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Cumberland Pharmaceuticals Inc.
Annual Report 2023

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FY2023 Annual Report · Cumberland Pharmaceuticals Inc.
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Working together to provide  
     unique products that improve patient care

2023 Annual Report

2023 Highlights
Delivering Our Products to New Patients

May  |  Caldolor® Newborn Indication & Study Publication
The FDA approved expanded labeling for our Caldolor product, an intravenously delivered 
formulation of ibuprofen, to include use in infants. The non-narcotic agent may now be 
administered for the treatment of pain and fever in patients 3 to 6 months of age. With this newly 
approved labeling, Caldolor is the only non-opioid product approved to treat pain in infants that is 
delivered through injection.

We also shared the positive results from a clinical study investigating the safety and 
pharmacokinetics of Caldolor in newborns, published in the journal Pediatric Drugs. The results of 
the study support the growing body of evidence that demonstrates Caldolor is a safe therapeutic 
option available to practitioners for the treatment of fever and pain in infants, children and adults.

June  |  Expanded Oncology Sales Division
We expanded our oncology sales division as we work to deliver our newest brand Sancuso® –  
to help cancer patients tolerate their chemotherapy treatments. Sancuso is the first and only  
FDA-approved prescription patch for the prevention of nausea and vomiting in patients receiving 
certain types of chemotherapy.  

October  |  New Vibativ® Pediatric Study Publication
We announced a new publication in Antimicrobial Agents and Chemotherapy detailing the 
results of the first clinical study investigating the safety and pharmacokinetics of our Vibativ 
product in children 2 to 17 years of age. Vibativ is an intravenous antibiotic approved by the FDA 
for the treatment of hospital-acquired and ventilator-associated bacterial pneumonia, as well 
as complicated skin and skin structure infections caused by certain gram-positive bacteria. The 
results of the study suggest that a single dose of Vibativ is safe in children and they experience 
reduced exposure to Vibativ, compared with the same body weight-based dosing in adults.

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To Our Shareholders, 
Employees & Partners:

In many ways 2023 was a building year for Cumberland, 
as we continued to integrate our newest products, while 
also delivering several significant achievements.

During the year we took a fresh look at our mission 
statement and refined it to better capture the spirit of 
what we do each day at Cumberland. Our mission is 
now: working together to provide unique products that 
improve the quality of patient care.

Additionally, we shared the results of the first pediatric 
study investigating the safety and pharmacokinetics of 
our Vibativ product. The results suggest that a single 
dose of Vibativ can be safely administered to children to 
fight certain serious skin and lung infections.

Meanwhile, we completed the expansion of our oncology 
sales division as we work to deliver our newest brand, 
Sancuso, to cancer patients.

In designing this statement, we considered several factors. 

First, we wanted our mission to address the 
constituencies we serve, which include patients in need 
of care, as well as health care providers, our employees, 
shareholders, partners and community.

We also sought to reflect Cumberland’s culture, where 
teamwork is prized, emphasized and expected – in order 
to achieve our goals.

Next, it needed to demonstrate our focus on developing, 
acquiring and distributing differentiated brands.

And finally, we wanted to emphasize that the patient is 
at the core of everything we do. Our collective efforts 
are directed at providing unique products that serve as 
better alternatives for poorly met medical needs.

Now, as we report on the progress we made throughout 
2023, we are pleased to share a few exciting updates 
including the growth opportunities for our portfolio of 
branded medicines.

Following the FDA’s approval to expand the labeling 
for Caldolor, our non-narcotic agent may now be 
administered for the treatment of pain and fever in 
patients 3 to 6 months of age. This expanded use 
was further supported by the publication of positive 
results from a clinical study investigating the safety 
and pharmacokinetics of Caldolor in newborns. We are 
thrilled to extend Caldolor’s labeling for these youngest 
of patients.

As we remain focused on delivering our products to 
patients within the U.S., we continue to work with our 
partners in their efforts to register and launch Vibativ 
in several international markets, which should provide 
significant future catalysts for the brand.

We also continue to progress our pipeline of innovative 
products designed to improve patient care and patients’ 
quality of life. Our ifetroban product candidate is being 
evaluated in a number of Phase II clinical trials for 
patients with a series of unmet medical needs. 

It has now been dosed in nearly 1,400 subjects and 
has been found to be safe and well tolerated in those 
individuals. We look forward to sharing the results from 
these studies as they emerge and then deciding on the 
best development path for the product, which we believe 
has the potential to benefit many patients.

We remain committed to fulfilling our newly 
refined mission by building a portfolio of specialty 
pharmaceutical brands, which we do by maximizing the 
potential of our commercial brands, progressing our 
pipeline and also pursuing select acquisitions.

All the best,

A.J. Kazimi
Chairman and Chief Executive Officer

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Products to  
    enhance patients’ lives

For more information on Cumberland’s approved products, 
including safety and full prescribing information, please visit 
links to the individual product websites, which can be found 
on our corporate website, www.cumberlandpharma.com.

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Products to  

    enhance patients’ lives

Addressing unmet medical needs  
through our product portfolio

With a focus on underserved, specialty markets, including hospital acute 
care, gastroenterology and oncology, we develop and acquire medicines 
that are designed to offer distinct advantages over prior treatments. 

Our portfolio of FDA-approved brands is supported through our 
hospital, field, and oncology sales divisions along with our national 
accounts and field-based medical teams across the United States.

Our commercial product line includes the brands shown below.

(acetylcysteine) An injection used 
for the treatment of acetaminophen 
poisoning, which is the leading cause of 
drug toxicity in the U.S.

(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 

(ibuprofen) The first injectable therapy 
approved in the U.S. for the treatment of 
both pain and fever 

(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

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Building a Pipeline of 
Differentiated Products

In addition to our portfolio of FDA-approved brands, we continue to advance our pipeline of new 
product candidates. All part of our ifetroban program, our development candidates have the potential 
to help multiple patient populations and are designed to treat conditions for which there is currently no 
FDA-approved pharmaceutical treatment.

Our Pipeline Includes:

Preclinical 

IND

Phase I

Phase II

Phase III

NDA

Dyscorban® 
An oral capsule to treat cardiomyopathy associated with duchenne 
muscular dystrophy (DMD), a fatal, genetic neuromuscular disease

The FDA has cleared the Investigational New Drug (IND) application 
for this program and a Phase II clinical trial in DMD patients has been 
initiated, with enrollment advancing.

The FDA has also provided grant awards of over $1 million to  
support this study.

Vasculan® 
An oral capsule to treat systemic sclerosis (SSc), also known 
as scleroderma, a rare, debilitating autoimmune disorder that 
results in a thickening of the skin and internal organs 

With FDA clearance of our IND, this Phase II study in SSc patients 
is well underway.

We are also developing an oral capsule to treat  
idiopathic pulmonary fibrosis (IPF), the most common  
form of progressive fibrosing interstitial lung disease

Following FDA clearance of our IND, we are in the 
process of initiating our Phase II study in IPF patients  
in centers of excellence across the U.S.

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Cumberland  
Emerging Technologies
A collaboration to advance biomedical innovation

The U.S. leads the world in biomedical innovation, 
including the development of new medicines. 
To create a long-term product pipeline and also 
help build the local biomedical industry, we 
formed Cumberland Emerging Technologies 
(CET). As a majority owned subsidiary of 
Cumberland Pharma, CET helps inventor 
scientists and life science companies develop 
health care solutions and provides needed 
support to advance these solutions toward the 
commercial marketplace.

CET partners with several major academic 
research institutions, led by joint activities with 
Vanderbilt University and the Vanderbilt Medical 
Center. Together we work to identify early-stage 
biomedical research opportunities and develop 
the resulting new biopharmaceutical product 
candidates to improve patient care.

CET has also established and manages the 
Nashville Life Sciences Center, which serves as 
an incubator for Middle Tennessee’s emerging 
biomedical industry. 

CET represents a joint initiative between 
Cumberland Pharmaceuticals, Vanderbilt 
University, Launch Tennessee – a state-
supported network created to empower 
Tennessee’s entrepreneurial ecosystem –  
and WinHealth Pharmaceuticals – our 
international partner. 

At CET we team with academic research groups 
and support the development process for 
selected projects, providing critical expertise on 
intellectual property, regulatory, manufacturing 
and marketing issues essential to the successful 
development of new biomedical products.

The Life Sciences Center provides offices, 
laboratory space, and equipment to early-stage 
companies looking to develop their technologies 
and products. We maintain the Cumberland 
Pharmaceuticals formulation and testing 
laboratory at the CET Life Sciences Center.

Nearly 30 life science companies exist today 
because of CET, including a vibrant group of 
current tenants at the Life Sciences Center as well 
as a growing number of successful graduates.

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Providing Medicines to 
Patients Around the World
A look at our key international partnerships

Bringing our medicines to patients throughout 
the world through a growing network of 
distinguished international partners

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

Mexico
PiSA Pharmaceutical is our 
commercial partner for Caldolor.

Saudi Arabia and Jordan
Tabuk Pharmaceutical 
Manufacturing Company is our 
commercial partner for Vibativ.

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To provide for the availability of our products, we have established a network of 
distribution partners. Our international partners are responsible for registering 
and commercializing select Cumberland products, allowing us to provide our 
unique medicines to better the quality of patient lives in their countries.

Russia and CIS
R-Pharm JSC is our commercial 
partner for Vibativ.

South Korea 
D.B. Pharm Korea Co. Ltd. is 
our commercial partner for 
Caldolor and Vibativ.

China 
WinHealth Pharma Group is our 
commercial partner for Caldolor 
and Acetadote, and an investor in 
Cumberland Emerging Technologies.

SciClone Pharmaceuticals is our 
commercial partner for Vibativ.

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Australia 
Phebra Pty Ltd. is our 
commercial partner for 
Acetadote and Caldolor.

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

The once-daily antibiotic infusion with a dual 
mechanism of action indicated for MRSA and MSSA

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Sustainability 2023 At a Glance

ENVIRONMENT 

Supplies 
Contracted with third-party 
companies for the  
manufacturing, packaging  
and warehousing of  
our products

Waste  
Ensured strict 
guidelines and 
processes for the safe, 
permanent disposal of 
all unused product

Returns
Received and 
disposed of 

5,891

pounds of 
damaged and 
expired products

SOCIAL 
Community
Involvement

Cumberland Pharma Foundation
Contributed to Denver Health,  
Loyola University, Tennessee State 
Museum, American Heart Association, 
Tennessee Historical Society,  
Belmont University &  
University of Mississippi

Sponsorships 
Nashville Health Care Council’s Wall 
Street’s View of Healthcare Event

Associations 
•  Nashville Health Care Council
•   Life Science Tennessee 
•  Nashville Chamber of Commerce 

Life Sciences Center  
Provide a lab and incubator to help build 
the biomedical industry in our area

GOVERNANCE
Board  

Independent – 7 of 8 

Tenure – Average 9.8 years

Age – Average 66 years

Male/ Female – 6/1

Turnover – None

Board 
Meeting 
Attendance

100%

Standing 
Committee 
Attendance 

100%

SOCIAL 
Employees

Male – 56%     
Female – 44%  

Minorities – 15% 

Ages
6.5% below 30
27.5% between 30 & 50 
66% over 50  

Turnover – 19.1% 

Additions – 20% 

Career Development Program  
Available to all corporate employees 

Cumberland Academy  
Provides industry training for 
corporate employees 

Tenures
35% @ 5 or more years 
25% @ 10 or more years 
10% @ 15 or more years  

Training  
Average $4,000 
per full-time 
employee 

Work-related 
injuries  
None 

SOCIAL 
Patients

Provided

3

million doses
 of our products to patients

Clinical Trials Safety
No trials terminated due to failure 
to practice good clinical standards  

Advocacy Groups Supported
•   Muscular Dystrophy Association
•   Parent Project Muscular Dystrophy  

Drug Safety Results
•   No products listed in 
the FDA’ s MedWatch 
Safety Alerts 

•  No products recalled

Patient AffordAbility 
We cover up to 71% of 
patient Rx costs through 
coupons for our GI brand 

GOVERNANCE
Compliance    

GOVERNANCE
Government Relations    

Code of Conduct   
Establishes guidelines for all  
Board members and employees

Cumberland Health 
& Wellness PAC 
Supports candidates, 
elected officials and 
relevant legislation

Ethical Marketing  
No government 
judgments, decrees 
or fines 

Health Care 
Professionals  
All reports regarding 
relations filed on time 

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Selected Financial Data

Our strategy involves maximizing the potential of our existing brands while continuing to build a 
portfolio of unique, differentiated products. The result of these efforts has strengthened our market 
presence, diversified our revenue stream and delivered positive cash flow from operations in 2023.

(dollars in thousands except per share data)

Net Revenues 
Less Total Expenses
Net Income (Loss)

Cash Flow from Operating Activities

Total Assets

Total Liabilities

Total Equity

2019

$47,553
51,091

(3,538)

3,056

104,549

53,464

51,085

2020

   $37,441 
40,780

(3,339)

5,415

96,463

49,590

46,873

2021

$35,985 
39,493

(3,508)

6,342

84,460

41,858

42,602

2022

$42,011
47,661

(5,650)

8,453

92,925

56,951

35,974

2023

$39,553  
45,884

(6,331)

6,094

81,776

52,516

29,260

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)

2019

2020

2021

2022 

2023 

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

($3,538)

($6,625)

($5,597)

($5,650)

($6,331)

(79)

4,404

1,486

          –

(243)

56

4,749

1,047

440

(75)

35

4,606

742

(1,051)

(26)

           246

           263

           98

69

5,328

447

1,368

(98)

586

46

8,280

365

(347)

(287)

668

($2,276)

($146)

($1,193)

$2,050 

 $2,394 

Adjusted Diluted Earnings per Share

($0.32)

($0.01)

($0.08)

$0.14 

$0.17

Diluted Weighted-Average Common
    Shares Outstanding:

15,764

15,162

14,905

14,809

14,526

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

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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
Professor of Medicine
Division of Pulmonary & Critical Care Medicine
Vanderbilt University Medical Center

Kenneth J. Krogulski
Lead Director
Managing Partner and  
Chief Investment Officer
Berkshire Asset Management

Caroline R. Young
Director
Vice President of Partnership Development
Frist 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

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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, 2023, 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
Wednesday, April 24, 2024
Cumberland Headquarters
1600 West End Avenue, Suite 1300
Nashville, TN 37203

Independent Registered 
Public Accounting Firm
Carr, Riggs & Ingram, LLC
3011 Armory Drive, Suite 300
Nashville, TN 37204
(615) 665-1811

Transfer Agent and 
Registrar
Continental Stock Transfer  
& Trust Company
1 State Street, 30th Floor
New York, NY 10004
(800) 509-5586
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