarithromycin for the treatment of Helicobacter pylori (H. pylori) infection and duodenal ulcer disease. 
It is the first FDA approved triple combination medication to contain omeprazole as the proton pump inhibitor 
and is prescribed over a shortened treatment period of ten days. Under the terms of the agreement, the Company 

F-17

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

will promote the product to gastroenterologists across the United States through its field sales force which 
also promotes its Kristalose brand. Pernix will promote the product through its specialty sales force focusing 
on select primary care physicians. The companies will cooperate in the marketing and other activities needed 
to support the commercialization of the brand. The Company paid an upfront payment of $4.0 million to Pernix 
Therapeutics on October 29, 2013.  There are also additional milestones at the first and second anniversary 
dates of the execution of the agreement totaling $4.0 million in the aggregate. Royalty payments ranging from 
15% to 20% based on tiered levels of gross profits will be paid by Cumberland to Pernix Therapeutics monthly.

The  $4.0  million  upfront  payment  the  Company  paid  to  Pernix Therapeutics  on  October  29,  2013  is 
included in product and license rights and will be amortized over the remaining expected useful life of the 
acquired asset, currently the life of the agreement, which ends in June 2032. 

In 2011, the Company acquired the Kristalose trademark and FDA registration from Mylan Inc.  The 
agreement  requires  the  Company  to  make  future  quarterly  payments  over  a  seven-year  period  equal  to  a 
percentage of Kristalose net sales. The payments are being treated as consideration for the assets acquired, 
and are being capitalized and amortized over the remaining expected useful life of the acquired asset, currently 
the  term  of  the  agreement,  15  years.  During  2013,  the  Company  paid  $0.8  million  to  Mylan  in  quarterly 
Kristalose payments. 

During 2013, the Company recorded an additional $2.1 million in intangible assets for capitalized patent 

costs, including amounts incurred in the protection of the Company's intellectual property.  

Amortization expense related to product and license rights, trademarks and patents was $0.9 million, $0.5 
million and $0.7 million in 2013, 2012 and 2011, and is expected to be approximately $1.2 million in each of 
the years 2014 through 2018.

(7) 

Other Current Liabilities

Other current liabilities consisted of the following at December 31:

Rebates, product returns, administrative fees 
and service fees

Employee wages and benefits

Accrued inventory purchases
Other

Total other current liabilities

2013

2012

$

2,437,140

$

1,110,726

1,236,000

726,051

3,371,863

1,473,983

—

418,960

$

5,509,917

$

5,264,806

(8) 

Debt

In July 2011, the outstanding term debt balance of $4.0 million was paid in full. The Company did not 
incur any prepayment penalties or other fees associated with the payoff. In connection with the repayment, 
approximately $0.1 million of unamortized deferred loan costs associated with the term debt was written off  
and these costs are included in interest expense in the consolidated statement of operations for the year ended 
December 31, 2011.

In August 2011, the Company entered into a Fifth Amended and Restated Loan Agreement with its primary 
lender (the "Agreement") to provide for an increase in the line of credit to $10 million. The credit facility may 
be increased up to $20 million upon the satisfaction of certain conditions. The interest rate is the BBA LIBOR 

F-18

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Daily  Floating  Rate  plus  an Applicable  Margin,  as  those  terms  are  defined  in  the Agreement  (2.17%  at 
December 31, 2013). In addition, a commitment fee of 0.25% per annum is charged on the unused line of 
credit. The credit facility was extended to expire on December 31, 2014, and the Company does not have any 
outstanding principal amounts on the credit facility. Interest and the unused line fee are payable quarterly.  
Borrowings under the line of credit are collateralized by substantially all of the Company’s assets.

Under the Agreement, the Company is subject to certain financial covenants including, but not limited 
to, maintaining a Leverage Ratio and Interest Coverage Ratio, as those terms are defined in the Agreement, 
that are determined on a quarterly basis. 

During March 2013, the Company and its primary lender amended certain provisions of the Agreement 
related to the repurchase of the Company's common stock. Previously, the Agreement allowed the Company 
to expend $10 million for share repurchases over the term of the Agreement.  The amendment allows the 
Company $10 million for share repurchases from March 1, 2013 through the remaining term of the Agreement. 

During March 2014, the Company and its primary lender amended certain provisions of the Agreement 
related to the aggregate ownership of the Company's common stock over 30% as well as amending certain 
covenants in which the Company was not in compliance with as a result of the net loss during 2013.  As a 
result of the amendment, the Company is in compliance with all covenants.

Furthermore, the lender may terminate the Agreement and require the Company to repay all outstanding 
amounts under certain conditions, as described in the Agreement, including, but not limited to: cross-default 
on any other credit agreement with an outstanding principal amount in excess of $500,000, material adverse 
change in our business condition, operations or properties, violation of any covenant or a change in control 
of the Company.

(9) 

Shareholders’ Equity

(a)  Initial Public Offering

On August 10, 2009, the Company completed its initial public offering of 5,000,000 shares of common 
stock at a price of $17.00 per share, raising gross proceeds of $85.0 million. After deducting underwriting 
discounts of approximately $6.0 million and offering costs incurred of approximately $4.2 million, the 
net proceeds to the Company were approximately $74.8 million. Contemporaneously with the offering, 
each outstanding share of preferred stock was automatically converted into two shares of common stock.

(b)  Preferred Stock

The Company is authorized to issue 20,000,000 shares of preferred stock. The Board of Directors is 
authorized  to  divide  these  shares  into  classes  or  series,  and  to  fix  and  determine  the  relative  rights, 
preferences,  qualifications  and  limitations  of  the  shares  of  any  class  or  series  so  established.  At 
December 31, 2013 and 2012, there was no preferred stock outstanding.

(c)  Common Stock

During 2013, 2012 and 2011, the Company issued 19,743 shares, 20,199 shares and 10,144 shares 
of common stock, respectively, valued at $56,000, $78,000 and $59,000, respectively, as compensation 
for services, which is included in general and administrative expenses in the consolidated statements of 
operations. 

In  the  second  quarter  of  2012,  the  Company  implemented  an  Option  Exchange  Program  (the 
"Exchange  Program")  whereby  certain  outstanding  stock  options  could  be  exchanged  for  shares  of 
restricted stock.  The Exchange Program expired on May 21, 2012, at which time 424,475 outstanding 
options were exchanged for 147,828 shares of restricted stock.  The restriction period on the restricted 

F-19

 
 
 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

stock lapses from one to four years after issuance.  The Exchange Program was designed to provide a 
value-for-value exchange of equity instruments.  The fair value of each exchanged option was determined 
on the date the Exchange Program commenced using the Black-Scholes option pricing model, and the 
following assumptions:

Dividend yield

Expected term (years)

Expected volatility

Risk-free interest rate

Range of Assumptions

—
1.3 - 7.3

37% - 78%

0.23% - 1.50%

The Exchange Program resulted in no incremental compensation expense during 2012.  The remaining 
unrecognized compensation costs for the exchanged options on the date of the exchange was approximately 
$0.3 million, and will be recognized over the restriction period.

The payment of dividends is restricted by the Agreement with the Company’s primary lender.

(d)  Warrants

In connection with the issuance of shares of common stock to a related party in 2004, the Company 
issued warrants to purchase 40,000 shares of common stock at $6.00 per share at any time within 10 years 
of issuance. All of these warrants were outstanding and exercisable as of December 31, 2013 and 2012.

In 2006, the Company signed a new line of credit agreement along with a term loan agreement with 
a financial institution. In conjunction with these agreements, the Company issued warrants to purchase 
up to 3,958 shares of common stock at $9.00 per share that expire in April 2016.  All of these warrants 
were outstanding and exercisable as of December 31, 2013 and 2012. 

In connection with the amendment to the debt agreements in 2009, the Company issued warrants to 
purchase up to 7,500 shares of common stock at $17.00 per share that expire in July 2019.  All of these 
warrants were outstanding and exercisable as of December 31, 2013 and 2012.

(e)  Share Repurchases

On May 13, 2010, the Company announced a share repurchase program to purchase up to $10 million 
of its common stock pursuant to Rule 10b-18 of the Securities Act. In January 2011, April 2012 and 
January 2013, the Company's Board of Directors replaced the prior authorizations with new $10 million 
authorizations for repurchases of the Company's outstanding common stock. The Company repurchased 
1,008,105 shares, 1,268,809 shares and 743,073 shares of common stock for approximately $4.8 million, 
$8.1 million and $4.2 million during the years ended December 31, 2013, 2012 and 2011, respectively. 

F-20

 
 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(10) 

Earnings Per Share

The following table shows the computation of the numerator and the denominator used to calculate diluted 

earnings per share for the years ended December 31:

Numerator:

Net (loss) income attributable to
common shareholders

Denominator:

Weighted-average shares outstanding
– basic

Dilutive effect of restricted stock and
stock options

Weighted-average shares outstanding
– diluted

2013

2012

2011

$

(2,104,614) $

5,842,492

$

5,657,856

18,332,997

19,564,625

20,342,913

—

222,912

229,219

18,332,997

19,787,537

20,572,132

The Company's anti-dilutive restricted shares and stock options outstanding were as follows for the years 

ended December 31:

Anti-dilutive shares

407,954

687,430

1,079,904

2013

2012

2011

F-21

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(11) 

Income Taxes

The components of the Company's net deferred tax assets at December 31 are as follows:

Deferred Tax Assets

Net operating loss and tax credits

Property and equipment and intangibles

Allowance for accounts receivable

Reserve for expired product

Inventory

Deferred charges

Cumulative compensation costs incurred on deductible
equity awards

Total deferred tax assets

Deferred Tax Liabilities

Intangible assets

Net deferred tax assets, before valuation allowance

Less: deferred tax asset valuation allowance

Net deferred tax assets

2013

2012

$

2,144,460

$

1,159,865

214,478

235,446

600,406

1,495,895

666,236

1,378,690

6,735,611

153,361

74,362

706,960

1,185,419

582,480

1,251,382

5,113,829

(2,683,587)
4,052,024
(131,617)
3,920,407

$

(2,665,022)
2,448,807
(108,318)
2,340,489

$

As a result of the Exchange Program, discussed in Note 9 Shareholder's Equity, the Company recognized 
a deferred tax asset in 2012 related to the expected tax benefit of previously recognized compensation expense 
for incentive stock options that were exchanged.  The deferred tax asset will be realized when the restrictions 
lapse on the restricted stock.

The following table summarizes the amount and year of expiration of the Company's federal and state 

net operating loss carryforwards as of December 31, 2013:

Years of expiration

Federal

State

2014

2015 - 2017

2018 - 2024

2029

2033

Total federal and state net operating loss
carryforwards

$

$

$

— $

2,249,078

—

—

43,398,774

1,975,521

45,374,295

$

$

504,822

51,629,844

—

2,032,527

56,416,271

The Company has total recognized carryforward tax assets of $0.3 million for charitable contribution 
carryforwards, foreign tax credits  and AMT carryforwards.   In addition, the Company has recognized as of 
December 31, 2013 federal Orphan Drug and Research and Development tax credits of $1.0 million that expire 
between 2021 and 2033.

F-22

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

The Company has unrecognized federal net operating loss carryforwards as a result of the exercise of 
nonqualified options of approximately $43.4 million. These benefits occurred as a result of the actual tax 
benefit realized upon an employee's exercise exceeding the cumulative book compensation charge associated 
with the awards and will be recognized in the year in which they are able to reduce current income taxes 
payable.  Accordingly, deferred tax assets are not recognized for these net operating loss carryforwards or 
credit carryforwards resulting from the exercise of nonqualified options.  The usage of these net operating 
losses carryforwards resulted in the Company paying minimal income taxes in 2009 through 2012, and the 
Company expects to pay minimal income taxes in 2014.  The Company has $56.4 million of state net operating 
loss carryforwards.  This amount includes $51.8 million from the exercise of nonqualified options during 
2009.  The state net operating loss carryforwards above include approximately $2.8 million that is subject to 
a full valuation allowance at December 31, 2013.

Income tax (expense) benefit includes the following components for the years ended December 31:

2013

2012

2011

Current:

Federal

State and other

Total current income tax expense

$

(45,287) $

(11,580)

(56,867)

(3,185,743) $
(820,669)
(4,006,412)

(1,992,804)
(422,290)
(2,415,094)

Deferred:

Federal

State

Total deferred income tax benefit
(expense)

1,426,701

153,217

1,579,918

Total income tax expense

$

1,523,051

$

677,190

84,446

(1,543,261)
(121,849)

761,636
(3,244,776) $

(1,665,110)
(4,080,204)

The Company's deferred tax benefit in 2012 was primarily a result of the income tax benefit arising from 
the Exchange Program.  The Company’s deferred tax expense in 2011 was primarily due to the write-off for 
tax purposes of the Kristalose license rights but maintained as a component of products rights for book purposes, 
and due to inventory write-downs. 

Deferred income tax is comprised of the following components for the years ended December 31:

F-23

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

2013

2012

2011

Deferred tax (expense) benefit,
excluding items below

Inventory write-downs

Creation of operating loss carryforwards

Creation (utilization) of tax credit
carryforwards

Change in valuation allowance due to
changes in net deferred tax asset
balances

Deductible equity awards

Allowance for accounts receivable

Intangible assets

Deferred income tax benefit
(expense)

$

37,940

$

310,477

788,342

(39,870) $
179,755

25,552

196,631

108,699

439,744

817,840

11,348

56,395

(23,299)

127,308

161,084

(18,565)

(15,291)
667,171

—
(164,380)

(13,597)
(330,329)
—
(2,646,511)

$

1,579,918

$

761,636

$

(1,665,110)

The valuation allowance at December 31, 2013 and 2012 is primarily related to state tax benefits at CET 

that will likely not be realized.

The Company’s effective income tax rate for 2013, 2012 and 2011 reconciles with the federal statutory 

tax rate as follows: 

Federal tax expense at statutory rate

State income tax expense (net of federal
income tax benefit)

Permanent differences associated with
general business credits

Permanent differences associated with
stock options

Other permanent differences
Other

Net income tax expense

2013

2012

2011

34 %

4 %

5 %

— %

— %

(1)%

42 %

34 %

4 %

— %

(5)%

3 %

— %

36 %

35 %

4 %

(1)%

2 %

2 %

— %

42 %

The Company’s 2009 federal tax return was selected for examination during 2012, and this examination 
was completed during the year with no significant findings or adjustments.  Federal tax years that remain open 
to examination are 2010 through 2013. Due to a 2009 net operating loss carryback, federal tax years 2006 
through 2008 remain open to the extent of net operating losses utilized in those years. State tax years that 
remain open to examination are 2008 to 2013.  The Company has no unrecognized tax benefits in 2013, 2012 
or 2011.

Excluding the alternative minimum tax (AMT) tax credits, the Company will need to generate future 
taxable income of approximately $11.3 million in order to fully realize the deferred tax assets. Taxable income 
(loss), excluding tax deductions generated by the exercise of nonqualified options, for 2013, 2012 and 2011 
was a loss of approximately $(2.0) million,  income of $9.4 million and income of $5.7 million, respectively. 
Based upon the level of taxable income over the last three years and projections for future taxable income 

F-24

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

over the periods in which the deferred tax assets are deductible, management believes it is more likely than 
not that the Company will realize the benefits of these deductible differences, net of the existing valuation 
allowances at December 31, 2013. The amount of the deferred tax assets considered realizable, however, could 
be reduced in the near term if estimates of future taxable income during the carryforward period are reduced.

(12) 

Stock-Based Compensation Plans

The Company has grants outstanding under three equity compensation plans, with two available for future 
grants of equity compensation awards to employees, consultants and directors. All of the equity plans were 
approved by shareholders. The 2007 Long-Term Incentive Compensation Plan (the 2007 Plan) and the 2007 
Directors’ Incentive Plan (the "Directors’ Plan") superseded the 1999 Stock Option Plan. The 2007 Plan and 
the Directors’ Plan provide for the issuance of stock options, stock appreciation rights and restricted stock. 
Vesting is determined on a grant-by-grant basis in accordance with the terms of the plans and the related grant 
agreements. The Company has reserved 2.4 million shares of common stock for issuance under the 2007 Plan 
and 250,000 shares for issuance under the Directors’ Plan.

The exercise price of stock options is generally 100% of the fair market value of the underlying common 
stock on the grant date. The exercise price of incentive stock options granted to a shareholder who owns more 
than 10% of the total combined voting power of all classes of stock must be at least 110% of the fair market 
value of the underlying common stock on the grant date. The maximum contractual term of stock options is 
ten years from the date of grant, except for incentive stock options granted to 10% shareholders, which are 
five years.

During 2011, the Company began issuing shares of restricted stock with no exercise price to employees 
and directors. Restricted stock issued to employees generally cliff-vests on the fourth anniversary of the date 
of grant. Restricted stock issued to directors vests on the one year anniversary of the date of grant.

Stock compensation expense is presented as a component of general and administrative expense in the 
consolidated  statements  of  operations.  Stock  compensation  expense  recorded  as  a  component  of  equity 
consisted of the following for the years ended December 31:

2013

2012

2011

Share-based compensation - employees

Share-based compensation -
nonemployees

Total share-based compensation

$

$

614,818

$

555,898

$

627,353

56,116

76,920

670,934

$

632,818

$

128,158

755,511

At December 31, 2013, there was approximately $1.5 million of unrecognized compensation cost related 
to share-based payments, which is expected to be recognized over a weighted-average period of 2.6 years. 
This amount relates primarily to unrecognized compensation cost for employees.

F-25

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Stock Options

Stock option activity for 2013 and 2012 was as follows:

Weighted-
average
exercise
price per
share

Weighted-
average
remaining
contractual
term (years)

Aggregate
intrinsic
value

Number of
shares

Outstanding, December 31, 2011

1,276,158

$

Options granted

Options exercised

Options forfeited or expired
Outstanding, December 31, 2012

Options granted

Options exercised

Options forfeited or expired

Outstanding, December 31, 2013

—

(173,688)

(435,599)
666,871

—

(171,100)

(139,275)

356,496

Exercisable at December 31, 2013

356,496

$

7.75

—

3.55

12.22
5.93

—

3.50

6.25

6.96

6.96

2.9

$

700,294

1.4

132,348

1.0

1.0

$

$

360

360

Information related to the stock option plans during 2013, 2012 and 2011 was as follows:

2013

2012

2011

Intrinsic value of options exercised

Weighted-average fair value of 
options exercised

$

$

212,444

0.12

$

$

495,480

1.00

$

$

1,742,103

2.06

F-26

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

The Company did not grant any stock options during 2013, 2012 or 2011.  

Restricted Stock Awards

As previously noted, the Company began issuing restricted stock to employees and directors in 2011 
under  the  provisions  of  the  2007  Plan  and  the  Directors’  Plan.  Restricted  stock  activity  was  as  follows:

Nonvested, December 31, 2011

Shares granted
Shares vested
Shares forfeited

Nonvested, December 31, 2012

Shares granted
Shares vested
Shares forfeited

Nonvested, December 31, 2013

Number
of shares

Weighted-
average
grant-date
fair value

$

136,170
286,453
(7,000)
(32,093)
383,530
195,925
(17,193)
(41,678)
520,584

5.41
4.87
5.28
5.68
4.99
4.78
3.58
3.97
5.05

The fair value of restricted stock granted was based on the closing market price of the Company’s common 

stock on the date of grant.

(13) 

Employee Benefit Plans

The Company sponsors an employee benefit plan that was established on January 1, 2006, the Cumberland 
Pharmaceuticals  401(k)  Plan  (the Plan),  under  Section 401(k)  of  the  Internal  Revenue  Code  of  1986,  as 
amended, for the benefit of all employees over the age of 21, having been employed by the Company for at 
least six months. The Plan provides that participants may contribute up to the maximum amount of their 
compensation as set forth by the Internal Revenue Service each year. Employee contributions are invested in 
various investment funds based upon elections made by the employees. During 2013, 2012 and 2011, the 
Company contributed approximately $50,000 in each year to the Plan as an employer match of participant 
contributions.

In 2012 and 2013, the Company established non-qualified unfunded deferred compensation plans that 
allow participants to defer receipt of a portion of their compensation. The liability under the plans was $0.3 
million as of December 31, 2013.  The Company had assets of $1.3 million, consisting of company-owned 
life  insurance  contracts  as  of  December  31,  2012,  generally  designated  to  pay  benefits  of  the  deferred 
compensation plans.

F-27

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(14) 

Leases

The Company is obligated under long-term real estate leases for corporate office space expiring in October 
2016. In addition, the research lab space at CET, under an agreement amended in July 2012, is leased through 
2018, with an option to extend the lease through April 2028. The Company also subleases a portion of the 
space under these leases. Rent expense is recognized over the expected term of the lease, including renewal 
option periods, if applicable, on a straight-line basis. Rent expense for 2013, 2012 and 2011 was approximately 
$0.9 million, $0.9 million and $0.8 million, respectively, and sublease income was approximately $0.5 million, 
$0.5 million and $0.4 million. Cumulative future minimum sublease income under noncancelable operating 
subleases totals approximately $0.5 million and will be paid through the lease ending in October 2016. Future 
minimum lease payments under noncancelable operating leases (with initial or remaining lease terms in excess 
of one year) are as follows:

Year ending December 31:

2014
2015
2016
2017
2018 and thereafter

Total future minimum lease payments

$

$

1,022,019
1,052,662
941,247
232,964
78,852
3,327,744

(15) 

Fair Value of Financial Instruments

In  2012,  the  Company  began  purchasing  marketable  securities  that  are  solely  classified  as  trading 
securities.  There were no transfers of assets between levels within the fair value hierarchy. The following 
table summarizes the fair value of these marketable securities, by level within the fair value hierarchy:

U.S. Treasury notes and
bonds

U.S. Agency issued
mortgage-backed securities -
variable rate

U.S. Agency notes and bonds
- fixed rate

December 31, 2013

December 31, 2012

Level 1

Level 2

Total

Level 1

Level 2

Total

$2,829,809

$

— $ 2,829,809

$2,473,596

$

— $ 2,473,596

— 3,049,754

3,049,754

— 3,708,920

3,708,920

— 1,496,700

1,496,700

— 1,505,177

1,505,177

SBA loan pools - variable rate

— 1,748,498

1,748,498

— 1,988,443

1,988,443

Municipal bonds - VRDN

4,895,000

— 4,895,000

7,010,000

— 7,010,000

Total fair value of
marketable securities

$7,724,809

$6,294,952

$14,019,761

$9,483,596

$7,202,540

$16,686,136

The  fair  values  of  all  other  financial  instruments  outstanding  as  of  December  31,  2013  and  2012 

approximate their carrying values.

F-28

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(16)  Market Concentrations

The Company currently focuses on acquiring, developing, and commercializing branded prescription 
products  for  the acute  care and  gastroenterology markets. The  Company’s  principal financial instruments 
subject  to  potential  concentration  of  credit  risk  are  accounts  receivable,  which  are  unsecured,  and  cash 
equivalents. The Company’s cash equivalents consist primarily of money market funds. Certain bank deposits 
may at times be in excess of the Federal Deposit Insurance Corporation insurance limits.

The Company’s primary customers are wholesale pharmaceutical distributors in the U.S.  Total gross 
revenues  by  customer  for  each  customer  representing  10%  or  more  of  consolidated  gross  revenues  are 
summarized below for the years ended December 31:

Customer 1
Customer 2
Customer 3
Customer 4

2013

19%
23%
23%
24%

2012

35%
30%
28%
1%

2011

36%
28%
31%
—%

The Company’s accounts receivable, net of allowances, due from these four customers at December 31, 

2013 and 2012 was 85.3% and 81%, respectively.

(17)  Manufacturing and Supply Agreements

The Company utilizes one primary supplier to manufacture each of its products and product candidates. 
Although there are a limited number of manufacturers of pharmaceutical products, the Company believes it 
could  utilize  other  suppliers  to  manufacture  its  prescription  products  on  comparable  terms.   A  change  in 
suppliers, problems with its third-party manufacturing operations or related production capacity, or contract 
disputes with suppliers could cause a delay in manufacturing or shipment of finished goods and possible loss 
of sales, which could adversely affect operating results.

(18) 

Employment Agreements

The Company has entered into employment agreements with all its full-time employees. Each employment 
agreement provides for a salary for services performed, a potential annual bonus and, if applicable, a grant of 
restricted common shares pursuant to a restricted stock agreement.

(19) 

Commitments and Contingencies

Commitments

In connection with the acquisition of certain Kristalose assets during 2011, the Company is required to 
make quarterly payments based on a percentage of Kristalose net sales through November 2018. The payments 
are being treated as consideration for the assets acquired, and are being capitalized and amortized over the 
remaining expected useful life of the acquired asset, currently the term of the agreement, 15 years. 

In connection with its licensing agreements for Caldolor, the Company is required to pay royalties based 
on Caldolor net sales over the life of the contracts. Royalty expense is recognized as a component of selling 
and marketing expense in the period that revenue is recognized. 

F-29

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

As discussed in Note 6, in connection with the agreement with Pernix to promote Omeclamox-Pak, the 
Company will make monthly royalty payments based on tiered levels of gross profits.  These costs will be 
period expenses of the Company.  There are also additional milestones at the first and second anniversary 
dates of the execution of the agreement totaling $4.0 million in the aggregate that the Company will capitalize 
and amortize over the remaining expected useful life of the acquired asset, currently the life of the agreement, 
which ends in June 2032. 

Legal Matters

In April 2012, the United States Patent and Trademark Office (the “USPTO”) issued U.S. Patent number 
8,148,356 (the “356 Acetadote Patent”) to the Company. The claims of the 356 Acetadote Patent encompasses 
the Acetadote formulation and includes composition of matter claims. Following its issuance, the 356 Acetadote 
Patent was listed in the FDA Orange Book. The 356 Acetadote Patent is scheduled to expire in May 2026, 
which time period includes a 270-day patent term adjustment granted by the USPTO.

Following  the  issuance  of  the  356 Acetadote  Patent,  the  Company  received  separate  Paragraph  IV 
certification notices from InnoPharma, Inc. ("InnoPharma"), Paddock Laboratories, LLC (“Paddock”), Mylan 
Institutional LLC (“Mylan”), Sagent Agila LLC ("Sagent") and Perrigo Company ("Perrigo") challenging the 
356 Acetadote Patent on the basis of non-infringement and/or invalidity. The Company responded by filing 
five separate infringement lawsuits, in the appropriate United States District Courts, to contest each of the 
challenges. 

On November 12, 2012, the Company entered into a Settlement Agreement (the “Settlement Agreement”) 
with Paddock and Perrigo to resolve the challenges and the pending litigation with those two companies.  On 
November 1, 2013, the United States District Court filed opinions granting Sagent’s and InnoPharma’s motions 
to dismiss the Company's suits. In November the Company agreed not to file an appeal or motion to reconsider 
and thereby resolving the challenges and the pending litigation with those two companies. The remaining 
infringement suit with Mylan is pending.

The Company continues to consider its legal options and intends to continue to vigorously defend and 

protect its Acetadote product and related intellectual property rights.

The Company is a party to various other legal proceedings in the ordinary course of its business. In the 
opinion  of  management,  the  liability  associated  with  these  matters,  other  than  the  issue  concerning  the 
Company's Acetadote  patents  discussed  above,  will  not  have  a  material  adverse  effect  on  the  Company's 
consolidated financial position, results of operations or cash flows.  

F-30

(20) 

Quarterly Financial Information (Unaudited)

The following table sets forth the unaudited operating results for each fiscal quarter of 2013 and 2012:

2013:

Net revenues

Operating income (loss)

Net income (loss)
attributable to common
shareholders

Earnings (loss) per share 
attributable to common 
shareholders (1)

Basic

Diluted

2012:

Net revenues

Operating income

Net income attributable
to common shareholders

Earnings per share 
attributable to common 
shareholders (1)

Basic

Diluted

First
Quarter

Second
Quarter

Third
Quarter

Fourth
Quarter

Total

$ 10,258,132

$ 7,081,088

$ 6,528,575

$ 8,159,667

$ 32,027,462

1,326,051

(1,140,544)

(1,514,768)

(2,472,077)

(3,801,338)

854,709

(639,018)

(819,942)

(1,500,363)

(2,104,614)

$

$

0.05

0.05

$

$

(0.03) $

(0.03) $

(0.04) $

(0.04) $

(0.08) $

(0.08) $

(0.11)

(0.11)

$ 10,256,212

$ 12,366,940

$ 12,531,719

$ 13,696,366

$ 48,851,237

646,015

1,939,931

2,979,163

3,252,993

8,818,102

423,208

1,744,290

1,869,494

1,805,500

5,842,492

$

$

0.02

0.02

$

$

0.09

0.09

$

$

0.10

0.10

$

$

0.09

0.09

$

$

0.30

0.30

(1)  Due to the nature of interim earnings per share calculations, the sum of the quarterly earnings per share amounts 

may not equal the reported earnings per share for the full year.

21) 

Subsequent event

On February 28, 2014, the Company entered into an agreement with Astellas Pharma US, Inc. ("Astellas") 
to acquire certain product rights, intellectual property and related assets of Vaprisol®. Vaprisol is a patented, 
prescription  brand  indicated  to  raise  serum  sodium  levels  in  hospitalized  patients  with  euvolemic  and 
hypervolemic hyponatremia. The product was developed and registered by Astellas and launched in 2006. It 
is one of two branded prescription products indicated for the treatment of hyponatremia.  The Company paid 
an upfront payment of $2.0 million to Astellas at closing. There is an additional milestone at the first anniversary 
date of the execution of the agreement of $2.0 million, dependent upon first year sales of Vaprisol achieving 
certain levels. 

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Valuation and Qualifying Accounts

Years ended December 31, 2013, 2012 and 2011

Schedule II

Description

Balance at
beginning of
period

Charged to
costs and
expenses

Charged to
other
accounts

Deductions

Balance at
end of period

Allowance for uncollectible
amounts, cash discounts,
chargebacks, and credits issued
for damaged products:

For the years ended 
December 31:

2011

2012

2013

$

163,748

$ 2,151,890

$

235,580

188,587

2,069,470

2,498,170

— $ (2,080,058) (1) $
—

(2,116,463) (1)
(2,093,641) (1)

—

235,580

188,587

593,116

Valuation allowance for
deferred tax assets:

For the years ended 
December 31:

2011

2012

2013

$

80,862

$

13,597

$

— $

94,459

108,318

13,859

23,299

—

—

—

—

—

$

94,459

108,318

131,617

(1)   Composed of actual returns and credits for chargebacks and cash discounts.

F-33

Exhibit 23.1

Consent of Independent Registered Public Accounting Firm 

The Board of Directors
Cumberland Pharmaceuticals Inc.: 

We  consent  to  the  incorporation  by  reference  in  the  registration  statement  No. 333-164376  on  Form  S-8  and  No. 
333-184091 on Form S-3 of Cumberland Pharmaceuticals Inc. of our reports dated March 11, 2014, with respect to 
the consolidated balance sheets of Cumberland Pharmaceuticals Inc. and subsidiaries as of December 31, 2013 and 
2012, and the related consolidated statements of operations and comprehensive (loss) income, equity, and cash flows 
for each of the years in the three-year period ended December 31, 2013, the related financial statement schedule, and 
the effectiveness of internal control over financial reporting as of December 31, 2013, which reports appear in the 
December 31, 2013 annual report on Form 10-K of Cumberland Pharmaceuticals Inc. 

/s/ KPMG LLP

Nashville, Tennessee
March 11, 2014 

CERTIFICATION OF CHIEF EXECUTIVE OFFICER
PURSUANT TO SECTION 302 OF
THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.1

I, A.J. Kazimi, certify that:

1.

2.

3.

4.

I have reviewed this Form 10-K of Cumberland Pharmaceuticals Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state 
a  material  fact  necessary  to  make  the  statements  made,  in  light  of  the  circumstances  under  which  such 
statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly 
present in all material respects the financial condition, results of operations and cash flows of the registrant 
as of, and for, the periods presented in this report;

The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls 
and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial 
reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be 
designed  under  our  supervision,  to  ensure  that  material  information  relating  to  the  registrant,  including  its 
consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in 
which this report is being prepared;

(b)  Designed such internal control over financial reporting, or caused such internal control over financial reporting 
to be designed under our supervision, 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;

(c)  Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report 
our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period 
covered by this report based on such evaluation; and

(d)  Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred 
during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual 
report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control 
over financial reporting; and

5.

The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal 
control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board 
of directors (or persons performing the equivalent functions):

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial 
reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize 
and report financial information; and

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role 

in the registrant’s internal control over financial reporting.

March 11, 2014

By:

/s/ A.J. Kazimi

  A.J. Kazimi
  Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATION OF CHIEF FINANCIAL OFFICER
PURSUANT TO SECTION 302 OF
THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.2

I, Rick S. Greene, certify that:

1.

2.

3.

4.

I have reviewed this Form 10-K of Cumberland Pharmaceuticals Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state 
a  material  fact  necessary  to  make  the  statements  made,  in  light  of  the  circumstances  under  which  such 
statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly 
present in all material respects the financial condition, results of operations and cash flows of the registrant 
as of, and for, the periods presented in this report;

The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls 
and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial 
reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be 
designed  under  our  supervision,  to  ensure  that  material  information  relating  to  the  registrant,  including  its 
consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in 
which this report is being prepared;

(b)  Designed such internal control over financial reporting, or caused such internal control over financial reporting 
to be designed under our supervision, 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;

(c)  Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report 
our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period 
covered by this report based on such evaluation; and

(d)  Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred 
during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual 
report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control 
over financial reporting; and

5.

The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal 
control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board 
of directors (or persons performing the equivalent functions):

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial 
reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize 
and report financial information; and

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role 

in the registrant’s internal control over financial reporting.

March 11, 2014

By:

/s/ Rick S. Greene

  Rick S. Greene
  Vice President and Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
Corporate Information

Stock Listing
NASDAQ Global Select
Market Ticker Symbol: CPIX

Annual Meeting
10:00 a.m. Central Time
Tuesday, April 15, 2014
Cumberland Headquarters
2525 West End, Suite 950
Nashville, Tennessee 37203

Independent Registered
Public Accounting Firm
KPMG LLP
401 Commerce Street, Suite 1000
Nashville, Tennessee 37219
(615) 244-1602

Transfer Agent and Registrar
Continental Stock Transfer 
& Trust Company
17 Battery Place
New York, New York 10004
(800) 509-5586
(212) 509-4000
cstmail@continentalstock.com

Company Headquarters
Cumberland Pharmaceuticals Inc.
2525 West End Avenue, Suite 950
Nashville, Tennessee 37203
Phone: (615) 255-0068
Toll Free: (877) 484-2700
Fax: (615) 255-0094

Forward-Looking Statement
This annual report includes 
forward-looking statements 
regarding expected future results 
of the company. A variety of factors 
could cause actual results to differ 
materially from expected results.
Please see the risk factors more 
fully described in our Annual Report 
on Form 10-K for the year ended 
December 31, 2013, which is 
filed with the U.S. Securities and 
Exchange Commission

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A n n u a l   R e p o r t

2525 West End Avenue, Suite 950
Nashville, Tennessee 37203
P 
(615) 255-0068
TF  (877) 484-2700
F 
(615) 255-0094
www.cumberlandpharma.com

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