Quarterlytics / Healthcare / Drug Manufacturers - Specialty & Generic / Cumberland Pharmaceuticals Inc. / FY2015 Annual Report

Cumberland Pharmaceuticals Inc.
Annual Report 2015

CPIX · NASDAQ Healthcare
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Ticker CPIX
Exchange NASDAQ
Sector Healthcare
Industry Drug Manufacturers - Specialty & Generic
Employees 91
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FY2015 Annual Report · Cumberland Pharmaceuticals Inc.
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5

Laying the foundation for

future

growth

2 0 1 5   A n n u a l   R e p o r t

growth 
 
 
 
 
 
 
 
 
 
 
Company Overview & Strategy

Cumberland Pharmaceuticals was founded with a clear mission: to improve patient 
care by providing effective medicines that offer clear advantages over existing 
treatments. Our commitment to innovation and improvement is paying off, as we 
have cultivated a strong industry reputation for elevating the quality of care for 
patients. With five FDA approved brands, we now have the most diversified revenue 
stream in our Company’s history.

With a focus on underserved niche 
markets, we maintain two national 
sales forces that concentrate on 
physician prescribers in the hospital 
acute care and gastroenterology 
medical specialties.  Through our 
marketing and sales campaigns we 
seek to maximize the potential of our 
current five prescription brands:

•  Acetadote® the intravenous 

treatment for acetaminophen 
poisoning, the leading cause of 
poisoning in the U.S.; 

•  Caldolor® the first injectable 

product approved in this country 
for the treatment of both pain and 
fever; 

•  Kristalose® a prescription laxative 
for the treatment of acute and 
chronic constipation;

•  Omeclamox®-Pak, a combination 
treatment for Helicobacter pylori 
infection and duodenal ulcer 
disease. 

•  Vaprisol®, the only injectable 

brand available to treat 
hyponatremia, the most common 
electrolyte imbalance in U.S. 
hospitalized patients.

Our clinical development team 
is working diligently to expand 
our pipeline and advance our 
innovative new product candidates. 
This year, we added a new Phase 
II development program with 
Boxaban®, an oral formulation of 
ifetroban. We are evaluating this 
candidate for the treatment of 
aspirin-exacerbated respiratory 
disease. We also continue to develop 
Hepatoren® an injectable form of 
ifetroban for patients suffering 
from hepatorenal syndrome. Each 
of these candidates is designed 
to treat conditions for which there 
is currently no FDA - approved 
pharmaceutical treatment.  We are 
encouraged by the favorable top 
line results from the initial Phase II 
studies completed in 2015 for both 
new drugs.

During the past year, we also 
made headway in increasing our 
international impact. Through 
agreements with select partners 
who are working to make our 
brands available to patients in their 
countries, we are expanding our 
worldwide presence and improving 
patient outcomes across the globe. 

We continue our strategy to build a 
diversified specialty product portfolio 
and deliver long-term value to our 
shareholders, as we remain focused 
on our mission of advancing patient 
care through the delivery of high 
quality pharmaceutical products. 

“We are building a 
foundation for long-term, 
sustainable growth while 
continuing our charge to 
make a difference in the 
lives of patients.”

Corporate Update

To Our Shareholders, Employees & Partners:

Cumberland delivered a series of positive developments in 2015 that helped lay the foundation 
for a strong start to 2016 while also bolstering our long-term growth.  

We ended the year with revenues of $33.5 million and adjusted earnings of $4.5 million or 
$0.26 per share. We also maintained a strong financial position with nearly $92 million in total 
assets, including $53 million in cash and reserves.

In 2015, we made significant progress with Caldolor®. We expanded the product’s labeling 
by gaining FDA approval for its use in pediatric patients (six months and older).   We also 
announced the publication of an integrated safety analysis which adds to the growing body 
of literature supporting Caldolor’s outstanding safety profile. Through our new co-promotion 
agreement with Piramal Critical Care, both our Caldolor and Vaprisol® brands will now be 
featured in many more hospitals throughout the U.S.  Additionally, we have seen an increasing 
international contribution to our Caldolor revenue, buoyed by the growth in shipments to 
South Korea and the product’s launch in Australia. 

We completed our initial Hepatoren® and Boxaban® clinical trials in 2015 and announced 
favorable top-line results from each of those studies. Fortunately, our Acetadote® patent 
position was strengthened through a favorable court ruling upholding the validity of our patent 
- which encompasses our new EDTA-free Acetadote formulation - through August 2025.

During the year, we entered into an alliance with Clinigen Group plc to bring select Clinigen 
products into the U.S. and expand our portfolio of branded hospital products. We also entered 
into a new agreement with Gastroentero-Logic, LLC to assume the remaining rights and 
responsibilities for the commercialization of Omeclamox®-Pak in the U.S. 

These key accomplishments in 2015 laid important groundwork for a successful 2016, and  
I am confident that our best days are ahead of us. I would like to acknowledge and thank my 
colleagues at Cumberland for their continued dedication. 

Our strategy is to grow the sales of our marketed products and pursue opportunities to further 
expand our portfolio. Supported by a strong financial position and an outstanding Cumberland 
team, we are in a position to do just that. Together, we remain focused on our mission of 
advancing patient care through the delivery of high-quality pharmaceutical products. 

With best wishes,

A.J. Kazimi
Chairman and 
Chief Executive Officer

1

2015 
Milestones

Favorable Caldolor® Phase IV  
studies published

Two Phase IV studies published in the journal Clinical 
Therapeutics supporting the tolerability and efficacy of 
a shortened infusion time of Caldolor and adding to the 
growing body of literature for the drug.  

Pipeline expanded with new Boxaban® 
Clinical Program 

Cumberland initiates the clinical development of 
Boxaban (ifetroban) oral capsule for the treatment of 
aspirin-exacerbated respiratory disease (AERD).

Strategic Alliance formed  
with Clinigen Group plc

Cumberland announces a marketing and distribution 
agreement with Clinigen, providing Cumberland access 
to Clinigen product’s for the U.S. and expanding its 
global footprint.

Co-promotion Agreement signed with 
Piramal Critical Care

Piramal increases Cumberland’s reach for Caldolor 
and Vaprisol by providing coverage to an additional 
group of hospitals where Piramal’s critical care sales 
force has existing relationships.

License Agreement signed with 
Gastroentero-Logic, LLC

Cumberland acquires remaining commercial rights 
to Omeclamox-Pak and adds responsibility for the 
product’s national accounts and supply chain activities.

Favorable Acetadote® patent ruling

An Illinois court upheld the validity of the patent that 
encompasses Cumberland’s EDTA-Free formulation 
of Acetadote and granted a permanent injunction 
preventing challengers from marketing a generic 
version of Acetadote until 2025.

Caldolor® launched in Australia

Caldolor launched by CSL’s Seqirus in Australia as the 
newest treatment for pain and reduction of fever in 
adults in that country.

FDA approves Caldolor® for  
pediatric patients

Caldolor receives FDA approval for the management of 
pain and reduction of fever use in pediatric patients six 
months and older.

2

CPIX at a Glance

Selected Financial Data

(dollars in thousands except per share data) 

2011 

2012 

2013 

2014 

2015

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

 $  51,143  
9,849  

$  48,851  
 8,818  

$  32,027  
   (3,801)  

$  36,902  
3,559  

$  33,519
1,112

19.3 % 

18.1 % 

(11.9) % 

9.6 % 

   5,628  
0.28  
   95,518  
 5,438  
   82,835  

5,806  
0.30  
  98,594  
4,972  
  85,566  

  (2,152)  
 (0.11)  
   87,614  
 776  
   79,292  

2,362  
0.14  
  95,405  
903  
  80,753  

3.3 %
671
0.04
  91,919
2,687
  76,820

Supplemental Financial Measures (1)

Adjusted Earnings (Loss) 
Adjusted Margin 
Adjusted Diluted Earnings 
     (Loss) per Share 

$  11,669  

$  10,356  

$  (1,825)  

$ 

6,310  

$  4,477

22.8 % 

21.2 % 

(5.7) % 

17.1 % 

13.4 %

$ 

0.57  

$ 

0.52  

$ 

(0.10)  

$ 

0.35  

$ 

0.26

Reconciliation of Net Income (Loss) Attributable to Common Shareholders to  
Adjusted Earnings and Adjusted Diluted Earnings Per Share (1)
(Unaudited)

(dollars in thousands except per share data) 

2011 

2012 

2013 

2014 

2015

Net Income (Loss) Attributable to 
     Common Shareholders 
Less: Net Loss at Subsidiary Attributable 
     to Noncontrolling Interests 
Net Income (Loss) 
Adjustments to Net Income (Loss) 
Income Tax Expense (Benefit) 
Depreciation and Amortization Expense 
Share-Based Compensation Expense 
Other Adjustments to Net Income (1) 
Interest Income 
Interest Expense 
Adjusted Earnings  

 $  5,658  

 $  5,842  

 $  (2,105)  

 $  2,424  

$ 

731

30  
5,628  

36  
5,806  

47  
  (2,152)  

62  
2,362  

60
671

4,080  
1,040  
779  
–  
(211)  
353  
 $  11,669  

3,245  
902  
636  
–  
(305)  
72  
$  10,356  

  (1,523)  
1,302  
675  
–  
(230)  
103  
 $  (1,825)  

1,381  
1,990  
761  
–  
(251)  
67  
 $  6,310  

576
2,247
623
495
(209)
74
$  4,477  

Adjusted Diluted Earnings per Share 
Diluted Weighted-Average Common 
     Shares Outstanding: 

 $ 

0.57  

$ 

0.52  

$ 

(0.10)  

 $ 

0.35  

$ 

0.26  

  20,572  

  19,788  

  18,333  

  17,900  

  17,095

(1) The supplemental financial measures are Non-GAAP as defined, the reconciliation of these supplemental measures is above.  

3

 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
      
      
 
 
  
 
  
 
  
  
                 
innovation5FDA Approved 
2Products in 

Products

Phase Two 
Development

Beth Zaborny 

Senior Manager, Regulato ry A ffa irs

“Our team was responsible for the 
development and FDA approval of our 
Acetadote and Caldolor brands. We are 
now focused on developing a growing 
number of new product candidates.”

4

We now have the most diversified product 
portfolio in our Company’s history.

 Acetadote®
Acetadote® (acetylcysteine) Injection is the first FDA approved intravenous 
treatment for acetaminophen overdose in the United States.  

Developed and launched by Cumberland, 
Acetadote not only signaled our entry 
into the marketplace but also began 
our reputation as an industry innovator. 
Acetaminophen overdose continues to 
be the leading cause of poisoning in the 
country, and too much acetaminophen can 
result in liver damage and – if untreated - 
even death. Since earning FDA approval, 
Acetadote has become a standard of care for 
acetaminophen overdose in the emergency 
department and intensive care units across 
the United States.

Acetadote’s product label was subsequently 
expanded with the FDA approval of a 
pediatric indication and additional safety 
data. We then developed and introduced 
a new, next generation formulation of 

Acetadote, free of all chelating, stabilizing, 
and preserving chemicals. An updated 
product indication with new dosing 
guidelines represented the most recent 
labeling updates for this product. 

With the advent of generic competition in 
the marketplace, we responded with the 
introduction of an Acetadote Authorized 
Generic. In 2015, a favorable court decision 
was upheld regarding a key Acetadote 
patent - declaring it valid and enforceable 
until August 2025.   We have maintained a 
significant market share between sales of 
our Acetadote brand and Authorized Generic, 
and this product line remains an important 
contributor to our business.

Caldolor®
Caldolor® (ibuprofen) Injection is the first FDA-approved intravenous 
treatment of both pain and fever.    

We designed Caldolor for patients who are 
unable to receive oral therapies for pain 
relief or fever reduction. Clinical trials 
have shown the drug to be effective in 
managing pain while decreasing the need 
for narcotics. Because of Caldolor’s added 
anti-inflammatory effect, best results are 
often seen when the product is administered 
prior to surgical procedures. 

Cumberland registered and launched 
Caldolor, and by the end of 2015 it was 
stocked in 1,300 U.S. medical facilities. We 

have focused our efforts toward expanding 
use and helping more patients in key 
hospitals that have already approved and 
stocked the product. As a result, Caldolor 
remains our fastest growing product.  
We believe it will become an increasingly 
important component of our revenue 
base, with sales enhanced by the recent 
FDA approval of the pediatric indication 
and dosing, publication of a manuscript 
demonstrating its outstanding safety  
profile, and by the product’s recent launch  
in Australia.

5

 Kristalose®
Kristalose® (lactulose) for Oral Solution is the only branded prescription 
laxative available in a powder formulation.

Featuring the established safety and efficacy 
of lactulose, combined with the convenience 
of a pre-measured dose, Kristalose 
represents a unique offering for treatment of 
acute and chronic constipation. 

As a dry-powder crystalline formulation of 
lactulose, Kristalose dissolves quickly in four 
ounces of water, offering patients a virtually 
tasteless, grit-free and essentially calorie-
free alternative to lactulose syrups. Its pre-
measured powder packets make the product 
easily portable. There are no age limitations 

or length of use restrictions for Kristalose 
and it is the only osmotic prescription 
laxative sampled to physicians.

We have repositioned the brand relative to 
other products in the laxative marketplace 
and introduced a couponing program with an 
e-prescribing feature in an effort to enhance 
patient product access. As a result of these 
efforts, Kristalose has become our largest 
selling product.

Omeclamox®-Pak
Omeclamox®-Pak is the newest triple therapy product for treating 
Helicobacter pylori (H. pylori) infection and related duodenal ulcer 
disease in this country.  

By combining omeprazole, clarithromycin, 
and amoxicillin—three well-known and widely 
prescribed medications—Omeclamox-Pak 
not only provides patients the convenience 
of simple, three-in-one packaging, but it is 
also offers them the first FDA-approved triple 
therapy combination medication to contain 
omeprazole.  As an effective proton pump 
inhibitor, omeprazole works to decrease 
stomach acid production. Clarithromycin and 
amoxicillin are both antibiotic agents that 
help the stomach lining to heal by hindering 
the growth of H. pylori. 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.

During 2014, our first full year 
of Omeclamox-Pak sales, the product 
experienced prescription drops due to an 
unforeseeable supply outage that resulted 
from our co-promotion partner’s shift in 
focus away from Omeclamox-Pak and 
toward their own new product. Prescriptions 
dropped, necessitating our shift to full 
branding and supply chain management. In 
2015, we assumed full responsibility for the 
Omeclamox-Pak brand and its supply chain. 

 Vaprisol®
Vaprisol® (conivaptan) Injection is the only injectable brand available to 
treat hyponatremia, the most common electrolyte imbalance seen in U.S. 
hospitalized patients. 

Imbalanced sodium and water levels can 
be associated with a variety of critical 
care conditions including congestive heart 
failure, liver failure, kidney failure, and 
pneumonia. As a vasopressin receptor 
antagonist, Vaprisol counteracts this 
condition, promoting free water secretion 
by raising serum sodium levels. Vaprisol is 
the only intravenously administered branded 
product for hyponatremia, offering a reliable, 
defined control with convenient pre-mixed 

IV dosing for hospitals and their patients. 
The drug’s effectiveness as an acute care 
product allows for broad use throughout the 
hospital including intensive care, neurology, 
nephrology, and oncology patients.

Cumberland acquired Vaprisol from 
Astellas in early 2014 and has assumed full 
responsibility for the product including its 
manufacture, distribution, and marketing.

6

7

 
“Cumberland has established a commercial infrastructure 
with all the capabilities needed to support our brands in 
the U.S. Our hospital team is dedicated to improving patient 
outcomes.”

Kelly Menzel 

Senior Direc tor, Hospital Sales

14 Increase in

reputation
1Mpatient doses of  
%

Caldolor  
net revenue

Caldolor delivered

6

7
7

commitment
4University
11International 

collaborations

partners

“Our formulation laboratories 
are designing new product 
candidates and supporting 
joint development programs 
with University based 
research teams.” 

Andrew Vila 

Formulati on  Scie n tist

8

Hepatoren and Boxaban are intravenous and oral formulations of ifetroban, a new chemical 
entity or NCE. Ifetroban is an antagonist which blocks activation of and signaling through 
the thromboxane receptor. This receptor is found in many tissues and plays a role in 
multiple biological processes. Cumberland acquired rights to ifetroban from Cumberland 
Emerging Technologies (CET) in early 2011. Together, with scientists at Vanderbilt 
University, we are developing ifetroban and evaluating a number of potential clinical 
indications for this molecule. Our ongoing work is has provided favorable non-clinical 
findings, providing greater insight into ifetroban’s mechanism of action and potential. 

 Hepatoren®

Hepatoren (ifetroban) injection is being 
developed for the treatment of patients 
with hepatorenal syndrome (HRS), a life 
threatening condition for which there is no 
FDA-approved treatment. Ifetroban is a new 
chemical entity which has the potential to 
help multiple patient populations.

Cumberland acquired the rights to ifetroban 
through a collaboration between Vanderbilt 
University and Cumberland Emerging 
Technologies (CET). We initiated clinical 
development for the intravenous formulation 
of this product candidate under the brand 
name Hepatoren®.  HRS is a life-threatening 
condition involving reduced liver function 
and progressive kidney failure with a high 
patient mortality rate and no pharmaceutical 
treatment. Approximately 450,000 patients 
in the United States suffer from medical 
conditions that make them susceptible to 

 Boxaban®

Boxaban® (ifetroban) Oral Capsule is being 
developed by Cumberland to treat patients 
suffering from aspirin-exacerbated respiratory 
disease (AERD). Its studies may also generate 
data that could allow ifetroban therapy to be 
considered for other patient populations. 

Cumberland received clearance for its 
Investigational New Drug (IND) Application 
from the FDA in early 2015 to commence a 
Phase II study for Boxaban® in patients  
with AERD.

Aspirin-exacerbated respiratory disease, 
also known as AERD, is a respiratory disease 
involving chronic asthma and nasal polyposis 
that is worsened by aspirin or nonsteroidal 

cirrhosis, and a subset of these patients 
develop HRS every year. 

In 2015, we completed enrollment in the Type 
II patient cohort of this study and announced 
top line results indicating that ifetroban was 
well tolerated in HRS patients at all dose 
levels, with no safety concerns identified.   
Importantly, we found that the patients 
receiving the higher dose levels of ifetroban 
were more likely to experience increases in 
their urine output compared to patients who 
received placebo. This signal of improvement 
in kidney function is encouraging and 
certainly warrants continuation of the 
development program. We then concluded 
enrollment for the Type I patient cohort in 
this study by the end of the year. Next steps 
include further analysis of the full data set 
and design of a follow-up study based on 
these findings.

anti-inflammatory drugs. Current treatment 
of AERD remains a challenge, as novel and 
effective treatment modalities are lacking 
for this unmet medical need. Approximately 
one in 20 asthmatic adults (nearly 1 million 
patients in the United States) suffer from 
AERD and the disease awareness is growing 
within the medical community.

Enrollment in the Phase II, multicenter study 
of Boxaban was completed in late 2015 with 
favorable top line results. We continue to 
evaluate the study data and plan the next 
steps in this development program. 

9

Partnerships Around the World 

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

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

1

2

5

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

2  Tennessee— 

Cardinal	Health	Inc. facility  

  provides warehousing,  
  shipping and other  
  distribution support for  
  our products in the U.S.

3  Venezuela— 

Valmorca is our commercial 

  partner for Caldolor®

4  Latin America— 
	 Grifols is our commercial 
  partner for Caldolor®

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

3

4

10

 
 
	
 
	
6  Arabian Gulf — 
	 GerminMed is our commercial   
  partner for Caldolor® and 
  Acetadote®

8  China— 	
	 Harbin	Gloria	Pharmaceuticals	Co.	Ltd			
is our commercial partner for Caldolor®  
  and Acetadote®, as well as an investor    
in Cumberland Emerging Technologies

7  India— 

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

9  South Korea— 
	 DB	Pharm	Korea	Co.	Ltd.	

is our commercial partner 
for Caldolor® and Vaprisol®

10 Indonesia & Pacific Rim— 
The	SOHO	Group is our 

  commercial partner for Caldolor®

11 Australia & New Zealand— 

Seqirus™,	part of the CSL Group,	is our  

  commercial partner for Caldolor®

	 Phebra	Pty	Ltd.,	is our commercial  
  partner for Acetadote®

8

9

6

7

10

11

11

11

	
 
 
 
	
	
	
 
 
	
 
 
New financing for CET accelerated progress 
and expanded the number of active programs.

In order to be successful over the long-term, we believe it is important 
to have a pipeline of innovative new product opportunities. We formed 
Cumberland Emerging Technologies (CET) for that purpose.  

CET is a joint initiative between Cumberland 
Pharmaceuticals Inc., Vanderbilt University, 
LaunchTN, and Gloria Pharmaceuticals. 
The mission of CET is to bring biomedical 
technologies and products conceived at 
Vanderbilt and other regional research 
centers to the marketplace. CET helps 
manage the development and commercial-
ization process for select projects, and 
provides expertise on intellectual property, 
regulatory, manufacturing and marketing 
issues that are critical to successful new 
biomedical products.

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. 
Due to the high demand for life sciences 
incubator space in Nashville, 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. 

Joseph R olwing 
Director, CET Life Sciences Center

12

 
2015 
Financial 
Review

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

22

39

39

39

40

40

42

43

55

55

55

56

56

56

56

57

62

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 medical 
specialties 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 gastroenterology sales forces in the United States and are establishing a network of international partners 
to bring our products to patients in their countries.

Our product portfolio includes:

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

•  Caldolor® (ibuprofen) Injection, for the treatment of pain and fever; recently approved for use 

in pediatric patients

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

and acute constipation;

•  Omeclamox®-Pak, (omeprazole, clarithromycin, amoxicillin) for the treatment of Helicobacter 

pylori (H. pylori) infection and related duodenal ulcer disease;

•  Vaprisol®  (conivaptan)  Injection,  to  raise  serum  sodium  levels  in  hospitalized  patients  with 

euvolemic and hypervolemic hyponatremia;

•  Hepatoren®  (ifetroban)  Injection,  a  Phase  II  candidate  for  the  treatment  of  critically  ill 
hospitalized  patients  suffering  from  liver  and  kidney  failure  associated  with  hepatorenal 
syndrome ("HRS"); and

•  Boxaban® (ifetroban) oral capsules, a Phase II candidate for the treatment of patients with aspirin-

exacerbated respiratory disease (AERD).

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.

Cumberland's growth strategy involves maximizing the potential of our existing brands while continuing to build 
a portfolio of differentiated products. We currently market five 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 identify and develop promising, 
early-stage product candidates, which Cumberland has the opportunity to further develop and commercialize.

1

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.

PRODUCTS

Our key products include:

Products

Indication

Acetadote®

Caldolor®

Kristalose®

Acetaminophen Poisoning

Pain and Fever, including pediatric patients

Chronic and Acute Constipation

Status

Marketed

Marketed

Marketed

Omeclamox®-Pak

H. pylori infection and related Duodenal Ulcer disease

Marketed

Vaprisol®

Hepatoren®

Boxaban®

Acetadote

Euvolemic and Hypervolemic Hyponatremia

Hepatorenal Syndrome

Aspirin-Exacerbated Respiratory Disease

Marketed

Phase II

Phase II

Acetadote  is  an  intravenous  formulation  of  N-acetylcysteine,  or  ("NAC"),  indicated  for  the  treatment  of 
acetaminophen poisoning. Acetadote, has been available in the United States since Cumberland's 2004 introduction of 
the product through our hospital sales force.  Acetadote is typically 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.

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. Completion of our first Phase IV commitment resulted 
in the FDA's 2006 approval of expanded labeling for the product for use in pediatric patients. Completion of our second 
Phase IV commitment in 2006 resulted in further revised labeling for the product with FDA approval of additional 
safety data in 2008. Completion of our third and final Phase IV commitment in 2010 culminated in the FDA’s approval 
of a new formulation for the product. The next generation formulation, contains no ethylene diamine tetracetic acid 
("EDTA") or other stabilization agent, chelating agent or preservative. In early 2011, Cumberland introduced this new 
Acetadote formulation replacing the original formulation which we no longer manufacture.

In June 2013, the FDA approved updated labeling for Acetadote revising the product's indication and providing 
new dosing guidance for specific patient populations.   As a result, dosing guidance is now included for patients weighing 
over 100 kg and new language has been added to alert health care providers that in certain clinical situations, therapy 
should be extended for some patients.

Beginning in 2012, the United States Patent and Trademark Office (the "USPTO") issued us a series of patents 
associated with our Acetadote product.  These patents are discussed in Part I, Item I, "Business - Trademarks and 
Patents" of this Form 10-K.  On November 8, 2012, we learned that the FDA approved an abbreviated new drug 

2

application (ANDA) filed by InnoPharma, Inc. and referencing Acetadote.  That product, with the old formulation 
containing EDTA, was subsequently introduced by APP, a division of Fresenius Kabi USA, at the end of 2012. In early 
2013, we entered into an agreement with Perrigo Company resulting in the distribution of our Authorized Generic 
acetylcysteine injection (the "Authorized Generic") product.  Both Acetadote and our Authorized Generic utilize the 
new, EDTA-free formulation which accounted for continued significant market share during 2015.  We are seeking 
additional claims to protect our intellectual property associated with Acetadote through patent applications which are 
pending with the USPTO.   

In November 2015, an Illinois judge issued a final ruling in favor of Cumberland Pharmaceuticals Inc. in a patent 
case associated with Acetadote. By ruling in Cumberland's favor, the court upheld the validity of the patent which 
encompasses  our  EDTA-Free  formulation  and  has  a  term  until August  2025. The  court  also  granted  a  permanent 
injunction preventing challengers from marketing a generic version of our Acetadote product before the expiration of 
Cumberland’s patent in August 2025.

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 during the middle portion of 2009 following a priority review. The product is indicated for use by adults 
and pediatric patients six months and older for the management of mild to moderate pain and the management of 
moderate to severe pain as an adjunct to opioid analgesics, as well as the reduction of fever. It was the first FDA-
approved intravenous therapy for fever.  At December 31, 2015, Caldolor has been purchased by over 1,300 health care 
facilities in the United States.  

In late 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 and then 
focused on building more sales volume and treating a broader range of patients within those stocked facilities.   We 
promote Caldolor in the United States through our dedicated hospital sales force.

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.  Also included in these 
studies was an evaluation of a shortened infusion time for the product and pre-surgical administration. The data from 
these Phase IV studies, including an updated integrated safety database, was submitted to the FDA in early 2015 with 
a request for updated labeling for the product. In late 2015, we received FDA approval of Caldolor for use in pediatric 
patients six months of age and older. Caldolor is the first and only injectable non-steroidal anti-inflammatory drug 
(NSAID) approved for use in pediatric patients. Caldolor’s pediatric approval came after the FDA’s review of safety 
and efficacy data from clinical trials in hospitalized febrile children and in children undergoing tonsillectomy surgery. 
We also continue to pursue and evaluate potential improvements to the product’s packaging.  

Kristalose

Kristalose is a prescription laxative administered orally for the treatment of acute and chronic constipation. An 
innovative, dry powder crystalline formulation of lactulose, Kristalose is designed to enhance patient compliance and 
acceptance. Kristalose is the only prescription laxative available in pre-measured powder packets.  Kristalose dissolves 
easily in four ounces of water, offering patients a virtually taste-free, grit-free and essentially calorie-free alternative 
to lactulose syrups.  We conducted a preference study which indicated that seventy seven percent of patients surveyed 
prefer the taste, consistency and portability of Kristalose over similar products in syrup forms.

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 and internists.  Using the preference 
data as a cornerstone of our marketing efforts, we have made significant gains following our repositioning of the brand 

3

in early 2014.  The new marketing strategy includes an enhanced patient coupon program and expanded managed care 
coverage for the product. 

In late 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.  During 2014, 
we also entered into a long-term supply agreement and new packaging agreements for the product. By entering into 
these transactions, we streamlined the supply chain for the product and are exploring opportunities to further develop 
the brand.

Omeclamox-Pak

We launched our promotion and distribution efforts to support Omeclamox-Pak in early 2014.  Our field sales 
force promotes Omeclamox-Pak to the gastroenterologist segment, which accounts for the largest component of the 
prescriber base for this product.  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 twice a day dosing before meals.

While there are competing products, Omeclamox-Pak is one of the few actively marketed products for this condition.  
In addition, compared to the competing branded products, Omeclamox-Pak combines the lowest pill burden and fewest 
days of therapy.  Our involvement with Omeclamox-Pak began in October 2013, through an agreement with Pernix 
Therapeutics ("Pernix").  In November 2015, Cumberland entered into an exclusive license and supply agreement with 
Gastro-Entero Logic, LLC (“GEL”) and assumed full commercial responsibility for Omeclamox-Pak  in the United 
States  and  terminated  our Agreement  with  Pernix.    Cumberland  is  now  responsible  for  the  supply  chain,  national 
accounts and all sales promotion of Omeclamox-Pak as part of the GEL agreement.  Cumberland will also now seek 
a new co-promotion partner to support the product with primary care physicians. 

Vaprisol

In early 2014, we entered into an agreement with Astellas Pharma US, Inc. ("Astellas") to acquire Vaprisol, including 
certain product rights, intellectual property and related assets.  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 then launched in 2006. It is one of two branded prescription products indicated 
for the treatment of hyponatremia, and the only intravenously administered branded treatment.  

Hyponatremia, an imbalance of serum sodium to body water, is the most common electrolyte disorder among 
hospitalized patients.  These electrolyte disturbances occur when the sodium ion concentration in the plasma is lower 
than normal and are often associated with a variety of critical care conditions including congestive heart failure, liver 
failure, kidney failure and pneumonia. Vaprisol raises serum sodium to appropriate levels and promotes free water 
secretion.  

We re-launched active promotion of the brand during the middle of 2014 utilizing our hospital sales force, which 

also features our Caldolor and Acetadote products.

Hepatoren

In 2011, we entered into an agreement to acquire the rights to ifetroban, a new Phase II product candidate. 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.

4

We have commenced manufacturing of an intravenous formulation of ifetroban and the FDA has cleared our IND 
application  for  this  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.

Boxaban

We have also completed the manufacturing of an oral formulation of ifetroban and the FDA has cleared an IND 
amendment for this product candidate. We have initiated clinical development under the brand name Boxaban (ifetroban) 
capsules and are evaluating this candidate for patients suffering from aspirin-exacerbated respiratory disease (AERD) 
a condition for which there is no U.S. approved pharmaceutical treatment. Also known as Samter’s Triad, AERD is a 
respiratory disease involving chronic asthma and  nasal polyposis that is worsened  by aspirin or nonsteroidal anti-
inflammatory drugs. Approximately one in twenty asthmatic adults in the U.S. suffer from AERD and awareness of 
the disease is growing within the medical community.

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.  We believe that active promotion of our products, supported 
by  non-personal  promotional  activities  developed  and  implemented  by  our  marketing  team,  can  maximize  the 
opportunity for our brands.

Further develop our existing products and develop new late stage product candidates

We continue to evaluate our products following FDA approval to determine if further clinical work could expand 
the potential market opportunities for our products and help new patient populations.  In addition, we may explore 
further clinical work that could be used to support our sales and marketing activities and maximize their efforts to 
further penetrate existing markets.  Our clinical team is also working to develop late stage product candidates that could 
further expand our product portfolio if approved by the FDA.  

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 brands. We focus on under-promoted, FDA-
approved drugs as well as late-stage development products that address poorly met medical needs. We plan to continue 
to target product acquisition candidates that are competitively differentiated, have valuable intellectual property or 
other  protective  features,  and  allow  us  to  leverage  our  existing  infrastructure.    We  will  also  continue  to  explore 
opportunities for label expansion to bring our products to new patient populations.  The Caldolor pediatric approval 
reflects our successful implementation of this strategy.

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 are building 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 support 
our partners’ registration and commercialization efforts in their respective territories.  The 2015 launch of Caldolor in 
Australia by Seqirus is an example of our international partnerships.  

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 at CET. CET partners with universities and other research organizations 

5

to develop promising, early-stage product candidates, and Cumberland has the opportunity to negotiate rights to further 
develop and commercialize them in the U.S and other markets.

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 50 
sales representatives and district managers, direct our national marketing campaigns and maintain key national account 
relationships. 

Hospital market:  We promote Caldolor, Vaprisol 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. Outside market data continues to indicate that the majority of pharmaceutical 
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 under-served and highly concentrated, and 
that it can be penetrated effectively by a small, dedicated sales force without large-scale promotional activity.  
Our position within the acute care market and existing hospital sales team provided the rationale for adding 
Vaprisol as a third acute care product.  Our strategy has been to increase the focus of our hospital sales team 
on targeted, high priority accounts.  

In November 2015 we announced a co-promotion agreement with Piramal Critical Care ("Piramal"). Through 
this agreement, Piramal co-promotes two of Cumberland’s branded hospital products, Caldolor and Vaprisol 
throughout the United States. Piramal will help expand Cumberland’s reach for these products by providing 
coverage to an additional group of hospitals where Piramal’s critical care sales force has existing relationships. 
Cumberland will maintain its promotional efforts supporting the products, continue its focus on its existing 
group of medical centers across the United States and continue to provide the marketing, national accounts, 
distribution, and medical support for the brands. The multi-year collaboration will provide expanded sales 
promotion for the two brands, increased communication to medical professionals and enhanced availability 
of the products to support patient care.  

Gastroenterology market:  We promote Kristalose and Omeclamox-Pak through a dedicated field sales team 
addressing a targeted group of physicians who are large prescribers of 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  products.  Our  focus  on  the 
gastroenterology  market  and  our  existing  field  sales  infrastructure  provided  us  with  the  rationale  to  add 
Omeclamox-Pak.  Our field sales force now features both Kristalose and Omeclamox-Pak during most of their 
physician calls, expanding our presence in the gastroenterology market.

Our  sales  and  marketing  executives  conduct  ongoing  market  analysis  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 established our own capabilities to support the commercialization of our products in the U.S.  Our international 
strategy is to identify and partner with other companies that have the appropriate capabilities to support our products in their 
respective countries. We have entered into a series of agreements to establish a network, which is summarized in the table 
below, which includes information on the company, licensed product, territory and status:

6

International Partner

Product(s)

Territory

Phebra Pty Ltd

Acetadote

Australia and New Zealand

Alveda Pharmaceuticals, Inc.

Caldolor

Canada

DB Pharm Korea Co., Ltd.

Alliance Pharm PTE Ltd.

Seqirus (a CSL company)

Sandor Medicaids Pvt. Ltd.

GerminMED

PT. SOHO Industri Pharmasi

PT. ETHICA Industri Farmasi

Laboratorios Grifols, S.A.

Caldolor &
Vaprisol

Vaprisol

Caldolor

Caldolor

Caldolor &
Acetadote

Caldolor

Caldolor

Caldolor

South Korea

Singapore

Australia and New Zealand

India

Qatar and Arabian Peninsula

Pacific Rim

Indonesia

Spain, Portugal and the majority of South
America

Gloria Pharmaceuticals Co. Ltd.

Caldolor &
Acetadote

China

Status

Marketed
Marketed

Marketed

Distributing

Marketed

Registration

Registration

Registration

Registration

Development

Development

Clinigen Healthcare Limited

Laboratorios Valmorca, C.A.

Vaprisol

Caldolor

Most territories outside the U.S. and Singapore

Pending

Venezuela

Registration

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; 
• 
•  Calculating and paying any royalties, as applicable. 

Providing the transfer price for supplies of product; and

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; and

We are currently working to support our existing international partners and to identify other companies to represent 

our products in select additional territories.

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 for all our products as well as obtaining FDA approvals for Acetadote and Caldolor.

7

Clinical development

Our clinical development personnel are responsible for: 

• 

• 

• 

creating clinical development strategies; 

designing, implementing and monitoring our clinical trials; and

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 and medical science liaisons. 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.

CLINICAL DEVELOPMENT 

Caldolor Approved for Pediatric Use

During November 2015, Caldolor received FDA approval for use in pediatric patients six months and older for 
management of pain and reduction of fever. The approval was based on data submitted to the U.S. Food and Drug 
Administration  (FDA)  as  part  of  a  post-marketing  commitment  following  approval  of  Caldolor  in  adults  in  2009. 
Caldolor is the first and only injectable non-steroidal anti-inflammatory drug (NSAID) approved for use in pediatric 
patients.

Caldolor’s  pediatric  approval  came  after  the  FDA’s  review  of  safety  and  efficacy  data  from  clinical  trials  in 
hospitalized febrile children and in children undergoing tonsillectomy surgery. The pivotal fever study demonstrated 
a statistically significant greater reduction in temperature for patients receiving Caldolor, as compared to acetaminophen.   
Seventy-four percent of Caldolor treated patients became afebrile by the end of the first dosing interval. A total of 143 
pediatric patients, ages six months and older, have received Caldolor in controlled clinical trials. The most common 
adverse reactions (incidence greater than or equal to 2%) in pediatric patients treated with Caldolor were infusion site 
pain, vomiting, nausea, anemia and headache.

8

The recommended dosing for pediatric patients ages six months to twelve years of age is 10 mg/kg up to a 
maximum single dose of 400 mg Caldolor every four to six hours as necessary. For patients ages twelve to seventeen 
years of age, the recommended dosing is 400 mg of Caldolor every four to six hours as necessary for management of 
pain and/or reduction of fever. The product is diluted and administered intravenously over a ten minute infusion and 
the maximum daily dose in pediatric patients is 2,400 mg.

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. We continue to use this data in our marketing materials and 
to support our sales force in promoting 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.

Publication of Caldolor Shortened Infusion Time Studies

In January 2015, Clinical Therapeutics, The International Peer-Reviewed Journal of Drug Therapy, published  
two articles with data from two Caldolor (ibuprofen) registry studies.  One study entitled, "A Multicenter, Open-Label, 
Surgical Surveillance Trial to Evaluate Safety and Efficacy" provided for eligible enrolled patients 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 thirteen clinical sites were enrolled in this study. Intravenous 
ibuprofen reduced fever and pain and the shortened infusion time was well tolerated.

The other registry study entitled "A Multicenter, Open-Label, Surgical Surveillance Trial to Evaluate Safety" 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 twenty one clinical sites were enrolled in this study. 
The shortened infusion time was well tolerated.

Publication of Caldolor Integrated Safety Analysis

In October 2015 there was a publication of an integrated safety analysis adding to the growing body of literature 
that support the safety of Caldolor. The data in this cumulative safety analysis is derived from ten sponsored clinical 
studies investigating intravenous ibuprofen for the treatment of pain and/or fever in adult patients.  Over 1,750 adult 
patients have been included in safety and efficacy trials over eleven years. The publication is available as an open access 
article in the Journal of Pain Research.

 The incidence of adverse events, changes in vital signs and clinically significant laboratory parameters were 

summarized and compared to patients receiving placebo or active comparator drug. Patients receiving Caldolor 
required less morphine and experienced fewer adverse events relative to those who received placebo with morphine 
rescue. Results from the integrated analysis continue to demonstrate the safety of Caldolor, supporting its use in 
hospitalized patients.

Caldolor Label Safety Update

In  July  2015,  the  FDA  decided  to  strengthen  the  existing  cardiovascular  warning  for  nonsteroidal  anti-
inflammatory drugs (NSAIDs). This is a class label change for all NSAIDs including over-the-counter and prescription 
products. It was previously thought that all NSAIDs may have similar cardiovascular risks. While newer information 
makes it less clear that the cardiovascular risks are similar for all NSAIDs, this information is not sufficient for the 
FDA to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular 

9

NSAID. While we have not seen a cardiovascular side effect in our extensive Caldolor safety database, we will update 
our Caldolor label for this requested information once it becomes finalized by the FDA.

Caldolor Continuing Education 

We have extended the availability of a web-based, accredited, continuing education seminar featuring the benefits 
of preoperative use of Caldolor in the hospital setting.  The seminar has been distributed to over 60,000 health providers 
with a growing number of participants completing the seminar for continuing education credit.  

Hepatoren Top Line Study Results

We are developing Hepatoren as a potential treatment for Hepatorenal Syndrome ("HRS") - a life threatening 
condition, with a high mortality rate and no approved pharmaceutical therapy in this country.  We initiated a sixty four 
patient Phase II study to evaluate the safety, efficacy and pharmacokinetics of Hepatoren for this unmet medical need.

The study was designed to evaluate escalating dose levels of Hepatoren in HRS patients. Progression to higher 
dose levels is reviewed and approved by an independent safety committee.  The study was stratified into Type I or Type 
II patients with HRS based upon the progression of their disease.

We completed the enrollment of Type II patients at the end of 2014.  Top line results from these patients indicate 
that Hepatoren was overall well tolerated with no safety concerns noted. Furthermore, the patients receiving the higher 
dose levels of Hepatoren were more likely to experience increases in urine output, a signal of improved kidney function, 
compared to patients who received placebo. Based on these results, we will proceed with clinical development of this 
product candidate.

We subsequently completed enrollment of the Type I patients during the third quarter of 2015 and the analysis of 

those patient results is underway.  

Boxaban Phase II Program

During 2015, Cumberland announced an expansion of its pipeline with another Phase II development program. 
The Company is developing Boxaban for the treatment of Aspirin-Exacerbated Respiratory Disease ("AERD").  AERD 
is a respiratory disease involving chronic asthma and nasal polyposis that is worsened by aspirin.  It is characterized 
by sharp increases in inflammatory mediators and platelet activity within the respiratory system. Ifetroban, an active 
thromboxane receptor antagonist, may interfere with these pathways to modify the disease and provide symptomatic 
relief.

Cumberland completed manufacturing of Boxaban oral capsules and initiated a Phase II clinical study to 
evaluate Boxaban in patients suffering AERD. The study was designed to gather initial safety and tolerability data 
on ifetroban in AERD patients.  It was a multicenter study of sixteen patients with enrollment at several U.S. 
medical centers including the Scripps Clinic.  The enrollment in this study was recently completed and top line 
results indicate that no adverse events were experienced by patients receiving Boxaban when compared to those 
receiving placebo.  Further analysis of the full data set obtained from the study is underway.

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 business development opportunities 
through our international network of advisory firms and individual pharmaceutical industry and medical advisors. 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 additions of Omeclamox-
Pak and Vaprisol reflect our business development process and follow 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 

10

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. 

Clinigen Strategic Alliance

In September 2015, we announced our strategic alliance with Clinigen Group plc (AIM: CLIN) ("Clinigen"), a 
global pharmaceutical and services company.  Clinigen is a specialty pharmaceutical and services company focused 
on providing medicines to patients with high unmet needs through clinical trials, licensed and ethically unlicensed 
supply.

The  alliance  will  combine  the  respective  strengths,  expertise  and  geographical  footprints  of  Cumberland  and 
Clinigen  with  respect  to  potential  future  products.    Under  the  agreement,  we  will  have  the  opportunity  to  support 
Clinigen products through distribution, marketing and promotion within the United States.  Clinigen will be responsible 
for the marketing, promotion, distribution and sale of our pharmaceutical products in select markets outside of the 
United States, allowing us to use Clinigen’s international reach to enter new markets for our products.  During 2016 
we entered into an amendment to this strategic alliance agreement that outlines the support Cumberland will provide 
to one of Clinigen's product in the United States. Cumberland expects to launch the support for the Clinigen product 
during the second half of 2016. 

CET Collaboration

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 
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  Universities  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 
and Boxaban.

CET  Financing

In 2014, we organized an equity financing to recapitalize and strengthen the financial position of CET. This financing 
included an investment of approximately $1.0 million from Harbin Gloria Pharmaceuticals Co., Ltd. (“Gloria”) for 
their participation in CET.  As a result, Gloria received shares in CET and joined the CET ownership group.  As part 
of this transaction, Gloria will have the first right to negotiate a license to CET developed products for the Chinese 
market. The funds from this new investment are being used to support and accelerate the development of CET product 
candidates. CET’s lead product candidate is ifetroban which is being developed by Cumberland under the brand names 
Hepatoren and Boxaban.

Prior to April 2014, we owned 85% of CET, with the balance of the enterprise owned by Vanderbilt University 
and the Tennessee Technology Development Corporation.  In connection with Gloria’s investment in CET, we also 
provided an additional investment in CET of $1.0 million in cash and $2.4 million in loan forgiveness.  Upon completion 
of the additional investment by Gloria and Cumberland in April 2014, we held an 80% ownership in CET. 

MANUFACTURING AND DISTRIBUTION

We partner with third parties for 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 
and timely delivery.

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Manufacturing

Our key manufacturing relationships include:

Caldolor

•  We initiated the manufacturing of Caldolor at two facilities during 2015. Both manufacturers have provided 
supplies  of  Caldolor  for  our  international  markets.    During  2015,  we  began  the  process  of  securing  two 
manufacturers for commercial supply of Caldolor for the United States.  All four manufacturers are expected 
to provide commercial supplies of the product in 2016. 

Acetadote

•  During the fourth quarter of 2014, we entered into an agreement with a U.S. based manufacturer to supply our 
Acetadote product.  We transferred the Acetadote manufacturing process to this supplier, received FDA clearance 
and began receiving commercial units from this facility during 2015.

Kristalose

•  We have an agreement for the purchase of Kristalose API with an international supplier.  This written agreement 
formalized and extended our existing relationship with this raw materials supplier.  We also have manufacturing 
relationships with  two  Kristalose packagers.   Under  these  agreements, we  provide Kristalose API  to  these 
manufactures and they package the API (for both commercial sale and samples)  into 10 gram and 20 gram 
finished product units for our purchase and distribution. 

Omeclamox-Pak

•  Under the previous agreement, Pernix, was responsible for providing us with the supply of Omeclamox-Pak.  
Based  on  our  new  agreement  with  GEL,  effective  in  November  2015,  Cumberland  assumed  supply  chain 
responsibilities and now works directly with GEL for the manufacture, packaging and supply of  Omeclamox-
Pak commercial and sample units. 

Vaprisol

•  As part of the acquisition of Vaprisol, we purchased an existing supply of raw material inventory.  In addition, 
as part of this transaction, we were assigned a commercial supply agreement with the existing manufacturer 
who provided supplies of Vaprisol.  That manufacturer continues to supply commercial inventory to Cumberland 
under this agreement. 

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. 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 

12

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. 

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, 
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.   

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 
challenging the 445 Acetadote Patent on the basis of non-infringement, unenforceability and/or invalidity.

13

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.   

On February18, 2014, the USPTO issued U.S. Patent number 8,653,061 (the “061 Acetadote Patent”) which is 
assigned to the Company. 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 May 13, 2014, the USPTO issued U.S. Patent number 8,722,738 (the “738 Acetadote Patent”) which is assigned 
to Cumberland.  The claims of the 738 Acetadote Patent encompass administration methods of acetylcysteine injection, 
without specification of the presence or lack of EDTA in the injection. Following its issuance, the 738 Acetadote Patent 
was listed in the FDA Orange Book and it is scheduled to expire in April 2032.  

On December 11, 2014 and March 3, 2015, the Company became aware of Paragraph IV certification notices from 
Aurobindo Pharma Limited and Zydus Pharmaceuticals (USA) Inc., respectively, challenging the 356, 445, 061, and 
738 Acetadote Patents on the basis of non-infringement.

On February 10, 2015, the USPTO issued U.S. Patent number 8,952,065 (the “065 Acetadote Patent”) which is 
assigned to us.  The claims of the 065 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acute liver failure.  The 065 Acetadote Patent is scheduled to expire in August 2025.

On September 30, 2015, the United States District Court for the Northern District of Illinois, Eastern Division 
("District Court") ruled in our favor in our lawsuit against Mylan for infringement of the 445 Acetadote Patent.  The 
opinion  upheld our  445 Acetadote  Patent  and  expressly  rejected  Mylan's  validity  challenge.     The  District  Court 
ruled that Mylan is liable to us for infringement of the 445 Acetadote patent in light of Mylan's Abbreviated New Drug 
Application in which Mylan sought to market a generic version of Acetadote.  On November 17, 2015, the District 
Court entered an order enjoining Mylan and its affiliates from selling or using its generic version of Acetadote until 
August 2025, the date of expiration of the 445 Acetadote Patent. On October 30, 2015, Mylan filed a notice of appeal 
to the U.S. Court of Appeals for the Federal Circuit.

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.  During 2014, we obtained additional patents for the brand. 
On May 27, 2014, the USPTO issued U.S. Patent number 8,735,452 (the “452 Caldolor Patent”) which is assigned to 
us.  The claims of the 452 Caldolor Patent encompass methods of treating pain using intravenous ibuprofen.  Following 
its issuance, the 452 Caldolor Patent was listed in the FDA Orange Book and is scheduled to expire in September 2029.

On October 28, 2014, the USPTO issued U.S. Patent number 8,871,810 (the “810 Caldolor Patent”) which is 

assigned to us.  The claims of the 810 Caldolor Patent encompass methods of treating pain using intravenous ibuprofen.   
Following its issuance, the 810 Caldolor Patent was listed in the FDA Orange Book and is scheduled to expire in 
September 2029. 

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During the third quarter of 2015, we obtained three additional patents for Caldolor. On July 7, 2015, the USPTO 
issued U.S. Patent number’s 9,072,710 (the “710 Caldolor Patent”) and 9,072,661 (the “661 Caldolor Patent”) which 
are assigned to us.  The claims of the 710 Caldolor Patent and the 661 Caldolor Patent include composition and methods 
of treating pain, inflammation and fever using intravenous ibuprofen.  These Caldolor Patents are scheduled to expire 
in March 2032.

On August 25, 2015, the USPTO issued U.S. Patent number 9,114,068 (the “068 Caldolor Patent”) which is assigned 
to us.  The claims of the 068 Caldolor Patent include methods of treating pain and inflammation using intravenous 
ibuprofen.  Following its issuance, the 068 Caldolor Patent was listed in the FDA Orange Book and is scheduled to 
expire in September 2029.  We also have additional patent applications related to Caldolor which are pending with the 
USPTO.

Vaprisol

We own numerous U.S. patents and related international patents for Vaprisol.  These patents were acquired in our 
February 2014 acquisition of certain product rights, intellectual property and related assets of Vaprisol from Astellas.  
The primary patent is U.S. Patent No. 5,723,606 (the “606 Vaprisol Patent”) which includes composition of matter 
claims  that  encompass  the Vaprisol  formulation  as  well  as  methods  for  the  intravenous  treatment  of  patients  with 
euvolemic hyponatremia.  The 606 Vaprisol Patent is listed in the FDA Orange Book and expires in December 2019.

Remaining Products

We have no issued patents for our Kristalose or Omeclamox-Pak products.  We have patent applications relating 

to our Hepatoren and Boxaban products pending with the USPTO.

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: 

• 

• 

• 

• 

• 

• 

• 

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

brand awareness and recognition driven by sales, 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 

15

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 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 products that contain 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 Mallinckrodt plc;

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

•  Dyloject, an injectable diclofenac product approved by the FDA during 2015. 

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 
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® , an oral product indicated for the treatment of chronic idiopathic constipation in adults, and is 

marketed by Sucampo Pharmaceuticals Inc. and Takeda Pharmaceutical Company Limited.

•  MovantikTM, an oral product indicated for the treatment of opioid-induced constipation in adults with 

chronic non-cancer pain.

•  Linzess®, an oral product 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; and

•  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 

16

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. 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. The prescription 
combination products, indicated for treatment of H. pylori, which we believe are our primary competitors are:

• 

• 

PrevPac®, an oral product marketed by Takeda Pharmaceutical Company.  There are also approved generic 
versions of PrevPac;

Pylera®, an oral product marketed by Actavis Pharma, Inc. and Forest Laboratories, Inc.; and

•  Helidac®, an oral product marketed by Prometheus Therapeutics.

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 then launched 
in 2006. It is one of two branded prescription products indicated for the treatment of hyponatremia, and the first and 
only intravenously administered branded treatment.  The other competing product is Samsca, an oral product marketed 
by Otsuka Pharmaceutical Company.

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, 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.

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 

17

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. 

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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 

19

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.

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 collected data regarding reportable transfers 
of value and have reported such data to CMS. 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 products sold to Medicaid beneficiaries. 

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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 the product, the FDA reviews the events to assess which ones may indicate a 
problem with that particular drug. 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. A number of 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. 

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 

21

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, 2015, we had 78 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;

•  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 

22

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 five products: Acetadote, Caldolor, Kristalose, Vaprisol 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.

The FDA has requested prescribers and 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. 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 requires manufacturers to appropriately label 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 continue to be administered primarily to hospital and surgery center 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 individuals hospital physicians to prescribe Caldolor 
repeatedly.  The commercial success of Caldolor also depends on our ability to coordinate supply, distribution, marketing, 
sales and education efforts. As with our other products, if 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.

Caldolor: 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 manufacturers for the commercial supply of Caldolor. We have 
successfully transferred the Caldolor manufacturing process to two of these manufacturers and these two suppliers have 
manufactured inventory under these agreements. During 2015, we began the process of obtaining a third supplier for the 
manufacture of commercial supply of Caldolor and expect to obtain commercial supply from this manufacturer during 2016.  
If the manufacturers of Caldolor are unable to produce marketable inventory in sufficient quantities, in the agreed upon time 
period, we could suffer an inability to meet demand for our product.   

Acetadote: Acetadote was previously manufactured and packaged by two entities: at Bayer’s facility in Kansas through 
January 2014 and in Ireland by Mylan through April 2014.  During the fourth quarter of 2014, we entered into an agreement 
with a U.S. based manufacturer to supply our Acetadote product.  We have transferred the Acetadote manufacturing process 
to this supplier and received and sold commercial units from them during 2015.  If the manufacturer of Acetadote is unable 

23

to produce marketable inventory in sufficient quantities, in the agreed upon time period, we could suffer an inability to meet 
demand for our product. 

Kristalose: The active pharmaceutical ingredient for Kristalose is manufactured at a single facility in Italy and we have 
manufacturing agreements with two Kristalose packagers. If these facilities are damaged or destroyed, or if local conditions 
result in a work stoppage, we could suffer an inability to meet demand for our product. 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. 

Omeclamox-Pak: Under the agreement we signed with Pernix, they were responsible for providing Omeclamox-Pak 
inventory.  Effective with the November 2015 agreement with GEL, Cumberland assumes supply chain responsibilities and 
will now work directly with GEL to ensure availability of Omeclamox-Pak.  If we are unable to obtain marketable inventory 
in the future we could suffer an inability to meet demand for our product. 

Vaprisol: As part of the acquisition of Vaprisol, we purchased an existing supply of raw material inventory.  In addition, 
as part of this transaction, we were assigned a commercial supply agreement with the manufacturer Astellas used to prepare, 
package, inspect and label Vaprisol.  The manufacturer continues to supply commercial inventory to Cumberland under this 
agreement. If the manufacturer of Vaprisol is unable to produce additional marketable inventory in sufficient quantities, in 
the agreed upon time period, we could suffer an inability to meet demand for our 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, Gloria 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.

24

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.

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. Not all foreign 
jurisdictions may represent attractive opportunities for our products due to pricing, competitive, regulatory or other factors. 
In certain 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, Vaprisol, 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 brands into our operations. If we do 
not successfully integrate acquired product brands into our operations, our growth opportunities may be limited.

We added two marketed products to our portfolio of brands: Omeclamox-Pak in the fourth quarter of 2013 and Vaprisol 
during the first quarter of 2014.   We successfully launched our promotional efforts to support both brands during 2014. If 
we are unable to continue to build on our initial success with these brands or we are unable to successfully integrate the 
marketing, sale and distribution of any other potential products into our current infrastructure or if they require significantly 
greater resources than originally anticipated, we may face financial and operational risks and uncertainties. If we are unable 
to successfully integrate any acquired brands, both current and future, these product acquisitions may not be beneficial to 
us in the long term. 

Our  Hepatoren  and  Boxaban  product  candidates  have  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 and Boxaban product 
candidates. Hepatoren (intravenous ifetroban) and Boxaban (oral ifetroban) are candidates used to treat hepatorenal syndrome 
("HRS") and aspirin exacerbated respiratory disease ("AERD"), respectively. However, ifetroban has not been approved by 
the FDA for marketing, and these product candidates are still subject to risks associated with their development. 

The FDA has cleared our IND's for these product candidates as we evaluate them as treatments for these conditions. 
Delays in the enrollment and completion of the clinical studies could significantly delay commercial launch and affect our 
product development costs. Moreover, results from the clinical studies may not be favorable. 

Even if they are eventually developed and approved by the FDA, they may never gain significant acceptance in the 
marketplace and therefore never generate substantial revenue or profits for us. Physicians may determine that existing drugs 

25

are  adequate  to  address  patients'  needs.  The  extent  to  which  these  product  candidates  will  be  reimbursed  by  the  U.S. 
government or third-party payors is also currently unknown.

As a result of the foregoing and other factors, we do not know the extent to which Hepatoren and Boxaban 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 experience 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 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, surgery centers 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.

26

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

Our CET joint initiative with Vanderbilt University, Gloria 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, scientific 
staff, and sales representatives and managers. If we lose the services of any key personnel, in particular, A.J. Kazimi, our 
Chief Executive Officer, or other members of senior management 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 have a 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, sales 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, 2015, we had 78 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;

27

• 

• 

• 

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 payment of 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, security breaches, adverse events or other 
disruptions within our information technology infrastructure 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 ordinary course of our business, we store sensitive data, including intellectual 
property, our proprietary business information and that of our customers.  We also maintain personally identifiable information 
of our employees in our data centers and on our networks. The secure processing and maintenance of this information is 
critical to our operations. 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. Despite our security measures, our information technology and infrastructure may be vulnerable to attacks by 
hackers or breached due to employee error, malfeasance or other disruptions. Any such breach could compromise our networks 
and the information stored there could be accessed, publicly disclosed, lost or stolen. 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. 

28

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 
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 and 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 and 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 and adversely affect 
our operating results and our overall financial condition.

29

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 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.

We must comply with the Physician Payment Sunshine Act.

We are required to comply with the United States Physician Payment Sunshine Act, which requires manufacturers 
of drugs, medical devices and biologicals that participate in U.S. federal healthcare programs to report certain payments 
and items of value given to physicians and teaching hospitals.  Manufacturers are required to report this information 
annually to The Centers for Medicare & Medicaid Services (CMS).  Cumberland has implemented a series of policies 
and procedures for every employee involved in the data collection process, and has systems in place to capture the data, 
which is verified by an outside firm that specializes in reporting the payments.  Cumberland has also established a 
redundant system to ensure that data was reported completely, in the correct format, and on time.  Despite these policies, 
procedures and systems, we cannot assure you that we will collect and report all data accurately.  If we fail to accurately 
report this information, we could suffer severe penalties.

RISKS RELATING TO INTELLECTUAL PROPERTY

Our strategy to secure and extend marketing exclusivity or patent rights may provide only limited or no 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 
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.

30

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.

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, 
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.

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.

31

On May 13, 2014, the USPTO issued U.S. Patent number 8,722,738 (the “738 Acetadote Patent”) which is assigned 
to us.  The claims of the 738 Acetadote Patent encompass administration methods of acetylcysteine injection, without 
specification of the presence or lack of EDTA in the injection. Following its issuance, the 738 Acetadote Patent was 
listed in the FDA Orange Book and it is scheduled to expire in April 2032.  

On December 11, 2014 and March 3, 2015, we became aware of Paragraph IV certification notices from Aurobindo 
Pharma Limited and Zydus Pharmaceuticals (USA) Inc., respectively, challenging the 356, 445, 061, and 738 Acetadote 
Patents on the basis of non-infringement.

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 February 10, 2015, the USPTO issued U.S. Patent number 8,952,065 (the “065 Acetadote Patent”) which is 
assigned to us.  The claims of the 065 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation to 
treat patients with acute liver failure.  The 065 Acetadote Patent is scheduled to expire in August 2025.

On September 30, 2015, the United States District Court for the Northern District of Illinois, Eastern Division 
("District Court") ruled in our favor in our lawsuit against Mylan for infringement of the 445 Acetadote Patent.  The 
opinion  upheld our  445 Acetadote  Patent  and  expressly  rejected  Mylan's  validity  challenge.     The  District  Court 
ruled that Mylan is liable to us for infringement of the 445 Acetadote patent in light of Mylan's Abbreviated New Drug 
Application in which Mylan sought to market a generic version of Acetadote.  On November 17, 2015, the District 
Court entered an order enjoining Mylan and its affiliates from selling or using its generic version of Acetadote until 
August 2025, the date of expiration of the 445 Acetadote Patent. On October 30, 2015, Mylan filed a notice of appeal 
to the U.S. Court of Appeals for the Federal Circuit.

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

or may not be issued.  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 U.S. patents and related international patents which include composition of matter claims that 
encompass the Caldolor formulation, including methods of treating pain using intravenous ibuprofen 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. patents are 
listed in the FDA Orange Book, with one expiring in November 2021, four others expiring in September 2029 and 
one other expiring in September 2030.

We have numerous U.S. patents and related international patents for Vaprisol.  These patents were acquired in 

our February 2014 acquisition of certain product rights, intellectual property and related assets of Vaprisol from 
Astellas.  The primary patent is U.S. Patent No. 5,723,606 (the “606 Vaprisol Patent”) which includes composition 
of matter claims that encompass the Vaprisol formulation as well as methods for the intravenous treatment of 
patients with euvolemic hyponatremia.  The 606 Vaprisol Patent is listed in the FDA Orange Book and expires in 
December 2019.

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 

32

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 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 contractually obligated 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 compromise the issuance of our existing patent applications. 

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 

33

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 
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 distraction of 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 company actively seeking to deliver significant growth. As we execute our business strategy of adding 
new products, like Vaprisol and Omeclamox-Pak, increasing market share in Caldolor and Kristalose 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.

34

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, 2015, intangible assets 
relating to products represented approximately 23% 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.  We are unable to predict the impact of global credit market 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 maintain 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, 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.

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 

35

in these principles can have a significant effect on our reported results and may even retroactively affect previously 
reported transactions.

For example, in recent years, the U.S.-based Financial Accounting Standards Board, ("FASB"), has worked 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 revenue recognition 
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 1, 2016, 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 difficult economic circumstances, 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 the 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 procedures 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 administrative 
and civil penalties, criminal penalties, and private litigation with shareholders. The consequences could have a material 
effect on our ability to effectively market our products and operate our business. 

36

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 to report on the effectiveness of our internal 
controls over financial reporting. Our testing 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 identify 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.

Some  provisions  of  our  third  amended  and  restated  charter,  bylaws  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.

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. 

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,” 

37

“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, but are not limited to:

•  The possible or assumed future results of operations, including the accuracy of our estimates regarding 

expenses, future revenues, capital requirements and needs for additional financing; 

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

and the cost of capital to us;

•  Our competitive position and competitors, including the size and growth potential of the markets for our 

products and product candidates;

•  The success, cost and timing of our product development activities and clinical trials; and our ability to 

successfully commercialize our product candidates;

•  The performance of our third-party suppliers and manufacturers; and the retention of key scientific and 

management personnel;

•  Our  expectations  regarding  our  ability  to  provide  intellectual  property  protection  for  our  product 

candidates; and

•  Changes in reimbursement available to us, including changes in Medicare and Medicaid payment levels 
and availability of third-party insurance coverage and the effects of future legislation or regulations.

38

Item 1B. Unresolved Staff Comments.

None.

Item 2. Properties.

As of December 31, 2015, we leased approximately 25,500 square feet of office space in Nashville, Tennessee for 
our corporate headquarters. The lease expires in October 2022.  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.

Item 3. Legal Proceedings.

     On April 14, 2014, we filed with the American Arbitration Association a request for arbitration with Mylan Inc., 
Mylan Institutional LLC, Mylan Pharma Group Limited, and Mylan Teoranta (collectively, “Mylan”). We are seeking 
to arbitrate claims against Mylan in connection with our Alliance Agreement dated January 15, 2002, and Manufacturing 
and Supply Agreement as amended April 25, 2011, which require that Mylan and its affiliates manufacture and supply 
acetylcysteine drug product, including Acetadote, for us exclusively until April 2016. We have asserted in the request 
for arbitration claims against Mylan for breach of contract, breach of implied covenant of good faith and fair dealing, 
and unjust enrichment and seek monetary damages or to enjoin Mylan and its affiliates from selling or supplying 
acetylcysteine drug product to another entity or person until April 2016. 

     On September 14, 2015, the arbitrator issued a final award in our favor, enjoining Mylan Pharma Group Limited 
and  Mylan Teoranta,  together  with  all  their  affiliates,  from  selling,  delivering,  or  giving  away  any  acetylcysteine 
injectable drug product to another entity or person until April 30, 2018. The award notes that as the prevailing party, 
we are entitled to reimbursement of our attorney’s fees and related costs associated with the arbitration. 

     Also see the discussion of our Acetadote patent defense legal proceedings contained in Part 1, Item 1, Business -
Trademarks and Patents, of this Form 10-K, which is incorporated by reference herein. 

39

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.” As of March 4, 2016, we had 79 shareholders of record of our common stock.  This excludes 
shareholders whose shares are held by brokers and other institutions on behalf of shareholders. The closing price of 
our common stock on the Nasdaq Global Select Market on March 4, 2016 was $4.81 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 2015 and 2014:

Fiscal year ended December 31, 2015:

First quarter

Second quarter

Third quarter

Fourth quarter

Fiscal year ended December 31, 2014:

First quarter

Second quarter

Third quarter

Fourth quarter

High

Low

$7.09

7.78

7.52

6.50

5.19

4.59

5.20

6.20

$5.62

6.06

5.50

5.03

4.33

4.20

4.42

4.50

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.

Performance Graph

The stock performance graph below illustrates a comparison of the total cumulative stockholder return on our 
common stock since December 31, 2010 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 December 31, 2010, and that all dividends were reinvested.

40

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, January 2013, January 2015 and January 
2016, our Board of Directors replaced the prior authorizations with $10 million authorizations for repurchases of our 
outstanding common stock.  We repurchased 829,003 shares, 881,810 shares, and 1,008,105 shares of common stock 
for approximately $5.3 million, $4.3 million, and $4.8 million during the years ended December 31, 2015, 2014 and 
2013, respectively.

The following table summarizes the activity, by month, during the fourth quarter of 2015:

Period

Total Number
of Shares (or
Units)
Purchased

October

November

December

Total

43,552

38,978 (1)

34,339

116,869

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

43,552

38,978

34,339

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

$5,406,839

5,179,445

4,990,101

Average
Price Paid
per Share
(or Unit)

$5.79

5.83

5.51

(1)  Of this amount, 4,783 shares were repurchased directly in a private purchase at the then-current fair market value of 

common stock.

41

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:

2015

Years Ended December 31,

2012
2013
2014
(in thousands, except per share data)

2011

Net revenues

Costs and expenses

Operating income (loss)

Net income (loss) attributable to
common shareholders

Earnings (loss) per share – basic

Earnings (loss) per share – diluted

$

33,519

$

36,902

$

32,027

$

48,851

$

51,143

32,407

1,112

33,343

3,559

35,829
(3,801)

40,033

8,818

41,293

9,849

731

0.04

0.04

$

$

2,424

0.14

0.14

$

$

(2,105)
(0.11) $
(0.11) $

5,842

0.30

0.30

$

$

5,658

0.28

0.28

$

$

Balance sheet data:

2015

2014

As of December 31,

2013
(in thousands)

2012

2011

Cash and cash equivalents

$

38,203

$

39,866

$

40,869

$

54,349

$

70,599

Marketable securities
Working capital

Total assets

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

Retained earnings

Total equity

14,564

54,700

91,919

2,687

19,550

76,820

14,841

57,065

95,405

1,032

18,818

80,753

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

42

 
 
 
 
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  for  the  treatment  for  pain  and  fever,  Kristalose®  (lactulose)  for  Oral  Solution,  a 
prescription laxative, Omeclamox®-Pak, (omeprazole, clarithromycin, amoxicillin) for the treatment of Helicobacter 
pylori (H. pylori) infection and related duodenal ulcer disease, Vaprisol® (conivaptan) Injection, to raise serum sodium 
levels in hospitalized patients with euvolemic and hypervolemic hyponatremia, Hepatoren (ifetroban) Injection, a Phase 
II candidate for the treatment of critically ill hospitalized patients suffering from hepatorenal syndrome ("HRS") and 
Boxaban® (ifetroban) oral capsules, a Phase II candidate for the treatment of patients with aspirin-exacerbated respiratory 
disease (AERD).

We market and sell our approved products through our hospital and field sales forces in the United States, which 

together comprised approximately 50 sales representatives and managers as of December 31, 2015.

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.

The following is a summary of our 2015 highlights and recent developments. For more information, please see 

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

• 

In  September  2015,  we  announced  our  strategic  alliance  with  Clinigen  Group  plc  (AIM:  CLIN) 
("Clinigen"), a global pharmaceutical and services company.  Under the agreement, we will have the 
opportunity to support Clinigen products through distribution, marketing and promotion within the United 
States. During 2016 we entered into an amendment to this strategic alliance agreement that outlines the 
support Cumberland will provide to one of Clinigen's product in the United States. Cumberland expects 
to launch the support for the Clinigen product during the second half of 2016.

•  We obtained a favorable court ruling upholding the validity and enforceability of our key Acetadote patent 
in September 2015.  By ruling in our  favor, the court upheld the validity of the patent which encompasses 
our  EDTA-Free  formulation  and  has  a  term  until August  2025.  The  court  also  granted  a  permanent 
injunction preventing challengers from marketing a generic version of Acetadote before the expiration of 
our patent in August 2025. 

43

•  We continued our international expansion during 2015, and Caldolor became our fastest growing brand 
with increased revenue contributions from international sales following the product’s launch in Australia.

•  After its new positioning a year earlier, Kristalose continued as our largest selling brand and we were able 

to improve the product’s gross sales deductions from managed care contracts.

•  We maintained a significant market share for Acetadote through the combined sales of our branded and 

Authorized Generic products.

•  We completed initial Phase II studies for our Hepatoren and Boxaban product candidates. The Company 
is developing Boxaban for the treatment of Aspirin-Exacerbated Respiratory Disease ("AERD"). AERD 
is a respiratory disease involving chronic asthma and nasal polyposis that is worsened by aspirin. 

• 

In  October  2015,  we  executed  a  Strategic  Alliance  Agreement  with  Piramal  Enterprises  Limited 
("Piramal") for the manufacture and supply of Active Pharmaceutical Ingredients ("API"). Under the this 
agreement, we will collaborate with Pirarmal on the manufacture and supply of API for New Chemical 
Entities ("NCE") in development at CET.  Piramal will provide both development and commercial supplies 
of API for select product candidates. Piramal is a diversified conglomerate with operations in over thirty 
countries and five API manufacturing plants. 

•  During October 2015, we announced the publication of an integrated safety analysis adding to the growing 
body of literature that support the safety of Caldolor. The data in this cumulative safety analysis is derived 
from ten sponsored clinical studies investigating intravenous ibuprofen for the treatment of pain and/or 
fever in adult patients.  Over 1,750 adult patients have been included in safety and efficacy trials over 
eleven years. The  publication is available as open access articles in the Journal of Pain Research.

•  We also entered into a co-promotion agreement in November 2015 with Piramal Critical Care to expand 
the support for our Caldolor and Vaprisol products. Piramal will provide coverage for an additional group 
of hospitals where Piramal's critical care sales force has existing relationships. The collaboration will 
provide expanded sales promotion and increased communication to medical professionals, to support 
patient care throughout the U.S. 

• 

• 

In November 2015, we announced the approval of Caldolor for pediatric patients six months of age and 
older. The approval was based on data submitted to the U.S. Food and Drug Administration (FDA) as 
part of a post-marketing commitment following approval of Caldolor in adults in 2009. Caldolor is the 
first and only injectable non-steroidal anti-inflammatory drug (NSAID) approved for use in pediatric 
patients. 

In November 2015, we entered into a new agreement with Gastoenterlogics Inc. to assume remaining 
commercial rights to Omeclamox-Pak for the U.S. We had previously signed an agreement with Pernix 
to jointly commercialize the product in the U.S. However, Pernix was not able to provide the expected 
primary care support given the arrival of their newly acquired products. Simultaneous with our  new GEL 
Agreement, Cumberland and Pernix terminated their arrangements. We will continue promotion to the 
gastroenterology  community  through  its  field  sales  force  and  seek  a  new  co-promotion  partner  with 
national primary care capabilities in the U.S.

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 

44

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, Vaprisol, 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 1.5% percent of net revenues in 2015, 0.6% in 2014, and 2.9%
in 2013.

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 $0.4 million and $0.4 million at December 31, 2015 and 2014, 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:

2015

2014

2013

Balance, January 1

Current provision

Actual product returns and credits issued

Balance, December 31

$

$

5,234,800

$

2,437,140

$

3,371,863

10,981,168
(9,439,945)
6,776,023

$

14,972,112
(12,174,452)
5,234,800

$

4,181,403
(5,116,126)
2,437,140

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 
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 $6.8 million, $5.2 million and $2.4 
million as of December 31, 2015, 2014 and 2013, respectively. Of these amounts, our estimated liability for fee for 
services represented $1.1 million, $0.9 million and $0.5 million, respectively, while our accrual for product returns 
totaled $2.2 million, $2.1 million and $1.6 million, respectively. If the actual amount of cash discounts, chargebacks, 

45

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 $0.3 million in the year ended December 31, 2015, $0.3 million in 
the year ended December 31, 2014 and $0.1 million in the year ended December 31, 2013.  A change in our product 
return estimate of one percentage point would have impacted net sales by $0.4 million, $0.5 million and $0.3 million
for the years ended December 31, 2015, 2014 and 2013, 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, 2015 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 
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, 2015, we have unrecognized federal net operating loss carryforwards 
associated with the exercise of nonqualified options of $43.0 million.  In addition to these unrecognized federal net 
operating loss carryforwards, as of December 31, 2015, we have recognized federal Orphan Drug and Research and 
Development tax credits of $1.1 million that expire between 2021 and 2033.

46

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.

Research and Development

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 not differed materially from 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.

47

RESULTS OF OPERATIONS 

Year ended December 31, 2015 compared to year ended December 31, 2014

The following table presents the statements of operations for the years ended December 31, 2015 and 2014:

Net revenues

Costs and expenses:

Cost of products sold

Selling and marketing

Research and development

General and administrative

Amortization

Total costs and expenses

Operating income

Interest income

Interest expense

Income before income taxes

Income tax expense

Net income

$

2015

Years ended December 31,
2014

Change

$

33,519,051

$

36,901,871

$

(3,382,820)

4,968,170

13,994,768

3,847,651

7,607,588

1,989,264

32,407,441

1,111,610

209,183
(73,856)
1,246,937
(575,829)
671,108

$

5,053,165

14,902,202

3,389,419

8,401,560

1,596,689

33,343,035

3,558,836

251,447
(67,074)
3,743,209
(1,380,744)
2,362,465

$

(84,995)
(907,434)
458,232
(793,972)
392,575
(935,594)
(2,447,226)
(42,264)
(6,782)
(2,496,272)
804,915
(1,691,357)

Net revenues. Net revenues for the year ended December 31, 2015 were approximately $33.5 million compared 
to $36.9 million for the year ended December 31, 2014, representing a decrease of $3.4 million or 9.2%.  The following 
table summarizes net revenues by product for the years presented:

Years ended December 31,

2015

2014

Change

Products:

Acetadote

Omeclamox-Pak

Kristalose

Vaprisol
Caldolor

Other

$

8,489,167

$

11,906,232

$

3,037,078

15,733,327

2,641,484

3,112,128

505,867

4,111,916

14,932,271

3,011,997

2,721,346

218,109

Total net product revenues

$

33,519,051

$

36,901,871

$

(3,417,065)
(1,074,838)
801,056
(370,513)
390,782

287,758
(3,382,820)

Revenue increases in two of our five branded prescription products were offset by decreases in Omeclamox-Pak 
revenue of $1.1 million, Acetadote product revenue of $3.4 million and Vaprisol product revenue of $0.4 million. Our 
products with revenue gains were led by increases in Kristalose revenue of $0.8 million and Caldolor revenue of $0.4 
million . 

Kristalose revenue increased by $0.8 million or 5.4% over the prior year period primarily due to new positioning 
for the product.  We increased the price of Kristalose during the first quarter of 2014 to bring Kristalose more in line 
with the other marketed branded prescription products in its class.  Concurrent with the price increase, we increased 
our patient focused initiatives to enhance patient affordability and increase demand.  During the year ended December 31, 
2015, we also experienced improvements in product net revenue per unit as we incurred a lower level of net revenue 
deductions from managed care contracts.  

48

 
 
 
 
The Caldolor product revenue experienced a $0.4 million improvement, which represents an increase of 14.4%
during 2015 compared to 2014.  Caldolor sales volumes and net revenue were positively impacted by the efforts of our 
sales force, marketing initiatives and a temporary shortage of a competing product.  Caldolor sales were also positively 
impacted by the return of international sales in South Korea as well the product's launch in Australia. While we expect 
2016 Caldolor annual product revenue to continue to grow compared to 2015, we continue to anticipate quarterly 
fluctuations due to wholesaler buying patterns and other factors. 

Acetadote net revenue for the  year ended December 31, 2015 included $4.5 million in revenue from sales of our 
Authorized Generic distributed by Perrigo, compared to $5.8 million last year. This decrease in sales of our Authorized 
Generic product accounted for approximately 37.2% of the decline in total Acetadote revenue.  The Authorized Generic 
sales were impacted by a temporary packaging delay and resulting shortage of marketable product that impacted revenue 
during a portion of the year.  Our branded Acetadote product net revenue decreased $2.1 million due to a reduction in 
sales volume as a result of generic competition, along with an increase in revenue deductions related to an increase in 
expired product during the first quarter of 2015.  It is likely that there will be further reductions in our revenue generated 
by Acetadote and our Authorized Generic as a result of generic competition. 

Omeclamox-Pak revenue declined 26.1% during 2015 compared to the prior year.  The decrease was the result of 
lower sales volume partially offset by improved pricing.  The sales volume decrease was impacted by the lack of sales 
calls supporting the product by our co-promotion partner for this period.

Vaprisol revenue decreased 12.3% during 2015 compared to the prior year primarily due to lower sales volume 
during a portion of the twelve months ended December 31, 2015, which was partially offset by improved pricing.  A 
portion of the sales volume decrease was attributable to the period in which we transitioned our marketable inventory 
from the Astellas labeled product to our Cumberland labeled product. 

Cost of products sold. Cost of products sold for the year ended December 31, 2015 decreased 1.7% as compared 
to the same period in the prior year.  As a percentage of net revenues, cost of products sold increased to 14.8% compared 
to 13.7% during the prior year.  This results partially from a change in the product sales mix as well as $0.3 million in 
inventory write-downs during 2015 for potentially obsolete inventory. 

Selling and marketing. Selling and marketing expense for 2015 totaled approximately $14.0 million, which was 
a decrease of $0.9 million compared to the prior year's expense of $14.9 million. The decrease was the result of a $0.3 
million reduction in Omeclamox product royalties as well as decreases in sales force salaries and related costs.  These 
decreases were partially offset by an increase in non-personal promotional spending. We continue to actively manage 
our selling and marketing efforts and expenses under our strategy to efficiently support our five commercial brands.     

Research and development. Research and development costs for the  year ended December 31, 2015 were $3.8 
million, compared to $3.4 million last year, representing an increase of $0.5 million, or 13.5%.  This change was the 
result of a $1.2 million required fee that accompanied the Caldolor sNDA filed with the FDA during the first quarter 
of 2015.  This submission was successful and the FDA approved Caldolor for a pediatric indication.  This increase was 
offset by a $0.3 million reduction in costs as we were able to reduce our acquired contingent study liabilities related 
to the Vaprisol acquisition.  We continued to fund clinical studies for both our Boxaban and Hepatoren product candidates 
during 2015.  A portion of our research and development costs are variable based on the number of studies, sites and 
participants involved in our product development activities.   

General and administrative.  General and administrative expense was $7.6 million for 2015, compared to $8.4 
million  during  2014.    The  $0.8  million  decrease  was  primarily  driven  by  a  $0.3  million  decrease  in  contingent 
consideration as the result of a reduction in the cost of the Vaprisol acquisition.  General and administrative expense 
was also benefited by a reduction in our travel and legal fees along with a $0.3 million decrease in compensation and 
benefit expense during the period. 

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 2015 totaled approximately $2.0 million, 
which was an increase of $0.4 million over the prior year. The increase in amortization was attributable to additional 
product and license rights, capitalized patents and patent defense costs.

Income tax expense. Income tax expense for the year ended December 31, 2015 was $0.6 million, compared to 
income tax expense of $1.4 million in 2014. The change was the result of the reduction in pretax income for 2015 as 

49

compared to last year.  As a percentage of income before income taxes, income tax expense was 46.2% in 2015 compared 
to 36.9% in 2014.  The income tax rate for the year ended December 31, 2015 was primarily a result of other permanently 
non-deductible differences, including adjustments to our valuation allowance and increases in our state income tax rate, 
including changes from legislation.  Our recurring expenses that are non-deductible for tax purposes grew during 2015, 
but the primary impact was the result of these costs being a higher percentage of income before income taxes. The 
income tax rate for the year ended December 31, 2014 was positively impacted by a reduction in our state tax expense. 

Year ended December 31, 2014 compared to year ended December 31, 2013

The following table presents the statements of operations for the years ended December 31, 2014 and 2013:

Net revenues

Costs and expenses:

Cost of products sold

Selling and marketing

Research and development

General and administrative

Amortization

Total costs and expenses

Operating income (loss)

Interest income

Interest expense

Income (loss) before income taxes

Income tax (expense) benefit

Net income (loss)

$

2014

Years ended December 31,
2013

Change

$

36,901,871

$

32,027,462

$

4,874,409

5,053,165

14,902,202

3,389,419

8,401,560

1,596,689

33,343,035

3,558,836

251,447
(67,074)
3,743,209
(1,380,744)
2,362,465

$

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) $

(386,257)
514,457
(2,226,082)
(1,088,416)
700,533
(2,485,765)
7,360,174

21,156

36,348

7,417,678
(2,903,795)
4,513,883

Net revenues. Net revenues for the year ended December 31, 2014 were approximately $36.9 million compared 
to $32.0 million for the year ended December 31, 2013, representing an increase of $4.9 million or 15.2%.  The following 
table summarizes net revenues by product for the years presented:

Years ended December 31,

2014

2013

Change

Products:

Acetadote

Omeclamox-Pak

Kristalose

Vaprisol

Caldolor

Other

$

11,906,232

$

18,846,753

$

4,111,916

14,932,271

3,011,997

2,721,346

218,109

1,045,815

9,118,475

—

2,089,655

926,764

Total net product revenues

$

36,901,871

$

32,027,462

$

(6,940,521)
3,066,101

5,813,796

3,011,997

631,691
(708,655)
4,874,409

 Net product revenues. The revenue increase was driven primarily by increases in Kristalose product revenue of 
$5.8 million, Omeclamox-Pak revenue of $3.1 million and Vaprisol revenue of $3.0 million. A decrease in branded 
Acetadote product revenue of $3.5 million and a decrease in Authorized Generic Acetadote product revenue of $3.4 
million partially offset this overall revenue increase. 

50

 
 
 
 
Kristalose revenue increased 63.8% over the prior year primarily due to new positioning for the product.  We 
increased the price of Kristalose during the first quarter of 2014 to bring Kristalose more in line with the other marketed 
branded prescription products in its class.  Concurrent with the price increase, we increased our patient focused initiatives 
to enhance patient affordability and increase demand.

The increase in revenue was also attributable to a 30.2% increase in Caldolor through our growth in international 
and domestic sales.  The addition of Vaprisol in early 2014 and the benefit of a full year of Omeclamox-Pak compared 
to a partial year of sales for the brand during 2013 also contributed to the revenue increase.  

The year over year decrease in Acetadote net revenue was primarily due to decreased sales volume of the branded 
Acetadote and Authorized Generic product largely as a result of generic competition. Acetadote product revenue for 
2014 included $5.8 million in sales of the Authorized Generic product compared to prior year sales of $9.2 million.    

Other revenue. Other revenue was $0.2 million in 2014 compared to $0.9 million in 2013.  The decrease was 
primarily  the  result  $0.6  million  of  upfront  payments  we  received  during  2013  in  connection  with  out-licensing 
agreements with international commercial partners.   

Cost of products sold. As a percentage of net revenues, cost of products sold decreased to 13.7% during 2014, 
compared  to  17.0%  in  the  prior  year.   The  decrease  in  costs  of  sales  as  a  percentage  of  net  revenue  was  partially 
attributable to a change in the product sales mix and an increase in our sales prices.  The comparative decrease is also 
attributable to the recognition of $0.9 million in inventory write-downs during 2013 for potentially obsolete inventory. 

Selling and marketing. Selling and marketing expense for 2014 was $14.9 million, compared to $14.4 million for 
the prior year, representing an increase of $0.5 million.  The increase was the result of increased sales, including a $0.4 
million increase in Omeclamox-Pak product royalties and increased distribution costs of products and product samples.    

Research and development. Research and development costs in 2014 were $3.4 million, compared to $5.6 million 
during 2013, representing a decrease of approximately $2.2 million, or 39.6%.   This change was a result of decreased 
product development and clinical study costs during 2014 following the conclusion of clinical studies related to Caldolor 
during 2013. 

General and administrative. General and administrative expense for 2014 totaled approximately $8.4 million, 
compared to $9.5 million in 2013. The $1.1 million decrease was attributable to decreases in salary, wages and benefits, 
travel costs, legal expenses and consulting fees, as we continued to realign the organization to support the mix of brands.

Amortization. Amortization expense is the ratable use of our capitalized intangible assets including product and 
license rights, patents, trademarks and patent defense costs.   Amortization expense for 2014 was $1.6 million compared 
to $0.9 million in 2013, representing an increase of $0.7 million. The increase in amortization was attributable to 
additional product and license rights, capitalized patents and patent defense costs.

Income tax (expense) benefit. Income tax expense for the year ended December 31, 2014 totaled approximately 
$1.4 million, representing a $2.9 million increase in expense over the prior year income tax benefit of $1.5 million.  
The primary reason for the increase was the result of pretax income in 2014 compared to a pretax loss in 2013. As a 
percentage of income before income taxes, income tax expense was 36.9% for 2014 compared to a benefit percentage 
of  41.4%  for  2013. The  tax  expense  for  2014  was  positively  impacted  by  the  extension  of  the  U.S.  research  and 
development tax credit for 2014, along with the reduction in our state tax expense during 2014. The tax benefit for 
2013 was positively impacted by the reinstatement of the U.S. research and development tax credit during 2013.

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, 2015, 2014 and 2013, we generated $5.9 million, $6.7 million and $0.7 million in cash flow from operations, 
respectively, and we borrowed $1.7 million on our line of credit during 2015.  We believe that our internally generated cash 
flows and amounts available under our line of credit will be adequate to finance internal growth and fund capital expenditures. 

51

We invest a portion of our cash reserves in variable rate demand notes ("VRDNs") and a portfolio of government-backed 
securities (including U.S. Treasuries, government-sponsored enterprise debentures and government-sponsored adjustable 
rate, mortgage-backed securities).  The 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, 2015 and 2014, we had approximately $14.6 million and $14.8 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)

2015

2014

$

$

$

38,203,059

14,564,115

52,767,174

54,700,327
5.4

$

$

$

39,866,037

14,841,418

54,707,455

57,065,489
5.2

Revolving line of credit availability

$

10,300,000

$

12,000,000

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

2015

2014

2013

Cash provided by (used in):

Operating activities

Investing activities

Financing activities

Net (decrease) increase in cash and 
cash equivalents 

$

5,876,865

$

(2,344,972)

(5,194,871)

$

6,693,431
(6,034,440)
(1,662,411)

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

$

(1,662,978) $

(1,003,420) $

(13,479,924)

Operating activities provided $5.9 million in cash during the year ended December 31, 2015.  The net $1.7 million decrease 
in cash and cash equivalents for 2015 was attributable to cash used in investing and financing activities, which was partly 
offset by the $5.9 million in cash generated from operations.  Cash used in investing activities included a net cash investment 
in our intangible assets of $2.6 million, which was partially offset by net proceeds of $0.4 million associated with our investing 
activities in marketable securities.  Our financing activities included $5.3 million in cash used to repurchase shares of our 
common stock, $1.7 million used to settle the remaining cash consideration for Vaprisol and $1.7 million in cash provided 
by borrowings under our line of credit.  Cash provided by operating activities benefited from the non-cash expenses of 
depreciation, amortization and share-based compensation costs totaling $2.8 million and included positive changes in our 
working capital of $2.0 million.  During 2015, we recognized approximately $0.1 million of excess tax benefits.  The excess 
tax benefit represented the income taxes that would have been paid if not for the tax deductions created upon the exercise 
of nonqualified stock options. 

As noted above, we continue to repurchase shares of our common stock, as 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.

Operating activities provided $6.7 million in cash during the year ended 2014, with the net decrease in cash and cash 
equivalents for 2014 mainly attributable to cash used in our investing activities.  Cash used in investing activities included 
a $2.0 million up-front payment for the acquisition of Vaprisol, a $3.1 million increase in intangible assets, and a net investment 
in marketable securities of $0.8 million. Our financing activities included the repurchase of shares of our common stock 
totaling  $4.3  million  partially  offset  by  the  $1.0  million  investment  Gloria  made  in  CET.  During  2014,  we  recognized 
approximately $1.7 million of excess tax benefits.  The excess tax benefit represented the income taxes that would have been 
paid if not for the tax deductions created upon the exercise of nonqualified stock options. 

52

 
 
 
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.    We also repaid the outstanding 
balance of our revolving line of credit of $4.4 million during 2013. 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.

Debt Agreement

On June 26, 2014, we entered into a Revolving Credit Loan Agreement (“Loan Agreement”) with SunTrust Bank. The 
agreement replaced the August 2011 Fifth Amended and Restated Loan Agreement with our previous primary lender which 
was to expire on December 31, 2014.   There are $1.7 million in borrowings under the Loan Agreement at December 31, 
2015.  The Loan Agreement provides for an aggregate principal amount of up to $20 million and it has a three year term 
expiring on June 26, 2017.  The initial revolving line of credit is up to $12 million, an increase from the $10 million under 
the previous agreement.  We have the ability to increase the borrowing amount up to $20 million, upon the satisfaction of 
certain conditions. 

The interest rate on the Loan Agreement is based on LIBOR plus an interest rate spread.  There is no LIBOR minimum 
and  the  LIBOR  pricing  provides  for  an  interest  rate  spread  of  1.0%  to  2.85%  (representing  an  interest  rate  of  1.2%  at 
December 31, 2015).  In addition, a fee of 0.25% per year is charged on the unused line of credit. 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 Loan Agreement, we are subject to certain financial covenants, including, but not limited to, maintaining 
an EBIT to Interest Expense Ratio and a Funded Debt Ratio (as such terms are defined in the Loan Agreement) that are 
determined on a quarterly basis.  We were in compliance with all covenants at December 31, 2015.

Minimum Product Purchase Requirements

Our manufacturing and supply agreements do not require minimum annual purchase obligations. 

Contractual cash obligations

The following table summarizes our contractual cash obligations as of December 31, 2015:

Contractual obligations(1)

Total (2)

2016

2017

2018

2019

2020

Payments Due by Year

Amounts reflected in the
balance sheet:

Line of credit(3)
Estimated interest on 
debt (3)

Other cash obligations not
reflected on the balance
sheet:

Operating leases
Purchase obligations (4)

Total (1)

$

38,625

$

25,750

$

12,875

$

— $

— $

30,600

20,400

10,200

—

—

—

—

6,324,377

1,075,243

1,039,618

901,568

838,896

2,469,052

—

—

—

—

—

—

$ 6,393,602

$ 1,121,393

$ 1,062,693

$

901,568

$ 838,896

$ 2,469,052

(1)  The table of contractual obligations excludes amounts due under the Kristalose purchase agreement and the Omeclamox-Pak 
royalty agreement as these amounts cannot be determined until sales of these products 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.  Omeclamox-Pak includes a royalty expense as 
part of the period costs of the agreement. 

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

(3)  The line of credit payments represent the estimated unused line of credit payments and the estimated interest on debt represents 
the interest on the principal outstanding on the line of credit.  These amounts are based on the $12 million line of credit assuming 
the current $1.7 million balance outstanding on December 31, 2015 is consistently outstanding through June 2017.  Interest  and 
unused line of credit payments are due and payable quarterly in arrears. 

53

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

OFF-BALANCE SHEET ARRANGEMENTS

During 2015, 2014 and 2013, we did not engage in any off-balance sheet arrangements.

RECENTLY ISSUED BUT NOT YET ADOPTED ACCOUNTING PRONOUNCEMENTS 

In May 2014, the Financial Accounting Standards Board (the "FASB") issued amended guidance in the form of a 
FASB Accounting Standards Update ("ASU"), "Revenue from Contracts with Customers".  The core principle of the 
new guidance is to recognize revenues when promised goods or services are transferred to customers in an amount that 
reflects the consideration to which an entity expects to be entitled for those goods or services. The new guidance defines 
a five step process to achieve this core principle and, in doing so, additional judgments and estimates may be required 
within the revenue recognition process.  The new standard will replace most of the existing revenue recognition standards 
in U.S. GAAP when it becomes effective.  In July 2015, the FASB issued a one year deferral of the adoption date, 
which extended the effective date for us to January 1, 2018. Adoption prior to January 1, 2017, the original effective 
date, is not permitted. The new standard can be applied retrospectively to each prior reporting period presented or 
retrospectively with the cumulative effect of the change recognized at the date of the initial application. We are assessing 
the potential impact of the new standard on financial reporting and have not yet selected a transition method by which 
we will adopt the standard.

In April  2015,  the  FASB  issued  amended  guidance  in  a  FASB ASU,  "Interest-Imputation  of  Interest",  which 
simplifies the balance sheet presentation of debt issuance costs.  Under the new guidance, debt issuance costs related 
to a recognized debt liability will be presented on the balance sheet as a direct deduction from the liability.  This treatment 
is consistent with the presentation of debt discounts.  The new guidance is effective for fiscal years beginning after 
December 15, 2015, and interim periods within those fiscal years.  Early adoption is permitted, and the new guidance 
should be applied retrospectively.  In August 2015, The FASB issued additional related guidance in the form of another 
ASU "Interest-Imputation of Interest" that specifically addressed "Line -of-Credit Arrangements".  The new guidance 
allows the presentation of deferred debt issuance costs as an asset and subsequently amortizing these costs over the 
term of the line-of-credit arrangement.  This guidance applies whether or not there are any borrowings on the line-of-
credit. We do not anticipate adoption of either ASU to have a material effect on our consolidated financial statements 
and disclosures.

In July 2015, the FASB issued amended guidance in the form of a FASB ASU on, “Inventory: Simplifying the 
Measurement of Inventory.”  The amended guidance requires entities to measure inventory at the lower of cost or net 
realizable value. Net realizable value is the estimated selling prices in the ordinary course of business, less reasonably 
predictable costs of completion, disposal, and transportation. The requirement would replace the current lower of cost 
or market evaluation. Accounting guidance is unchanged for inventory measured using last-in, first-out (“LIFO”) or 
the retail method.  The amendments in this update are effective for fiscal years beginning after December 15, 2016.  
The accounting guidance should be applied prospectively and early adoption is permitted. We are evaluating the potential 
impact of this adoption on our consolidated financial statements and disclosures.

In November 2015, the FASB amended guidance in the form of a FASB ASU on, "Balance Sheet Classification 
of Deferred Taxes", which requires that all deferred tax assets and liabilities be classified as noncurrent on the balance 
sheet  instead  of  separating  deferred  taxes  into  current  and  noncurrent  amounts.  The  FASB  determined  that  this 
simplification could reduce cost and complexity without decreasing the usefulness of information provided to financial 
statement users. The amendments in this update are effective for fiscal years beginning after December 15, 2016.  The 
accounting  guidance  may  be  applied  prospectively  or  retrospectively  and  early  adoption  is  permitted.  We  do  not 
anticipate adoption of this balance sheet classification ASU to have a material effect on our consolidated financial 
statements and disclosures. 

In February 2016, the FASB issued guidance in the form of a FASB ASU, "Leases".  The new standard establishes 
a right-of-use (ROU) model that requires a lessee to record an ROU asset and a lease liability on the balance sheet for 
all leases with terms longer than 12 months. Leases will be classified as either finance or operating, with classification 
affecting the pattern of expense recognition in the income statement. A modified retrospective transition approach is 
required  for  lessees  for  capital  and  operating  leases  existing  at,  or  entered  into  after,  the  beginning  of  the  earliest 
comparative period presented in the financial statements, with certain optional practical expedients available.  The new 
standard is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal 
years.  We are evaluating the impact of our pending adoption of the new standard on our consolidated financial statements 
and disclosures.

54

There are no other 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.

We invest in VRDNs and a portfolio of government backed securities (including U.S. Treasuries, government 
sponsored enterprise debentures and government sponsored adjustable rate mortgage backed securities) to obtain a 
higher return while preserving our capital. The VRDNs are generally issued by municipal governments and are backed 
by a financial institution letter of credit. The VRDNs allow us the ability 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 primary risk related to interest rates for these accounts are that they will produce 
less income than expected if market interest rates fall.  Based on the $14.6 million in marketable securities outstanding 
at December 31, 2015, 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 based on LIBOR plus an interest rate spread.  
There is no LIBOR minimum and the LIBOR pricing provides for an interest rate spread of 1.0% to 2.85% (representing 
an interest rate of 1.2% at December 31, 2015).   As of December 31, 2015, we had $1.7 million in borrowings outstanding 
under our revolving 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 2015, 2014 and 2013. 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.

55

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, 2015. Based on that evaluation, they have 
concluded that our disclosure controls and procedures were effective as of December 31, 2015 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 is included on page F-1 of this annual report on 

Form 10-K, and incorporated herein by reference.

During our fourth quarter of 2015, there were no changes in our internal control over financial reporting (as defined 

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

Item 9B. Other Information.

Dr. Amy D. Rock, who had been serving as Cumberland’s Vice President, Regulatory & Scientific Affairs, 
transitioned out of that role effective March 8, 2016 as she pursues interests outside of the Company.  She will 
continue as an adviser to the Company. 

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 2016 annual meeting of shareholders, which is expected to be filed with the SEC on or around March 11, 
2016.

PART IV

56

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

Consolidated Balance Sheets

Consolidated Statements of Operations and Comprehensive Income (Loss)

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-32

57

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

10.1†

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

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

58

  
  
Exhibit
Number
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#

10.14#

10.15#

Description
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 9, 2016, effective as of January 1, 2016, by and between 
A.J. Kazimi and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 9, 2016, effective as of January 1, 2016, by and between 
Martin E. Cearnal and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 9, 2016, effective as of January 1, 2016, by and between 
Leo Pavliv and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 10, 2016, effective as of March 10, 2016, by and between 
Michael Bonner and Cumberland Pharmaceuticals Inc.

Employment Agreement dated March 9, 2016, effective as of January 1, 2016, by and between 
James L. Herman and Cumberland Pharmaceuticals Inc.

59

Exhibit
Number

10.17#

10.18#

10.19#

10.20

10.21†

10.21.1†

10.21.2†

10.21.3††

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

Third Amendment to Office Lease Agreement, dated September 29, 2015, 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 
November 6, 2015

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

60

Exhibit
Number

10.25††

10.28†

10.29†

10.30#

10.31†

10.32†

10.33

21

23.1

31.1

31.2

32.1

Description

License  and  Supply  Agreement,  dated  November  16,  2015,  by  and  between  Cumberland 
Pharmaceuticals Inc. and Gastro-Entero Logic, 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

Revolving  Credit  Loan  Agreement,  dated  June  26,  2014,  by  and  between  Cumberland 
Pharmaceuticals Inc. and SunTrust Bank 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, 2014

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.

61

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 14, 2016.

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/ Michael Bonner
Michael Bonner

/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 14, 2016

March 14, 2016

March 14, 2016

March 14, 2016

March 14, 2016

March 14, 2016

March 14, 2016

March 14, 2016

Chairman and CEO
(Principal Executive Officer and
Director)

Senior Director and CFO
(Principal Financial and 
Accounting Officer

Director

Director

Director

Director

Director

Director

62

MANAGEMENT’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING

The management of Cumberland Pharmaceuticals Inc. and its subsidiaries (the "Company") 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, 2015. 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 (2013).

Based on its assessment, management has concluded that, as of December 31, 2015, the Company’s internal control 

over financial reporting was effective based on those criteria.

/s/ A. J. Kazimi
A. J. Kazimi
Chief Executive Officer
March 14, 2016

/s/ Michael Bonner
Michael Bonner
Chief Financial Officer
March 14, 2016

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, 2015 and 2014, 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, 2015. In connection with our audit 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, 2015. 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, 2015 and 2014, and the 
results of their operations and their cash flows for each of the years in the 
period ended December 31, 2015, 
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.

/s/ KPMG LLP
Nashville, Tennessee
March 14, 2016

F-2

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Balance Sheets

December 31, 2015 and 2014

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:

2015

2014

$

38,203,059
14,564,115

$

39,866,037
14,841,418

6,077,120

4,270,143

1,468,913

2,528,724

67,112,074
536,450

21,168,596

1,210,786

1,891,053

5,504,728

5,600,319

1,351,324

3,651,145

70,814,971
651,030

21,568,541

578,592

1,791,980

$

91,918,959

$

95,405,114

$

2,877,479

$

3,242,713

9,534,268

12,411,747

1,700,000

987,429

15,099,176

10,506,769

13,749,482

—

902,841

14,652,323

Common stock – no par value; 100,000,000 shares authorized;
16,379,501 and 17,118,993 shares issued and outstanding as of
December 31, 2015 and 2014, respectively

Retained earnings

Total shareholders’ equity

Noncontrolling interests

Total equity

Total liabilities and equity

57,338,294

19,549,614

76,887,908
(68,125)
76,819,783

61,942,410

18,818,263

80,760,673
(7,882)
80,752,791

$

91,918,959

$

95,405,114

See accompanying notes to consolidated financial statements.

F-3

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Operations and Comprehensive Income (Loss)

Years ended December 31, 2015, 2014 and 2013

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 income (loss)

Interest income

Interest expense

Income (loss) before income taxes

Income tax (expense) benefit

Net income (loss)

Net loss at subsidiary attributable to noncontrolling
interests

Net income (loss) attributable to common
shareholders

Earnings (loss) per share attributable to common
shareholders:

Basic

Diluted

Weighted-average common shares outstanding:

Basic

Diluted

Comprehensive income (loss) attributable to
common shareholders

Net loss at subsidiary attributable to
noncontrolling interests

Total comprehensive income (loss)

$

$

$

$

$

2015

2014

2013

$

33,013,184

$

36,683,762

$

31,100,698

505,867

218,109

926,764

33,519,051

36,901,871

32,027,462

4,968,170

13,994,768

3,847,651

7,607,588
1,989,264

32,407,441

1,111,610

209,183
(73,856)
1,246,937
(575,829)
671,108

5,053,165

14,902,202

3,389,419

8,401,560
1,596,689

33,343,035

3,558,836

251,447
(67,074)
3,743,209
(1,380,744)
2,362,465

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)

60,243

61,258

46,804

731,351

$

2,423,723

$

(2,104,614)

0.04

0.04

$

$

0.14

0.14

$

$

(0.11)
(0.11)

16,715,970

17,094,754

17,617,765

17,899,632

18,332,997

18,332,997

731,351

$

2,423,723

$

(2,104,614)

60,243

61,258

671,108

$

2,362,465

$

46,804
(2,151,418)

See accompanying notes to consolidated financial statements.

F-4

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Cash Flows

Years ended December 31, 2015, 2014 and 2013

Cash flows from operating activities:

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

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

Noncash interest expense
Noncash investment (gains) losses
Net changes in assets and liabilities affecting operating activities,
net of effect of business combination:

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

Net cash provided by operating activities

Cash flows from investing activities:

Additions to property and equipment
Cash paid for acquisitions
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
Repurchase of common shares

Cash settlement of contingent consideration
Exercise of stock options
Sale of subsidiary shares to noncontrolling interest
Excess tax benefit derived from exercise of stock options

Net cash used in financing activities
Net decrease 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:

2015

2014

2013

$

671,108

$

2,362,465

$

(2,151,418)

2,246,809
490,227
622,503
(90,982)
46,422
(77,155)

(572,392)
1,330,176
(263,084)
1,475,964
(2,731)
5,876,865

(142,965)
—
(2,556,465)
7,883,171
(7,528,713)
(2,344,972)

1,700,000
(5,338,967)
(1,668,252)
21,366
—
90,982
(5,194,871)
(1,662,978)
39,866,037
38,203,059

27,434
52,238

$

$

1,989,564
(309,330)
761,663
(1,653,028)
38,634
(52,040)

(974,304)
1,532,563
(1,011,365)
3,846,482
162,127
6,693,431

(163,258)
(2,000,000)
(3,101,565)
3,437,645
(4,207,262)
(6,034,440)

—
(4,315,444)
—
—
1,000,005
1,653,028
(1,662,411)
(1,003,420)
40,869,457
39,866,037

28,440
17,077

$

$

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)

$

$

Change in unpaid invoices for purchases of intangibles

967,146

(1,574,847)

543,905

See accompanying notes to consolidated financial statements.

F-5

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Consolidated Statements of Equity

Years ended December 31, 2015, 2014 and 2013

Cumberland Pharmaceuticals Inc.
Shareholders

Common stock

Shares

Amount

Retained
earnings

Non-
controlling
interest

Total equity

Balance, December 31, 2012

18,937,107

67,197,167

Net loss

Share-based compensation

19,743

670,934

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

(129,834)
(46,804)

Exercise of options and
related tax benefit

Repurchase of common
shares

Balance, December 31, 2013

Net income

36,758

6,748

(1,008,105)
17,985,503

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

Share-based compensation

15,300

760,894

16,394,540

2,423,723

(176,638)
(61,258)

Exercise of options and
related tax benefit

Sale of subsidiary shares to
noncontrolling interest

Repurchase of common
shares

—

—

(881,810)

Balance, December 31, 2014

17,118,993

Net income

1,653,028

Share-based compensation

86,102

622,503

3,409

112,348

Exercise of options and
related tax benefit

Repurchase of common
shares

769,991

—

230,014

1,000,005

(4,315,444)
$ 61,942,410

$ 18,818,263

$

731,351

(4,315,444)
(7,882) $ 80,752,791
(60,243)
671,108

Balance, December 31, 2015

16,379,501

(829,003)

(5,338,967)
$ 57,338,294

$ 19,549,614

$

(5,338,967)
(68,125) $ 76,819,783

85,566,487
(2,151,418)
670,934

6,748

(4,800,908)
79,291,843

2,362,465

760,894

1,653,028

622,503

112,348

See accompanying notes to consolidated financial statements.

F-6

 
 
 
 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements

(1)  Organization

Cumberland Pharmaceuticals Inc. and its subsidiaries (the "Company," "Cumberland," or in certain context 
"our"  or  "we")  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 medical specialties 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 unmet or poorly met medical 
needs.

Cumberland  focuses  its  resources  on  maximizing  the  commercial  potential  of  it's  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  expand  its  portfolio  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 80%. 
In 2014, the Company organized equity financing to recapitalize and strengthen the financial position of CET. This 
financing included an investment of approximately $1.0 million from Harbin Gloria Pharmaceuticals Co., Ltd. 
(“Gloria”) for their participation in CET.  As a result, Gloria received shares in CET and joined the CET ownership 
group. As noted above, the ownership interests of CET includes Gloria and Cumberland, while the remaining 
interest is owned by Vanderbilt University and the Tennessee Technology Development Corporation. The operating 
results  of  CET  are  allocated  to  noncontrolling  interests  in  the  consolidated  statements  of  operations  were 
approximately $60,243, $61,258 and $46,804 for the years ended December 31, 2015, 2014 and 2013, 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. 

F-7

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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. Operating segments are identified as components of 
an enterprise about which separate discrete financial information is evaluated by the chief operating decision maker, 
or  decision-making  group,  in  making  decisions  regarding  resource  allocation  and  assessing  performance. The 
Company,  which  uses  consolidated  financial  information  in  determining  how  to  allocate  resources  and  assess 
performance, evaluated that our specialty pharmaceutical products compete in similar economic markets and similar 
circumstances.    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 $0.9 million, $0.6 million and $0.8 million for the years ended December 31, 2015, 2014 and 2013, 
respectively.

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 

F-8

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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, 2015 and 2014, cash equivalents consist primarily of money market funds. 

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, 
2015 and 2014, 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.

F-9

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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.

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.  If there are any changes made to the useful life of the product and license rights, the costs associated 
with such a change, if any, will be capitalized and amortized over the revised useful life.

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 
or a patent has been declared invalid, related costs associated with the patent application are 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 ratably 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.  The Company recorded no impairment charges during 2015, 2014 and 2013.

F-10

 
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, and 
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 is 
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-11

 
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  expenses  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 $0.8 million in 2015, $1.0 million in 2014 and $0.9 
million in 2013. 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. These costs were $2.6 million, $2.5 million and $2.1 million in 
2015, 2014 and 2013, 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, 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-12

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

Comprehensive Income (Loss)

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

Earnings (Loss) 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. 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 May 2014, the Financial Accounting Standards Board ("FASB") issued amended guidance in the form of 
a FASB Accounting Standards Update ("ASU"), "Revenue from Contracts with Customers".  The core principle 
of the new guidance is to recognize revenues when promised goods or services are transferred to customers in an 
amount that reflects the consideration to which an entity expects to be entitled for those goods or services. The 
new guidance defines a five step process to achieve this core principle and, in doing so, additional judgments and 
estimates may be required within the revenue recognition process.  The new standard will replace most of the 
existing revenue recognition standards in U.S. GAAP when it becomes effective.  In July 2015, the FASB issued 
a one year deferral of the adoption date, which extended the effective date for the Company to January 1, 2018. 
Adoption prior to January 1, 2017, the original effective date, is not permitted. The new standard can be applied 
retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of the change 
recognized at the date of the initial application. The Company is assessing the potential impact of the new standard 
on financial reporting and has not yet selected a transition method by which it will adopt the standard.

In April 2015, the FASB issued amended guidance in a FASB ASU, "Interest-Imputation of Interest", which 
simplifies the balance sheet presentation of debt issuance costs.  Under the new guidance, debt issuance costs 
related to a recognized debt liability will be presented on the balance sheet as a direct deduction from the liability.  
This treatment is consistent with the presentation of debt discounts.  The new guidance is effective for fiscal years 
beginning after December 15, 2015, and interim periods within those fiscal years.  Early adoption is permitted, 
and the new guidance should be applied retrospectively.  In August 2015, The FASB issued additional related 

F-13

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

guidance in the form of another ASU "Interest-Imputation of Interest" that specifically addressed "Line -of-Credit 
Arrangements".    The  new  guidance  allows  the  presentation  of  deferred  debt  issuance  costs  as  an  asset  and 
subsequently amortizing these costs over the term of the line-of-credit arrangement.  This guidance applies whether 
or not there are any borrowings on the line-of-credit. The Company does not anticipate adoption of either ASU to 
have a material effect on its consolidated financial statements and disclosures.

In July 2015, the FASB issued amended guidance in the form of a FASB ASU on, “Inventory: Simplifying 
the Measurement of Inventory.”  The amended guidance requires entities to measure inventory at the lower of cost 
or net realizable value. Net realizable value is the estimated selling prices in the ordinary course of business, less 
reasonably predictable costs of completion, disposal, and transportation. The requirement would replace the current 
lower of cost or market evaluation. Accounting guidance is unchanged for inventory measured using last-in, first-
out (“LIFO”) or the retail method.  The amendments in this update are effective for fiscal years beginning after 
December 15, 2016.  The accounting guidance should be applied prospectively and early adoption is permitted.  
The Company is evaluating the potential impact of this adoption on our consolidated financial statements and 
disclosures.

In November 2015, the FASB amended guidance in the form of a FASB ASU on, "Balance Sheet Classification 
of Deferred Taxes", which requires that all deferred tax assets and liabilities be classified as noncurrent on the 
balance sheet instead of separating deferred taxes into current and noncurrent amounts. The FASB determined that 
this simplification could reduce cost and complexity without decreasing the usefulness of information provided 
to financial statement users. The amendments in this update are effective for fiscal years beginning after December 
15, 2016.  The accounting guidance may be applied prospectively or retrospectively and early adoption is permitted. 
The Company does not anticipate adoption of this balance sheet classification ASU to have a material effect on 
its consolidated financial statements and disclosures. 

In  February  2016,  the  FASB  issued  guidance  in  the  form  of  a  FASB ASU,  "Leases".   The  new  standard 
establishes a right-of-use (ROU) model that requires a lessee to record an ROU asset and a lease liability on the 
balance sheet for all leases with terms longer than 12 months. Leases will be classified as either finance or operating, 
with classification affecting the pattern of expense recognition in the income statement. A modified retrospective 
transition approach is required for lessees for capital and operating leases existing at, or entered into after, the 
beginning of the earliest comparative period presented in the financial statements, with certain optional practical 
expedients available.  The new standard is effective for fiscal years beginning after December 15, 2018, including 
interim periods within those fiscal years.  The Company is evaluating the impact of its pending adoption of the 
new standard on Cumberland’s consolidated financial statements and disclosures.

(3)  Vaprisol and Omeclamox-Pak

Vaprisol

On February 28, 2014, the Company acquired certain product rights, intellectual property and related assets 
of Vaprisol  from Astellas Pharma US, Inc. ("Astellas"). 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 then launched in 2006. It is one of two branded prescription products 
indicated for the treatment of hyponatremia.  Cumberland's acquisition of Vaprisol is accounted for as a business 
combination and the products sales are included in the results of operations subsequent to the acquisition date.

 The Company provided an upfront payment of $2.0 million to Astellas at closing. The business combination 
provided for an additional milestone payment of up to  $2.0 million, dependent upon Cumberland achieving certain 
first year sales levels for the product.  The Company paid Astellas $1.7 million to fulfill the contingent consideration 
during April 2015. On a year-to-date basis the Company recognized a $0.3 million reduction in expense related to 
the contingent consideration as the cost of the Vaprisol acquisition was less than anticipated. Cumberland paid 

F-14

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

approximately $0.1 million under the acquired contingent liabilities and recognized a $0.3 million reduction in 
expense during 2015 upon the resolution of the underlying contingency. Cumberland's acquisition of Vaprisol is 
accounted for as a business combination and the products sales are included in the results of operations subsequent 
to the acquisition date. 

The following table summarizes the allocation of the fair value of the assets acquired and liabilities assumed 

as of the acquisition date for Vaprisol:

Intellectual property intangible assets
Inventories

Acquired contingent liabilities

Contingent consideration obligation

Total net assets acquired

$

$

2,990,000

1,410,000
(400,000)
(2,000,000)
2,000,000

The  contingent  consideration  obligation  represents  the  additional  milestone  payment  discussed  above.  
Cumberland prepared the valuations of the contingent consideration obligation and the intangible assets utilizing 
significant  unobservable  inputs. As  a  result,  the  valuations  are  classified  as  Level  3  fair  value  measurements.  
Vaprisol contributed $2.6 million and $3.0 million in net revenues during 2015 and 2014, respectively.  The pro-
forma effects of the acquisition on the consolidated financial statements were not deemed material for disclosure 
purposes.  

Omeclamox-Pak

During November 2015, Cumberland entered into a new agreement with Gastoenterlogics Inc. ("GEL") to 
assume the remaining commercial rights to Omeclamox-Pak for the United States. 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. The Company had previously signed an agreement with 
Pernix Therapeutics ("Pernix") to jointly commercialize the product in the U.S. during October 2013.  As part of 
the new GEL Agreement, Cumberland and Pernix terminated their arrangements. The Company will continue to 
market  and  sell  Omeclamox-Pak  and  is  now  responsible  for  the  supply  chain,  national  accounts  and  all  sales 
promotion as part of the GEL agreement. The Company will continue promotion to the gastroenterology community 
through its field sales force and seek a new co-promotion partner with national primary care capabilities in the 
U.S.

The agreement with GEL has a term through November 2035, with no additional upfront payments required.  
Royalty payments ranging from 15% to 20% based on tiered levels of gross profits are paid by Cumberland to 
GEL.

Under the Company's previous agreement with Pernix to distribute and promote Omeclamox-Pak it paid an 
upfront payment of $4.0 million to Pernix in October 2013.  The agreement called for additional milestones at the 
first  and  second  anniversary  dates  of  the  execution  of  the  agreement  totaling  $4.0  million  in  the  aggregate.  
Cumberland was not required to make either milestone payment to Pernix as all the criteria for these payments 
were not met, including Pernix's co-promotion obligations. Royalty payments ranging from 15% to 20% based on 
tiered levels of gross profits were paid by Cumberland to Pernix. 

The $4.0 million upfront payment that the Company paid in October 2013 is included in product and license 
rights and is being amortized over the remaining expected useful life of the acquired asset, currently the life of the 
original Pernix agreement, June 2032.  The agreement with GEL has a term of November 2035 and the Company 
has decided to maintain the original useful life for amortization purposes.  Omeclamox-Pak contributed $3.0 million
in net revenues during 2015 and $4.1 million during 2014.

F-15

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(4)  Revenues

Product Revenues

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

Products:

Acetadote

Omeclamox-Pak

Kristalose

Vaprisol

Caldolor

2015

2014

2013

$

8,489,167

$

11,906,232

$

18,846,753

3,037,078

15,733,327

2,641,484

3,112,128
33,013,184

$

4,111,916

14,932,271

3,011,997

2,721,346
36,683,762

$

1,045,815

9,118,475

—

2,089,655
31,100,698

Total net product revenues

$

 As discussed in Note 3, the Company acquired rights to Omeclamox-Pak and Vaprisol and both products 
contributed to Cumberland's net revenue during 2015 and 2014. On October 28, 2013, Cumberland entered into 
an agreement with Pernix to distribute and promote Omeclamox-Pak. Under the terms of the agreement, effective 
October 1, 2013, the Company began to record the revenue of this product and effective January 2014 Cumberland 
began distributing Omeclamox-Pak and promoting it to gastroenterologists across the United States.  On February 
28, 2014, Cumberland entered into an agreement with Astellas to acquire Vaprisol including certain product rights, 
intellectual  property  and  related  assets.  The  Company  began  selling  Vaprisol  in  March  2014  and  launched 
promotional efforts for the brand in May 2014.  

Cumberland supplies Perrigo Company ("Perrigo") with an Authorized Generic version of the Company's 
Acetadote product.  The Company's revenue generated by sales of its Authorized Generic distributed by Perrigo 
is included in the Acetadote product revenue presented above.   The Company's share of Authorized Generic revenue 
was $4.5 million, $5.8 million and $9.2 million during 2015, 2014 and 2013, respectively.

In 2011, the Company discontinued sales of the 400mg Caldolor offering domestically and focused on the 
800mg Caldolor offering.  During 2015 and 2014, Cumberland had total sales of $0.8 million and $0.5 million of 
its 400mg Caldolor offering outside the United States, respectively. 

The allowances in accounts receivable for chargebacks, cash discounts and damaged goods were $0.4 million
at December 31, 2015 and $0.4 million at December 31, 2014, and the accruals for rebates, product returns and 
certain administrative and service fees included in other current liabilities were $6.8 million and $5.2 million, at 
December 31, 2015 and 2014, respectively. 

Other Revenues  

The  Company  has  entered  into  agreements,  beginning  in  2012,  with  international  partners  for 
commercialization of the Company's products.  The international agreements provide that each of the partners are 
responsible for seeking regulatory approvals for the products, and following approvals, each partner will handle 
ongoing distribution and sales in the respective international territories.  The Company maintains responsibility 
for the intellectual property and product formulations.  Under the international agreements, the Company is entitled 
to receive non-refundable up-front payments at the time the agreements are entered into and 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 Company is also entitled to receive 
royalties on future sales of the products under the agreements. The international agreements provide for $1.4 million
in non-refundable up-front payments and milestone payments of up to $1.7 million related to regulatory approvals 
and up to $4.7 million in payments related to product sales.  As of  December 31, 2015, the Company has recognized 

F-16

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

a cumulative $1.5 million in upfront payments as other revenue and has not yet recorded any revenue related to 
the milestone payments associated with these international agreements.

Other revenues during 2015, 2014 and 2013 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 $0.2 million for the year ending December 31, 2015 and $0.1 million for each of the years ended 
December 31, 2014 and 2013. 

(5)  Inventories

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

Raw materials and work in process

Finished goods

Total inventories

2015

2014

$

$

2,576,621

1,693,522

4,270,143

$

$

2,571,465

3,028,854

5,600,319

Caldolor inventory on hand at December 31, 2015 and 2014 had varying original expiration dates ranging 
from the second quarter of 2014 and extending through January 2016.  During 2013 and again in 2014, the Company 
provided stability data to the Food and Drug Administration ("FDA") supporting the extension of the Caldolor 
product expiration dates by an additional year.  The FDA notified the Company that it had approved both requests 
to extend the original shelf life of the Caldolor 800mg vials from five to six years years in January 2014 and from 
six to seven years in March 2015. 

 At December 31, 2015 and 2014, the Company has recognized and maintained cumulative charges for potential 
obsolescence and discontinuance losses, primarily for Caldolor, of approximately $2.7 million and $3.2 million, 
respectively. 

In connection with the acquisition of certain product rights related to the Kristalose brand, the Company is 
responsible  for  the  purchase  of  the  active  pharmaceutical  ingredient  ("API")  for  Kristalose  and  maintains  the 
inventory at the third-party manufacturer.  As the API is consumed in production, the value of the API is transferred 
from raw materials to finished goods.  API for the Company's Vaprisol brand is also included in the raw materials 
inventory total at December 31, 2015 and 2014.

F-17

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(6)  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

2015

2014

$

839,563

$

332,126

618,808

792,268

171,649

703,187

1,243,025

1,223,453

3,033,522

2,890,557

(2,497,072)

(2,239,527)

$

536,450

$

651,030

Depreciation expense, including amortization expense related to leasehold improvements, was $0.3 million
during 2015 and $0.4 million during 2014 and 2013.  Depreciation expense is included in general and administrative 
expense in the consolidated statements of operations.

(7)  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

$

2015

2014

$

18,011,362
(3,541,305)
14,470,057

8,236,719
(1,551,430)
6,685,289

22,270
(9,020)
13,250

16,477,749
(2,225,949)
14,251,800

8,194,264
(877,523)
7,316,741

9,020
(9,020)
—

$

21,168,596

$

21,568,541

In February 2014, the Company acquired the rights of the branded prescription product Vaprisol from Astellas 
(discussed more fully in Note 3).  The intangible asset value is $3.0 million and is included in product and license 
rights.  The asset will be amortized through February 2022, the remaining expected useful life of the acquired 
asset, which coincides with the life of the primary intellectual property asset.

During 2013, the Company entered into an agreement with Pernix to distribute and promote the branded 
prescription product Omeclamox-Pak. The $4.0 million upfront payment the Company paid to Pernix Therapeutics 

F-18

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

on October 29, 2013 (discussed more fully in Note 3) is included in product and license rights and will be amortized 
through June 2032, the remaining expected useful life of the acquired asset.  The Company will continue to market 
and sell Omeclamox-Pak through its agreement with GEL and is now responsible for the supply chain, national 
accounts and all sales promotion.  

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 remaining term of the 15
year    agreement,  through  2026.    During  2015  and  2014,  the  Company  paid  $1.5  million  and  $1.3  million, 
respectively, to Mylan Inc. in Kristalose payments. 

During 2015 and 2014 the Company recorded an additional  $0.1 million and $3.3 million, respectively, in 
intangible assets for patents, trademarks and capitalized patent costs, including amounts incurred in the protection 
of the Company's intellectual property.  These costs will be amortized over the remaining expected useful life of 
the associated patents.

Amortization expense related to product and license rights, trademarks and patents was $2.0 million, $1.6 
million and $0.9 million during 2015, 2014 and 2013, respectively. The expected amortization expense for the 
Company's current balance of intangible assets are as follows:

Year ending December 31:

2016
2017
2018
2019
2020 and thereafter

$

$

2,103,553
2,103,553
2,103,553
2,103,553
12,754,384
21,168,596

(8)  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

Acquisition related accruals

Other

Total other current liabilities

(9)  Debt

Debt Agreement

2015

2014

$

6,776,023

$

1,034,991

—

1,723,254

5,234,800

1,154,093

2,360,960

1,756,916

$

9,534,268

$

10,506,769

On June 26, 2014, the Company entered into a Revolving Credit Loan Agreement (“Loan Agreement”) with 
SunTrust Bank. The agreement replaced the August 2011 Fifth Amended and Restated Loan Agreement with a 
previous lender which was to expire on December 31, 2014.   The Company had $1.7 million in borrowings under 
the Loan Agreement at December 31, 2015.  The Loan Agreement has an aggregate principal amount of up to 

F-19

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

$20.0 million, and it has a three year term expiring on June 26, 2017.  The initial revolving line of credit is up to 
$12.0 million, an increase from the $10.0 million under the previous agreement.  The Company has the ability to 
increase the borrowing amount up to $20.0 million, upon the satisfaction of certain conditions.  

The interest rate on the Loan Agreement is based on LIBOR plus an interest rate spread.  There is no LIBOR 
minimum and the LIBOR pricing provides for an interest rate spread of 1.0% to 2.85% (representing an interest 
rate of 1.2% at December 31, 2015).  In addition, a fee of 0.25% per year is charged on the unused line of credit. 
Interest expense and the unused line fee are payable quarterly.  Borrowings under the line of credit are collateralized 
by substantially all of our assets.

 Under the Loan Agreement, the Company is subject to certain financial covenants, including, but not limited 
to, maintaining an EBIT to Interest Expense Ratio and a Funded Debt Ratio, determined on a quarterly basis.  The 
Company was in compliance with all covenants at December 31, 2015. 

The Company incurred no early termination penalties upon termination of the previous Agreement and incurred 
less than $0.1 million in deferred financing costs related to the Loan Agreement, which will be amortized to interest 
expense using the effective interest method over the term of the Loan Agreement. 

Previous Debt Agreement

The August 2011 Fifth Amended and Restated Loan Agreement carried an interest rate of the LIBOR Daily 
Floating Rate plus an applicable margin, as defined by the agreement (2.17% at December 31, 2013). Interest and 
an unused line of credit fee (0.25% per annum) were payable quarterly. There were no borrowings outstanding on 
the credit facility at December 31, 2014 or at any time during 2014.

Under the previous agreement, the Company was subject to certain financial covenants including, but not 
limited to, maintaining a leverage ratio and interest coverage ratio, as defined in the agreement.  In March 2014 
and May 2014, the previous agreement was amended for certain provisions related to the aggregate ownership of 
the Company's common stock over 30% and certain other financial covenants.  As a result of the amendments, the 
Company was in compliance with all covenants.  

(10)  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, 2015 and 2014, there was no
preferred stock outstanding.

(c)  Common Stock

During 2015, 2014 and 2013, the Company issued 86,102 shares, 15,300 shares and 19,743 shares of common 
stock, respectively, as a result of restricted shares vesting as well as other common share issuances.  Cumberland 
issued 3,409 and 36,758 common shares under option exercise transactions during 2015 and 2013, respectively.  
There were no option exercise transactions during 2014.  The payment of dividends is restricted by the Agreement 
with the Company’s primary lender.

F-20

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(d)  Warrants

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, 2015 and 2014. 

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, 2015 and 2014.

(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, January 2013, January 
2015 and January 2016, the Company's Board of Directors replaced the prior authorizations with new $10 million
authorizations  for  repurchases  and  retirement  of  the  Company's  outstanding  common  stock.  The  Company 
repurchased  829,003 shares,  881,810 shares and 1,008,105  shares of common stock for approximately $5.3 
million, $4.3 million and $4.8 million during the years ended December 31, 2015, 2014 and 2013, respectively. 

(f)  Cumberland Emerging Technologies

In April 2014, the Company received approximately $1.0 million from Gloria for its participation in CET.  As 
a result, Gloria received shares in CET and will have the first right to negotiate a license to CET developed products 
for the Chinese market. Prior to April 2014, Cumberland owned 85% of CET, with the balance of the enterprise 
being owned by Vanderbilt University and the Tennessee Technology Development Corporation.  In connection 
with  Gloria’s  investment  in  CET,  the  Company  also  provided  an  additional  investment  in  CET.    Cumberland 
contributed $1.0 million in cash and provided $2.4 million in loan foregiveness to CET in exchange for newly 
issued  shares.      Upon  completion  of  the  additional  investment  by  Gloria  and  Cumberland  in April  2014,  the 
Company’s ownership in CET is 80%.  As CET is a consolidated subsidiary, the Company reports the operating 
results of CET and allocates the noncontrolling interests to the non-majority partners.  

(11)  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 income (loss) attributable to
common shareholders

Denominator:

Weighted-average shares
outstanding – basic

Dilutive effect of restricted stock and
stock options

Weighted-average shares
outstanding – diluted

2015

2014

2013

$

731,351

$

2,423,723

$

(2,104,614)

16,715,970

17,617,765

18,332,997

378,784

281,867

—

17,094,754

17,899,632

18,332,997

F-21

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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

ended December 31:

Anti-dilutive shares

46,633

194,237

407,954

2015

2014

2013

(12)  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

2015

2014

$

2,274,994

$

2,205,260

326,499

145,200

849,579

1,154,507

660,973

1,675,757

7,087,509

300,301

172,008

817,736

1,412,477

1,504,835

1,676,729

8,089,346

(3,162,502)
3,925,007
(185,497)
3,739,510

$

(3,707,535)
4,381,811
(152,074)
4,229,737

$

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, 2015:

Years of expiration

Federal

State

2016 - 2018

2019 - 2028

2029

2030 - 2035

Total federal and state net operating loss
carryforwards

$

— $

—

42,973,043

1,984,927

562,865

38,585,151

10,266,915

1,615,752

$

44,957,970

$

51,030,683

The Company has total recognized carryforward tax assets of $0.2 million for foreign tax credits and AMT 
carryforwards.  In addition, the Company has recognized as of December 31, 2015 federal Orphan Drug and Research 
and Development tax credits of $1.1 million that expire between 2021 and 2035. 

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 $43.0 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 Company's utilization of these net operating loss carryforwards and 
a net operating loss in 2013, resulted in minimal income taxes paid in each of the years 2009 through 2015.  The 
Company expects to pay minimal income taxes in 2016 through utilization of these net operating loss carryforwards. 
The Company has $51.0 million of state net operating loss carryforwards.  This amount includes $45.1 million from 
the exercise of nonqualified options during 2009 and 2015.  The state net operating loss carryforwards above include 
approximately $3.9 million that is subject to a valuation allowance at December 31, 2015.

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

2015

2014

2013

Current:

Federal

State and other

Total current income tax expense

Deferred:

Federal

State

Total deferred income tax benefit
(expense)

$

(41,326) $

(44,276)

(85,602)

(385,723)

(104,504)

(490,227)

Total income tax benefit (expense)

$

(575,829) $

(1,440,010) $
(250,064)
(1,690,074)

(45,287)
(11,580)
(56,867)

213,552

95,778

1,426,701

153,217

309,330
(1,380,744) $

1,579,918

1,523,051

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

Deferred tax (expense) benefit,
excluding items below

Inventory

Operating loss carryforwards

Tax credit carryforwards

Valuation allowance due to changes in
net deferred tax asset balances

Deductible equity awards

Allowance for accounts receivable

Deferred charges

Reserve for expired product

Intangible assets

Deferred income tax benefit
(expense)

2015

2014

2013

$

26,193

$

(257,970)

34,465

35,272

(33,405)

(972)

(26,808)

(59,028)

31,784

(239,758)

$

85,844
(83,418)
17,424

43,398

(20,457)
298,039
(63,438)
838,556

217,330
(1,023,948)

60,739

310,477

788,342

196,631

(23,299)
127,308

161,084

83,755
(106,554)
(18,565)

$

(490,227) $

309,330

$

1,579,918

The valuation allowance at December 31, 2015, 2014 and 2013 is primarily related to state tax benefits at CET 

and CPSC that will likely not be realized.

F-23

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

The Company’s effective income tax rate for 2015, 2014 and 2013 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

Other permanent differences

Other

Net income tax expense

2015

2014

2013

34 %

4 %

(3)%

10 %

1 %

46 %

34 %

5 %

(1)%

1 %

(2)%

37 %

34 %

4 %

5 %

— %

(1)%

42 %

During 2012, the Company’s 2009 federal tax return was examined with no significant findings or adjustments.  
Federal tax years that remain open to examination are 2010 through 2014. 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 2014.  The Company has no unrecognized tax benefits in 
2015, 2014 and 2013.

Excluding the alternative minimum tax (AMT) tax credits, the Company will need to generate future taxable 
income in order to realize its deferred tax assets.  Based upon the level of taxable income over the last three years 
and projections for future taxable income 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, 2015. The amount of deferred tax assets considered realizable, 
however, could be reduced in the future periods if estimates of future taxable income during the carryforward period 
are reduced.

(13)  Stock-Based Compensation Plans

The Company has grants outstanding under three equity compensation plans, with two of the plans 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:

F-24

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

2015

2014

2013

Share-based compensation - employees

Share-based compensation -
nonemployees

Total share-based compensation

$

$

456,749

$

660,963

$

614,818

165,754

99,931

622,503

$

760,894

$

56,116

670,934

At December 31, 2015, there was approximately $1.8 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.

Stock Options

Stock option activity for 2015 and 2014 was as follows:

Weighted-
average
exercise price
per share

Weighted-
average
remaining
contractual
term (years)

Aggregate
intrinsic
value

Number of
shares

Outstanding, December 31, 2013

356,496

$

Options granted

Options exercised

Options forfeited or expired

Outstanding, December 31, 2014

Options granted

Options exercised

Options forfeited or expired

Outstanding, December 31, 2015

—

—

(198,140)

158,356

—

(5,652)

(140,404)

12,300

Exercisable at December 31, 2015

12,300

$

6.96

—

—

6.46

7.62

—

5.75

7.41

10.89

10.89

1.0

$

360

0.4

2,320

1.6

1.6

$

$

—

—

The Company did not grant any stock options during 2015, 2014 and 2013, and no options were exercised during 

2014 .  Information related to the stock option plans during 2015, 2014 and 2013 was as follows:

2015

2014

2013

Intrinsic value of options exercised

Weighted-average fair value of 
options exercised

$

$

3,875

3.26

$

$

— $

212,444

— $

0.12

F-25

 
CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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 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.  Restricted stock activity was as follows:

Nonvested, December 31, 2013

Shares granted
Shares vested
Shares forfeited

Nonvested, December 31, 2014

Shares granted
Shares vested
Shares forfeited

Nonvested, December 31, 2015

Number
of shares

Weighted-
average
grant-date
fair value

$

520,584
219,734
(11,300)
(36,181)
692,837
225,661
(81,270)
(97,179)
740,049

5.05
4.68
4.78
5.41
4.92
6.72
5.22
5.49
5.36

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.  The restricted stock grants are included in the diluted weighted shares outstanding computation 
until they cliff-vest.  Once vested they are included in the basic weighted shares outstanding computation. 

(14)  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 2015, 2014 and 2013, 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 $0.7 million and 
$0.6 million as of  December 31, 2015 and 2014, respectively.  The Company had assets consisting of company-
owned life insurance contracts generally designated to pay benefits of the deferred compensation plans of $1.8 
million and $1.7 million as of December 31, 2015 and 2014, respectively.

F-26

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(15)  Leases

The Company is obligated under long-term real estate leases for corporate office space that was extended 
during the third quarter of 2015.  Prior to this extension, the lease would have expired in October 2016, the lease 
is now set to expire in October 2022 . 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 2015, 2014 and 2013
was  approximately  $1.0  million,  $1.0  million  and  $0.9  million,  respectively,  and  sublease  income  was 
approximately $0.6 million, $0.5 million and $0.5 million. Cumulative future minimum sublease income under 
noncancelable operating subleases totals approximately $0.1 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:

2016
2017
2018
2019
2020 and thereafter

Total future minimum lease payments

(16)  Fair Value of Financial Instruments

$

$

1,075,243
1,039,618
901,568
838,896
2,469,052
6,324,377

The Company owns marketable securities that are solely classified as trading securities as of December 31, 
2015.    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, 2015

December 31, 2014

Level 1

Level 2

Total

Level 1

Level 2

Total

$

— $

— $

— $1,338,010

$

— $ 1,338,010

— 5,700,335

5,700,335

— 4,003,375

4,003,375

— 2,447,066

2,447,066

— 3,251,336

3,251,336

SBA loan pools - variable rate

— 1,681,714

1,681,714

— 1,413,697

1,413,697

Municipal bonds - VRDN

4,735,000

— 4,735,000

4,835,000

— 4,835,000

Total fair value of
marketable securities

$4,735,000

$9,829,115

$14,564,115

$6,173,010

$8,668,408

$14,841,418

The fair values of all other financial instruments outstanding as of December 31, 2015 and 2014 approximate 
their carrying values.  There were no changes to the valuation techniques for the Level 2 marketable securities 
during 2015 or 2014. 

F-27

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

(17)  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 
insurance limits provided by the Federal Deposit Insurance Corporation.

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

2015

22%
28%
32%
9%

2014

21%
27%
34%
11%

2013

19%
23%
23%
24%

The Company’s accounts receivable, net of allowances, due from these four customers at December 31, 2015

and 2014 was 71% and 91%, respectively.

(18)   Manufacturing and Supply Agreements

The Company utilizes one or two primary suppliers 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.

(19)  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.

(20)  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. 

As discussed in Note 3, in connection with the agreements with Pernix and GEL to promote Omeclamox-Pak, 
the Company is required to make monthly royalty payments based on tiered levels of gross profits.  These costs 
will be period expenses of the Company. 

F-28

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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. 

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, Cumberland 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, the Company supply's Perrigo with an Authorized Generic version of 
its Acetadote product (the “Authorized Generic”).   

On May 18, 2012, Cumberland 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 the Company evaluate the reduction or removal of EDTA from its original Acetadote formulation. On November 
7, 2012, the FDA responded to the Citizen Petition denying its request and on November 8, 2012, the Company 
learned that the FDA approved the ANDA referencing Acetadote filed by InnoPharma, Inc.  Cumberland 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, the Company began to 
supply  Perrigo  with  its Authorized  Generic.    On  January  7,  2013,  Perrigo  announced  initial  distribution  of 
Cumberland's 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 Cumberland. 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 Cumberland received separate Paragraph IV certification notices from Perrigo, Sagent 

F-29

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements — (Continued)

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, The  Company  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, Cumberland filed a lawsuit for infringement of the 356 Acetadote Patent against Akorn, Inc. in United States 
District Court.   

On February18, 2014, the USPTO issued U.S. Patent number 8,653,061 (the “061 Acetadote Patent”) which 
is assigned to the Company. 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 May 13, 2014, the USPTO issued U.S. Patent number 8,722,738 (the “738 Acetadote Patent”) which is 
assigned  to  Cumberland.    The  claims  of  the  738  Acetadote  Patent  encompass  administration  methods  of 
acetylcysteine injection, without specification of the presence or lack of EDTA in the injection. Following its 
issuance, the 738 Acetadote Patent was listed in the FDA Orange Book and it is scheduled to expire in April 2032.

On December 11, 2014 and March 3, 2015, the Company became aware of Paragraph IV certification notices 
from Aurobindo Pharma Limited and Zydus Pharmaceuticals (USA) Inc., respectively, challenging the 356, 445, 
061, and 738 Acetadote Patents on the basis of non-infringement. 

On February 10, 2015, the USPTO issued U.S. Patent number 8,952,065 (the “065 Acetadote Patent”) which 
is assigned to us.  The claims of the 065 Acetadote Patent encompass the use of the 200 mg/ml Acetadote formulation 
to treat patients with acute liver failure.  The 065 Acetadote Patent is scheduled to expire in August 2025.

On September 30, 2015, the United States District Court for the Northern District of Illinois, Eastern Division 
("District Court") ruled in Cumberland's favor in its lawsuit against Mylan for infringement of the 445 Acetadote 
Patent.  The opinion upheld Cumberland's 445 Acetadote Patent and expressly rejected Mylan's validity challenge. 
  The District Court ruled that Mylan is liable to the Company for infringement of the 445 Acetadote patent in light 
of Mylan's Abbreviated New Drug Application in which Mylan sought to market a generic version of Acetadote.  
On November 17, 2015, the District Court entered an order enjoining Mylan and its affiliates from selling or using 
its generic version of Acetadote until August 2025, the date of expiration of the 445 Acetadote Patent. On October 
30, 2015, Mylan filed a notice of appeal to the U.S. Court of Appeals for the Federal Circuit.

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

(21)  Quarterly Financial Information (Unaudited)

The following table sets forth the unaudited operating results for each fiscal quarter of 2015 and 2014:

2015:

Net revenues

Operating income

Net income attributable to
common shareholders

Earnings per share attributable 
to common shareholders (1)

Basic

Diluted

2014:

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

$ 8,686,774

$ 8,909,741

$ 7,885,048

$ 8,037,488

$ 33,519,051

4,116

673,931

270,884

162,679

1,111,610

46,281

407,398

126,613

151,059

731,351

$

$

— $

— $

0.02

0.02

$

$

0.01

0.01

$

$

0.01

0.01

$

$

0.04

0.04

$ 8,093,244

$ 9,750,168

$ 9,729,047

$ 9,329,412

$ 36,901,871

408,051

1,215,609

989,038

946,138

3,558,836

286,320

722,570

745,920

668,913

2,423,723

$

$

0.02

0.02

$

$

0.04

0.04

$

$

0.04

0.04

$

$

0.04

0.04

$

$

0.14

0.14

(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.

F-31

CUMBERLAND PHARMACEUTICALS INC. AND SUBSIDIARIES

Valuation and Qualifying Accounts

Years ended December 31, 2015, 2014 and 2013

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:

2013

2014

2015

$

188,587

$ 2,498,170

$

593,116

438,357

5,166,568

3,903,285

— $ (2,093,641) (1) $
—

(5,321,327) (1)
(3,960,402) (1)

—

593,116

438,357

381,240

Valuation allowance for
deferred tax assets:

For the years ended 
December 31:

2013

2014

2015

$

108,318

$

23,299

$

— $

131,617

152,074

20,457

33,423

—

—

—

—

—

$

131,617

152,074

185,497

(1)   Composed of actual returns and credits for chargebacks and cash discounts.

F-32

Officers and Directors

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

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

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

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

Michael	P.	Bonner
Senior Director, Finance & Accounting and  
Chief Financial Officer

In Memoriam

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

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

James	R.	Jones
Former Managing Partner
KPMG LLP-Nashville

Thomas	R.	Lawrence
Chairman
Aetos Technologies Inc.

Tan	Cheow	Choon
Senior Director, International Business

Kelly	Menzel
Senior Director, Hospital Sales

Cindy	B.	Patton
Senior Director, Sales & Marketing

Todd	M.	Anthony
Senior Director, Sales Training

Barry	L.	Lee
Product Director

Todd	Rice,	M.D.
Director, Medical Affairs

C

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Corporate Information

Stock Listing
NASDAQ Global Select
Market Ticker Symbol: CPIX

Annual Meeting
9:30a.m. Central Time
Tuesday, April 28, 2015
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

Corporate 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.