Quality Medicines to Enhance
Patients’ Quality of Life
2022 Annual Report
2022 Highlights
A New Brand, New Partnerships, New Horizons
1
Acquired & Launched
New Oncology
Medicine – January
We acquired the U.S. rights, from
Japan-based Kyowa Kirin, to
Sancuso, the first and only FDA-
approved prescription patch for the
prevention of nausea and vomiting
in patients receiving certain types of
chemotherapy treatment. To support
Sancuso, we established a dedicated
oncology sales division, Cumberland
Oncology, which will feature the
newest addition to our portfolio.
3
Formed New
Partnership
for Mexico – October
We announced an agreement with PiSA
Pharmaceutical for the registration
and commercialization in Mexico of
Caldolor – Cumberland’s non-narcotic
pain relief product. When administered
immediately before surgery, Caldolor
enables patients to wake up after
their procedure in significantly less
pain and then continue to experience
significantly less pain during their
recovery. It can also considerably
reduce the need for post-operative
opioids and improve patients’ quality
of life by reducing opioid-related side
effects and the potential for addiction.
2
Entered into
New Agreement
for Vibativ in the
Middle East – March
We established distribution for our
Vibativ product in the Middle East,
through a partnership with Tabuk
Pharmaceutical Manufacturing
Company. Vibativ is a potentially life-
saving treatment for patients with
hospital-acquired and ventilator-
associated pneumonia resulting from
a range of Gram-positive bacterial
pathogens, including those that are
considered difficult-to-treat and are
multidrug-resistant. Through our
partnership, Tabuk will introduce the
product in Saudi Arabia, Jordan and
potentially other countries in the
Middle East.
4
Opened New
Headquarters –
November
We opened our new headquarter
offices at the Broadwest campus
in the Vanderbilt/West End corridor
of Nashville. Our move allows the
company to accommodate our
growth, support our team, and better
serve our international base
of customers and partners.
Cumberland Pharmaceuticals — Quality Medicines to Enhance Patients’ Quality of Life To Our
Shareholders, Employees & Partners:
We welcomed a return to a more typical operating
environment as 2022 progressed, following the economic
and societal effects of the pandemic. We were excited
to see enrollment in our clinical trials resume, patient
procedures return to more customary levels and access
for our sales representatives improve as they gained more
face-to-face meetings with medical professionals.
What the pandemic did not change was our mission to
deliver high-quality medicines to improve patient care.
We remained focused on further expanding our product
portfolio, starting the year with the exciting and significant
announcement of our Sancuso® acquisition from the U.S.
affiliate of Japan-based Kyowa Kirin. During the year, we
successfully transitioned Sancuso from Kyowa Kirin and
we’re supporting the brand through our new sales division
– Cumberland Oncology. Sancuso is designed to support
cancer patients and we are honored to provide this unique
product to patients throughout the U.S. who can benefit
from it.
While Cumberland remains focused on featuring our
Caldolor® and Vibativ® brands in the United States, we’re
excited and eager to bring the products to patients in
other countries.
In the fourth quarter of 2022, we entered into an
agreement with PiSA Pharmaceutical for the exclusive
supply and distribution of our Caldolor product in Mexico.
We believe Caldolor will serve an important role in the
careful management of pain there, and we’re pleased to
work with PiSA to establish a successful partnership.
Earlier in 2022, we announced a new partnership with
Saudi-based Tabuk Pharmaceutical to introduce Vibativ
into the Middle East. The arrangement provides Tabuk
exclusive rights to distribute Vibativ in Saudi Arabia and
Jordan, with the option to expand into other countries in
the region.
Meanwhile, our Vibativ partner for the Chinese market,
SciClone Pharmaceuticals, had their approval application
in China accepted for review in September 2021. We’ve
since been supporting SciClone and their requests
associated with review of that submission. They are
working toward the approval and believe that there is
significant potential for Vibativ in their country.
In addition to expanding our international partnerships,
we’re working to build a pipeline of innovative products
that address unmet medical needs. These product
candidates are designed to improve patient care and
patients’ quality of life. In 2022, we continued efforts to
progress our series of Phase II clinical trials. We look
forward to sharing the results from these studies as they
emerge and then advancing these development programs,
which we believe have the potential to help many patients.
Toward the end of the year, we moved into our new
headquarter offices on the Broadwest campus in the
Vanderbilt/West End corridor of Nashville. We are
delighted to continue our presence and participation in
the Nashville health care community, which represents
the largest concentration of health care companies in
the U.S. Our new headquarters also keeps us close to
the Vanderbilt Medical Center, where we continue our
collaboration to develop innovative new medicines. The
new, state-of-the-art facility allows us to accommodate
our growth, support our team and better serve our
patients, customers and partners.
While we’re pleased to share so many exciting
developments contributing to our growth, we also
understand the importance of recognizing and addressing
our impact on the environment, our employees and the
community. Last year, we shared our 2021 Sustainability
Report, outlining our activities pertaining to environmental,
social and governance issues. This year, we have added
a table to this annual report sharing an update on our key
sustainability metrics for 2022.
With a new product to promote in Sancuso, an improving
operating environment and a robust pipeline, we’re very
optimistic about our future and look forward to delivering
quality medicines to enhance patients’ quality of life.
All the best,
AJ Kazimi
Chairman and Chief Executive Officer
1
2022 Annual Report Better Medicines for Better Lives
Our Portfolio Continues to Expand in Order to Improve Patient Care
In developing and acquiring medicines, we focus on medical conditions that do
not currently have a satisfactory treatment, targeting specialty markets including
hospital acute care, gastroenterology and oncology.
Our portfolio of FDA-approved brands continues to fulfill our mission of
providing medicines that enhance patients’ quality of life. These products are
promoted through our hospital, field and oncology sales divisions throughout
the United States, and internationally through select partnerships.
Our commercial product line includes the brands shown to the right.
For more information on Cumberland’s approved products,
including full prescribing information, please visit links to
the individual product websites, which can be found on the
company’s website, www.cumberlandpharma.com.
2
Cumberland Pharmaceuticals — Quality Medicines to Enhance Patients’ Quality of Life (acetylcysteine)
An injection used for the treatment of acetaminophen
poisoning, the leading cause of drug toxicity in the U.S.
(ibuprofen)
The first injectable therapy approved in the U.S. for the
treatment of both pain and fever
(lactulose)
The only branded prescription laxative product that combines
the established safety and efficacy of lactulose with the
convenience and portability of a pre-measured dose
(granisetron)
The first and only FDA-approved prescription patch that
prevents nausea and vomiting in patients receiving certain
types of chemotherapy treatment
(conivaptan)
The first and only intravenously administered vasopressin
receptor antagonist, which is used to raise serum
sodium levels in hospitalized patients with euvolemic and
hypervolemic hyponatremia
(telavancin)
An injection used for the treatment of certain serious
bacterial infections including hospital-acquired and
ventilator-associated bacterial pneumonia, as well as
complicated skin and skin structure infections
3
2022 Annual Report
New to the Product Line: Sancuso
Helping Patients Find Relief From Chemotherapy Side Effects
The newest addition to our portfolio, Sancuso is a unique
patented oncology support product – the first and only
FDA-approved prescription patch for the prevention of nausea
and vomiting in cancer patients receiving certain types of chemotherapy treatment.
The active drug in Sancuso, granisetron, slowly dissolves through a thin layer that
adheres to the patient’s skin and is released into their bloodstream over several days,
working continuously to prevent chemotherapy-induced nausea and vomiting. It is
applied 24 to 48 hours before receiving chemotherapy and can prevent nausea and
vomiting for up to five consecutive days. Alternative oral treatments must be taken
several times (day and night) to deliver the same therapeutic doses.
There were an estimated 1.9 million new cases of cancer in the U.S. in 20221 and each
year more than 1 million Americans undergo chemotherapy2, with many suffering from
the side effects of their treatment.
With Sancuso, patients are given a simple, easy-to-apply
preventative solution that does not require swallowing pills
– which can be difficult for patients experiencing nausea.
We are honored to introduce this brand through our
commercial organization, ensuring that it is delivered to
the patients across the country who can benefit from it.
1 https://www.cancer.org/latest-news/facts-and-figures-2022.html
2 https://www.cdc.gov/cancer/preventinfections/providers.htm
4
Cumberland Pharmaceuticals — Quality Medicines to Enhance Patients’ Quality of Life 5
2022 Annual Report When your first
antibiotic fails
Serious bacterial infections
need serious antibiotics.
For more information, including full prescribing
and safety information, visit www.vibativ.com.
When your first
antibiotic fails
Serious bacterial infections
need serious antibiotics.
The Impact of Our Science
Patients Who Have Benefited
“ A 51-year-old patient with diabetes, heart disease and other underlying health
conditions was admitted to the hospital for COVID-19. He developed MSSA
hospital-acquired bacterial pneumonia, and initial treatment with vancomycin
resulted in no notable improvement in the patient’s condition. His antibiotic was
then switched to Vibativ (telavancin), and within 48 hours he experienced clinical
improvement with blood cultures clear of bacteria. He was cured of pneumonia,
had no reported adverse events to Vibativ and was discharged to home.”
Dr. Joseph Reilly, PharmD
Clinical Pharmacist Specialist
Infectious Disease Residency Program Director
Atlanticare Regional Medical Center | Pomona, NJ
Cumberland’s Vibativ has been used across the country to help patients
who develop secondary bacterial infections in their lungs. This case study
illustrates that once-daily dosing of telavancin can effectively and safely
treat pneumonia due to Gram-positive infection among COVID-19 and
other patients.
For more information, including full prescribing
and safety information, visit www.vibativ.com.
“ He was cured of pneumonia, had no reported adverse
events to Vibativ and was discharged to home.”
7
2022 Annual Report The Impact of Our Science
Patients Who Have Benefited
“ I was admitted to the emergency room after a biking accident that caused a
tibial plateau fracture on my left leg and a split laceration down to the muscle
on my forearm. Rather than getting generic ketorolac or any opioids to manage
the pain as my lacerations were sewn up, I received 800 milligrams of Caldolor
(intravenous ibuprofen) through a rapid infusion. Caldolor has a 10-milligram
morphine equivalency with none of the opioid side effects, so Caldolor is all I
needed for pain control for those few hours I was at the hospital.”
Dr. Stephen Southworth, M.D.
Orthopaedic Surgeon
Orthopaedic Institute of North Mississippi | Tupelo, MS
In addition to receiving Cumberland’s Caldolor as a patient himself,
Dr. Southworth has conducted his own research on the drug and has
used it in over 2,000 surgical procedures at one of the largest regional
medical centers in the country. Patients who receive Caldolor have
been shown to wake up from their procedure in significantly less pain,
then remain in significantly less pain, while also needing significantly
fewer opioids.
“ so Caldolor is all I needed for pain control
those few hours I was at the hospital”
9
2022 Annual Report Developing New Medicines
for Better Quality of Life
We enjoy a robust pipeline of new medicines designed to address a
variety of unmet medical needs and improve patients’ quality of life.
Our Pipeline of Product Candidates Includes:
Preclinical IND Phase I Phase II Phase III NDA
Boxaban®
Dyscorban®
Vasculan®
10
Cumberland Pharmaceuticals — Quality Medicines to Enhance Patients’ Quality of Life Preclinical IND Phase I Phase II Phase III NDA
Sustainability
2022 at a Glance
Environment
Supplies
Contract with third party
companies for the
manufacturing, packaging
and warehousing of our
products
Waste
Ensure strict
guidelines and
processes for the safe,
permanent disposal of
all unused product
Returns
Received and
disposed of
2,756
pounds of
damaged and
expired products.
Social
Community
Involvement
Cumberland Pharma Foundation
Contributed to Denver Health,
MSU Foundation, TN State Museum,
American Heart Association,
TN Historical Society &
University of Mississippi
Sponsorships
• Nashville Healthcare Awards
• Wall Street’s View of Healthcare
• Women to Watch in Healthcare Event
Associations
• Nashville Health Care Council
• Life Science Tennessee
• Nashville Chamber of Commerce
Life Sciences Center
Helping to build the biomedical industry
in middle Tennessee
Social
Employees
Male – 55.3%
Female – 44.7%
Turnover – 17%
Additions – 11%
Minorities – 15.3%
Ages
7% below 30
26% between 30 & 50,
67% over 50
Career Development Program
Available to all corporate employees
Cumberland Academy
Provides industry training for
corporate employees
Tenures
36% @ 5 or more years,
27% @ 10 or more years,
8% @ 15 or more years
Training
Average $4,000
per full-time
employee
Work-related
injuries
None
Social
Patients
Product
Provided
2.2million
patient doses
Drug Safety Results
• No products listed in the FDA’ s
MedWatch Safety Alerts
• No products identified in the
FDA Adverse Event Reporting
System
• No products recalled
Patient AffordAbility — We cover up
to 80% of patient Rx costs through
coupons for our GI brands
Clinical Trials Safety
No trials terminated
due to failure to
practice good
clinical standards
Advocacy Groups
Supported
• Muscular Dystrophy
Association and
• Parent Project
Muscular Dystrophy
Governance
Board
Independent – 7 of 8
Tenure – Average 9.1 years
Age – Average 65 years
Male/ Female – 5/1
Turnover – None
Board
Meeting
Attendance
100%
Governance
Government
Relations
Cumberland Health &
Wellness PAC
Supports candidates,
elected officials, and
relevant legislation
Governance
Compliance
Code of Conduct
Establishes guidelines for all
Board members and employees
Ethical Marketing
No government
judgments, decrees
or fines
Health Care
Professionals
All reports regarding
relations filed on time
11
2022 Annual Report Selected Financial Data
Our growth strategy involves maximizing the potential of our existing brands while continuing
to build a portfolio of differentiated products. The result of these efforts has strengthened
our market presence, diversified our revenue stream, and delivered positive cash flow from
operations in 2022.
(dollars in thousands except per share data)
2018
2019
2020
2021
2022
Net Revenues
Less Total Expenses
Net Income (Loss)
$ 40,742
47,705
(6,963)
$ 34,388
37,926
(3,538)
$ 37,441
40,780
(3,339)
$ 35,985
39,493
(3,508)
$ 42,011
47,581
(5,570)
Cash Flow from Operating Activities
3,112
3,056
Total Assets
Total Liabilities
Total Equity
112,694
104,549
57,123
55,571
53,464
51,085
5,415
96,463
49,590
46,873
6,342
8,453
84,460
41,858
42,602
92,925
56,951
35,974
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)
2018
2019
2020
2021
2022
Net Income (Loss) from Continuing
Operations
Adjustments to Net Income (Loss)
Income Tax Expense (Benefit)
Depreciation and Amortization
Share-Based Compensation
Other Adjustments to Net Income (1)
Interest Income
Interest Expense
Adjusted Earnings
$ (7,039)
$ (9,212)
$ (6,569)
$ (5,597)
$ (5,650)
17
2,983
1,365
–
(564)
(79)
4,404
1,486
–
(243)
56
4,749
1,047
440
(75)
35
4,606
742
(1,051)
(26)
196
246
264
98
69
5,328
447
1,368
(98)
586
$ (3,043)
$ (3,398)
$ (146)
$ (1,193)
$ 2,050
Adjusted Diluted Earnings per Share
$ (0.19)
$ (0.22)
$ (0.01)
$ (0.08)
$ 0.14
Diluted Weighted-Average Common
Shares Outstanding:
15,614
15,396
15,162
14,905
14,809
(1) The supplemental financial measures are Non-GAAP as defined, the reconciliation of these supplemental measures is above.
12
Cumberland Pharmaceuticals — Quality Medicines to Enhance Patients’ Quality of Life
Board of Directors
A.J. Kazimi
Chairman
Chief Executive Officer
Cumberland Pharmaceuticals
James R. Jones
Director
Former Managing Partner
KPMG LLP-Nashville
Dr. Gordon R. Bernard
Director
Executive Vice President for Research
Vanderbilt University Medical Center
Kenneth J. Krogulski
Lead Director
President and Chief Investment Officer
Berkshire Asset Management
Caroline R. Young
Director
Vice President of Partnership Development
First Cressey Ventures
Former President
Nashville Health Care Council
Martin S. Brown
Director
Attorney of Counsel
Adams and Reese LLP
Former Board Director
Brown-Forman Corporation
Joseph C. Galante
Director
Former Chairman
Sony Music Nashville
Former President
RCA Records
In Memoriam
We were deeply saddened to lose two of our dedicated board members over the last year – Marty Cearnal
and Joey Jacobs. Each was an outstanding leader, valued colleague and dear friend to many.
MARTIN E. CEARNAL
Former Chief Commercial Officer
Cumberland Pharmaceuticals
Former President
Cumberland Sales Corporation
JOEY JACOBS
Former Chairman and Chief
Executive Officer
Acadia Healthcare Co. Inc.
Former Chairman and
Chief Executive Officer
Psychiatric Solutions, Inc.
13
2022 Annual Report Corporate Information
Forward-Looking
Statements
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, 2022, which is filed with the U.S.
Securities and Exchange Commission.
Company Headquarters
Cumberland Pharmaceuticals Inc.
1600 West End Avenue,
Suite 1300
Nashville, TN 37203
Phone: (615) 255-0068
Toll Free: (877) 484-2700
Fax: (615) 255-0094
Stock Listing
NASDAQ Global Select
Market Ticker Symbol: CPIX
Annual Meeting
9:30 a.m. Central Time
Tuesday, April 25, 2023
Cumberland Headquarters
1600 West End Avenue, Suite 1300
Nashville, TN 37203
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1222 Demonbreun Street, Suite 950
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(615) 454-9800
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